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Indian Journal of Forensic Medicine and Pathology

Volume  17, Issue 3, July- September 2024, Pages 161-168
 

Original Article

Autopsy Findings in Custodial Deaths: A Four-Year Experience from a Medical College in West Bengal

Saswata Biswas1, Deepsekhar Dalal2, Satrajit Roy3, Hiranmay Bala4, Arijit Dey5

1Assistant Professor, Department of Forensic Medicine, Medical College, Kolkata, Kolkata 700073, West Bengal, 2Associate Professor & Head, Department of Forensic Medicine, Midnapore Medical College, West Bengal 721101, 3Junior Resident, Department of Forensic Medicine, Medical College, Kolkata, Kolkata 700073, West Bengal, 4Demonstartor, Department of Forensic Medicine, College of Medicine & Sagore Dutta Hospital, Kamarhati 700058, Kolkata, 5Associate Professor, Department of Forensic

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DOI: https://dx.doi.org/10.21088/ijfmp.0974.3383.17324.2

Abstract

Introduction: The death of an individual in custody garners attention from lawmakers and the administration, and if such a death is sudden, it is often associated with media attention. Methodology: This original study conducted at the Medical College of West Bengal from 2020 to 2023 scrutinizes the causes of death in the custody of correctional homes during this period, obtains the frequency of sudden deaths, which is natural, and recommends ways to reduce it in the future. All custodial deaths coming to autopsy during this study period were considered. After thorough scrutiny of all received documents, a complete autopsy was conducted; including toxicological analysis and histopathology examination, and the cause of death was opined. Results: During the study period, 118 cases of custodial deaths were autopsied in our centre, of which 49 subjects were inmates of the correctional home. There were 28 sudden deaths, of which the manner was natural in 14 cases. In these cases, primary pulmonary causes were seen in five cases; primary cardiac causes were seen in four cases; combined pulmonary and cardiac causes were seen in two cases; and others, including malignancy and gastro-intestinal causes, were seen in three cases. Among the 21 deaths that received hospital care, combined cardiac and pulmonary causes were the most common, followed by primary pulmonary causes. The frequency of sudden deaths among inmates is around 28.5%, which is about 10% in the general population. Poor medical facilities in correctional homes lead not only to the failure of disease diagnosis in the early stages but also to the failure of documentation. As a result, the patient reaches the hospital in critical condition, and death gets labelled as sudden due to the inability to make a diagnosis in a short period of time. A mere commitment to the adoption of Nelson Mandela rules cannot make a change; rather, a specialty medicine subject like custody medicine should be considered to have a positive impact on the health of inmates.
 


Keywords : Sudden death; Autopsy trends; Custodial care; Nelson Mandela rules.
Corresponding Author : Arijit Dey,