The Ohio State University Wexner Medical Center (OSUWMC) Regional Autopsy Center (RAC) is a state-of-the-art facility located on the medical center campus. Our primary goal is to provide referring institutions, physicians and family members with accurate information regarding immediate and underlying cause(s) of death. The Department of Pathology supports pathologists and neuropathologists who are licensed and board-certified medical doctors, each with specialized expertise in non-forensic autopsy pathology. In addition to autopsy pathologists, there are more than 30 faculty members within the Department of Pathology, many of whom are internationally recognized as experts in Surgical Pathology, Cytopathology, Dermatopathology, Hematology, Toxicology, Microbiology and Genetics, available for consultation.

The Regional Autopsy Center performs between 200 and 300 autopsies annually for OSUWMC hospitals, various contract facilities throughout Ohio, and private requests from individuals within the community.

An autopsy enables the pathologist to analyze of the cause of death, nature of disease(s), and effects of treatment. Additionally, autopsies are an essential component in the advancement of medical science and in the education of future physicians. To this end, the RAC works in conjunction with The Ohio State University College of Medicine training medical students, residents, and fellows.

Our autopsies are performed only with the written consent of the legal next-of-kin. The procedures are performed according to national practice standards established by the College of American Pathologists College of American Pathologists.

For all private autopsy requests: a preliminary report presenting the gross findings is typically issued to the family within 5-7 business days of the autopsy. After completion of all microscopic and special studies, a final report detailing a thorough analysis and evaluation will typically be issued to the physicians and family within 45-60 business days.

For all OSUWMC patients, and those referred to us by other medical facilities: all autopsy reports are sent to the attending physician and any other physicians designated by the legal next-of-kin. A letter is mailed to the families upon completion of the Final Autopsy Report, typically within 45-60 working days. Families may contact the OSUWMC Medical Information Management Department to request a copy of the Final Autopsy Report.

Our fees for privately requested autopsies are assigned based on the services required, and can be found by selecting the Requesting an Autopsy link. Transportation using the OSUWMC contract company is an additional charge. If the decedent was an in-patient at any one of The Ohio State University Hospitals within the past 2 years, the autopsy may be performed free of charge, and will be accepted at the discretion of the pathologist on-call. Verification of in-patient status is required.

We are HIPAA compliant and ensure the privacy and security of all personal health information without sacrificing the quality of the services provided.

Autopsies are performed Monday through Saturday, with the exception of New Year's Day, Thanksgiving Day, and Christmas Day. Regular office hours for the OSUWMC Regional Autopsy Center are:

• Monday - Friday 8:00am to 4:00pm

If you are calling after-hours, please leave a detailed voice message and we will return your call on the following business day.

1. DETERMINE WHETHER AN OSUWMC AUTOPSY IS APPROPRIATE FOR YOUR NEEDS

Medicolegal cases, or those suspicious for unnatural death and/or negligence, are conducted by a coroner. Contact your county coroner for additional information. OSUWMC will conduct autopsies that provide anatomic diagnoses at the time of death with potential information regarding immediate and underlying causes of death when possible. Our pathologists only provide diagnostic information, and will NOT testify in court proceedings or offer opinions pertaining to the circumstances surrounding the death, including any negligence or malpractice. See FAQ.

Declination Criteria - we retain the right to decline autopsy requests based on the criteria below as well as our conclusions based on the medical information and records we receive.

1. Weight > 600lbs
2. Non-natural event in the cause of death sequence or obvious litigious intent
3. Rapidly progressive dementia due to prion disease such as Creutzfeldt-Jakob Disease (CJD), onset within 1-2 years (consultation with National Prion Disease Pathology Surveillance Center may be required)
4. Culture positive tuberculosis (TB) or other Biosafety Level (BSL) 3/4 infectious process
5. Embalmed decedents
6. Number of days from death to autopsy > 7 days
7. Time of death to refrigeration (34-40 °F) > 8 hours (not time of pronouncement)
8. Requests for only toxicology or other ancillary testing
9. Lack of funeral home designation
10. Lack of signing physician for the Death Certificate


2. DETERMINE WHO IS LEGALLY PERMITTED TO REQUEST AN AUTOPSY

Power of Attorney and Legal Guardianship are extinguished upon death.

The legal next-of-kin is the only individual who can consent to an autopsy and is assigned ONLY in this order (per Ohio Revised Code 2108.81):

• Spouse (separated or otherwise); same-sex marriages are now recognized by Ohio law
• Children
• Parents
• Siblings
• Extended Family


3. DETERMINE WHETHER THE COST IS RIGHT FOR YOU

If the decedent was admitted to OSUWMC within the last 2 years, the cost of the autopsy is covered by the Medical Center. Otherwise, costs vary depending upon the extent of the procedure and the required diagnostic testing. Typically, autopsies range from $2000 to $3000 (See Fee Schedule) with additional costs for transportation at the request of the family. All fees are due before the start of the procedure by check or credit card.

4. CONTACT THE REGIONAL AUTOPSY CENTER FOR FURTHER INFORMATION AND INSTRUCTIONS

Please note that we do not accept all cases and your request may be denied at this time based on pre-determined criteria that will be discussed during the screening process.

5. ONCE PROMPTED TO DO SO BY CENTER STAFF, COMPLETE THE 4 FORMS BELOW. ALL DOCUMENTATION MUST BE ACCURATELY AND ENTIRELY COMPLETED OR THE CASE WILL NOT BE ACCEPTED. UPON PROPER COMPLETION OF ALL 4 FORMS, FAX TO 614-685-4167 OR EMAIL TO AUTOPSY@OSUMC.EDU.

Once the forms are faxed/emailed, you must contact the Regional Autopsy Center to notify staff of their submission.

1. Death & Donation Request Form
To capture information pertaining to date/time of death, physician signing the death certificate, and the designated funeral home.
2. Autopsy Consent Form
To capture the signature of the legal next-of-kin, his/her contact information, and the type of autopsy requested with any limitations or special requests.
3. Authorization for Release of Medical Information Form
To authorize the release of clinical information from any physicians, specialists, nursing homes, care centers, or hospitals in which the decedent was treated. ENSURE THAT ALL SUCH CONTACTS ARE LISTED WITH ACCURATE PHONE AND FAX NUMBERS as information is requested via secured fax.
4. Agreement of Financial Responsibility Form
To indicate the form of payment and authorize the cost associated with the type of autopsy requested. Checks may be delivered with the decedent. Credit card information will be obtained via telephone upon acceptance of the case.
5. Infant Autopsy Consent Form
To capture the signature of the legal next-of-kin (the mother and father), his/her/their contact information, and the type of autopsy requested with any limitations or special requests. Where the form asks for the patient's name, please input "mother's last name, mother's first name, Baby of."


6. OSUWMC REGIONAL AUTOPSY CENTER WILL ACCEPT OR DECLINE THE CASE

OSUWMC cannot accept all requests for autopsy. The process of acceptance generally takes 2 to 4 business days. Before we determine whether we can accept the request, all forms must be properly completed by the legal next-of-kin, we must receive medical records from other facilities and physicians, and our pathologists must review those records. Our office will provide you with updates as we progress through the various steps in the process.

7. UPON ACCEPTANCE, AUTOPSY STAFF WILL APPROVE TRANSPORTATION OF THE DECEDENT AND PROCESS CREDIT CARD INFORMATION (if applicable)

If you utilize the transport offered by the Center, the necessary arrangements will be made. If you utilize the transport of a funeral home or livery service, the center will communicate instructions directly to the transport service.

8. COMPLETION OF THE PROCEDURE AND TRANSPORT TO FUNERAL HOME

Upon completion of the procedure, autopsy staff will arrange for transportation to the designated funeral home.

9. RESULTS REPORTING

You will receive a Preliminary Autopsy Report within 5-7 business days and a Final Autopsy Report within 30-60 days of the procedure. After these target dates, you may contact office staff for a status update.

The Ohio State University Wexner Medical Center’s (OSUWMC) Regional Autopsy Center may perform procurement services for researchers that are independently affiliated with OSU or via association with programs such as the Total Cancer Care Program (TCCP). Procurement services are dependent upon completion of various documents and confirmation of financial arrangements. While we make every effort to fulfill requests to the specifications of the protocols, we cannot guarantee an exact postmortem procurement timeframe due to staffing limitations on weekends and holidays.

NOTE: all OSU-affiliated researchers are required to work in conjunction with OSU Tissue Procurement Services (TPS).

Guidelines for OSU-Based Researchers Requesting an Autopsy

CONTACTING THE REGIONAL AUTOPSY CENTER (RAC) AND TISSUE PROCUREMENT SERVICES (TPS)

Before contacting RAC, researchers must contact TPS and complete an online application to begin the process of validating research IRBs, protocols, and consents. Once applications are approved by TPS, researchers must contact RAC to begin the process of completing the forms required for autopsy procurement services. The documentation required by TPS and RAC are both required to move forward with planning a procurement.

REGIONAL AUTOPSY CENTER FORMS REQUIRED (3):

1. Autopsy Consent Form
• Check “Removal of _______ for research purposes only...” for autopsy type/service; then add the institution's name in the "release to" blank
• The patient may consent if competent and of sound mind, otherwise, the legal next-of-kin must consent in the following order (DPOA is extinguished upon expiration and next-of-kin status is assigned according to Ohio Revised Code)
• Spouse – Estranged or Otherwise
• Majority of Adult Children
• Both Parents (if living)
• Majority of Adult Siblings
• Both Grandparents (if living)
• Other Family
2. Death and Donation Request Form
   • Complete as thoroughly as possible. We acknowledge that much of this information must be obtained following expiration and we will undertake the task of acquiring this information when appropriate.
   • We will not accept the request until a funeral home is designated by the legal next-of-kin
   • It is optimal if transportation arrangements are determined prior to expiration in order to expedite the process and limit stress to the family (i.e. will the designated funeral home provide transportation or will our contracted livery service perform the transportation for an additional cost?)
3. Agreement of Financial Responsibility Form
   • Select the appropriate autopsy type with its associated cost (NOTE: the type/cost may not be calculated prior to death based on the intricacies of some research protocols. Speak with an Autopsy staff member for more information.)
   • Select “Transportation” if our contracted livery service will be performing the transportation for an additional fee
   • The bottom portion must be completed and signed by a responsible party prior to submission, regardless of whether the costs are known before the start of the procedure

COSTS FOR PROCUREMENT

The costs listed below are for procurement services only. Additional costs may be assigned for transportation, storage, shipment, and/or other processing protocols. While TPS services are not charged to researchers affiliated with the TCCP, autopsy-related charges are separate and must be funded by the researcher.

• Brain Only or Single-Cavity: $628
• Brain & Spinal Cord Only or Double-Cavity: $814
• Other: TBD based on complexity

OTHER CONSIDERATIONS

• The decedent must be transported to OSUWMC Regional Autopsy Center as quickly as possible following death. If immediate transportation is not possible, the decedent must be stored in a refrigerated (34 – 40° Fahrenheit) cooler either at a facility or at a funeral home.
• Decedents will not be accepted at OSUWMC unless the above-listed documentation has been completed and verified, a funeral home has been designated, and the decedent is properly labeled with a minimum of the full name and date-of-birth.
• If the research protocol requires a preparation or shipment kit, this should be provided to RAC prior to the death of the patient.
• If death occurs after-hours, the party processing the death and transportation must alert the after-hours OSUWMC staff to ensure acceptance. It must be clearly conveyed that the decedent is a previously accepted private autopsy listed in the Pending Cases file.

CONTACT INFORMATION

1. OSU Tissue Procurement Services – Main Office Number: 614-293-5449 or Email: OSU TPS.
2. OSUWMC Regional Autopsy Center – Main Office Number: 614-247-7499 or Email: OSUMC Autopsy Center.
• Routine Office Hours
• Monday-Friday: 8:00am – 4:00pm
• Holiday Hours - There are no office hours on University holidays

The Ohio State University Wexner Medical Center’s (OSUWMC) Regional Autopsy Center may perform procurement services for non-OSU-affiliated researchers, pending completion of various documents and confirmation of financial arrangements. While we make every effort to fulfill procurement requests to the specifications of the protocols, we cannot guarantee an exact postmortem procurement timeframe due to staffing limitations on weekends and holidays.

RESEARCH DOCUMENTS REQUIRED (3):

1. Institutional Review Board (IRB) with current approval or, in lieu of an IRB—if/when an IRB is not applicable, due to postmortem tissues being used—written documentation attesting to IRB exemption by an authorized official overseeing the research study
2. Research Protocol that gives specific instructions for procurement, storage, and shipment
3. Consent Form for the research study, signed by patient or NOK

OSUWMC FORMS REQUIRED (4):

1. User Agreement for Investigators Form (a.k.a., Material Transfer Agreement or MTA Form)
• Recipient Signature is that of the Principal Investigator
• Official Authorized to Sign for the Agency is the official of the overseeing IRB attesting to the validity of the agreement or other such entity
2. Autopsy Consent Form
• Check “Removal of _______ for research purposes only...” for autopsy type/service; then add the institution's name in the "release to" blank
• The patient may consent if competent and of sound mind, otherwise, the legal next-of-kin must consent in the following order (DPOA is extinguished upon expiration and next-of-kin status is assigned according to Ohio Revised Code)
• Spouse – Estranged or Otherwise
• Majority of Adult Children
• Both Parents (if living)
• Majority of Adult Siblings
• Both Grandparents (if living)
• Other Family
3. Death and Donation Request Form
   • Complete as thoroughly as possible. We acknowledge that much of this information must be obtained following expiration and we will undertake the task of acquiring this information when appropriate.
   • We will not accept the request until a funeral home is designated by the legal next-of-kin
   • It is optimal if transportation arrangements are determined prior to expiration in order to expedite the process and limit stress to the family (i.e. will the designated funeral home provide transportation or will our contracted livery service perform the transportation for an additional cost?)
4. Agreement of Financial Responsibility Form
   • Select the appropriate autopsy type with its associated cost (NOTE: the type/cost may not be calculated prior to death based on the intricacies of some research protocols. Speak with an Autopsy staff member for more information.)
   • Select “Transportation” if our contracted livery service will be performing the transportation for an additional fee
   • The bottom portion must be completed and signed by a responsible party prior to submission, regardless of whether the costs are known before the start of the procedure

A LETTER TO THE PARTICIPANTS

We ask that you deliver a letter to the families participating in your research study on behalf of OSUWMC Regional Autopsy Center. This letter will provide your families with additional information about our required documentation and their potential role in determining the method of transportation to/from our facility.

• A Letter from OSUWMC to Research Participants and Their Families

COSTS FOR PROCUREMENT

The costs listed below are for procurement services only. Additional costs may be assigned for transportation, storage, shipment, and/or other processing protocols.

• Brain Only or Single-Cavity: $628
• Brain & Spinal Cord Only or Double-Cavity: $814
• Other: TBD based on complexity

OTHER CONSIDERATIONS

• The decedent must be transported to OSUWMC Regional Autopsy Center as quickly as possible following death. If immediate transportation is not possible, the decedent must be stored in a refrigerated (34 – 40° Fahrenheit) cooler either at a facility or at a funeral home.
• Decedents will not be accepted at OSUWMC unless the above-listed documentation has been completed and verified, a funeral home has been designated, and the decedent is properly labeled with a minimum of the full name and date-of-birth.
• If the research protocol requires a preparation or shipment kit, this should be provided to the Regional Autopsy Center prior to the death of the patient.
• If death occurs after-hours, the party processing the death and transportation must alert the after-hours OSUWMC staff to ensure acceptance. It must be clearly conveyed that the decedent is a previously accepted private autopsy case listed in the Pending Cases file.

CONTACT INFORMATION

1. OSUWMC Regional Autopsy Center – Main Office Number: 614-247-7499 or Email: OSUMC Autopsy Center.
• Routine Office Hours
• Monday-Friday: 8:00am – 4:00pm
• Holiday Hours - There are no office hours on University holidays

1. What will we get from the autopsy?

We review the medical history and medical charts and provide our opinion about the immediate and underlying causes of death. Also, we provide clinicopathologic correlation of our autopsy findings with clinical history and laboratory data. By request, we can perform additional studies, such as toxicology, drug levels and genetic tests.

2. Do you perform medicolegal (i.e., forensic) autopsies?

No. We only perform clinical autopsies. Although all of our staff pathologists are board certified medical doctors, each with multiple years of both anatomic and clinical experience, they are not forensic pathologists. All medicolegal cases, as well as, and in particular, all cases in which there is suspicion of an unnatural death, such as one believed to be caused by medical malpractice, by the actions of a layperson or by the decedent him/herself, should be handled by the county coroner's office wherein the death occurred; Moreover, if the deceased has a history of any of the following: motor vehicle accident (MVA) with injury, gunshot or cold weapon wound, a mental disorder, or mental retardation and developmental disability (MRDD), these cases must be referred to the presiding coroner's office first-regardless of when in the past such an event occurred (i.e., MVA injury, gunshot wound, etc.) or condition was diagnosed (i.e., mental disorder or MRDD). Only if the case is not accepted by the applicable coroner's office will we consider performing the autopsy; however, we will provide only the services/information described in Q1. Be advised that neither our autopsy report nor the attending pathologist will provide any opinion regarding the manner of death. That is, we will not provide any opinion about whether the medical care received by the deceased was adequate or appropriate, or if any particular medical procedure was necessary or properly administered.

3. What is the difference between a medicolegal/forensic autopsy and a clinical autopsy?

The primary difference is that a medicolegal autopsy addresses the manner of death and a clinical autopsy does not. A clinical autopsy is usually performed to diagnose which disease caused the death when antemortem efforts (or lack thereof) have failed to do so. Also, a clinical autopsy is often conducted, despite the likely cause of death having been well established antemortem, to study the disease process in situ, solely for the sake of enriching medical knowledge and training. A medicolegal autopsy generally only seeks to establish the cause and manner of death.

4. What does manner of death mean?

The manner of death is an explanation of how a death arose and is designated as being either natural or unnatural. A natural manner of death is exclusively by disease and is thereby within our facility's domain and purview. An unnatural manner of death is when any form of injury or action directly causes or contributes to the death- and is subsequently classified as being an accident, homicide, suicide or undetermined. An unnatural manner of death thereby connotes culpability, which is not within our facility's domain or purview.

5. What is the difference between one of your pathologists and a forensic pathologist?

A forensic pathologist is a board certified pathologist who has undergone at least one additional year of exclusive forensic training.

6. Who is authorized to request an autopsy?

Only the legal next-of-kin(s) of the decedent may consent to an autopsy. For more details about who is/are considered legal next-of-kin(s), please select Requesting an Autopsy.

7. How much will the autopsy cost?

If the deceased was an in-patient at any of The Ohio State University Wexner Medical Center Hospitals within the past 2 years, the autopsy, excluding transportation costs, may be performed at the Hospital's expense. Verification of in-patient status by Autopsy Services staff is required. Private autopsy costs vary and depend on the extent of the autopsy requested. Please select Fee Schedule for more information. Some diseases and conditions (e.g. mesothelioma, medical kidney diseases, dementia, Alzheimer's and others) require extensive workup of special tests, such as electron microscopy, immunofluorescence and immunohistochemistry, genetic tests, which will increase the total price. Please contact our office for specific information. We offer transportation services for an additional charge, at your request. Please select Fee Schedule for more information. Please note that acceptance of any autopsy, private or otherwise, as well as conduction of special testing for cases already accepted, is on a case by case basis and solely at the discretion of the attending pathologist.

8. Will you keep any body parts?

Yes. We will retain only what is necessary to make a diagnosis or to allow for a possible follow-up examination. Some organs we keep in full (e.g. the heart, brain, etc.), because additional sections and/or further examination may be necessary to more accurately render a diagnosis. All other tissues/organs are returned to the body.

9. Who receives the autopsy reports?

For all private autopsy requests: a preliminary report presenting the gross findings is typically issued to the family within 5-7 business days of the autopsy. After completion of all microscopic and special studies, a final report detailing a thorough analysis and evaluation will typically be issued to the physicians and family within 45-60 business days. For all OSUWMC patients, and those referred to us by other medical facilities: all autopsy reports are sent to the attending physician and any other physicians designated by the legal next-of-kin. A letter is mailed to the families upon completion of the Final Autopsy Report, typically within 45-60 business days. Families may contact the OSUWMC Medical Information Management Department to request a copy of the Final Autopsy Report.

10. What information do I need to provide when the autopsy is requested?

Before calling us, please prepare the following information:

a) Your relationship to the deceased and whether you are a legal next of kin.

b) Full name and date of birth of the deceased

c) The date, time and place of death. If the death was occurred not in a medical facility and the deceased did not have a history of chronic disease, was the coroner office notified or not.

d) Brief medical history

e) Name and contact information of the primary care physician

f) Name and contact information of any medical facility (hospital, rehabilitation center, nursing home, hospice) when the deceased was admitted in the past year

11. If the Coroner assumes jurisdiction, but does not perform and autopsy can I have one done at OSUWMC?

Sometimes the coroner assumes jurisdiction but will not do an autopsy. If this happens and the next-of-kin would like an autopsy, he/she/they may contact the Regional Autopsy Center.

Occasionally, the Coroner’s office will have a decedent brought to their facility but will only perform an external exam. If the family desires an autopsy and the decedent was an OSUWMC Inpatient within the previous two years, the autopsy can be performed at RAC free of charge. However, transportation costs from the Coroner’s Office to OSUWMC are at the expense of the family. If the decedent was not an Inpatient at OSUWMC within the previous two years, please refer to the Fee Schedule.

Please contact the OSUWMC Regional Autopsy Center with questions.

Fee Schedule for Private Autopsy

Autopsy Type	Base Autopsy Rate*
Complete Examination	$3,110
Complete Examination, Excluding Head	$2,590
Chest Only	$2,365
Abdomen & Pelvis Only	$2,365
Brain Only (includes dementia work-up)	$2,766
Mesothelioma Work-up (in addition to above-listed base rate)	$1,140
Asbestosis Work-up (in addition to above-listed base rate)	$955
Dementia Work-up (in addition to above-listed base rate; included in brain-only autopsies)	$1,660
> 400lbs	$40 (surcharge)

Our clearly marked funeral home entrance is on the rear of the DHLRI building. The entrance is accessible only via an access drive between Harding Hospital and DHLRI (posted signage indicates “EMS Only”). Please park in one of the parking spaces marked “Morgue Only.” Outside of normal business hours and on holidays, please call OSU Security for assistance at 614-293-8500.