Unsupervised post-mortems conducted in WC due to overwhelming workloads - claim

2017-06-23 14:46

Cape Town – Untrained forensic officers with only matric qualifications and driver's licences have been dissecting organs from corpses at the Tygerberg mortuary without supervision for well over 10 years, a forensic officer has claimed.

However, the Western Cape department of health has told News24 all dissections are conducted under the "strict supervision" of trained pathologists.

The department said it was commonly accepted that untrained forensic officers dissect bodies under the supervision of trained pathologists. 

It said a forensic officer does not require a qualification to assist trained, qualified pathologists.

Pathologists may conduct post-mortems and forensic officers assist them.

However, speaking under condition of anonymity, a forensic officer working for the Tygerberg mortuary for at least three years on Thursday told News24 that he was trained to dissect bodies from other untrained forensic staff. 

"The workload is so much that you’ve got monkey see monkey do… so you just let your buddy show you how to do it... just to get the work done," the officer said. 

post mortem
Job advertisement for a forensic officer at the Tygerberg Mortuary by the Western Cape Health department (James de Villiers, News24).

Under supervision

In copies of forensic officer job advertisements obtained by News24, it reads that a qualification in matric and a driver's licence is all that is required to apply for the position.

It furthermore states that forensic officers are required to assist forensic pathologists with post-mortems.

But the Tygerberg forensic officer alleged that the dissection of organs from corpses was not done under the supervision of trained forensic pathologists. 

"On many occasions, [there are instances where] we are under the supervision of doctors that are still in their four-year specialising phase, meaning they are not registered by the Health Professions Council as pathologists, but they are busy with their four-year diploma which they get in forensics," he said. 

"And in many cases… these guys or girls don’t know how to do what I’m doing themselves so how can they supervise me?”

"The people that are supposed to be supervising me, not all the time but the majority of the time, they aren’t themselves qualified in that field and the other thing is they don’t themselves know how to do that actual removal of the organs."

The Tygerberg mortuary falls under the Tygerberg Academic Hospital which offers medical teaching through Stellenbosch University. 

He said officers remove the organs to prepare the bodies for the supervising official and later replace the organs back into the body once the formal post mortem is completed. 

It is not clear whether a system currently exists to ensure that the organs do not leave the mortuary premises. 

The provincial health department has not yet responded to a News24 query about this sent on Thursday.

'It is a blatant lie…'

The officer alleged that all forensic officers were forced to sign a statement at the end of each day stating they only carried a body to the table for trained pathologists to conduct the post-mortems. 

However, the provincial health department was not aware of any statement.

"It is a blatant lie… back in 2015 we questioned the fact why can’t it stand on that very statement that I was responsible for the removing [the organs] and [acknowledge] my role in the autopsy, because as that statement reads to a lay man in the street, it means that I only pointed out the said body to the pathologist or the authorised person," the officer said.

During the questioning of the statement in 2015, the officer said authorities threatened forensic officers to sign it. 

"We got a response from our deputy director… who forwarded an email to our chief of the dissection area when he instructed her to tell us that 'listen, if we don’t want to sign the statement anymore we are breaking some or other laws.'"

In written answers to News24, the Western Cape Emergency Medical and Forensic Pathology Services said forensic officers do not perform post-mortems, but merely assist pathologists with dissections. 

"All dissections are carried out under strict supervision of the forensic medical practitioner; in fact, the divisional protocol is that if a [pathologists] were to be expected to attend to a matter outside of the facility, the dissection is discontinued and the body covered until such time as the [pathologist] returns to the dissection hall," spokesperson Robert Daniels said. 

He said there was nothing sinister about pathologists in training supervising forensic officers as they were fully qualified medical doctors registered with the Health Professions Council of South Africa (HPSCA). 

The HPSCA has not responded to emails or phone calls from News24 since last Wednesday. 

The National Health department did not respond to a request for comment. 

Stellenbosch University referred all enquiries to the provincial health department. 

post mortem
Job advertisement for a forensic officer at the Tygerberg Mortuary by the Western Cape Health department (James de Villiers, News24).

'Doesn't seem ethically right'

On Wednesday, News24 reported that the health portfolio committee heard that post-mortems in South Africa have been conducted by untrained officials since 2006 when the service was moved from the South African Police Service to provincial governments. 

The Tygerberg forensic officer said that untrained officials had been doing post-mortem dissections when the service was also still under police guardianship.  

"You are a constable at the police or you are an assistant so you have to listen to the sergeant; you have to listen the captain and just go ahead and do it and it became a favour thing between the doctor and the police assistant that were helping," the officer said. 

"It doesn't seem ethically right, but they never rectified it so it just went on and on and on and now we are sitting at this point."

The officer said he wants a piece of paper from authorities to affirm that he is allowed to conduct dissections on his own without interfering with justice. 

"These aren't bodies which are being donated to science, cadavers for medical studies, it’s the public, it's the communities we serve that’s going through this so you have to do something," he said. 

He wanted to have pride in the work he has been doing. 

"Here we are allowed to remove and just go on as you please because of the workload. There [are] some guys who can just close their eyes and do it, they don’t care anymore, there’s no ethical part to it anymore because of the workload and we haven’t had any form of training."

"When you do something wrong, yes, the pathologist will get upset and mention it to you, but I just turn my back and walk away because I haven’t been trained to do that."

Read more on:    hpcsa  |  cape town  |  healthcare

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