Autopsy review on ‘suspicious deaths' of Sri Lankans who died abroad: a study from Colombo North Teaching Hospital (CNTH)

Abstract

BACKGROUND: Many Sri Lankans have left as migrant workers for the past three decades. When such a person dies in the host country and the family is in doubt about the death, investigations are initiated in Sri Lanka including an autopsy. OBJECTIVE: To study the epidemiological details of the deceased persons, the difference of the cause and the circumstance of death after being subjected to an autopsy in Sri Lanka. DESIGN, SETTING AND METHODS: A retrospective descriptive analysis was carried out on suspicious deaths that occurred in other countries based on autopsy reports, and the case notes attached to them (including certificates of deaths and autopsy reports sent by host countries) at the Medico-Legal Unit of CNTH from January 2003 to March 2007. RESULTS: Out of 52 deaths examined, 69% died in the Middle East, whereas 17% and 10% died in Asia and Europe. 50% and 44% were skilled and unskilled workers respectively. The mean time interval of receiving a body was 3 weeks from the date of death. Analysis of documents revealed that only 51% deaths had a cause of death (COD) and 18%, 12%, 8% of deaths were suicides, accidents and homicides respectively. 69% of cases revealed a COD after autopsy in Sri Lanka. Majority were related to trauma (40%). Comparison of autopsy reports revealed that our injury detection was much better (p=0.001). CONCLUSIONS: Since many deaths abroad are trauma related, an autopsy examination should be made mandatory in Sri Lanka to resolve problems of insurance and compensation of these migrant workers.