“Standardization of Equipment and Other Facilities for Post-Mortem at District HQs”

Micro-Mission: 04 (Infrastructure)

‘Promoting Good Practices and Standards’ 97 Standardization of Equipment and Other Facilities for Post-Mortem at District HQs: MM 04

1.0 INTRODUCTION: epidemic-related deaths, police, a member of the Criminal Justice System is usually the sole Murder is the most heinous crime and its customer of the services offered at a mortuary. investigation requires a multi-disciplinary Therefore, mortuary is a vital link in the Criminal approach. Police -Doctor Interface is a Justice System, although, this fact is hardly ever professional necessity in investigation of cases recognized. Standardization of equipment and of unnatural death. The investigation begins at other facilities for post-mortem at district the scene of crime and takes up shape in a headquarters is therefore, highly recommended mortuary or the postmortem house. Dead body for consistent procedure and fair trial of is an object of investigation, both for the police homicide cases. and the doctor. In India, a police officer draws the inquest or Panchnama of the dead body to 2.0 BACK GROUND ascertain whether a person has died under suspicious circumstances or an unnatural death 2.1 The scene of mortuaries in India is under Section 174 of Cr.P.C. However, if the dismal and depressing, not only for the doubt to the cause of death persists in his mind, operators-the doctor or the police but also for the police officer has the discretion to seek the the victim’s family. The ambience of a opinion of a medical man. He sends the body to postmortem house is appalling, the basic a mortuary at the authorized Government ingredients for its operations are missing and the Hospital, usually at the district headquarters, for services are grossly inadequate. The reason is postmortem examination. Morgue is the place obvious-chronic neglect of mortuaries, which are in a mortuary where dead bodies are received part of the health set up. The mortuary is lowest and stored and in the Autopsy Room doctors in the priority list of health department of any dissect the body. The police accept the body back State. Mostly it is in a dilapidated and unhygienic along with some additional materials like viscera condition. or things recovered from the body by the doctor. The Postmortem Report is a piece of 2.2 It is not an exaggeration to say that both documentary evidence containing doctor’s the Stake Holders of a postmortem examination, observations and findings along with his opinion i.e., the health and police personnel avoid on five points- the cause of death, time since attendance at mortuary. The lowest rank and file death, in what manner, e.g. homicide, suicide, of police is often delegated the task of accident or under natural circumstances, whether forwarding and receiving the dead body at a injuries would have taken place before or after mortuary. The services of sweepers of the death, other additional information, e.g. weapons mortuary substitute for the expert task of used, presence of foreign body, etc. dissecting the dead body by the doctors. Obliviously, autopsy, the most ‘objective part’ A mortuary is the State owned depository of a murder investigation is ill-supervised. of all dead bodies where doctor, a member of the Health Services, is the expert service 2.3 The Criminal Procedure Code does not provider. Postmortem Examination, although not stipulate police-doctor interaction at the time of a mandatory requirement, is more often than not, autopsy; it is, albeit desirable in most cases, unavoidable in all cases of unnatural death. With except for the cases of death in police custody. the only exception of investigation into The doctor may like to satisfy himself on certain

‘Promoting Good Practices and Standards’ 99 National Police Mission Compendium on Projects aspects of the dead body, such as conditions at through the Chief Medical Officer of the district. the scene of crime, the manner in which body At times, a second autopsy or constitution of a was handled and transported, etc. Similarly, the medical board becomes necessary and in view police officer may like to inspect the presence of the perishable nature of the biological of a foreign body once the dead body is material, expeditious and intact exchange of uncovered or may get to know about the extent information between the mortuary and the police and shape of a wound. While handing over the or the court is essential. dead body, the doctor may like to advise the police officer on some clue recovered such as 3.0 THE PROJECT marks on clothes/ bullet or other artifacts/ 3.1 Title: smears/viscera, etc. Thus doctor-police interactions at a mortuary, before or during or “STANDARDIZATION OF after the postmortem examination, can shape up EQUIPMENT AND OTHER the investigation in a professional manner FACILITIES FOR POST-MORTEM AT without compromising the integrity of evidence. DISTRICT HQs”

2.4 In the recent past, media reports on 3.2 Vision: manipulation of the bio-medical evidence in certain high profile homicide cases have caught z To enforce minimum standards of public attention. However, it remained oblivious operational requirement (tools, whether mishandling was done by the police or infrastructure and maintenance) of a the doctor, intentionally or unintentionally, as the mortuary uniformly at all Districts HQs mortuary was a gray area for everyone, because z To promote coordination between the police as such videography or photography of autopsy and the medical men in cases of unnatural is not mandatory. As a matter of prudence, the death referred under 174 sub-clause 3 National Human Right Commission has made Cr.P.C. videography of postmortem procedures compulsory in cases of police encounter. 3.3 Objective:

2.5 As the Human Rights of the dead are z Immediate Objective: To create facilities not recognized, the treatment of a dead body in for autopsy at district mortuaries that a mortuary is often ignored. The work load of a benefits all the users, i.e. the doctors, the mortuary increases manifold during riots or mass police and the public; disasters. The instances of insensitivity of the lower rank functionaries of police and medical z Ultimate Objectives: department towards the kith and kin of the z Improved elucidation of bio-medical deceased even in usual times are common. The evidence by the medical men: Shift from lack of space and facilities for the victim’s family sweeper to Doctor at a mortuary add up to their woe. z Better appreciation of bio-medical evidence 2.6 The jurisdiction of a district court by the investigating agency- extends over the I.O. of a murder case with the (Both doctor and the police IOs are PWs; accountability of the district S.P. and over the prosecution fails due to the gap between doctor who conducts postmortem examination doctor and the police) ‘Promoting Good Practices and Standards’ 100 Standardization of Equipment and Other Facilities for Post-Mortem at District HQs: MM 04

z The facilities should improve hygienic A. The mortuaries are assets of the health environment for the benefit of doctors and department but police is the chief user. mortuary staff Therefore, the mortuary should be designed to ensure participative z Quick victim identification in mass disasters or unidentified dead bodies interaction between the health and police departments. z Intact Chain of custody in cases where ancillary investigation follows postmortem B. The legal mandate of police and doctor z Improved Public Perception conducting a postmortem examination are clearly defined. However, contents of a 3.4 Sponsors postmortem report can be questioned during the investigation or trial stage. Therefore, The Chief Minister of the State of Bihar video recording and automation of sanctioned budget to the Health Department of postmortem procedures should be Bihar Government for this project that was ensured. routed through their agency Bihar Medical Infrastructure Construction Limited. C. The Rights of the Family Members of the deceased (including the right to expect a 4.0 SITUATIONAL ASSESSMENT AND decent treatment of the dead body after PROBLEM ASSESSMENT death) should be protected. It is the 4.1 Work load: responsibility of the State to provide basic amenities to the visitors and coffin to the z Patna Medical College & Hospital is the dead with minimum disfiguration. apex centre for autopsy in and around Patna district- 10 P.M. per day. D. Specialist ancillary investigations (such as forensic examination of viscera or other z Other Medical Colleges at Patna (IGIMS, material, further study for the purpose of NMCH)<5P.M.perday entymology, microbiology, histo pathology, z Other Medical Collegesin the State etc.) may call for intact chain of custody (MUZAFFARPUR, GAYA, of bio-medical evidence after BHAGALPUR, DARBHANGA, Katihar) postmortem. <5 P.M. per day z District Hospitals in other districts- 1-2 E. Quicker and less invasive procedures for P.M. per day. victim identification by way of finger z It may be noted that mass disasters may call printing/ photography/ body radiology/ for unexpected work load.Kanpur Dehat D.N.A./embalming etc. are required within Hospital conducted 150 PM in 2 days in the mortuary besides open mortuary for the wake of the recent train accident of 2nd highly decomposed bodies. December, 2016 F. Minimization of risk of cross infections call 4.2 Situational Assessment: The following for stringent measures of hygiene at the criteria were considered for standardization morgue and the autopsy room of postmortem facilities- ‘Promoting Good Practices and Standards’ 101 National Police Mission Compendium on Projects

4.3 Problem Statement: z Time gap between evisceration and collection of tissues by the police for A. Infrastructure forensic examination z Existing mortuaries in a dilapidated D. Problem at police-public interface: condition or even make-shift structures. z No waiting room and basic amenities z At most places, autopsy instruments have available for police or kin of the deceased not been purchased for a long time. at the mortuary z No provision of round the clock electric z No dedicated vehicle for transportation of supply or a functional cold storage for dead body from scene of crime to the bodies, camera or CCTV, incinerator, X-ray mortuary machine z Murder Cases/ Accidents/ disasters arouse z As dedicated land for mortuary not public reaction. Public disturbance at the available, therefore, the land available scene of crime affect documentation of the within the premises only has to be inquest developed into mortuary. z Kins’ Right to expect a decent treatment of B. Problem with existing man power: the dead body often violated at the mortuary z No sanctioned post of autopsy surgeons; Standardization of PM Facilities doctors on general duty conduct autopsy by roster Deliverables: z One or two sweepers only available to assist A. SPACE the doctor on duty B. EQUIPMENTS. C. POWER SUPPLY & C. Problem at police-doctor interface: REFRIGERATION D. STAFF z Constables or village chaukidars (and not the IO or the officer who drew the inquest) A. PROVISION OF SPACE accompany a dead body to the mortuary; 1. MORTUARY – With 2 O.T. Tables (water z Facts recorded at the scene of crime may and drainage system) & fly proofing be different from observations at the (20’x20’) mortuary 2. OPEN MORTUARY OF FIBER GLASS z No briefing by the doctor on duty regarding ROOF & WALLS- (20’x10’)- for the PM findings or ancillary evidence decomposed bodies/mass casualties with z Time gap between postmortem and its wind jet documentation 3. COLD STORAGE- Stainless Morgue for 4 z Postmortem by specialist board often dead bodies. (15’x14’) delayed (Bio-Medical evidence is 4. WAITING HALL- For attendants with wash perishable and body remains cremated room and drinking water facilities. before re-autopsy) (15’x20’)

‘Promoting Good Practices and Standards’ 102 Standardization of Equipment and Other Facilities for Post-Mortem at District HQs: MM 04

5. DOCTOR’S CHAMBER with washroom 2. Enamel tray, bucket etc. Instrument trolley (15’x10’) & dissecting set 6. STAFF ROOM (15’x10’) 3. Magnifying glass/Microscope. 7. POLICE ROOM =(10’x15’) 4. Metal detector 8. OFFICE/RECORD ROOM =(10’x15’) 5. Evisceration instruments and storage 9. VISCERA CUM EXHIBITION ROOM 6. Dissecting Set including Photo lab= (13.5’x14’) (consisting of Knives, Scissors, Forceps, Allis of different Sizes, 10. X-RAY CHAMBER =(17’x10’) Autopsy Saw, Bone Cutter/ rib Cutter, 11. Laboratory for histopathology and Brain Knife etc. biochemistry =(12’x14’) Chisel, Hammer,Scalpel, Needle, Threads 12. STORE FOR EQUIPMENT/ CHEMICALS & Needle Holder etc (12’x14’) Gloves, Masks, Apron & Slippers) 13. INCINERATOR AND DUMP 7. Histopathology set-up (optional)

B. EQUIPMENTS C. POWER SUPPLY& REFRIGERATION B-I. For Transport and Storage - To sustain O.T. Light , fan ,exhaust fan, 1- Trolly “Push in and out” A.C., Refrigerator, Plumbing and boring with 2- Morgue (Deep Freezer Storage at 2-5ºC; pump IS marked steel) D. STAFF :- (In addition to Medical 3- Power Backup for Morgue Officers) B-II. For Identity and chain of custody- 1. Record Keeper-cum-Clerk -01 1. Weighing Machine & Metallic tape or 2. Morgue Attendant -01 Graduated Metal Scale 3. Sweeper -02 4. Technician (biochemistry, Pathology) 2. Camera with video facility/ Zoom Camera above autopsy table (Optional) 5. X-Ray Technician 6. Trained Photographer 3. CCTV Camera (> 2 megapixel, 1 TB 7. Guard -02 DVRa>21 Days backup).

4. 100 Ma X-Ray machine portable z Estimate of MORTUARY for District 5. Forensic Equipments for tissue DNA Hospitals sampling z Built-up area of Mortuary – 315.70 sqm. 6. Automation/lamination facility/xeorx Cost of Civil Works -69.55 Lakh per unit facility 1) Air Conditioning [i] Cost of A.C. of Mortuary 1,30,000/- B-III. For Autopsy- (4.5 Ton) [ii] Cost of Morgue (4 body) 5,00,000/- 1. Autopsy table of stainless steel with water ———————— drainage facility-2 no. Rs. 6,30,000/- ‘Promoting Good Practices and Standards’ 103 National Police Mission Compendium on Projects

(2) Generator (10KVA) 3,10,000/- Fitting (for morgue ) - Anodized Aluminum fitting. (3) Portable X-ray Aluminum 1,50,000/- body [4] FLOORING - Water impervious floors sloping to a (4) CCTV Camera with Accessories 50,000/- drain in mortury Vitrified tiles of (5) Ordinary Video Camera 15,000/- 600x600 mm size. z Optional Autopsy focus 50,000/- zooming cameras [5] ROOF/COLUMN/BEAM - R.C.C. (M:25) as per structural design. (6) Instruments & O.T. 5,00,000/- Tables (02) [6] FINISHING (7) Automation/ Lamination/ 1,00,000/- External Xerox/Fax - Water Proof Cement Paint over 20 mm (8 Incinerator 1,50,000/- thick cement plaster Internal - Dry distemper over 12mm thick (9) Solar water heater 500lpd 60,000/- ————————— cement plaster (1:6) Rs. 19,65,000/- [7] PAINTING OF DOORS z Physical Progress-Govt. of Bihar sanctioned - Synthetic enamel paint 2 or more coats 36 mortuary buildings at District Level over a coat & WINDOWS (Sadar) Hospitals at the above rate of primer. z Project complete in 22 districts; under construction in 6 districts; yet to start in 8 [8] LIGHTING districts - Fluorescent lighting over autopsy table with at least one having tilting z TECHNICAL SPECIFICATIONS arrangement. z [1] FOUNDATION - As per structural design based on Constraints and critical assessment of soil investigation. implementation strategy

[2] SUPERSTRUCTURE 1. Land must be identified before tendering - Framed construction with 250 mm thick brick masonry. 2. Project civil work must be sanctioned in totality including heavy items- morgue, [3] DOORS & WINDOWS genset, etc. Frames - Door frames of pressed steel. 3. Equipments for operational readiness Door Shutter should be tendered along with the civil work - 35mm thick factory made flush door 4. Joint Supervision at every stage of shutter. construction by medical and police wings Window 5. Co-ordination between Engineers and the - Fully glazed (frosted glass) steel users; feedback mechanism window with M.S. Grill. ‘Promoting Good Practices and Standards’ 104 Standardization of Equipment and Other Facilities for Post-Mortem at District HQs: MM 04

6. Plumbing/Electricity/Ventilation of 11. Human Right Perspective CleaCoff in Mortuary requires special focus “The Bone Woman” has written that We weren’t exhuming bodies and then, say 7. Wind jet in Open Mortuary if RCC roof/ counting them; we listened to them, studied otherwise tents with AC facility may be them, knew them…. – both police and tried doctor should have this ethos.

8.. Morgue should have dedicated power back- Amartya sen says in “Elements of a theory up of human rights” Page-347: “The understanding that some rights are not fully realized, and may 9. Sanctioning of requisite posts in medical not be fully realizable under present side (Even an M.B.B.S. can do autopsy and circumstances, does not, in itself, entail anything pathology) like the conclusion that these are, therefore, not rights at all. Rather that understanding suggests 10. Multi tasking by Police in providing guard, the need to work towards changing the prevailing trained photographer, family counseling, circumstances to make the unrealized rights etc. realizable, and ultimately, realized.

‘Promoting Good Practices and Standards’ 105 Plan of Mortury attached Projects on Compendium Mission Police National PooigGo rcie n Standards’ and Practices Good ‘Promoting 106