# APPENDIX B2 (iii)

# "Stat" Autopsies on Patients in the Alzheimer's Disease Study

1\. Since current data indicate that 12 hours is the longest postmortem
interval in which immunohistochemistry and neurochemistry will be
useful, stat and after-hours autopsies on these patients will be
performed only if the body is received by the Pathology Department
within 12 hours of the time of death. All other autopsies will be
handled on a routine basis.

2\. NIA personnel must be present at the time of autopsy to receive the
brain. Other tissues, such as sympathetic ganglia that are not routinely
examined at autopsy, must be dissected by NIA personnel.

3\. Autopsies will not be performed until administrative approval has
been obtained from the Clinical Center Admissions Office.

4\. The patient record must be available for review by resident and
attending pathologist prior to beginning the autopsy and should be
hand-carried. Autopsy examinations will not be performed until an
adequate examination of the clinical record has occurred. Persons
requesting stat autopsies must be sufficiently familiar with the patient
to provide a summary of the clinical status of the patient in the
hours-days-weeks prior to death.

5\. The checklist and authorization form (see Appendix B2) are provided
to assist NIA and pathology staff in preparing for stat autopsies. The
authorization form (or photocopy) must be presented with the clinical
record.

6\. Final authority on whether or not to perform a stat or after-hours
autopsy on any patient, or on what portions of an autopsy to perform on
a stat basis, resides with the autopsy service attending pathologist.

# APPENDIX B2 (iv)

**The "Stat" Autopsy**

**"Stat" Autopsy Authorization Form**

An immediate autopsy is being requested on patient

for the purpose of

The patient\'s problem list includes (in order of priority):

\(1\)

\(2\)

\(3\)

\(4\)

\(5\)

\(6\)

The most important questions to be answered at autopsy include:

\(1\)

\(2\)

\(3\)

Special Infectious Disease Precautions to be taken:

Radiation Safety Publications:

Clinical Care Physician Phone numbers

Approved:

(Yes or No) Resident Date

Staff Pathologist *and/or* Chief of Autopsy

Reason for disapproval:

**Clinician's Checklist for "Stat" Autopsy**

Before the patient expires:

\(1\) Notify the Pathology Department (496-3325) or pathology resident
on call (496-4567) that a "stat" autopsy is anticipated.

\(2\) Notify the Clinical Center Admission Office (496-2341 or 3315 or
3141) of the pending "stat" autopsy.

After the patient expires:

\(1\) Complete the report of death (NIH 1082) and write the death note
in the patient's record.

\(2\) Contact the admission office for assistance in obtaining
administrative authorization for the autopsy.

\(3\) Contact the next-of-kin for permission to perform the autopsy
(Exception: medical examiner's case). Antemortem consent is *not* valid.

\(4\) As soon as it becomes clear that consent is forthcoming, contact
the Pathology Department or the pathology resident on call.

\(5\) *Immediately hand-carry* the medical chart to the pathology
resident.

\(6\) Complete the "Stat Autopsy Authorization Form" (copy attached).

\(7\) Be available with the appropriate containers to collect the
tissues *at the time*