| Introduction
|
|
|
|
| This
chapter
describes
what
took
place
during
the
post
mortem
examination
of
Mr Isaacs'
body
and
the
procedures
in
place
at
Prestwich
hospital
and
mortuary
in
1987.
|
|
|
|
| Sources
of
information |
|
|
|
| This
chapter
is
based
on
the
Prestwich
Mortuary
Registers,
other
documents
available
from
Prestwich
Hospital
and
the
recollections
of
those
involved
in
the
post
mortem
in
1987.
|
|
|
|
| Background |
|
|
|
| Prestwich
Mortuary |
|
|
|
| In
1987
Prestwich
mortuary
served
as
a
community
mortuary
for
the
North
Manchester
districts
of
Prestwich
and
Whitefield.
The
bodies
of
those
who
died
unexpectedly
in
the
community
or
in
accidents,
and
other
deaths
reported
to
the
Coroner
from
these
districts,
were
taken
to
Prestwich
mortuary
for
post
mortem
examination.
|
|
|
|
| The
mortuary
also
served
Prestwich
hospital
both
for
the
conduct
of
hospital
post
mortems
and
to
provide
for
the
recently
dead
when
there
was
no
post
mortem.
As
a
hospital
mortuary,
Prestwich
would
occasionally
receive
the
bodies
of
patients
who
had
died
in
local
nursing
or
residential
homes
when
a
limited
hospital
post
mortem
was
requested
or
needed.
|
|
|
|
| In
August
1989
post
mortem
examinations
at
Prestwich
mortuary
ceased.
Thereafter
all
post
mortems
on
Coroners'
cases
and
deaths
in
Prestwich
hospital
were
carried
out
in
the
mortuary
at
Fairfield
Hospital,
Bury,
which
had
served
as
the
other
community
mortuary
for
the
northern
part
of
the
Borough
before
1989.
|
|
|
|
| Prestwich
Hospital |
|
|
|
| In
the
1970s,
Prestwich
Hospital
was
a
large,
predominantly
long-stay
mental
hospital.
While
one
ward
was
allocated
to
the
care
of
acute
medical
admissions,
the
patients
in
the
other
wards
were
there
for
mental
illness
or
mental
handicap.
Many
were
institutionalised,
having
been
in
hospital
for
decades.
|
|
|
|
| In
the
early
1980s
and
into
the
1990s,
the
gradual
transfer
of
long-stay
patients
to
community
care
led
to
a
progressive
reduction
in
the
number
of
inpatients
in
Prestwich
Hospital
which
is
now
a
shadow
of
its
former
size.
|
|
|
|
|
|
| In
the
1980s
and
earlier
decades,
a
proportion
of
the
long-stay
patients
had
lost
touch
with
their
families.
When
long-stay
patients
with
no
known
next
of
kin
died,
one
of
the
administrative
staff
of
the
hospital
appointed
by
the
Hospital
Secretary,
later
the
Chief
Executive,
undertook
the
responsibilities
that
would
normally
fall
to
the
relatives,
including
giving
consent
for
a
hospital
post
mortem
if
one
was
requested.
|
|
|
|
| Procedures
at
Prestwich
mortuary
at
the
time
of
Mr
Isaacs'
death
in
February
1987
|
|
|
|
| To
reflect
its
dual
function,
two
separate
registers
were
maintained
for
the
bodies
of
persons
taken
to
Prestwich
mortuary
-
the
Register
of
Outside
(Police)
Deaths
and
the
Register
of
Hospital
Deaths.
|
|
|
|
| The
Register
of
Outside
Deaths
records
the
particulars
of
each
body
received
at
Prestwich
mortuary,
including
the
name,
address
and
age
of
the
deceased,
the
time
the
body
was
received
and
the
person
removing
the
body
to
the
mortuary.
This
in
most
cases
was
a
police
officer.
The
second
page
of
the
register
records
the
name
and
signature
of
the
undertaker
removing
the
body,
the
date
and
time
of
removal
and
the
place
of
burial
or
cremation.
|
|
|
|
| In
cases
where
a
post
mortem
was
carried
out,
the
register
records
whether
this
was
a
Coroner's
or
hospital
post
mortem.
|
|
|
|
| The
Mortuary
Register
of
Hospital
Deaths
is
no
longer
available.
It
is
believed
to
have
been
destroyed,
along
with
other
records,
when
a
record
store
was
flooded.
However,
a
register
of
all
patients
admitted
to
Prestwich
Hospital
survives.
This
document
records
details
of
all
discharges
and
deaths
from
Prestwich
Hospital
between
January
1982
and
December
1989.
From
the
in-patients
register
it
is
possible
to
identify
the
patients
in
Prestwich
Hospital
whose
deaths
were
reported
to
the
Coroner.
The
register
does
not,
however,
record
why
the
death
was
reported.
|
|
|
|
| The
register
entry
for
the
body
of
Mr
Isaacs |
|
|
|
| The
transfer
of
Mr
Isaacs'
body
to
Prestwich
mortuary
is
recorded
in
the
Outside
Deaths
Register.
The
body
was
received
at
the
mortuary
at
8.45pm
on
26 February 1987(1).
As
Mr
Walkden,
the
mortician,
was
not
on
duty
when
Mr Isaacs'
body
was
taken
to
the
mortuary,
one
of
the
hospital
porters
would
have
unlocked
the
mortuary
door
and
filled
in
the
first
page
of
the
register.
|
|
|
|
| The
date
of
Mr
Isaacs'
death,
his
age
and
address
are
correctly
shown.
His
body
was
received
from
WPC
Rigby.
The
second
page
records
that
a
Coroner's
post
mortem
was
carried
out.
Mr
Isaacs'
body
was
removed
by
Goldfines
(the
Jewish
undertakers)
on
27
February
1987
for
burial
at
Agecroft
Cemetery.
The
removal
entry
is
signed
'B Goldfines'
and
initialled
by
the
mortician,
Mr
Walkden,
but
the
time
is
not
recorded(1).
|
|
|
|
Other
relevant
documents
|
|
|
|
| In
addition
to
the
Mortuary
Register,
the
police
'751
report'(2)
and
Dr
Farrand's
report
to
the
Coroner
on
the
findings
of
the
post
mortem
examination
provide
contemporaneous
information
about
the
post
mortem.
|
Annex
13
|
|
|
| Persons
at
the
post
mortem
examination
of
Mr
Isaacs |
|
|
|
| The
post
mortem
examination
took
place
at
11.00am
on
27
February.
Dr
Farrand
and
Mr Walkden
were
present
throughout
and
WPC
Rigby
was
present
at
the
start
of
the
examination.
If
others
were
present,
their
names
are
not
recorded
in
any
surviving
documents.
|
|
|
|
| Dr
R
J
Farrand |
|
|
|
| Dr
Farrand
holds
an
NHS
appointment
as
Consultant
Pathologist
(Microbiology)
at
Bolton
General
Hospital.
In
addition
to
his
NHS
duties,
Dr
Farrand
had
regularly
undertaken
Coroners'
post
mortem
examinations
at
Prestwich
Mortuary
since
1975.
In
that
year
Dr
Farrand
was
asked
to
carry
out
post
mortems
by
Mr Leonard Gorodkin,
who
was
then
Coroner
for
North
Manchester.
Dr
Farrand
continued
to
undertake
post
mortems
at
Prestwich
when
Mr
North
was
appointed
Coroner
in
1978.
He
still
acts
as
pathologist
for
Mr
Barrie
Williams
who
was
appointed
Coroner
for
the
district
in
1995.
|
|
|
|
| Mr
Dennis
Walkden |
|
|
|
| Mr
Dennis
Walkden
was
the
mortician
at
Prestwich
from
1973
until
1988
when
he
transferred
to
Fairfield
Hospital,
Bury.
He
still
works
as
the
senior
mortician
at
Fairfield
Hospital.
Apart
from
a
short
period
in
the
1970s,
Mr
Walkden
was
the
only
mortician
at
Prestwich
Hospital.
Mr
Walkden
and
Dr
Farrand
had
worked
together
since
1975.
|
|
|
|
| WPC
Sharon
Rigby
(now
Mrs
Dunn) |
|
|
|
| Having
supervised
the
removal
of
Mr
Isaacs'
body
to
the
mortuary,
it
was
WPC Rigby's
duty
to
identify
the
body
to
Dr
Farrand.
Dr
Farrand's
report
to
the
Coroner,
dated
27
February
1987,
records
that
she
did
so.
|
Annex
13
|
|
|
| Recollections
of
those
present |
|
|
|
| No
one
present
at
the
post
mortem
now
has
any
recollection
of
this
particular
post
mortem
examination.
This
is
not
surprising
as
both
Dr
Farrand
and
Mr
Walkden
have
attended
numerous
similar
examinations
in
the
15
years
since
February
1987.
At
the
time
there
was
nothing
unusual
about
the
examination
of
Mr
Isaacs'
body.
|
|
|
|
Retention
of
Mr
Isaacs'
brain
|
|
|
|
| While
both
Dr
Farrand
and
Mr
Walkden
acknowledge
that
Mr
Isaacs'
brain
could
not
have
been
returned
to
his
body
at
the
end
of
the
examination,
neither
specifically
recalls
this.
|
|
|
|
| In
fact,
the
records
show
that
Mr
Isaacs'
brain
was
removed
at
11.15am.
It
is
clear
from
the
entries
in
the
Manchester
University
brain
book
that
the
brain
was
retained
for
the
purpose
of
research.
There
is
no
suggestion
in
the
post
mortem
report
that
retention
was
needed
for
any
purpose
related
to
determining
the
cause
of
death,
or
that
Dr
Farrand
needed
histological
examination
of
the
brain
in
order
to
notify
the
Coroner
of
the
cause
of
Mr
Isaacs'
death.
In
these
circumstances,
to
satisfy
the
requirements
of
the
Human
Tissue
Act,
consent
for
retention
should
have
been
obtained
from
Mrs Isaacs
prior
to
the
post
mortem.
Consent
would
have
been
refused.
|
|
|
|
| The
retention
of
Mr
Isaacs'
brain
was,
however,
not
unusual
at
Prestwich
mortuary.
Many
brains
had
already
been
retained
in
similar
circumstances
following
instructions
received
from
the
Coroner's
office,
as
described
in
Chapter 10.
|
|
|
|
| WPC
Rigby
has
no
recollection
of
the
examination,
although
she
does
distantly
remember
what
happened
when
she
attended
Mr
Isaacs'
house
on
26
February
1987.
|
|
|
|
| Dr
Farrand's
report
to
the
Coroner |
|
|
|
| This
report
states
the
cause
of
death
as
'Hanging'
and
that
the
brain
appeared
'normal'.
The
report,
however,
does
not
mention
the
retention
of
Mr
Isaacs'
brain.
|
Annex
13
|
|
|
| Was
Mr
Isaacs'
brain
the
only
organ
retained? |
|
|
|
| In
view
of
the
family's
concerns
that
other
organs
might
have
been
retained,
Dr Farrand
and
Mr
Walkden
were
both
asked
about
any
other
practice
of
organ
or
tissue
retention.
Neither
has
any
recollection
of
other
organs
being
retained
for
research,
Chapter
4.
|
|
|
|
| Other
brain
retentions
at
Prestwich
mortuary |
|
|
|
| Chapters
10,
12
and
21
describe
the
retention
of
brains
for
the
joint
programme
in
the
Departments
of
Physiology
and
Psychiatry
at
Manchester
University.
|
|
|
|
| Chapter
26
sets
out
the
arrangement
through
which
a
small
number
of
brains
were
retained
and
transferred
to
the
brain
bank
at
Addenbrooke's
Hospital,
Cambridge,
before
the
joint
programme
began
at
Manchester
University
in
1985.
|
|
|
|
| Chapter
8
outlines
the
separate
system
for
retaining
brains
for
research
in
the
Cerebral
Function
Unit
of
the
Department
of
Neurology
at
Manchester
University.
|
|
|
|
| Organs
retained
for
diagnostic
reasons
|
|
|
|
| In
principle,
there
could
have
been
situations
when
retention
of
a
whole
organ
was
needed
for
further
tests
to
establish
the
cause
of
death.
The
brain
was
the
organ
most
often
retained
for
diagnosis,
but
in
Mr
Isaacs'
case
his
brain
was
not
retained
for
this
reason.
|
|
|
|
| Retention
of
lungs |
|
|
|
| The
retention
of
lungs
was
the
only
other
example
of
systematic
organ
retention
at
Prestwich
mortuary
that
either
Dr
Farrand
or
Mr
Walkden
could
remember.
This
occurred
when
a
Coroner's
post
mortem
was
ordered
because
the
cause
of
death
was
related,
or
possibly
related,
to
an
industrial
lung
disease.
In
these
post
mortems
the
lungs
were
retained
and
forwarded
by
courier
to
a
designated
centre
for
specialist
examination.
This
system
was
not
limited
to
Prestwich
mortuary
and
was
reported
to
me
by
pathologists,
morticians
and
Coroners'
Officers
in
many
places.
|
|
|
|
| Other
organ
retention
for
research
|
|
|
|
| When
asked
about
other
organ
retention
practices,
Dr
Farrand,
Mr
Walkden
and
PC Joe
Cassalls,
the
Coroner's
Officer,
all
replied
that
in
the
1980s
there
were
no
other
research
teams,
apart
from
the
Cerebral
Function
Unit,
Chapter
8,
who
obtained
organs
for
research
from
Coroner's
post
mortems
at
Prestwich
mortuary.
|
|
|
|
| Tissue
blocks |
|
|
|
| While
retention
of
whole
organs
to
determine
the
cause
of
death
was
rare,
tissue
blocks
were
retained
more
frequently
for
histology.
In
view
of
his
findings
as
reported
to
the
Coroner,
Dr
Farrand
considers
he
would
have
had
no
reason
to
retain
any
tissue
blocks
after
the
post
mortem
on
Mr
Isaacs.
|
|
|
|
| What
followed
the
post
mortem? |
|
|
|
| After
the
post
mortem,
Mr
Isaacs'
brain
would
have
been
placed
in
the
mortuary
fridge
to
await
collection
by
a
member
of
staff
of
the
Department
of
Physiology
of
the
University.
Mr
Walkden
completed
a
form
for
the
University,
including
Mr
Isaacs'
name,
age,
date
and
time
of
death,
and
the
time
the
brain
was
removed
(11.15am).
|
Annex
16
|
|
|
| Other
information
recorded
on
the
form
are
the
cause
of
death
(Hanging)
and
the
names
of
Mr
Isaacs'
general
practitioner
(Dr
Rosenberg)
and
the
pathologist
(Dr Farrand).
Dr
Rosenberg's
address,
written
in
different
handwriting,
appears
to
have
been
added
later.
Mr
Walkden
confirmed
that
most
of
the
handwriting
on
this
form
is
his
own.
He
completed
a
similar
form
for
each
brain
that
was
collected
for
the
joint
programme.
|
|
|
|
| Later
on
27
February,
Mr
Isaacs'
brain
was
collected
by
an
unidentified
member
of
the
University.
|
|
|
|
| Summary |
|
|
|
| The
surviving
documents
provide
contemporary
details
of
the
post
mortem
examination
of
the
body
of
Mr
Isaacs
on
27
February
1987.
These
do
not
mention
retention
of
his
brain,
except
for
the
note
completed
by
Mr
Walkden
which
shows
that
Mr
Isaacs'
brain
was
undoubtedly
retained
for
use
at
the
University. |
|
|
|
| At
Prestwich
mortuary
in
the
1980s
some
brains
were
retained
from
Coroner's
cases
for
diagnostic
reasons.
Apart
from
these,
brains
were
retained
for
three
different
research
activities
-
two
at
Manchester
University
and,
until
1985,
for
the
Cambridge
brain
bank,
Chapter
26.
|
|
|
|
| The
retention
of
lungs
for
confirmation
of
industrial
disease
was
the
only
other
systematic
example
of
diagnostic
organ
retention
from
Prestwich
mortuary.
|
|
|
|
| References |
|
|
|
| 1 Entry
in
Prestwich
Mortuary
Register
of
Outside
Deaths.
|
|
| 2 '751
police
report'.
|
|
|
|
