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consider requesting other States to provide the necessary specialist(s).
Ideally, the appointed pathologist would obtain a complete “case history” before beginning the
examination: he should acquaint himself with the details of the circumstances of the accident, details of the
operating crew’s medical and personal histories, familiarize himself with the internal layout of the cockpit
and passenger compartments of the aircraft type concerned, and make a thorough examination of the
accident site - all before commencing the examination of the bodies. Such an approach is rarely, if ever,
practicable. The pressures that exist following most fatal aircraft accidents are such that examination and
disposal of the bodies must be handled as quickly as practicable and any delay avoided. Many factors may
demand speed; the extreme example is that of a tropical climate with no refrigeration facilities.
A practical approach has been found to be for the pathologist to be briefed at the outset by the
Investigator-in-Charge concerning the salient features of the accident and to be informed whether any
particular ideas as to the type of accident may have been aroused. This does not have to be a lengthy or
detailed briefing but sufficient only to allow the pathologist an opportunity to make a special point of
searching, during the course of the normal complete examination, for supporting or contradictory evidence
relative to any other evidence which may already be available to the Investigator-in-Charge. At frequent
intervals during the investigation, the pathologist and the head of the Human Factors Group, or the
Investigator-in- Charge as appropriate, should confer. The pathologist can thus get an up-to-date picture and
learn of developments that may bear upon his work; he in turn can report any of his findings that could
provide a lead for members of other groups. This is the principle of the Group System in which it is essential
that the human factors team play a full part.
Tasks at the accident site
Authorities differ in opinion as to the extent to which the pathologist should be personally involved in the
tasks at the accident site. He must, of course, be aware of all that has to be done there and the evidence he
may expect to be collected or preserved by others. He will have to utilize and correlate this evidence with
his own findings. These tasks are discussed in the AIG Manual.
As is implied in that manual, it is probably ideal that the pathologist goes to the accident site as soon as
possible - certainly this is so in the accident involving many fatalities. It is always a great advantage to the
pathologist to be aware from the beginning of the general situation at the accident site. His presence and
interest are likely to ensure that the procedures (outlined in Chapter 18 of the AIG Manual), designed
essentially to preserve all evidence of possible value in the medical investigation, are carefully and
satisfactorily carried out.
ICAO Preliminary Unedited Version — October 2008 IV-1-6
The tasks at the mortuary
Whether or not the pathologist visits or works at the scene, he must be intimately aware of conditions in the
local mortuary for it is there that his main pathological duties will be carried out. For this reason it is highly
desirable that authorities involved in the pre-planning of an aircraft disaster situation should be advised by
a pathologist on the matters referred to in Chapter 18 of the AIG Manual with special reference to the
suitability, and the methods of adaptation, of any buildings proposed for use as main or temporary
mortuaries.
The tasks in the mortuary cover both the search for evidence relating to accident investigation and
identification of the bodies of the dead. The general principles of the identification of the dead will be
known to most physicians and certainly to all pathologists. They are outlined for the information of
non-medical accident investigators in the AIG Manual, Chapter 18 and subsequent appendix.
It is difficult, if not impossible, to design the perfect form to document something so variable as the
findings arising from the examination of a body from an aircraft accident. It is necessary to record details
about a body relating to its identification, the cause, and the circumstances of its death. Since
ever-increasing numbers of persons may be killed in a given accident, it is expedient to reduce the number
of forms for each body as far as possible, to reduce their complexity, and to provide forms that can be used
and handled with ease. They should be at once simple yet comprehensive; they must be appropriate whether
a body is substantially intact and fully clothed, or naked and partially disintegrated. Thus any form to be of
value in an aircraft accident must be a compromise between a many-paged document, comprehensively
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Manual of Civil Aviation Medicine 2(127)
