Utility of forensic toxicology and histopathological examination in community-related deaths at a Teaching Hospital in India - A retrospective study

Objectives: This retrospective study was undertaken to assess the utility of forensic toxicology and histopathological examination to determine the cause of death in community-related deaths that were brought dead to a teaching hospital in India. 
Methods: All community deaths in 2020 were studied based on the inquest report, medico-legal autopsy report, histopathological examination report, and forensic toxicology report at RVRS Medical College, Rajasthan, India. The probable cause of death after the medicolegal autopsy and the final cause of death after receiving reports of forensic toxicology and histopathological examination were compared to assess the utility of chemical analysis and histopathological examination. 
Results: Viscera were preserved for forensic toxicology in 171 cases. Out of these, 53 were cases of mechanical injuries, and in 4 cases, probable cause after a medico-legal autopsy was undetermined. Out of a total of 171 cases, viscera were preserved for histopathological examination in 54 cases. Out of these, 12 were cases of other natural causes, 2 were cases of snake bite, and 2 were cases of hanging as a probable cause after medico-legal autopsy. Histopathological examination was useful in 3 cases of other natural causes, 3 cases of undetermined causes, and 1 case of snake bite. Overall, forensic toxicology caused an impact on the cause of death in only 16 cases out of 171 cases, and histopathological examination caused an impact on the cause of death in only 7 cases out of a total of 54 cases. 
Conclusion: The current retrospective study suggests that microscopic examination and forensic toxicology investigations should be used, as and when needed, in specific circumstances, but are not necessary as a routine investigation in each and every case.