Final Diagnosis, Inc.

08/23/2025

A friend of Marcie’s from out of state mentioned today that they had hired a national private autopsy firm (name intentionally withheld) to determine a cause of death for their family member in another state. I happened to look up this firm, and it appears they make arrangements with funeral homes (a map of the US and many funeral homes) around the country where a pathologist (hopefully licensed/qualified/board certified) then travels to come in and do an autopsy.

What is notable about the majority of these various national autopsy providers (my experience over the years) is that they never seem to mention “who” is actually doing these autopsies.

Who are these experienced and competent forensic pathologists? A famous case that I can speak of (out there already) was the Michael Brown second autopsy stemming from Ferguson, near St Louis. That autopsy was performed by a lay person (Shawn Parcells). Check out on Google. This is but one example of what can happen. In fact, that lay provider also did the TV reenactment. I was shocked. So ask: Is the exam actually being done by the pathologist or by a lay tech? If it is “assisted” by a lay tech, is that pathologist physically there during the dissection?

Is this company owned or run by a lay person and thus just a “referral service”?

Is that pathologist medically licensed in that state?

Are they able to take quality/clean photos?
How many do they take on average?

Is the family educated to whether that autopsy may answer the questions or not?

Some advertise performing toxicology with either no autopsy or with a partial autopsy. Performing toxicology without the benefit of a complete autopsy is fruitless. Was the family educated about toxicology?

I wholeheartedly support my competent forensic pathology colleagues in establishing services as much like my own. However, my stomach turns when I see lay individuals who startup referral autopsy practices or autopsy practices that are suggested to be “forensic” when the providers may lack training or are subcontracted on “the fly”. Interestingly, it is not like the cost is that much less (and sometimes it is more) than to come to Tampa. It depends on funeral plans as well .

Does the pathologist discuss the merits with the client and explain the process-before being hired?

Do these facilities have a lab setup much like a true medical examiner/coroner autopsy suite? Do they stock tools and backup tools? Or is it a funeral home prep room and the pathologist with a portable “toolbox”?

Is there added cost to use such a funeral prep room? Usually there is. Typically a hidden ost of $600 and up. Ask .

If these companies that provide autopsies are in fact experienced with vetted doctors, they would/should actually be able to mention who the pathologist(s) are. Websites for autopsy services that mention no pathologist providers, be wary. Ask questions . Ask to speak to doctor BEFORE signing anything.

I typically speak to families before and always after.
We do not charge for that initial educational/info gathering call. (This company I heard about today apparently does charge, $75 for 10 min of initial call-in). We talk many out of an autopsy exam if it is not likely going to add value or even answer their questions. Many of these free calls we engage in may be upwards of 30-60 minutes. My investigators listen, and we educate.

We take over 100 images of pertinent positive and negative images on every autopsy case. All with a clean (not scrubbed in) trained photograher who floats around me while another tech Is there for other tasks and assistance-not to do the case.

I personally perform the dissection with a few areas of assistance.

If I am unable to be available (meeting/vacation), I have a comparable experienced same board certfied FP who can cover (Dr Chrostowski). Often the cases wait for me for when I return to Tampa because I have spoken to them at length, and already know the intricate details.

I am board certified in anatomic, clinical, and forensic pathology with 35 years experience.

Despite the geographic distances, sometimes air transport, vehicular transport, coming to Tampa for an exam might actually be less expensive that these lay-owned referral services. It is worth checking.

Above all, beware of lay autopsy middle people. Ask to speak to the doctor as you get close to making the commitment. If they can’t, look around for someone else. That’s a sign. It MATTERS who you hire.

08/18/2025

Great recent cases. Sadly, but fortunately for this one family, a repeat pattern is emerging, whereby a second autopsy yields a great deal of data that the original Medical Examiner never spent the time to examine. Anterior neck layered disssection not done to completion, thryoid still covered. Hyoid never removed. Nor the tongue . Bowels never opened. Skin not dissected to expose any tissue away from traditinal incision to identify easily missed trauna (this was a custody death).

I cannot wait to read what they say they looked at in the first autopsy report. I can only hope that they do not mention doing and seeing things they did not. This is one of the dangers of templated text.

I used to say second autopsies were unlikely to yield much if another board certified FP already did one. I do not say that anymore, unless I really have experience in seeing that pathologists work (in person). Sadly, with dozens of these re-exams in the last few years I would estimate that over 50% have relevant findings, and could actually change the opinion of cause and manner. Huge surprise here and I need to formallly write this up with the redacted data and photo documentation when I can (with family auth).

In the private setting I have the luxury of time. I have the luxury of the best staff and the best photographers. Speed is not my gauge. Quality, care and doing the right thing is the metric.

05/31/2024

Marcie and I are here representing Final Diagnosis, Inc. and The Autopsy Doctor at the Florida Independent Funeral Directors of Florida (IFDF) meeting. This is such a nice group of dedicated professionals. Funeral directors are usually the ones who direct families to us and this gives us an opportunity to educate and learn more about their world as well. Looking forward to next year!

05/02/2022

05/02/2022

Gastric mucormycosis in an chronic alcoholic with autopsy findings of a hemorrhagic gastritis. You only see if you look. Most pathologists at least in the ME world see the hemorrhage and move along (kind of expected). But if you look you find. Interesting case. This organism tends to occur in immune compromised hosts from a variety of hosts. No organisms seen elsewhere. Traditional H&E stain.

12/08/2021

Many commonly found autopsy services which one may find on a Goggle search are run and owned by non-pathologist lay persons who ultimately seek out the services of a local pathologist. In turn, that pathologist may or may not be board certified, and in fact they may or may not be someone specifically trained to optimally characterize or exclude trauma (if they lack additional sub-specialty training in forensic pathology). Trauma could be physical, or it could be drug related and it could be in the setting of a second autopsy or decomposition where artifacts and pitfalls abound. Autopsies are the practice of medicine and they require experience. Knowing when to refer back at various points to a medical examiner or coroner is also critical. There is no statute of limitations on reporting or reassigning a death as a traumatic one. Just because it was referred once does not mean that “new news” will not be relevant.

Some autopsy companies do not use actual doctors in the dissection phase. Some purportedly have operated with no pathologist on site at all. In most states, the practice of autopsy requires a state Medical license in the locale of exam. Ask questions if you face hiring an autopsy pathologist. Are the dissectors forensic pathologists? Are they board certified? Are they licensed in that state? Do they even have an autopsy facility? Do they have dedicated photographers? Is the company you called owned by a board certified forensic pathologist? Otherwise it’s only a referral agency in the middle. That adds cost and diminishes what is ultimately paid to those who actually do the work.

If you have worked with Final Diagnosis Inc. as a client, as a business partner, an attorney, or know Dr. Daniel Schultz as a forensic pathologist in any professional capacity, we would greatly appreciate a word or two about your experience. It could be left here as a comment and if you say “please post this to you website”, we will directly move it to a rolling comment list at our website: www.TheAutopsyDoctor.com.

Not all autopsy requests are reasonable, and just getting a call and setting one up is not the answer. Why? We know enough and we care enough to tell a caller when an autopsy is likely NOT going to add valuable data. A good proportion of our incoming calls often end in Dr. Schultz talking a family out of an autopsy. Sometimes a few minutes on the phone makes all the difference. Those interactions usually have no cost. Later legitimate and interesting exams continue to arrive as trust is earned.
Funeral homes happen to listen and they certainly see exactly what we do.

FORENSIC PATHOLOGIST, private Tampa, FL lab

11/11/2021

Thanks to all of those selfless and brave men and women on this Veteran’s Day. You are all heroes and we appreciate that sacrifice for our nation. We have always discounted our fees at Final Diagnosis, Inc. for veteran cases and that includes autopsies, consults, and other expert time to families of deceased veterans who may later wonder “what happened”?

10/27/2021

Last week we took over the two other office units next to Final Diagnosis Inc., expanding another 1600 square feet in order to build not only a second and more suitable environment to teach pathology residents, medical students, future medical students, other health care professsionals, criminal justice, and forensic pathology/death investigation hopefuls. We will have a very large conference room for teaching as well as for depositions with attorneys, meetings with families. Only cases where consent is given and identifiers erased are used to teach. The new autopsy suite is still in planning but I want the room to attract other similarly expereinced, and especially enthusiastic forensic pathologists to help and feel like their own space. We will have office space for them as well. We engage not only in autopsies, but consults on cases either never autopsied or autopsied but where questions still linger.

We are The Autopsy Doctor(s), powered by Final Diagnosis Inc. Board certified, experienced, and most importantly, doctors willing to talk to you, well before we engage, even to the point of talking a potential client out of an autopsy or second autopsy if facts suggest that it isn’t going going to add value.
This is our greatest satisfaction.

06/13/2020

https://theautopsydoctor.com/second-autopsy/

Second autopsies by Final Diagnosis, Inc. can provide reassurances on the validity of an initial autopsy report. That said, second autopsies offer unique challenges. They can occasionally uncover m…

04/26/2019

Pearls of postmortem wisdom:

1. Postmortem toxicology devoid of autopsy data is like determining the winner of a hockey game by only taking into account one team’s score.
2. Every autopsy has a surprise, if you look.
3. Most autopsies reveal more than one potential cause of death, it just depends on picking the right one(s) and that means knowing some history.
4. Death certificates as a broad collective are probably the single most worthless piece of “statistical data” for cause of death, even manner determinations. The REAL benefit and reason for a death certificate is to simply document for the government ) than to document that someone has died. The cause part is basically a (hopefully educated) guess on most. Add an autopsy and you move above 50% certainty (enough for civil issues and to convince a jury anyway). Without an autopsy, many differentials, uncertainty, and speculation rightfully exist.
5. Radiology is NOT the gold standard for identifying trauma or ruling out trauma. If you suspect trauma, or you believe it not actually to be present (ie a fracture or a bleed that is or isn’t) the BEST way to know (and document) is via a carefully done and photographed autopsy.