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Procurator FiscalA lawyer—employed within the Crown Office and Procurator Fiscal Service, which is part of the Scottish Government and its forensic system—who is responsible for initiating criminal prosecutions. The Procurator Fiscal’s best-known role is as the local public prosecutor, but he or she has a separate duty to investigate all sudden, suspicious, accidental, unexpected and unexplained deaths and any deaths occurring in circumstances causing serious public concern.
Deaths that must be reported to the Procurator Fiscal.
• Where there is evidence or suspicion of homicide;
• By drowning;
• By burning or scalding or as a result of fire or explosion;
• Caused by an accident involving the use of a vehicle including an aircraft, a ship or a train;
• Resulting from an accident in the course of work, including voluntary or charitable work;
• Where the circumstances indicate the possibility of suicide;
• Following an abortion or attempted abortion, whether legal or illegal;
• Of a person subject to legal custody, including any death of such a person en route to a Police station or prison (for example during prisoner transport or in hospital);
• Occurring in health premises in the community including a GP's surgery, health centre, dental surgery or similar facility;
• Due to violent, suspicious or unexplained circumstances.
Deaths related to neglect or complaint
• Where the circumstances seem to indicate fault or neglect on the part of another person;
• If not already reported, where a complaint is received by a Health Board or NHS Trust and the complaint is about the medical treatment given to the deceased with a suggestion that the medical treatment may have contributed to the death of the patient.
Deaths of children
• Of a newborn child whose body is found, which may be characterised as sudden unexplained death in infancy (SUDI) or the like;
• Of a child from suffocation, including overlaying;
• Of a child in foster care;
• Of a child in the care of a Local Authority;
• Of a child on a Local Authority "at risk" register.
• Caused by an industrial disease or industrial poisoning;
• Due to a disease, infectious disease or syndrome which poses an acute, serious public health risk including:
– Any form of food poisoning;
– Hepatitis A, hepatitis B (± delta-agent co-infection (hepatitis D)), hepatitis C and hepatitis E;
– Any hospital-acquired infection;
– Legionnaires disease.
Deaths associated with medical or dental care
• Which was unexpected having regard to the clinical condition of the deceased prior to his or her receiving medical care;
• Which is clinically unexplained;
• Which appears to be attributable to a therapeutic or diagnostic hazard;
• Which is apparently associated with lack of medical care;
• Which occurs during the administration of a general or local anaesthetic;
• Which may be associated with the administration of an anaesthetic;
• Caused by the withdrawal of life-sustaining treatment to a patient in a persistent vegetative state (This is to be distinguished from the removal from a life-support machine of a person who is brain-stem dead and cannot breathe unaided.);
• Occurring as a result directly or indirectly of an infection acquired while under medical or dental care while on NHS premises, including hospitals, GP surgeries, health centres and dental surgeries;
Any drug-related death, as a result of ingestion of any drug where the death does not fall into any category above.
Any death not falling into any of the foregoing categories where the cause remains uncertified or where the circumstances of the death may cause public anxiety.
Deaths associated with medical or dental care, including deaths which may be due to medication (however administered) or diagnostic or therapeutic procedures (operations, investigations, X-ray procedures, etc.). "Medical care" should be interpreted broadly and includes surgical, anaesthetic, nursing or any other kind of medical care whether being given in a hospital, a GP’s surgery, the patient’s home or elsewhere. It also includes deaths from “hospital-acquired” infections.
Deaths where there is a possibility of criminal proceedings, including homicide but also from a road traffic death, an overdose of controlled drugs, an accident at work or a contravention of food safety legislation.
In any case where it will be necessary to prove the fact and cause of death in subsequent court proceedings, the Procurator Fiscal will instruct a post-mortem examination by two pathologists. This may be two forensic pathologists or it may be a forensic pathologist and a specialised pathologist, for example a paediatric pathologist if the death is that of a child.
Deaths for which the disease can be accurately diagnosed in life and cause of death certified without a post-mortem examination—e.g., mesothelioma, which requires a combination of radiological evidence and an ante-mortem pleural biopsy with histologic examination using immunohistochemical staining techniques (e.g., positivity for Calretinin, CK 5/6, EMA, Vimentin) may conclusively diagnose mesothelioma and sufficie to allow settlement of a compensation claim.