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Future postmortems of Dengvaxia vaccinees should be done by UP-PGH, experts.

By Charina Clarisse Echaluce

A forensic pathologist recommended that future post-mortem examinations on Dengvaxia child vaccines be performed by an expert from the University of the Philippines-Philippine General Hospital (UP-PGH) or the Philippine Society of Pathologists (PSP).

Dr. Maria Cecilia Lim, a member of the PGH-Dengue Investigative Task Force, explained that a medical autopsy is different from what is being done in autopsies for traumatic deaths caused by gunshots, stabbings, and fatal accidents.

"Medical autopsies, which include all these Dengvaxia-suspected deaths, must be performed by pathologists, not by general practitioners.... You need to understand that forensic expert is a generic term. Only forensic pathologists know how to do autopsy," she stressed.

(From left) Dr. Maria Cecilia Lim, Dr. Gerardo Legaspi, Dr. Rolando Enrique Domingo, and Dr. Juliet Sio-Aguilar


The Public Attorney's Office (PAO) has lately been conducting forensic examinations on children who received the dengue vaccine manufactured by Sanofi Pasteur.

"I have never worked with PAO. We do not know how they work. We encourage that the future autopsies be performed together with a representative from PGH or from the PSP," Lim noted.

She stressed that medical autopsy is much more complicated than simply opening a body.

"Not all doctors are created equal. Why? First, autopsy is not a subject in med school. Medical students might go to med school not observing autopsy. Even surgeons who regularly open up bodies will not be able to perform an adequate autopsy. Just because you're a doctor doesn't mean you know how to perform a [medical] autopsy," she added.

Lim emphasized that a medical autopsy is 10 times more difficult than a forensic autopsy.

"Training for the autopsy starts on Day One, when you take your pathology residency training which takes four years. Forensic pathology takes another year doing nothing but autopsy five days a week. A medical autopsy is 10 times more difficult than a forensic autopsy.... You also need to understand that even NBI and PNP have pathologists in their team to help them with non-traumatic deaths," she explained.

She maintained that a medical autopsy is much complicated that what we see on television.

"Autopsy is not simply opening the body and looking at the different organs, like we usually see on TV. It's actually a more complicated process," Lim said.

"Findings are correlated or connected with all the clinical data that we have; iyong symptoms ng patient, iyong resulta ng laboratory, resulta ng radiology," Lim explained.

"You do not take one finding during the autopsy and automatically narrow it down or blame it on a particular condition or a particular vaccine, forgetting the other things in the other organs which you have neglected to look at," she explained further.

Asked if she thinks the autopsies performed by the PAO team are not enough, Lim replied: "In our experience kasi, even with other institutions, iyong documentation... we have to document these cases. Actually sa PGH po, 'pag tiningnan ninyo... 'yong siguro minimum of 30 shots per autopsy, lahat ng organs may pictures para hindi na naming kailangang tingnan. This is also the reason why we want to be there during the autopsy because we get a lot of information from the feel of the organs, not just by looking at pictures."

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Title Annotation:Sticky
Publication:Manila Bulletin
Date:Feb 3, 2018
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