Research pointers: Unexplained differences in sex ratios at birth in Europe and North America.

That the documentation of about 10% of deceased patients contained errors at the beginning of the study suggests that clinical staff were paying insufficient attention to the identification and details of deceased patients. Although some of the discrepancies were arguably less important, such as errors in unit number or address, a substantial proportion could have had serious consequences. These include misidentification of the body (body received in the mortuary with the wrong name) or property and non-notification of pacemakers. Pathology is one of the most intensely scrutinised medical specialties. Clinical Pathology Accreditation (UK) sets standards for medical laboratories and mortuaries and insists on external quality control measures and regular internal audits. However, the mandatory quality assurance procedures refer only to the internal quality control of all examinations and do not specifically refer to mortuary services. Our experience of inspections by Clinical Pathology Accreditation is that little emphasis is put on regular internal quality control audit of the mortuary or on any other internal quality assurance procedures. The error rate fell during our study, probably because staff were regularly alerted to errors as part of the audit. We therefore believe that such audits are essential for a mortuary to run effectively and safely and to gain public confidence.