A very unusual omission of marks

TBH’s inquest came up with some interesting facts.

The governmnet pathologist who did the second PM(Post mortem ) noticed the marks on the neck which , surprisingly, was not noticed reported during the first autopsy.

Since this case is still in coroner’s court, i would not want to make any conclusions just yet, but I just wish to point out the most basic things  a doctor must do during an autopsy.

When I was posted as a medical officer in a district hospital, since there was only one state pathologist who could not cover the whole state, we( all medical officers in district hospitals)  were required to do autopsy on accidents and sudden death cases. ONly those cases where we thought there might be suspicions on the cause of death, then only the pathologist would come and carry out the autopsy himself. It is very unlike nowadays. Yes, a district medical officer in those days managed all sorts of cases, including the death cases.

Even with limited knowledge ( since we were not trained pathologists and only with limited knowledge from what little we learned in medical schools) , we did quite well in our PMs. The most important basic rule in doing a post mortem is to go through the dead body inch by inch, and to record every visible injury, and that include scratches , bruises, needle markings, cuts or even abnormal discolorations. After that, every finding must be written down.

In fact, everything abnormal must be written down, even if the doctor doing the postmortem cannot account for the abnormalities. That can come later with the help of others ( say, by calling up a more experienced pathologist and relate the findings) as well as tocicology and tissue reports. Tissues must also be sent for microscopic examination and toxicology testings.

So it was very unusual why the neck markings on TBH was not noted in the first PM, given that there were 2 fully qualified  pathologists (not ordinary MOs ) doing the PM. The Thai Pathologist could even spot it from photographs, and these 2 PMs did not write down these neck markings.

I do not know the reasons why this is so. But to miss important markings such as those around the neck would immediately cast the whole PM reports as incomplete. If the report is incomplete, how  can anyone venture a cause of death based on an incomplete report? I think the 2 pathologists should come forward and answer why these markings were not reported.

I have written a few posts on TBH and I believe that no stones must be unturned to find out the real cause of death and not only let justice prevail but justice must be seen to have been let prevail. Otherwise the whole credibility of the government would be at stake.


Other posts on this case:
Disappointing half measure

When experts have no expertise

Press statement on the death of a MACC witness


16 Comments (+add yours?)

  1. pilocarpine
    Mar 02, 2010 @ 16:03:57

    not just the post mortems, the qualification of the pathologists must be questioned.

    I hope MMC do something about it.

    For the people of medicine to be politically bias can destroy the reputation of the whole industry.


  2. klm
    Mar 02, 2010 @ 16:16:38

    The whole credibility of the govt is already gone. Any professionals with a govt in front of the word is already counted as less than useless, to put it mildly.
    They are a waste of tax payers money. They are in govt services because they cannot get a job elsewhere.


  3. Chabalang
    Mar 02, 2010 @ 18:31:23

    Thanks for sharing from a medical viewpoint.

    I think a majority of the public have already “judged” (or jumped the gun) and have in mind of the TRUE cause of the death regardless of what the Govt. post-mortem report says. I have made my mind from what I read (Dr Rafick is quite a good read) and pictures of the body. It simply reflects on how I view the credibility of Govt/public institutions.

    How sad, eh?


  4. Ikan Sembilang
    Mar 02, 2010 @ 19:34:40

    When we were kids, we enjoyed watching an American tv series called ‘Hogan’s Heroes’. We always had a good laugh when Sergeant Schultz said, “I hear nothing, I see nothing, I know nothing!”


  5. Meng
    Mar 02, 2010 @ 19:41:23

    Were they told not to record it for specific reason.???

    Doc, the government has lost it’s credibility long ago???


  6. disgusted
    Mar 02, 2010 @ 22:16:40

    The earlier reports of THB’s spirit still lurking around and I don’t think he is satisfied either with the latest developments.

    And the government owes him big time: justice.

    If not, it does not matter the natural cause and effects will take place.

    This government is blind to justice anyway.


  7. ahoo
    Mar 03, 2010 @ 12:32:28

    This govt is not entirely blind to justice but to selective justice. They want justice if it is due to them and they want it badly. But for the “others” we have to pray for a righteous judge.

    This mess with so many pillars of the govt will have to take time to untangle and it is for the common folks to make a stand that enough is enough !


  8. Ken
    Mar 03, 2010 @ 12:37:06

    The 3rd govt pathologist tried to defend the 2 previous pathologists by saying the marks will only appear after 24 hrs and that is why they missed it.

    As a layman I find it hard to believe that bruise marks will only appear after 24 hrs. In any case cCan marks appear on a corpse when blood has stopped circulating?

    I wonder why these govt pathologists have to stoop so low. To keep their jobs? But if they are qualified doctors can’t they get a job outside the govt? Or is it for “race, religion and country?” But the Indian national doctor doesn’t fit this role.


  9. Dr Hsu
    Mar 03, 2010 @ 13:11:09

    it is very simple. Normally photos are taken before the post mortems on the injuries sustained. If the marks showed up in photos and was spotted by the Thai pathologist, why was it not reported in the PM report?

    I would not want to be subjudice and let you folks think about this.


  10. A true Malaysian
    Mar 03, 2010 @ 13:30:12

    I pity these people. Jaga ‘maruah bangsa’ also not to the extent. Sigh!!!


  11. klm
    Mar 03, 2010 @ 14:02:16

    These govt doctors are below our contempt. They are
    despicable and do not deserve to be human beings.


  12. ong
    Mar 03, 2010 @ 19:39:22

    Behaviour of first two pathologists is due either to political bias/inclination or to cowardice. Cowardice because they fear offending the MACC and the BN government. Behaviour of the Sungai Buloh hospital head pathologist Dr Shahidan Md Noor is due either to political bias/inclination or to cowardice and also due to a common practice among ALL professionals, more so among the medical profession, called ‘closing ranks’.

    Dr Shahidan Md Noor is even prepared to make a big fool of himself just to ‘close ranks’ with his fellow pathologists. Perhaps he, like other professionals, and not just the medical profession, who practice ‘closing ranks’ do so because they hope that if they ever commit a professionally negligent act, their fellow professionals will also cover up for them. I am sure Dr. Hsu, if he wants, can tell us all about ‘closing ranks’ among the medical profession.


  13. Taikohtai
    Mar 04, 2010 @ 06:09:24


    There’s no doubt that the professionals are not ‘allowed’ to do their job properly. We all remember the case of the Myanmar doc who was visited by the cops umpteen times after reporting on Saifool so much so he had to do a disappearing act himself.
    Such is the sad state of affairs in Malaysia these days. There is no protection for doing the right thing if it means the higher ups are implicated in wrongdoings. And the countless dead bodies that turn up in the police lockups doesn’t help matters, do they? In this aspect, we all concur with TDM’s observation that BN is rotten to the core.


  14. klm
    Mar 04, 2010 @ 12:12:43

    That is why govt employed professionals in Malaysia are not respected. They are just roman slaves. To be kicked about by the masters and punished if they do not obey instructions.


  15. mykantree
    Mar 05, 2010 @ 15:28:01

    Dear Dr Hsu,

    I think this article of yours have been very very circumspect about the first PM done by the govt pathologists. As you cannot be naive, it would therefore be read as misleading.

    Do you really really believe the stated and official findings of the 1st PM by the govt pathologists? Even the complete truthfulness of the 2nd one by Dr Shahidan?


  16. cbc
    Mar 10, 2010 @ 22:18:25


    you are your usual optimistic self.

    pigs can fly if this govt doesnt do anything to protect MACC which has been doing its bidding.


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