Investigation into Postmortem Hemorrhage Following the Removal of Indwelling Vascular Devices in Deceased Patients

Abstract

Objective: In the funeral industry, it is a recognized phenomenon that hemorrhage can occur due to postmortem changes (postmortem hemorrhage). We aim to investigate the prevalence of post-mortem hemorrhage following the removal of indwelling vascular devices in patients discharged as deceased from two Japanese acute care hospitals. Methods: The study included cases of patients who were discharged following death between February 2024 and April 2026. A documentation form containing information on the devices removed post-death was handed over to funeral directors. These forms, which recorded the presence of postmortem hemorrhage, the extent of contamination, and the time of onset, were subsequently collected for analysis. Results: The incidence of hemorrhage was 4.0% (9/224 sites). Hemorrhage occurred significantly more frequently at arterial puncture sites than at venous puncture sites (16% vs. 3%, p<0.05). In three cases, extensive contamination of clothing and bedding was observed. The median time of onset was approximately 17 hours after death, with a maximum duration of 38 hours observed in one case. In one instance, the hemorrhage was discovered by the bereaved family. Conclusion: This study clarified the frequency of postmortem hemorrhage following the removal of vascular devices and demonstrated that such events can occur long after death and lead to extensive contamination. These findings highlight the need to re-evaluate postmortem care protocols and to refine the methods used to provide explanations to bereaved families.