Clinicopathologic discordance-a not unexpected occurrence

Disagreements between clinical and forensic interpretations of post-mortem findings are sometimes influenced by prior experiences with particular patient cohorts. While patients who present clinically have characteristic indicators of disease (thus enabling diagnosis), symptoms and signs may not have been manifested by those who die suddenly and unexpectedly and present for medicolegal assessment. Thus, the determination of likely or possible lethal mechanisms requires an understanding of occult disease processes and idiosyncratic responses that may be very different from case to case. Summaries of cases should be undertaken with an awareness of the limitations of individual knowledge and may be augmented by collaboration and pooling of expertise.