FATAL: A Forensic AuTopsy Annotation tooL for digital recording of autopsy findings

The findings from forensic autopsies, where cause of death must be established and reported to legal authorities, are reported in paper-based formats. Practitioners are required to map 3D injury findings to 2D space. Here, we design and describe a digital Forensic AuTopsy Annotation tooL (FATAL), that can be used by practitioners to record systematically detailed autopsy findings onto an interactive 3D body model. We employ a user-centred design process involving an expert forensic medicine team. We describe the iteration process and the final functionality determined, based on in-depth analyses of forensic clinical workflows, and feedback on the types of complex cases confronting practitioners. FATAL functions include freehand drawing, a layer system for injury categorisation, trajectory plotting, surface area markings, and point-of-interest marking. Relevant external images, such as investigative report or autopsy photographs, can be loaded into the FATAL tool and assigned to individual annotations. The application streamlines workflows, supports template-driven documentation, and collates all forensic data into a single interface. Findings from the digital tool can be exported to a 2D report (PDF). We highlight the advancements in accuracy, efficiency, and reproducibility afforded by a digital tool for forensic autopsy documentation. Potential applications in forensic medical examinations beyond autopsies are described, along with specific areas for extension, such as supporting touch screen and pen inputs, export for 3D printing models and extending the tool's compatibility with custom 3D body models.