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. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This work was supported by a Lundbeck Foundation grant to M.V. Petersen (R322-2019-2758). ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes No data available