HERSHEY, Pa. (WHTM) – When 53-year-old Lorena Dawes died last year, her family was left with a lot of questions about her diagnosis and treatment.

“We were concerned about how she had suffered such a quick bout with liver disease,” her son, Kenneth R. Dawes, said.

Kenneth Dawes says in June 2019, his mother attended a family wedding.

“She was dancing and looked great,” he said. “Two weeks later she was in the hospital. She was there for over 30 days. She was admitted on June 26 and she died on July 28.”

The family requested an autopsy.

“We wanted to completely rule out any possible cause that hurt her or could potentially hurt other people,” Kenneth Dawes said.

The family also had concerns about the autopsy.

“For the same entity that provided care to also be the same entity that performs the autopsy seems to be a huge conflict of interest,” Dawes said.

“That is a question a lot of people have, especially when people are already concerned about the circumstances. They think that the hospital made a mistake and now they are worried the hospital maybe was going to try and cover it up,” said Brendan Lupetin.

Lupetin is an attorney with the Pittsburgh law firm Meyers Evans Lupetin & Unatin, which has been handling medical negligence cases for over 40 years.

Lupetin says an autopsy can play a key role in a medical malpractice suit, but a family has to make sure they get one. Under Pennsylvania law, autopsies are only required under certain circumstances.

“As far as it being legally required, there are eight or nine specific criteria that trigger a coroner investigation and then ultimately an autopsy. However, anyone can request an autopsy,” said Lupetin.

ABC27 found that teaching hospitals in the area perform their own autopsies, typically at no cost to the family. Private hospitals tend to work with a third party, like a larger academic medical institution where autopsies can be conducted by medical experts.

Some private hospitals will provide autopsies at no cost to the family when there are questions about undetermined death or disease. In all cases, autopsies can be requested by a physician or family member or ordered by a coroner.

“In teaching hospitals, autopsies are performed about 20% of the time that there are deaths, but in non-teaching hospitals, that number is almost nonexistent, well below 5%. Teaching hospitals justify the cost because it can help them evaluate and improve medical care. Private hospitals want to know who is going to foot the bill,” said Jerry Meyers, the firm manager of Meyers Evans Lupetin & Unatin.

Medical records are also important in cases of medical malpractice and federal and state law requires the records to be released.

“The person who is listed as the respondent on the death certificate has a right to request the patient’s medical records from the hospital. The hospital has 30 days in Pennsylvania from the time of payment, if there is a charge, to produce the records,” said Lupetin.

“There can be serious penalties if there is an effort to intentionally withhold records from a patient,” said Meyers.

According to Lorena Dawes’ autopsy, the official cause of death was an acute liver failure from nonalcoholic fatty liver disease. The family says the autopsy hasn’t answered all of their questions.

“The mistakes that happened at the beginning, including the lack of tests, I think created the catastrophic situation which would ultimately lead to her death,” said Kenneth Dawes. “What we have now are memories, photos, and if anything, it just feels good to know that we are doing our best to help get her story out there.”

If you suspect malpractice in a loved one’s death, you can call the coroner and ask them to investigate. The coroner will ultimately decide if an investigation will be opened.

You also have the right to choose who does the autopsy, but you may have to pay and autopsies can cost upward of $6,000.

The best way to prevent medical malpractice is by having an advocate with the patient while they are being treated in the hospital.

“Someone who is present and there for the purpose of hearing what the doctor says and seeing to it that what the doctor has said has been sufficiently translated so that the advocate and the patient actually understood it,” said Meyers. “You can not emphasize strongly enough to people that they need to be informed, and when things go wrong, they should insist on getting an explanation.

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Note: ABC27 is not naming the hospital because at this time there is no proof of malpractice