Current Problems and Issues in Death Investigations
What You Need To Know
by Karen Russo
© KRusso/ 2007-2011

Millions of families struggle to understand the horrific practices exhibited by the medical examiner and coroner system in this country and of those directly involved in that system-law enforcement agencies, prison and jail personnel, contracted medical personnel, hospitals, nursing homes, assisted living residences, and the funeral home industry.

Consider this for a moment . . .

• Unqualified coroners determining cause and manner of death.
• Medical examiners with no forensic training determining cause and manner of death.
• Conflicts of interest between M.E.s, sheriffs, funeral homes, contracted hospitals, nursing homes, prisons, jails.
• Homicides incorrectly deemed suicides.
• Families given inaccurate information about the death of a loved one.
• Arrogance of physicians in response to questions and concerns.
• The lax response to nursing home and hospital deaths.
• Questions ignored; phone calls not returned by medical examiners, coroners, law enforcement, prison and jail administrators.
• Cause and manner of death determined by hearsay.
• Medical records altered or missing.
• Deceased bodies transported without documentation.
• Bodies embalmed or cremated without authorization.
• Harassment of families by contracted funeral homes.
• Personal property missing.

Consider further . . .

• Prison and jail death investigations versus society's standards-Requirements aren't the same. Know what to do?
• Know what to do when an inmate dies? Dead but not dead?
• Inmate bodies-hide and seek.
• Know when you have an incomplete death certificate and what to do about it?
• Told there will be no autopsy? Know how to challenge that decision?
• Told there will be an autopsy? Know that you have options?
• Inability of medical examiner system to adequately and professionally handle mass fatalities.

Adequate investigations of death require the combined efforts and cooperation of law enforcement and other public-service agencies, medical professionals, and those within the forensic community. Cooperation between these entities however, is not automatic.

These front-line individuals, whether medical examiners, physicians, coroners, pathologists, forensic pathologists, funeral home personnel, prison administrators, or lay-people, are required to make important decisions which have far-reaching consequences. Put into the hands of the untrained or unskilled and without any independent oversight is dead-wrong.

There are gross deficiencies in the current death investigation process within each state. Death investigation practices vary greatly among medicolegal jurisdictions. There are no mandated standards or protocols that the medical examiner and coroner officers are to follow.

In order to "tease out" substandard and inadequate death investigation practices across the country, the Institute monitors and categorizes death investigations by type-whether a state medical examiner system, coroner system, or hybrid. We monitor questionable and substandard medical examiner and death investigation practices across the country performed by specific individuals, agencies and offices.

Within the U.S. those charged with the investigation of suspicious, unusual, and unnatural deaths have historically been under the umbrella of the coroner. However, in some states the word coroner is used interchangeably with the term medical examiner. By definition they do not mean the same thing.

Almost all coroner systems are intertwined in politics; and as a result, poor, biased and ineffectual death investigation is the result providing no recourse by family. Additionally, a wide variation in investigation quality is the norm when comparing one jurisdiction to another.

Limitations also exist in the use of the term medical examiner. Some systems limit the title "medical examiner" (M.E.) to mean board certified or eligible forensic pathologists; others use the term to mean pathologists, and others limit its use to mean physicians or coroners.

In some jurisdictions, other terms are used to delineate which M.E. is a board certified forensic pathologist, pathologist, physician, death investigator or non-physician death investigator. Terms such as "deputy chief M.E.," "deputy M.E.," "district M.E.," "regional M.E.," "county M.E.," "assistant M.E.," & "associate M.E" are all used to distinguish between different specialists, professions, training and educational background.

There is very little consistency from one jurisdiction to another when comparing terminology. In other words, in some states, the term "deputy M.E." is used to describe a board-certified forensic pathologist. In another state, that same title can mean a non-pathologist physician death investigator. And yet still, in a different state the same title can describe a non-physician death investigator.

The numerous titles given to M.Es, coroners and death investigators across the country causes a great deal of confusion, compounded by the fact that almost 50% or more of systems require no formal training in death investigation at all. Those that do require training do not enforce the requirement.

In addition to these already existing issues and problems is the refusal of the medical examiner & coroner system to provide information-not just to the general public but to the families that are directly affected by their substandard investigations and reports. Reports can be denied outright, never provided or if provided, are grossly incomplete.

Some jurisdictions have tried to fix these problems by implementing changes and regulations within their legislatures; others have completely done away with the coroner system altogether in favor of the medical examiner system

The Institute's recent book release entitled Fighting For Life, The Tricks and Traps of the Death Investigation System-A Guide for Those Navigating Through Death Within Prisons, Nursing Homes, Hospitals & Jails, lays out the problems and issues that are systemic within the death investigation system across the country, providing key information regarding the gross and ongoing deficiencies within that system. For additional information on the book click here.

If you are having difficulty with the Medical Examiner/Coroner system in your county or state, if you have a loved one who has died within a prison system, within a hospital setting, nursing home, due to an accident, personal injury, homicide or suicide, if you do not know what your rights are when dealing with a medical examiner or coroner's office, contact us.

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