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Coroners Don't Need Degrees To Determine Death

 

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The medical examiner's office in New Mexico is considered the gold standard.

EnlargeJohn W. Poole/NPR

The medical examiner's office in New Mexico is considered the gold standard.

John W. Poole/NPR

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February 2, 2011

More From Our Series

A morphology technician at   The New Mexico Office of the Medical Investigator stores one of the bodies that is autopsied there. The office was created by the state legislature in 1972 replacing the county coroner system.

The Real CSI: Death Detective Dysfunction

Levon Brooks was wrongfully convicted of raping and murdering a 3-year-old girl in Noxubee County, Miss., in 1990. After spending 18 years in prison, he was released from jail in 2008 with the help of DNA evidence and the  Mississippi Innocence Project.

Flawed Autopsies Send Two Innocent Men To Jail

A forensic pathologist prepares for an autopsy at The New Mexico Office of the Medical Investigator.

Discuss Post Mortem: Death Investigation In America

Death Investigation State By State

How Is Death Investigated In Your State?

Dr. Marcella Fierro, the former chief medical examiner in Virginia, is a member of the National Academies of Science panel that issued a report recommending an overhaul of the country's death investigation systems.

EnlargeJohn W. Poole/NPR

Dr. Marcella Fierro, the former chief medical examiner in Virginia, is a member of the National Academies of Science panel that issued a report recommending an overhaul of the country's death investigation systems.

John W. Poole/NPR

Ross E. Zumwalt, a forensic pathologist, is the chief medical examiner in New Mexico.

EnlargeJohn W. Poole/NPR

Ross E. Zumwalt, a forensic pathologist, is the chief medical examiner in New Mexico.

John W. Poole/NPR

Analysis

Autopsy data

Autopsy Data

Curt Green (CurtGreen)

Curt Green (CurtGreen) wrote:

Fortunately Silke you were able to straighten out the folks who had questions about Medicolegal death investigations

I realize I couldn't possibly shed any light because I am just an elected Coroner.

By the way, I would put my staffs qualifications and experience against a majority of the ME's offices in the country.

I guess my years of experience working ER's, decades of prehospital care, over a decade of recovery and removal experience, formal education, thousands of death investigations, thousands of physical exams, 7 certifications, experience as a diener, membership in NAME, IACME, WCMEA, Board Certified F-ABMDI, attendance at numerous national training conferences in numerous states within the last several years, lecturing at our local tech college couldn't possibly qualify me to give an opinion.

And by the way, to the gentleman who stated that a Coroner wouldn't be able to find the cause of death for someone who may have died as a result of someone "shooting microwaves through a wall" and "waiting years for them to die" and suggesting this is a homicide... You're right, I haven't found one yet but I am certainly going to spend a lot of my time looking for a "Homicide by microwave". Thanks for the tip.

Wednesday, February 09, 2011 12:31:05 PM

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tanja minkkinen (dorsalfinn)

tanja minkkinen (dorsalfinn) wrote:

@Curt That may be. But I doubt they would've done any better putting it together had they spoken to you, given your emotional and staccato-like attempt to articulate the "system" in WI.

Wednesday, February 09, 2011 5:49:03 AM

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Curt Green (CurtGreen)

Curt Green (CurtGreen) wrote:

Perhaps a reasonably intelligent person could put it together.

The series reporters weren't able to. They were after sensationalism.

Tuesday, February 08, 2011 1:24:06 PM

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tanja minkkinen (dorsalfinn)

tanja minkkinen (dorsalfinn) wrote:

@Curt If the "other article" to which you refer is the one where she says "please do some research before making an entire profession look incompetent and lazy", which you quote as well, I found it.

As for "missing (your) point and hers (refer to her comment on the other article)", I don't find anywhere in that comment where she addresses the interrelationship between coroners and MEs. She details the education needed to become a forensic pathologist.

She doesn't say anything there about "Each state is different and within a state each county may be very different."

While there may be some truth (have you now branched out beyond WI?) that "to provide answers to your questions would be impossible unless you are refering to a particular county within a state", I'll prefer her to give answers to my questions, thank you.

What I've learned from you is this: the system (at least in WI) of death investigation involving coroners and MEs is so convoluted that a layman like me shouldn't even begin to try to understand it. And it certainly does seem piecemeal and complicated, but I'm certain that a reasonably intelligent person can at least begin to put it together.

Monday, February 07, 2011 9:26:07 PM

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tanja minkkinen (dorsalfinn)

tanja minkkinen (dorsalfinn) wrote:

@Curt Please take note that I wrote to Dr Hummel, "...and I understand you may only be able to speak about the state in which you practice." So I didn't bring it down to a county level. Gee.

The tone of your initial post was, at minimum, aggressive. Furthermore, you blasted me for making statements that may not apply to WI's situation, while allowing that WI's system may be an 'anomoly'.

For the moment, I'm tempted to think the arrival of Dr Hummel here made you be a bit less cock-sure; clearly it made you cool down a bit.

Monday, February 07, 2011 8:59:10 PM

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Curt Green (CurtGreen)

Curt Green (CurtGreen) wrote:

Silke Lipp

My comment wasn't meant as an insult, I was pointing out that you were providing incorrect information based on the articles/series misinformation and extreme generalization that an ME is an ME and a Coroner is a Coroner. It all depends on where you are.

Jennifer's information is correct regarding the system she is familiar with but as you ask questions regarding specifics in relation to the roles and responsibilities of Coroners and ME's you seem to be missing my point and hers (refer to her comment on the other article). Each state is different and within a state each county may be very different. Therefore to provide answers to your questions would be impossible unless you are refering to a particular county within a state.

The article went for sensationalism.

They could have simply stated "Basic standards needed for Coroners and MEs and death investigators, and left it at that. Reviewing Jennifer's other comment regarding the series I would agree with her that the writers should "please do some research before making an entire profession look incompetent and lazy." I realize she was talking about pathologists but it applies to death investigators as well.

Monday, February 07, 2011 4:38:22 PM

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tanja minkkinen (dorsalfinn)

tanja minkkinen (dorsalfinn) wrote:

@Jennifer And two other questions... Is ever the coroner and ME one and the same person? Would a (non-ME) coroner ever perform an autopsy, whether legally-required (by statute) or not?

Sunday, February 06, 2011 1:22:08 PM

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tanja minkkinen (dorsalfinn)

tanja minkkinen (dorsalfinn) wrote:

@Jennifer Piecing it together, would I be correct to think that:

1) All counties have a coroner, elected or appointed, and
2) that office performs death investigations "in the field", both "cause & manner",
3) ultimately making a judgment whether the death requires, by statute, further investigation via autopsy performed by an ME, who may or not be based in that county? (I assume deaths deemed not to require an ME's autopsy can still be autopsied at a family's request, and by any board-certified pathologist.)
4) And coroners are peripheral to and not involved with in-hospital deaths?

Sunday, February 06, 2011 1:14:10 PM

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tanja minkkinen (dorsalfinn)

tanja minkkinen (dorsalfinn) wrote:

@Jennifer Thank you for weighing in with your unique expertise and for your close reading of my comments, correcting me as necessary and without the superfluous emotion expressed by the coroner. Some questions, and I understand you may only be able to speak about the state in which you practice:

What triggers a "routine hospital autopsy", other than at family's request? To clarify, one cannot own the title of Medical Examiner without residency training & board certification in both clinical pathology and forensic pathology (which, of course, presumes an MD or DO)? In counties that have an ME, is there only one? And she or he performs the autopsies on deaths which occurred under statute-defined, typically suspicious or unusual, circumstances including but not limited to the in-hospital cases you mentioned? Does every county have a coroner, regardless of whether it has an ME? If so, then in an instance where a rural county has no ME, who judges whether a death is an "ME case"? The coroner, who, in some cases, would be an elected official, such as @Curt? Would you agree with @Curt that "the most important part of any medico-legal death investigation is the field investigation"? Are coroners involved only with out-of-hospital cases?

Sunday, February 06, 2011 12:59:02 PM

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jennifer hummel (jmhummel)

jennifer hummel (jmhummel) wrote:

SikeLipp, as a pathologist, thank you for your mostly accurate comments. This series of articles is so inaccurate, it's exhausting to read!

To answer someone's question about hospital autopsies: any board certified pathologist can do those, because they completed the required number during pathology residency, and subsequently passed the boards. If a death in a hospital is deemed to be a medical examiner case (a.k.a. a forensic pathologist with an M.D. or D.O. who has passed both the pathology boards AND the forensic pathology boards; no other degrees are acceptable/valid), usually the medical examiner will come to the hospital to do the case rather than moving the body. This includes cases where for example, someone checked in to the ER but died less than 24 hours later or cases where people die soon after surgery. If during the course of a routine hospital autopsy, some sort of medical negligence is suspected, risk managment is notified as well as the medical examiner.

If anyone has questions, let me know rather than referring to this series of articles. The issues regarding budgeting and thinly-stretched resources are spot on, but the description of those involved and thier roles is incorrect in many instances.

Sunday, February 06, 2011 11:47:50 AM

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