Frontline--"Post Mortem" Death Investigation in the United States

 "Don't die in the wrong state"

In some states, the person who determines how someone dies is an elected official, not a doctor. The average citizen assumes the title of Coroner implies competent medical expertise. Nothing could be further from the real truth.  

"The coroner system was a wonderful system for the 10th century. That's when people couldn't read, and you walked around barefoot and lived in little huts. But this is the 21st century, and medical-legal work should be on a scientific basis, employing scientists."--Dr. Vincent DiMaio

The states that continue to use this outdated method have in effect 'politicized' death investigations by placing a lot of authority in the hands of a politician rather than where it belongs--with a qualified medical examiner. 

They aren't doctors, they're simply political animals with equally political debts to 'repay.' And that is the very last thing wide-eyed truth and unbiased justice needs in a suspicious death circumstance.

"You call a death an accident or miss a homicide altogether, a murderer goes free. Lots of very bad things can happen if a death investigation is not carried out competently."--Dr. Marcella Fierro

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What kind of system do we have in place in Alabama?

You probably can guess the answer before we tell you.

Alabama code only requires a "high school diploma or its equivalent" for an individual to run for the office of coroner. Coroner's offices should be run by a medical examiner, not an elected political talking head, because, as Dr. Fierro says, "very bad things can (and will) happen," particularly if the death is high profile or happens with police or state involvement.

In the state owned mental health facility of Partlow, which will soon be closing, suspicious deaths have been a dark part of Partlow's history, prompting some to claim the patients would be safer in the general community than in a state owned facility.

They're probably right from the stories we've researched on the facility.

In April 2011, it was announced that the state would close three satellite forensic labs due to recent state budget cuts. In 2009, in another effort to 'save money' the state stopped paying for transport of bodies to the three designated state labs for autopsies, thereby leaving the procedure to local coroners. Many of them do not even have morgues, and their local budgets were for all intents and purposes virtually non-existent.

The state lacks any professional accreditation by the National Association of Medical Examiners according to its latest listings, but to be fair, so do many other states because there is a glaring lack of federal oversight in death investigators and the offices in which they work. Other reasons that can explain a lack of accreditation include:

• No federal mandate equals little motivation in pursuing a certification process

• Insufficiently trained personnel

• Lack of funding, which can result in understaffed offices and outdated equipment

In the June 2010 edition of Forensic Magazine, the lack of funds illustrated additional problems in the state:

The Alabama Department of Forensic Sciences has a backlog of about 1,600 *untouched DNA cases that it’s hoping to reduce by adding staff. The department receives about 250 DNA cases a month and DNA processing requires more work per sample than it previously did. The lab director says that the lab is short about 18 positions and has an eight month backlog. *(Senator Richard Shelby announced in July of 2010 that $181 million had been earmarked for Alabama specifically for DNA backlog reduction and Forensic Science Grants, along with a bushel load of other millions for the state. It turned out to be a whole lot of crowing for nothing because these earmarks were attached to other bills that were so obscenely pork laden, many of them did not even get an up or down vote.)

Alabama has even less to be proud of with past instances of gross incompetence when it comes to competent death investigations.  

The Associated Press reported in a 2007 article on a state pathologist, who was one of the very few forensic pathologists in the state, and what they described was shocking:

From 1999 to 2004, Dr. Johnny Glenn was the only forensic pathologist performing autopsies in the poorest part of Alabama.  He was assisted only by lab technicians as he performed hundreds of autopsies annually, including at least one death penalty case. After his abrupt departure, it was discovered that Glenn routinely put aside his notes and often failed to finish final reports or diagrams that are crucial to death investigations. Two of his former colleagues say that Glenn was increasingly depressed during his tenure, that he was battling health problems, and that he was troubled by his inability to pass the exam to become certified by the American Board of Pathology, a certification that is not required to be a pathologist in Alabama, but is highly desirable.

"Death investigations should be carried out by doctors, and particularly doctors who have special expertise in forensics. This is not a new concept, it has been suggested four times now. It's a question of competency."--Dr. Marcella Fierro

Alabama seems to place little importance on getting it right when it comes to deaths from foul play and other mysterious circumstances--the system that is in place is antiquated at best, and broken at worst.  And there is no political will to make it better. The good people in the system, like most of our state agencies, are far outnumbered by the bad and/or indifferent ones. 

It's a problem that is only made worse by an obvious conflict of interest  like when the coroner has ties to a funeral home or mortuary. Alabama Code cites this as a misdemeanor, but continues to encourage it, even on the state forensic department level.

The authoritative study to come out on fixing what is so wrong with the death investigation system is continually ignored and predictably the problems get exponentially worse.

"Strengthening Forensic Science in the United States--A Path Forward" outlines The Model Act (Post-Mortem Examinations Act, ppg 242):

The purpose of the Post-Mortem Examinations Act is to provide a means whereby greater competence can be assured in determining causes of death where criminal liability may be involved. Experience has shown that many elected coroners are not well trained in the field of pathology, and the Act should set up in each state an Office headed by a trained pathologist, this Office to have jurisdiction over post-mortem examinations for criminal purposes. The Office would supersede the authority of Coroner’s Offices in this field. 

The report admits that changing a state system from the political status of coroner to the preferred appropriately trained status of medical examiner requires "political momentum."  That explains a lot of the problem in short order. Politics and competent death investigations are strange bedfellows, it creates a situation ripe for cover-up and convenient 'explain aways.'

It would behoove the states that keep this out-dated and incompetent system in place, like Alabama, to re-examine the issue to better serve her citizens and justice, not the state's needs to "better serve its customers" a catchy (and very odd) phrase in the Alabama Dept of Forensics document. Especially if the outcome means the difference between justice applied or justice denied and life and death.

Would you want the investigation of one of your family members' untimely and suspicious demise being left in the hands of a political office holder or a forensically trained medical doctor?

It's a rhetorical question yes, but also a valid one.

There's another reason why the living should care about the quality of death investigations:

Dr. Victor Weedn, the Maryland assistant medical examiner, said basic misunderstandings about the significance of death investigation have made it a hard sell.
“It’s difficult for people to spend money on medical examiner systems,” Weedn said. “They see it often as wasting money on the dead, without realizing that everything that is done in a medical examiner office, or a coroner office, is truly done for the living. We try to protect society. We look for deaths that are premature, or that should not have happened, so that we can go forth and correct those errors in society.”

Discussions about death admittedly are not a comfortable subject, most would rather avoid the conversation altogether, almost as much as they would death itself. One of those, of course, is unavoidable, the other becomes important when the victim is 'one of your own' and their untimely demise is surrounded by murky circumstances.

If the suspicious death occurs in Alabama, you may find it difficult to get a thorough and unbiased investigation with an autopsy performed by an experienced medical examiner, unless all the criteria, under the following 36 year old section of Alabama code, are met:

The Code of Alabama 1975, Section 36-18-2 states that investigations, including any necessary autopsy of unlawful, suspicious or unnatural deaths and crimes may only be ordered by the 1) Governor, 2) the Attorney General, 3) any circuit judge, or 4) any district attorney in the State of Alabama. ADFS cooperates with the coroners, sheriffs and other criminal justice agencies in Alabama in their investigations of crimes and deaths from unlawful, suspicious or unnatural causes.

In our current death investigation system, about all you can hope for is that the victim in your family hasn't 'picked' the wrong state system to die in.

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