AP Success - AP English Language: Medico-Legal Investigations

Medico-legal investigations are completed in a professional, ethical and timely manner and they are geared to assist in the determination of the cause and manner of death. This is accomplished through the continued cooperation between law enforcement agencies, health care professionals, and the public. The initial phase of the process typically starts with a report of death. In 2015, investigators processed 8,717 reports of death. In 5,721 (66 percent) of those cases, after undergoing a methodical and structured process of review to ensure they did not fall under the criteria of California Government Code 27491 requiring further investigation, we waived jurisdiction to the treating physician so he or she could attest the death certificate. Medical Examiner’s Jurisdiction was invoked in the other 2,996 (34 percent) of those reports. Investigators physically respond to the majority of the death scenes falling into the Medical Examiner jurisdiction. In 2015, we responded to 2,022 scenes (67 percent). An initial body and scene assessment is completed at the place of death, which can be virtually anywhere in the 4,261 square miles of San Diego County. Photographs are taken and relevant evidence is collected in order to assist in the investigation. The evidence may include weapons, biological specimens, medications, drugs, and drug paraphernalia. All the investigations are completed with a methodical and systematic approach and all the findings are documented in a comprehensive investigative report. Medical Examiner’s investigators have the difficult task of notifying the next of kin of the death. This process starts with the identification of the decedent –one of the most important duties of our office. Methods for identification include fingerprint and dental comparison, unique skeletal features, DNA analysis, visual comparison, or even serial numbers on implanted medical devices. This is a multidisciplinary approach which involves other county agencies. The process continues with a diligent search for the decedent’s family, with which the Medical Examiner’s Office has a high rate of success. (See John/Jane Doe Center for more information.) Those who die suddenly or unexpectedly often die with valuables—both monetary and sentimental—in their possession. It is extremely important that we ensure that these items make their way to the next of kin. Often, the retention of the decedent’s personal property is of the utmost importance to the family. We take this responsibility seriously, accurately tracking and recording the chain of custody until the property is returned to the family. When a death occurs at home, that person may leave behind many medications, many of which are often controlled substances. As part of our investigation, we collect and inventory all of the decedent’s prescription medications at the scene. This task serves three functions. First, by inventorying the remaining medications, including dosage and dates, we can gain an understanding as to whether there was medication overuse or non-compliance. Second, medications can give clues to an individual’s medical or social history, and provide names of prescribing physicians who may know critical information about the person’s history. Lastly, we remove medications from the home, eliminating the possibility of inappropriate use by other members of the household (especially children), as well as the possibility that the medications will become part of illegal trafficking. Medication disposal occurs at regular intervals after a period of secure storage at our offices. Medical Examiner investigators also discuss the circumstances of the death with the decedent’s family; conduct interviews at the scene; and obtain additional statements from witnesses, the treating physician and responding emergency personnel. They also offer the family free support through our Bereavement Center. Follow-up investigation is required in many cases, and may involve reviewing medical records, police reports and traffic accident reports. Medical Examiner investigators are the front line for our office—the eyes and ears of the Medical Examiner. Their caring attitudes, compassion, professionalism, and objectivity allow our office to conduct thorough, balanced and accurate death investigations while at the same time helping ease the difficulties the family will have during their time of grief.