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

5

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

10

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

15

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

20

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

25

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

30

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

35

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

40

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

45

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

50

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

55

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

60

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

65

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

70

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.

75

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

80

difficulties the family will have during their time of grief.