The Coroner is responsible for leading a team of medicolegal death investigators as well as running the administration of the office. The LCCO is responsible for destemming the cause and manner of deaths reported. A cause of death is simply that; the actor that led directly to the death. The manner is a category into which the cause is classified and there are five manners:
Homicide: The killing of one human being by another.
Suicide: The intentional taking of one’s own life.
Accidental: No intention of causing the death.
Natural: The disease process.
Undetermined: The death cannot be categorized into any other manner.
The way cause and manner is determined is by conducting medicolegal death investigations. The LCCO is notified of a deaths by medical personnel in a hospital.
Medical facilities: per the state statute governing the coroner’s office, (RCW 68) if the person is under a doctor’s case then this office does not assume jurisdiction and the treating physician signs the Death Certificate as long as the death is natural. If it is any of the other manners then we assume jurisdiction.
For deaths outside of medical facilities we are notified by law enforcement agencies who are handling the scene investigation.
The medicolegal death investigation begins with a representative of this office responding to the scene. Interviews are conducted with law enforcement, medical staff and decedent families to get a baseline series of events leading up to and what occurred after the death. The scene is documented with photographs and sketches. Evidence is located, marked and documented. A complete physical examination is conducted on the decedent to locate and document any wounds, marks or changes. Prescription medications are inventoried and counted down to determine the consistency of their ingestion.
Arrangements are made for the transportation of the decedent either back to the LCCO or directly released to the mortuary of the family’s choice. Medical records are ordered for review and the investigators then complete a comprehensive report.
Some cases require an autopsy and these include any type of non-natural deaths or apparent natural deaths in younger decedents with no medical history.
A toxicology is done where the decedent’s blood is drawn and sent to the Washington State Patrol Toxicology Lab for analysis. This testing will show what, if any, substances are in the decedent’s system and are very accurate. The results of toxicology are currently taking 3-4 months to return from the WSP lab.
The results of the autopsy and the toxicology results are examined and the cause and manner of death are based on those findings.
The LCCO is also responsible for the positive identification of the decedent which in most cases can be done by having someone who is related to or knew the decedent view them or a photograph. In cases where viewing is not possible due to sever injury or post mortem changes we use a variety of other methods:
DNA is where reality moves away from television. If the death is suspicious or a homicide the WSP DNA lab will do the identification process. Most of our identification cases are not criminal in nature and therefore we use the University of North Texas DNA program that is done for no fee. The problem with that route is the turnaround time is a minimum of a year and a half and we have had identification pending up to 2 years.
The LCCO is also responsible for locating and notifying the legal next of kin. In WA State the legal next of kin is defined by RCW 68.50.160 as:
The person designated by the decedent as authorized to direct disposition as listed on the decedent's United States department of defense record of emergency data, DD form 93, or its successor form, if the decedent died while serving in military service as described in 10 U.S.C. Sec. 1481(a) (1)-(8) in any branch of the United States armed forces, United States reserve forces, or national guard;
(b) The designated agent of the decedent as directed through a written document signed and dated by the decedent in the presence of a witness. The direction of the designated agent is sufficient to direct the type, place, and method of disposition;
(c) The surviving spouse or state registered domestic partner;
(d) The majority of the surviving adult children of the decedent;
(e) The surviving parents of the decedent;
(f) The majority of the surviving siblings of the decedent;
(g) A court-appointed guardian for the person at the time of the person's death.
Many times the next of kin is at the scene of the death but when they are not, locating them can be difficult. A decedent may have told people they have no family or that they are estranged for many years. We have access to many databases not open to the general public for us to try and find the legal next of kin. We search records and make many calls to try and find the family.
In cases where no family can be found, or we find family and they want nothing to do with the decedent, we hold the decedent for 90 days and then a indigent cremation is performed and the cremated remains are returned to this office. If the family does not want the cremated remains back or we cannot fin family the cremated remains are interned once per year at a local cemetery.
All autopsies are performed by a Board Certificated Forensic Pathologist who works through contractual services for us. To become a forensic pathologist they must graduate from medical school and then spend an additional 10 years training in order to be eligible to sit for the national board examination for forensic pathologist.
The LCCO does not do removals of decedents but has this done by local mortuaries at a fee for service contract that is open for bidding once yearly.
Once the family has chosen a final funeral home the Death Certificate is generated electronically by that funeral home in the Electronic Death Reporting System (EDRS) and it is assigned to the person who will be signing, either this office or the decedent’s primary physician. Once signed electronically it is filed with the county health district and then become certified.
The process of conducting medicolegal death investigations in order to determine the cause and manner of the death can, in some case, be a long process but the desired outcome is a an accurate finding of what happened. Everyone in this office realizes the responsible we have to speak for those people who no longer have a voice of their own. Investigations are conducted professionally and families are treated with dignity and respect.