'The system creaks along'
There are no comments for this page [ Add Comment ]Sunday, July 29, 2007
By Jesse Fruhwirth
Standard-Examiner Davis Bureau
Chief pathologist: Office easy to ignore for funding
SALT LAKE CITY -- The dead don't vote.
That's the reason, Chief Medical Examiner Dr. Todd Grey says, the Legislature underfunds the Office of the Medical Examiner.
Grey and three other forensic pathologists, as well as four autopsy assistants, analyze more than 2,000 bodies each year. Seventy percent, he said, receive a full autopsy that takes anywhere from 30 minutes to four days to complete. That's only a part of their work.
Another 1,500 to 2,000 death certificates are reviewed and approved by the office each year, though those bodies are never actually autopsied by office staff. Another 1,500 deaths are referred to the office, but denied because they are not within the office's jurisdiction.
"If you look at our funding and staffing levels compared nationally, we're in the toilet," he said.
The office received $2.5 million in 2007, an increase of $207,000 from the previous year. The office went over budget the previous year by $112,000, according to the Fiscal Year 2008 Appropriations Report.
Grey said the budget shortfalls can mean death certificates and causes of death take weeks to return to surviving family members, police and prosecutors.
In a recent incident, family members of 5-week-old Kayden Crook waited nearly three months for an autopsy report on the cause of the infant's death.
On April 10, the boy's father called police and said the baby ingested water while he was bathing him in a sink. The baby later died at a hospital. A spokesman said Layton police immediately suspected the father had harmed the child. However, police waited until July 10 before charging Bradley Richard Crook, 39, with second-degree felony child abuse homicide. Police said the autopsy, which eventually showed injuries consistent with shaken baby syndrome, delayed the charges.
Police investigators and prosecutors do not usually have a problem with the delay, however. Grey said that's because they have other aspects of the investigation to accomplish during the weeks while the medical report is finished.
It's the victims' families, waiting to complete insurance paperwork, who suffer, he said.
"Until there's a cause of death, no insurance company is going to pay anything," he said.
Due to caseload and staffing levels, most cause-of-death reports aren't completed for eight weeks, some longer. When it's a family's bread winner that has died, he said, it's a tremendous problem.
Assistant Davis County Attorney Steve Major agreed. He said the impact on his work from slow death certificates is minimal, but said he sees victims' suffering from it.
"If I were to die and a doctor were to sign my death certificate immediately -- like if I died in the hospital, then my wife could take it down and get insurance in a week or two," he said. "If I have to go down to the medical examiner -- if it's an unattended death, or something -- it could take eight weeks and in the meantime my wife can't do anything."
Hollywood portrayals of their work doesn't help, Grey said. Shows like "CSI: Crime Scene Investigation" have had an impact on what the public demands from his office.
"The 'CSI-effect' is I get a call the next day (after a death) from a family saying, 'What do you mean eight weeks?'<2009><2009>" he said. "Well, on TV, that's done during the commercial."
His office, tucked away in the hills of the University of Utah, isn't television. Grey said the characters on TV operate with a fictional, and seemingly limitless, budget. Sure, he said, many of the fancy tools and whiz-bang analyses that the CSI characters use are scientifically possible, but not for the money the state of Utah is willing to pay.
Grey, who frequently testifies in court to support his autopsy results, said he sees the "CSI-effect" affecting criminal trials as well.
"One of the problems with the 'CSI-effect' is it gives jurors a false impression of certainty and surety," he said. "In real life, that's never there."
For instance, he said, what if there's a murder victim, and there's not an obvious DNA-testable subsh as semen, on the body. There is, however, a soda can sitting nearby without any fingerprints on it. Spending $4,000 and crossing your fingers might bring up trace DNA evidence, he said, but it's not likely and it's certainly not in the budget in Utah.
Jurors, he said, are more likely to be swayed because they expect every corner of every crime scene to be scrutinized.
"The chances of getting any DNA off that can are minuscule," he said. "But the defense will make a big deal out of how that can wasn't tested. The 'CSI-effect' is jurors may be more willing to accept that argument than previously."
That's not a good thing, Grey said, because his office offers a unique, disinterested and objective opinion regarding a death -- criminal or otherwise.
A division of the Utah Department of Health, his office is independent from all the other players in a courtroom.
"Our reputation is pretty good that way (among attorneys)," he said. "No one thinks of us as stooges to the police or prosecutor."
He said there are no pressures on him or other pathologists to come to any particular conclusion. They seek the truth, and if the truth is muddled, he said, there's little reason for him to inflate the surety of the conclusions.
"When we do our examination and come to our conclusions, the only thing we're worried about is that our diagnoses are correct," he said. "I don't care one iota as to who gets charged with the crime, nor whether they're convicted or not."
Criminal autopsies are only a part of the job.
Of the 2,000 physical bodies that come to the office, roughly a quarter of them are determined to have died from drug overdoses, Grey said.
"Anna Nicole Smith is pretty run of the mill, unfortunately," he said, adding that prescription drug deaths have become epidemic.
Utahns die from illicit drug overdoses as well -- about 100 to 150 per year -- he said.
The drugs doctors give to patients legally, however, cause about 400 to 500 deaths per year, he said, most involving narcotics.
"There was nobody monitoring that issue before us," he said. "We've been screaming about that for years."
Regarding his quest to increase the budget, lighten workloads and get reports out faster, Grey said there's not much more that he can do.
He tried nine times, he said, to get the Legislature to change jurisdiction rules so that his office could regain certification. In 1995, the National Association of Medical Examiner revoked the certification due to legislative changes.
These days, he said, simply changing the rules to pre-1995 wouldn't regain the certification. In the interim, the workload he and his colleagues handle became too high for the association's taste.
"As long as the system is doing an adequate job, the pain level on the decision-makers is low," he said. "The system creaks along and then usually what happens is there's a catastrophic (foul) up and everyone says 'Wow.'<2009><2009>"
He said things may have to get worse before they get better.
"If a prosecutor loses some big case because of it, maybe they'll get together an
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