In Sheridan case, questioning the system

When the Somerset County prosecutor concluded in March that Cooper Health System CEO John P. Sheridan Jr. killed his wife, set their house on fire, and then committed suicide, it reignited concerns about the competency of New Jersey's medical examiner system.

By ruling the deaths a murder-suicide, the prosecutor's office closed the high-profile case. But the couple's four sons, who believe both their parents were murdered in September in their Montgomery Township home, have asked the state Attorney General's Office for a new investigation.

The Sheridan sons maintain the prosecutor's office is covering up a botched investigation and long-standing problems in the Medical Examiner's Office.

New Jersey has been without a top supervisor to oversee the state system since 2009 when Victor Weedn, the acting medical examiner, resigned in protest. In a letter to Gov. Jon S. Corzine, Weedn said the state agency was underfunded, understaffed, and should be independent of law enforcement.

State Sen. Joseph Vitale (D., Middlesex) first proposed legislation to fix the state Medical Examiner's Office about six years ago. Vitale, who hopes to move a bill out of committee in the fall, is seeking to create a regionalized system that would give the top medical examiner more authority to raise standards throughout the state.

"We have some medical examiners with a great deal of experience, and others without a lot of experience who have made bad decisions," Vitale said, referring to cases initially ruled as suicides or drug overdoses that were actually homicides.

In the Sheridan case, Vitale said, the Attorney General's Office, which oversees the Medical Examiner's Office, has "an obligation" to assist the family as they have asked. "They have legitimate concerns."

Kevin Roberts, a spokesman for Gov. Christie, said in a recent e-mail that the governor is planning to appoint a statewide examiner soon. "As you are aware, this position has been vacant for a dozen years going back to many administrations before us. As with all appointments, we are in the process of identifying and reviewing qualified potential candidates."

Medical examiners conduct investigations to determine cause of sudden deaths, and whether a fatality is homicide, suicide, accidental, or natural. New Jersey employs 14 doctors to cover seven counties. The remaining 14 counties hire their own medical examiners and run their own offices.

In 2013 - the last year for which statistics are available - 6,833 deaths were handled by state and county medical examiners. There were 4,096 autopsies. Autopsies were not performed on the remainder of the sudden deaths, but medical examiners did visually review the bodies, said Zach Hosseini, a spokesman for the New Jersey Office of the State Medical Examiner.

Problems within the state office were well-documented in a 1979 New Jersey State Commission of Investigation report that said the system was poorly run and lax.

The state's first medical examiner, Edwin H. Albano, in 1967 noted that doctors performing autopsies lacked forensic knowledge and training.

"And it's the fault of our archaic, chaotic, and untrustworthy system," Albano said at the time. "Medical experts strongly suspect that people may have gotten away with homicide under the state's archaic patchwork system of investigating sudden, suspicious deaths."

Experts and former medical examiners in New Jersey say the Sheridan family has raised reasonable questions. Over the years, child protection advocates, prosecutors, and law enforcement have raised concerns about suspicious deaths. They note the 1979 SCI report included recommendations - such as a system independent of law enforcement - that do not exist today.

None of New Jersey's medical examiner offices have accreditation by the National Association of Medical Examiners (NAME). Many of the doctors who perform autopsies have not passed forensic certification exams administered by the American Board of Pathology. In New Jersey, accreditation and certification are not required, but experts say the credentials are important.

"Board certification is essential for public confidence in the skill of a particular physician," said Marcus Nashelsky, NAME's president. Certification means a physician has completed an accredited post-medical school training program, which includes a residency and a rigorous exam, he said.

Similarly, Nashelsky said, offices should have accreditation to ensure sound policies, procedures, facilities, and staff.

Zhongxue Hua had been chief medical examiner in the Northern Regional Office in Newark from 2001 until 2007, when he resigned because he did not have the money to staff the office adequately and maintain the standards he said were needed.

Hua said before he resigned, he supervised Eddy Lilavois, the doctor who handled the Sheridan case. At that time, Lilavois was not permitted to do autopsies because he was not certified. After Hua left, Lilavois was promoted and his responsibilities included performing autopsies.

Hau said it is unfair to blame Lilavois for problems within the statewide Medical Examiner's Office that extend beyond the Sheridan case.

Mark Sheridan said his family believes his parents - both repeatedly stabbed - had been killed and the master bedroom set on fire to destroy evidence of the attack.

Acting Attorney General John J. Hoffman has not made any public statements about the Sheridan case and has declined requests by The Inquirer for an interview.

"Our parents did so much for us, for their community, and for the State of New Jersey. We are not going to allow their legacies to be destroyed by the baseless conclusion of the Somerset County Prosecutor's Office," said Mark Sheridan, an attorney. "This is about nothing more than protecting our parents' legacies, especially the legacy of our father."

Sheridan said Somerset County Prosecutor Geoffrey D. Soriano privately raised concerns with his family that the Northern Regional Medical Examiner's Office lacked proper staffing and resources. The Sheridan family then hired pathologist Michael Baden to do an independent autopsy on John Sheridan and to review Joyce Sheridan's wounds and autopsy findings.

Baden determined investigators had not recovered the weapon that caused John Sheridan's stab wounds.

Mark Sheridan alleges in letters to Soriano and the Attorney General's Office that Somerset officials persuaded Lilavois to rule John Sheridan's death a suicide as an "expedient" way to end an "embarrassing bungling" of the investigation.

Soriano and Lilavois, through spokesmen, declined to be interviewed.

Soriano defended the investigation by his office and the medical examiner. In an e-mail to The Inquirer, he said his office had not "twisted" Lilavois' arm.

"Frankly, at this point it's intellectually insulting and, at the same time, terribly inaccurate. Allegations like this keep this story active and, I suppose sell newspapers. But these are the times we live in," Soriano wrote.

"To be clear, we unequivocally deny that we pressured Dr. Lilivois [sic] in any manner, and we stand confidently behind our investigation."

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