On coroners vs. medical examiners

RE YOUR article about the state's coroners, which discussed, briefly, a coroner system vs. a state-run medical examiner system.

Having worked in both, I can offer some insights. I'm a board-certified medicolegal death investigator. I was also an autopsy technician in the medical-examiner system.

My first experience in death investigations was in a medical examiner's office in another state. I found it to be a well-oiled machine - until I went to work in a coroner system. I think Dr. Hofman's agenda would be a move to a system where there are no checks and balances, despite his call for more coroner regulation.

Lyell Cook asked, "How can you do this job effectively if you don't leave the office and are directing things from a hundred miles away?" This is the main issue at hand.

In my experience, medical examiners (not always certified forensic pathologists since many don't pass the test the first time) spend their day examining organs (the dieners do most of the cutting) and doing their dictations.

Three years working in a medical examiner's office, having autopsied more than 1,000 cases a year, in some instances there wasn't a single scene visited by a medical examiner. They did their "investigation" from the morgue. This wouldn't be how I'd want a family member's death investigated, natural causes or otherwise.

There have been many times I've seen a medical examiner turn down a case without doing an extensive investigation. In those cases, they do an external exam from the morgue. It's a good thing the cases that get autopsied are done because someone feels the need to do more work, rather than less.

Having a coroner system, where the forensic pathologist/medical examiner has someone to answer to (the coroner), means there's a check in place not found in a medical-examiner system. If the investigator works for the medical examiner, where is the ability to argue for an autopsy if your job would be in jeopardy for contradicting the doctor?

Every death scene is different, whether it's a homicide or a natural death, suicide or motor vehicle accident. The scene investigation is crucial.

Should there be more regulation regarding continuing education and a national standard? Absolutely, bearing in mind that the elected officials whom the coroner answers to must come up with money for training. I know of several medical examiners who do not stay current with new techniques, and in fact, still do not use computers.

I think Dr. Hofman has to come up with a better reason for his agenda other than that "coroners are elected." I know several who are retired police officers, with years and years of investigation, several who have spent years with a coroner's office or have experience participating in the actual autopsy, and are emergency medical technicians or paramedics.

Having worked in both systems, I think the medical-examiner system is the one that's outdated and gets by with the least amount of work.

AS FOR THE Cullen case, it was the Northampton County coroner who actually went against the pathologist, and stood his ground that this was a serial killer.

Had it been up to the pathologist, the cases would have been signed out as a natural death and would not have been brought to fruition.

And for the record, Northampton is one of the counties that appoints a coroner.

K. Gillis

Catasauqua, Pa.