How Can a Family Best Work with a Coroner or Medical Examiner? Interview with Judy Melinek, Part One

Today, SevenPonds speaks with Judy Melinek, M.D., a forensic pathologist who does autopsies for the Alameda County Sheriff Coroner’s Office in California. Dr. Melinek has a bachelor’s degree from Harvard and medical degree from the University of California, Los Angeles. She is also the author of a New York Times bestselling memoir, “Working Stiff: 262 Bodies and the Making of a Medical Examiner,” which was co-authored with her husband, T.J. Mitchell,  and the CEO of Pathology Expert Inc. 

Credit: pathologyexpert.com

Debra: Judy, thank you so much for answering these questions. I know your responses will help families learn a little more about medical examiners and how to deal with them. So, first of all, what does a medical examiner do?

Judy: A forensic pathologist is a doctor who investigates cases of sudden, unexpected or violent death. Sometimes the forensic pathologist is in charge of the case investigation system in a particular county; that person is called a medical examiner. Sometimes the forensic pathologist works for the coroner’s office, an administrative office run by a county official – sometimes the sheriff. In all cases, the forensic pathologist performs the autopsies, but the way the office is structured – whether medical examiner or coroner – defines how the rest of death investigation is conducted.

Debra: When is a death referred to a medical examiner?

Judy: Deaths are referred to the medical examiner or coroner when the death is sudden, violent, or unexpected. State law defines which cases these are. The reports are most frequently made by 911 dispatch, paramedics, or hospital staff when the death is pronounced.

Debra: What can a family expect when a medical examiner becomes involved?

Judy: Families can expect that the body may be brought to the medical examiner’s or coroner’s office for an autopsy, and that the decision about whether an autopsy will be performed will be based on the information received from medical records or law enforcement agencies. The family needs to cooperate with the questions raised by the coroner’s investigator or pathologist. They should be forthcoming with medical history, including drug or alcohol use history, because withholding the information may delay or confound the determination of the cause of death.

Debra: How do families typically react when the medical examiner becomes involved?

Judy: There is no “typical” reaction. Reactions can span from apathetic to seriously involved in the investigation, either by being helpful or obstructionist. Some families object to an autopsy on religious grounds. Sometimes family members are wary of talking to coroner’s investigators, especially if the death was the result of a criminal act or substance abuse. There are also family members who try to cover up evidence of a suicide because of insurance benefits, social stigma, or religious beliefs. When someone – anyone – interferes with a death investigation, it slows down the process and makes things more difficult for the investigators, the police and, ultimately, the family. But most often, it’s been my experience that family members are grateful that we are trying to figure out what happened and give them answers. I have had family members of the dead loved ones send me Christmas cards and birth announcements many years after a case was resolved.

Look for Part Two of this interview next week.