The Massachusetts Medical Examiner’s Office has made progress since last spring on backlogs in autopsy reports that caused delays in court cases, and delayed death certificates that prevented families from collecting insurance payouts on deceased loved ones, a recent report to the legislature shows. Still, severe backlogs remain.
After bad press last year, state legislators increased the Medical Examiner’s funding by $2 million and wrote a requirement into the state budget. They wanted the office to document its progress toward reducing backlogs. The resulting report was filed with the legislature last month.
It shows the Medical Examiner’s Office reduced the backlog by 900 cases. But at the end of 2014, more than 1,400 autopsy reports remained incomplete — some of them dating as far back as 2011.
The newly appointed Secretary of Public Safety, Daniel Bennett, says that still shows progress. Bennett was a first assistant district attorney in the Worcester County District Attorney’s Office.
"I appreciate the hard work they’re doing to improve their performance at all times, but I don’t know that anybody’s going to be totally satisfied with the Medical Examiner’s Office until we get the right number of doctors up there,” Bennett said.
The office needs a total of 17 medical examiners, Bennett says, but it has just 10. Consequently, the office performs autopsies in just 46 percent of all its cases — well below the 90 percent required by the National Association of Medical Examiners for accreditation. Massachusetts has only provisional accreditation.
The new report acknowledges the office’s low number of autopsies may mean in some cases "findings which would determine the manner of death, including homicides, will go undetected."
The office conducted a nationwide search to find medical examiner candidates and the report says none were identified, possibly because of the office’s reputation. Bennett says it’s also just tough to find good candidates — only about 40 doctors become accredited as medical examiners each year.
Two students of the state’s medical examiner fellowship program have agreed to stay on and work for the state, so that gets the commonwealth to 12 medical examiners. Still, to completely reduce backlogs, Bennett says he’ll advocate for more funding.
"We’re all going to talk to Gov. [Charlie] Baker, and I know he’s going to come up with a fair budget," he said. "There’s a lot of areas that need funding."
But Gerry Leone, former Middlesex District Attorney, says more money might not solve all the Medical Examiner Office’s problems.
"I think a comprehensive independent assessment has to be done of what the nature and scope of the problems are before you can decide that the panacea is just hiring more people," Leone said.
Leone says the office’s decisions should be scrutinized, like a decision by administrators in 2013 to switch toxicology services from UMass Memorial to the State Police Crime Lab. That was supposed to save $600,000 dollars and shorten turnaround times. Instead, turnaround times stretched to 134 days at one point. By December, that was down to 34 days. Still, Leone says something went wrong.
“If you let the tail wag the dog and you look at the results of the switch, then you think that something went wrong," he said. "And whether that was on the front end assessment of the switch actually being made, or how the switch was effectuated, something went wrong."
Management aside, the Medical Examiner’s Office has been structurally underfunded for years, and that has an impact, says David Siegel, who sits on the Medical Examiner’s oversight commission and is co-director of the Center for Law and Social Responsibility.
“You can’t ask too few people to do too much work forever and expect that that’s not going to cause problems," Siegel said.
Siegel says the Medical Examiner’s Office hasn’t gotten the funding it needs because its budget recommendations go through the Secretary of Public Safety.
"I think that really hampers the Medical Examiner’s ability to fully express the need for his agency’s resources," he said. "There’s a significant argument that this public health agency should be independent."
Siegel says the Medical Examiner’s Office shouldn’t be dependent on any particular administration — Democrat or Republican.
