Medicolegal Death Investigation Data — More Transparency Needed
What’s the main product of a coroner or medical examiner (C/ME) office? The answer is data — specifically, data about their death investigations. Data that answer questions about how many people are dying, who is dying, and what they’re dying from. We live in an age of data analysis and hyper-communication. Yet many coroner and medical examiner offices — government agencies — don’t provide access to the local medicolegal death investigation data they generate. Posting monthly death statistics and preparing annual reports are two ways to increase transparency.
Real-Time Medicolegal Death Investigation Data
The Centers for Disease Control and Prevention (CDC) manages, analyzes, and reports on national death statistics. But that process takes time, sometimes even years. The raw data they receive on homicides, accidents, suicides, undetermined deaths, and many natural deaths comes from the thousands of C/ME offices across the United States. Yet few of those offices provide that data — real-time local death information — to their communities.
Take a look at the website or social media platform of your county or city’s coroner or medical examiner office. Can you find the answers to these questions? How many deaths did the office investigate in the past month or year? Is the number of COVID-19 deaths increasing or decreasing? How many drug overdoses or homicides did the office investigate? How many autopsies did the office perform? If you live in Pennsylvania, the answers are hard to come by. According to this survey, only 11 (16.4%) of PA’s 67 coroner and medical examiner offices post monthly or quarterly death statistics on their website. A good example of one that does is the Bucks County (PA) Coroner’s Office.
On the other hand, the Philadelphia Medical Examiner’s Office (PMEO), Pennsylvania’s largest medicolegal death investigation office, had no statistics or annual reports on its website in 2021 or 2022.* Recently this author filed a Right-to-Know request with the PMEO simply to find out how many unintentional drug overdose deaths the office certified in 2021 (In case you’re wondering… it was 1,276).
Annual Reports
Annual reports, when timely and accurate, are important resources for health care professionals, county administrators, and the public. They are time capsules, tomorrow’s historical documents. Unfortunately, there are very few available. And without resources for digitizing and maintaining old records, those that do exist are probably on a shelf somewhere in the coroner’s office.
A recent study found that 80% of PA’s coroner and medical examiner offices had no annual report on their website. Furthermore, only four of 67 offices in the entire state had a 2020 annual report available online by late 2021. Those offices, like the Westmoreland Coroner’s Office, provide a model for other offices.
Accreditation standards of the International Association of Coroners and Medical Examiners (IACME) and the National Association of Medical Examiners (NAME) require C/ME offices to prepare annual reports that include detailed death investigation statistics. However, only five coroner offices and one medical examiner office in Pennsylvania are accredited.
Social Media
Few coroners or medical examiners use popular social media platforms to inform the public about their activities. One exception is Pam Gay, York County (PA) Coroner, who has been using Twitter for years to rapidly communicate real-time death investigation information.
Why so little Transparency for Medicolegal Death Investigation Data?
First, according to the Center for Rural PA’s state survey on death investigation, “Most C/ME offices lack expertise or funding for data management, analysis, or communication.”
Second, there is no statutory requirement to provide statistical data or annual reports in Pennsylvania.
Third, unless an office is accredited, there is no accountability. Voters elect most of PA’s coroners, so right now it’s up to them to hold their elected death investigation officers accountable for reporting on their official activities.
Take-Home Message
Coroner and medical examiner offices are publicly funded government agencies that generate critical public health and safety information. Voters should demand and state statutes should require these offices to report on their activities by posting medicolegal death investigation statistics.
* As of October 2022, Philadelphia has a new Medical Examiner, Dr. Constance DiAngelo, who is focusing on getting the office accredited.