Her dark blond hair hung, limp and dirty, on the gurney. Her fingers were black with fingerprinting ink, one of the resources the state medical examiners used to piece together the life that she had.
Not long ago, she had painted her toenails coral. The nail polish, bright and unchipped, bore no trace of what had sent her to the basement of Mississippi’s Forensics Lab in Pearl.
But her face did. By the time her boyfriend had sobered up enough to report her body floating in the pond near his home, detectives guessed she had been there for over half a day.
While assistant medical examiner Dr. Brent Davis conducted his exam, lab techs wheeled a fifth body into the room, zipped into a black bag. The exam room was at capacity, as it had been all morning. By the time the day was over, the three state medical examiners would perform 11 autopsies total.
This is an exceptionally high number, by all standards. One state over, Arkansas’s medical examiners each perform one exam a day on average.
But Mississippi’s Office of the Medical Examiner is severely understaffed, more so, in fact, than any other state medical examiner’s office in the country, according to a 2014 report from the National Association of Medical Examiners. Mississippi’s three medical examiners each performs between 500 and 600 autopsies a year, more than double the 250 that the National Association of Medical Examiners recommends.
And these staffing issues aren’t unique within the Department of Public Safety. Upstairs from the morgue sit three floors of the state crime lab. Over the last few years, budget cuts have whittled down what was once a staff of 120 to just 85. And with it, the backlog of cases has exploded, going from “basically zero to over 3,000 reports that are over 90 days old,” according to department director Sam Howell. Howell said he considers reports over 90 days old to be in the backlog.
“Time is of the essence in law enforcement. And with the lack of people and the high demand of requests we’re beginning to fail law enforcement in providing results in a timely matter,” Howell said.
Chief Medical Examiner Dr. Mark LeVaughn insists that his team’s top priority is always thoroughness and accuracy. But just an hour in the morgue reveals the incredible stress the three doctors endure — and the measures they take to keep the flow of bodies moving.
“We’re way beyond a public safety issue. We don’t have the recommended number of people working here,” LeVaughn said. “We are critically understaffed, and that’s a fact.”
Down in the morgue, two detectives hung back near the door as Davis continued the woman’s autopsy. Detective Jeff Joyner stepped forward.
“Can you say if she drowned?” he asked.
Davis couldn’t. When a body spends enough time submerged, he said, water can work its way into the lungs even if they’re not breathing. Davis waved the detectives closer. A navy blue bruise cupped the woman’s left eye socket. Davis folded back the skin on her face. The bruise was visible on the underside.
“Her heart was still beating when she got this,” Davis said. “I’d call it blunt force injuries, drowning with blunt force injuries. If I could get more information from you guys, let’s say this guy all of a sudden sobers up and confesses, “I did X,” then I can say if it’s consistent with that.”
“It’s significant enough to cause death?” Joyner asked, indicating the bruise. Davis said it was.
As he walked the detectives out, Davis promised to have someone send over a CD of autopsy images in the next few weeks. He didn’t want to make them wait on the finalized autopsy report.
“I’ll tell you right now, my turnaround time is horrific. It’s about a year,” Davis said, referring to the finalized report. “When I first got here it was two to three months. And every month it gets worse.”
As Copiah County Coroner, Ellis Stuart plays the liaison between victims’ families and the Medical Examiner’s office. He said he had waited longer than a year for a finalized autopsy report. And he admits this makes him nervous.
“The longer it takes to get someone to trial the more things could go wrong,” Stuart said. “The defendant is entitled to a speedy trial. But so is the victim.”
This is a problem for any state. But it’s particularly acute in Mississippi, which has the second highest murder rate in the country and a nascent drug epidemic. And this means that the staffing issues aren’t just a problem for the departments but also for the public.
“Anything that has lab work, be it narcotics, homicide, a burglary, gets touched by the crime lab, which ultimately affects the outcome of the criminal investigation,” said Director of Public Safety Marshall Fisher. “So it could become a public safety issue if the staffing shortage is not addressed. It probably already is.”
Lots of equipment, few employees
Mississippi’s new forensics laboratory, which opened in 2015, cost the state $30 million — and looks like it. At 90,000 square feet, the striking glass and steel building in Pearl nearly quadrupled the size of the old facility, in use since the middle of the last century.
Inside the laboratories are modern and bright, white walls with gray accents. Much of the equipment is as new as the building.
“I don’t think there’s a lab in the country that has better instruments than us,” said Chris Wise, the lab’s technical assistance section chief.
Just as striking as the equipment filling the building, however, are the people who don’t.
On a recent Wednesday morning in the toxicology lab, one forensic scientist sat at his desk, peering through a microscope. The four desks around him, each outfitted with the same equipment, were empty.
The trace evidence lab houses some of the crime lab’s most expensive equipment, including three $300,000 scanning electron microscopes, which analyze everything from gunshot residue to paint samples and hair fibers. The lab currently employs three people, but Jacob Burchfield, a forensic scientist in the department, said they could use five to six more.
“We are not short on equipment,” Burchfield said. “Just people.”
As a result, Burchfield estimated that the backlog in trace evidence reaches approximately 600 cases, many of which contain dozens of individual samples, each needing separate analysis. Firearms, which employs four examiners and needs approximately four more, has a backlog of 800 to 900 cases, according to Wise.
Each one of these cases is tied to a crime, and having a full analysis of the evidence can be “absolutely crucial to making cases,” according to Jackson Police Chief Lee Vance.
Downstairs in the morgue, Davis said he didn’t suspect the woman he autopsied had overdosed. But he thought drugs were involved somehow, especially given the mental state of the boyfriend who had reported her body.
He wouldn’t know for sure, however, for close to a month. Toxicology screenings are detailed. Every drug found in the blood is quantified, confirmed and then the amount in the blood is quantitated, or measured. But the crime lab’s toxicology lab is so short-staffed the medical examiner’s office doesn’t even bother sending its samples upstairs. They outsource to a lab in Philadelphia, Pa.
“We have tox upstairs but they can’t do everything. They can screen things but they can’t do the quantitative work,” LeVaughn said. “They’ve got instruments up there, that sit and collect dust, that can do anything you want it to. But they don’t have people to operate the machines.”‘
According to LeVaughn, the contract with the Philadelphia toxicology lab costs the state $300,000 a year.
Like many state agencies, the staffing issues in the crime lab boil down to one cause: funding. Not only have declining departmental funds chipped away at the number of positions — a decrease of nearly 30 percent since 2010 — but the jobs that are left, according to Howell, pay far less than similar positions in other states.
Legislators haven’t adjusted the department’s salary scale since 2007. So a chemist with a master’s degree in forensic chemistry starts with a salary of $32,000.
As a result, Howell said, attracting and retaining talent has become a struggle. University of Southern Mississippi and University of Mississippi both have forensic science programs. But graduates frequently leave for departments in other states. If they do stay in Mississippi, Howell said, many spend two years training at the crime lab, then use that as a springboard to programs outside of Mississippi.
“I’ve got employees all over the country — well, former employees,” Howell said with a dry laugh. “I lost one employee to the Virginia department of forensic science with a $20,000-a-year raise, doing the exact same work he was doing here. So we can’t compete. If we do get someone here and they’re a great employee and we train them, then they’re going to go somewhere else. That’s what we see happen all the time.”
“It’s a shame we have two highly touted programs in the state, and we’re training them to go somewhere else.”
For the most part, when the crime lab’s forensic scientists talk about their backlog, it’s an abstraction. Six hundred cases sound like a lot, but picturing them is difficult.
Down in the crime lab’s 4,400 square foot vault, the backlog is visible. Chris Wise walks down one of more than a dozen aisles. It’s about 20 feet long, filled with plastic bins and brown paper bags, each containing samples of trace evidence waiting to be analyzed. Wise taps a bin.
“Two years ago the backlog was to here,” he said motioning to the column of shelves in front of him. “Now we’re here,” he said, indicating everything behind him. The boxes filled almost two more rows of shelves. “So it’s doubled. In two years, it’s doubled.”
After data is analyzed, the crime lab returns it to the law enforcement agency that sent it over. More than 400 state and federal agencies, from local police departments to the Mississippi Bureau of Investigation, submit their evidence to the Mississippi Forensics Laboratory. As a result, at any given time, the outcomes of hundreds, if not thousands, of cases in the state are waiting on an accurate, thorough analysis from the crime lab.
In addition to preventing law enforcement from making arrests, delays can also cause problems for the wrongfully arrested, according to Tucker Carrington, who heads the Innocence Project at the University of Mississippi Law School.
“In the case of a sexual assault, if the lab work isn’t done, that’s someone who’s free to stay out there and commit sexual assaults,” Carrington said. “You can have a suspect who’s not arrested and charged or one who is arrested and charged. And if it’s not them there’s no way for them to say it’s (not a match).”
Howell said that the crime lab does everything it can to avoid holding up a case. If a detective or elected official asks them for results, that can move a case to the front of the line.
“We try not to make it a problem, where if someone will call, let us know that this is a critical situation, we’ll try and prioritize that case,” Howell said.
But Howell also acknowledged that this fosters an imbalance, where certain cases — for instance, those that receive media attention or those in which the victim’s family has pull — can end up getting answers faster.
“And that’s very frustrating. And I get a lot of frustrated calls from law enforcement and prosecutors that they can’t go ahead with what they need to do, that they’re waiting on us,” Howell said.
“When you start getting behind, arrests don’t occur, cases become cold.” Howell said. “It affects the entire state and the public safety of the entire state.”
Sen. Brice Wiggins, R-Pascagoula, spent seven years as an assistant district attorney prior to joining the Legislature. He agreed with Howell that backlogs can hinder all areas of law enforcement.
“It affects more than just the Department of Public Safety or the victims of crimes. It affects the coroners, it affects law enforcement,” he said, in reference to staffing issues in both the crime lab and medical examiner’s office. “It’s everybody in the system, and we owe it to the citizens that that’s being run right. So we have a ways to get there.”
“Our own worst enemy”
The Medical Examiner’s office doesn’t have the luxury of acquiring a backlog. Bodies, unlike physical evidence, can’t sit on a shelf.
So regardless of how many medical examiners are on staff, they are required to get through the same number of cases. In 2016, Mississippi’s three medical examiners completed just under 1,700 autopsies.
“Sometimes I think we’re our own worst enemy. We could easily have patients here for days, but families are going to complain to coroners, as they should,” LeVaughn said. “What suffers is the paperwork. We don’t have time.”
The National Association of Medical Examiners set 250 as its recommended maximum number of annual autopsies for two reasons. The first is accuracy. According to a 2008 study commissioned by the Mississippi Legislature, performing more than the recommendation “corresponds to a tendency for the forensic pathologist, regardless of skill, to engage in shortcuts or to make mistakes, including performing partial autopsies when a full one is warranted, failing to examine an injury or organ, or not completely recording relevant findings.”
The same study found that “at the threshold of 350 autopsies per year and beyond, a
pathologist’s mistakes may grow more flagrant and are more likely to involve errors in judgment.” Mississippi’s medical examiners each performed more than 550 last year.
“Our role is recognizing the significance of what we see,” said Assistant Medical Examiner Dr. Lisa Funté. “It’s not just noting that it’s a bullet hole, but interpreting what that means. If there’s stippling, whether it’s close range. And that takes time.”
The second reason the National Association of Medical Examiners gives for capping autopsies is burnout, a problem LeVaughn said he has witnessed firsthand. A few years ago, Mississippi had five medical examiners working statewide.
One retired. “I think the caseload got to him,” LeVaughn said. Then one took a job at the medical examiner’s office in Galveston, Texas. “It was a better paying job and a better case volume,” he said.
The flip side of this coin — and the bitter irony, according to LeVaughn — is that having so few pathologists on staff has made recruiting new ones next to impossible. In the last two years, LeVaughn said he has made offers to four doctors. Each one declined.
LeVaughn studies job postings from other states obsessively — he keeps a manila folder with dozens of them printed out — constantly comparing what they offer to his own department’s posting.
Right now the biggest problem he sees with Mississippi’s job posting is that there’s only one. Maryland, a state with a population double that of Mississippi’s, is advertising for three new hires. Its ad boasts that this will raise the total medical examiners in the state lab to 20.
“If you have a place with an excessive workload, and you just advertise one position, that’s key in the problem of attracting people here. If I could advertise four of five positions people would say, ‘Hey, they’re serious about managing caseload and getting things under control,'” LeVaughn said.
Only 24 states, including Mississippi, have state medical examiners’ offices. The rest use a patchwork system of county and city medical examiners to perform their autopsies.
When the National Association of Medical Examiners surveyed the 24 state medical examiner offices across the country in 2014, they determined that, based on the population of the state, Mississippi needed a total of 12 forensic pathologists to handle the caseload. That’s a 300 percent increase in staff, more than any other state surveyed.
But that recommendation assumes a murder rate close to the national average. Mississippi’s is almost double it, 8.7 per 100,000 people in 2015 versus 4.9 nationally. As a result, Mississippi sees nearly twice as many murders as other states its size. And every single one goes through the medical examiner’s office.
“I know we have the highest homicide rate of any of the job postings I’ve seen,” LeVaughn said. “It’s a very violent state.”
Arkansas, which has a population the same size as Mississippi, employs six medical examiners in its state office. Each handles approximately 250 autopsies a year, according to Dr. Charles Kokes, the chief medical examiner.
But even at that number, Kokes said his staff struggles to finalize 75 percent of its autopsies in 60 days. The National Association of Medical Examiners recommends a 90 percent completion rate in that time period. When told that the average case in Mississippi takes a year to complete, Kokes inhaled sharply, then sighed.
“At a certain point in time you run the risk of damaging the criminal justice system,” Kokes said. “You have these three pathologists who are working their tails off, but they’re not getting the cases out as quickly as they’d like to – so you have cases that are on hold, people sitting in jail, perhaps waiting on charges to be filed, you have court dates that need to be set and investigators who need to investigate more. Now there’s a lot of information that you can give an investigator verbally. But it’s the report that’s official.”
Arkansas is one of 16 state medical examiners’ offices nationwide to receive accreditation from the National Association of Medical Examiners. One of the prerequisites for accreditation is that medical examiners perform no more than 250 autopsies a year. Mississippi’s office has not been accredited, and until staffing doubles, LeVaughn said, “we’ll never get accredited. Ever.”
“If the accreditation is not granted because of the caseload we need to be looking at that,” said Wiggins.
LeVaughn said he has petitioned legislators for budget increases to no avail. His budget request for fiscal year 2018 asked for three new positions, which would bring the state total to six. So far he only has funding for one other position, the same one he has been trying to fill for several years. It’s for the Gulf Coast medical examiner’s office. Opened in 2011, it never has been staffed.
Some state officials recently have taken a backdoor approach to increasing staffing. Earlier this month, the Governor’s Opioid and Heroin Study Task Force recommended funding positions for two more medical examiners, as well as four more forensic scientists in the crime lab.
Senate Appropriations Chair Buck Clarke, R-Hollandale, said he was aware of the staffing issues in the medical examiner’s office and crime lab during the last session. But after declining revenues forced five mid-year budget cuts in 2017, money was tight across the board.
“During the end of the (legislative session) we look for critical needs. And then we’re hearing from the Department of Health that we’ve got to be able to examine water systems, well, that’s pretty critical. And then the Department of Mental Health says we can’t be putting (mentally ill) people in jail, so we’ve got to get funds to lessen that. And we take all those critical issues from other agencies and say, ‘What’s going to be our priority?'”
Clarke said he’s hopeful public safety can be a priority. Earlier this month, the Legislative Budget Office announced that revenue projections for July and August had exceeded expectations.
“We know it’s been a need. And the money’s getting better,” Clarke said. “Let’s knock on wood that we’ve turned a corner.”
But whether these will be approved in time to make a difference, if they are approved at all, remains to be seen.
“We could all leave if the opportunity comes,” LeVaughn said. “And there are many opportunities out there with a much lower caseload.”