Over law enforcement’s objections, autopsy privatization bill advances

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Larrison Campbell, Mississippi Today

Mississippi Chief Medical Examiner Dr. Mark LeVaughn

With a backlog of hundreds of cases in the state medical examiner’s office, lawmakers could allow counties to privatize some autopsy services.

But Mississippi’s chief medical examiner said he’s concerned that the bill would at best be ineffective and, at worst, derail potential criminal cases.

On Tuesday, a Senate judiciary committee unanimously passed Senate Bill 2400, which authorizes a three-year pilot program. Coroners in Itawamba, Lee, Harrison and Warren counties could choose to send bodies to private forensic pathologists rather than to the state medical examiner’s office in Pearl, which has limited staff and can take more than a year to produce a finalized autopsy report.

“I’m not looking to undermine (the medical examiners). I’m looking to give coroners the opportunity to expedite the process in certain cases,” said Sen. Chad McMahan, R-Guntown, who sponsored the legislation.

Currently the Department of Public Safety, which oversees the state crime lab and the state medical examiner’s office, opposes the legislation, which does not require the pathologist to be a board-certified forensic pathologist. Therese Apel, a public-safety spokeswoman, said this could cause problems in criminal trials.

“This bill weakens the requirements for pathologists who complete autopsies and places doctors in the awkward position at trial admitting they are not board certified in forensic pathology, overall leaving legal implications in its wake,” Apel said. “This weakened standard also presents insurmountable challenges to prosecutors who have criminal elements to prove (guilty) beyond a reasonable doubt, including elements that only forensic pathologists speak to: cause and manner of death.”

For nearly three years the backlog of finalized autopsy reports at the state Medical Examiner’s office, which performs 1,400 autopsies a year on any suspicious death or death of a child, has grown. Coroners, who have no control over the backlog and sometimes spend months dealing with angry, grieving families, initially approached McMahan about the legislation he said.

“The people in Mississippi deserve great service, and the coroners need some help,” McMahan said.

The reason for the backlog is that only two medical examiners are currently on staff, three fewer than the National Association of Medical Examiner’s recommends for the state’s caseload. Last year, the Legislature appropriated $1 million to the medical examiner’s office to hire more forensic pathologists, but they continue to struggle with recruitment, according to Mark LeVaughn, the chief medical examiner .

“We now (offer) a salary that’s about average, but the caseload scares candidates away,” LeVaughn said. Last year each medical examiner performed approximately 700 autopsies, more than three times the recommended number.

“And not many board-certified forensic pathologists graduate each year. (Nationally) it’s about 30. So they can be picky about where they go.”

The bill requires the pathologist to be board-certified in forensic pathology, as is industry standard, unless a “certified forensic pathologist is not available.” Currently, the Board of Medical Licensure lists dozens of pathologists in Mississippi. But the only forensic pathologists are those who already work for the state crime lab.

“If they know of a forensic pathologist in Mississippi, send them my number,” LeVaughn said.

Mississippi has struggled with its medical examiner system for decades. For nearly twenty years, the state relied on one doctor, Steven Hayne, to perform 80 percent of the state’s autopsies. Hayne, who was not a board-certified forensic pathologist, was fired in 2008 and has had his testimony discredited in dozens of cases in the years since.

Mississippi then tried privatizing its medical examiner’s office, contracting with Nashville-based Forensic Medical. After persistent backlogs and one scandal—involving one of the company’s forensic pathologists stealing drugs from bodies he’d examined in Mississippi—the state hired LeVaughn as its chief medical examiner in 2010.

Although the bill doesn’t specify which cases should go to the state medical examiner and which should go to private pathologists, McMahan said the coroners should still refer potential criminal cases to the state medical examiner’s office.

Mississippi Senate

Sen. Juan Barnett, D-Heidelberg

But Sen. Juan Barnett, D-Heidelberg, who voted to send the bill to the Senate floor, said he’s concerned that coroners could be pressured to use private pathologists, even when the medical examiner’s office is the appropriate choice.

“They’re just so bombarded with calls. Just wanting to get the heat off of them, they might be saying, let’s just send (the cases) over here,” Barnett said.

He also questioned whether the coroner, who determines when and where a person died but not the cause of death, is qualified to decide whether a case is criminal or not, a concern LeVaughn shares.

“There’s a whole bunch of times you’re looking at a case, and you’re like, ‘Oh my goodness, it’s more than what it seems,'” LeVaughn said. “So you get someone who doesn’t know how to recognize this, you’re in trouble.”

“We’re trying to get away from Mississippi’s history (of using) this uncertified outside pathology practice. I’m not saying it’s a bad idea, but the complications haven’t really been thought through.”