In some locations, typically rural, a medical examiner does not always go to the scene of a homicide. Instead, EMS transports the body to a local hospital where a doctor examines the victim. If an autopsy is to be performed the body is then transported to a state morgue which could be hours away.
In Virginia, for example, there are only four state morgue locations/district offices (Manassas, Norfolk, Richmond, and Roanoke) where autopsies are conducted. Each of the district offices is staffed by forensic pathologists, investigators, and various morgue personnel.
The Office of the Chief Medical Examiner is located in Richmond (the office where Patricia Cornwell’s fictional M.E., Kay Scarpetta, worked). This is also the M.E.’s office that conducted the autopsies on the homicide cases I investigated. The real-life Kay Scarpetta was our M.E.
There are several local M.E.’s in Virginia (somewhere around 150, or so) but they do not conduct autopsies. Their job is to assist the state M.E. by conducting field investigations, if they see fit to do so, and many do not. Mostly, they have a look at the bodies brought in to the hospitals by EMS, sign death certificates, and determine whether or not the case should be referred to the state M.E.’s office for autopsy. They definitely do not go to all death scenes. Some do, but not all.
Me standing on the left at a murder scene where a drug dealer was executed by rival gang members who then hid the body in a wooded area. I was asked to assist a sheriff’s office with the investigation. The medical examiner was called but elected to not go to the scene. The body and sheet used by the suspects to drag the victim were placed into a body bag and then transported to the morgue via EMS ambulance.
Pursuant to § 32.1-283 of the Code of Virginia, all of the following deaths are investigated by the OCME:
- any death from trauma, injury, violence, or poisoning attributable to accident, suicide or homicide;
- sudden deaths to persons in apparent good health or deaths unattended by a physician;
- deaths of persons in jail, prison, or another correctional institution, or in police custody (this includes deaths from legal intervention);
- deaths of persons receiving services in a state hospital or training center operated by the Department of Behavioral Health and Developmental Services;
- the sudden death of any infant; and
- any other suspicious, unusual, or unnatural death.
* Remember, “investigated” does not mean they have to go to the actual crime scene.
Again, me on the left as a sheriff’s office crime scene investigator points out the location of spent bullet casings, drag marks, and a blood trail. Pictured in the center are a county sheriff and prosecutor. The M.E. elected to not travel to the scene. As good luck would have it, we had the killers in custody at the conclusion of a nonstop 36-hour investigation.
After a lengthy interrogation, two of the four confessed to the murder. Of course, they each pointed to someone else as the shooter, and he, the actual shooter, placed the blame on his partners. But all four admitted to being present when the murder occurred and all four served time for the killing.
In the areas far outside the immediate area of Virginia’s four district offices of the chief medical examiner, where officials rely on local, part time medical examiners, it is typically police detectives/officers who determine when a body can be removed from the scene. EMS, after checking for signs of life, stand by until the police instruct them to transport the body.
If the local M.E. shows up, and they’re almost always called, he/she will have a say in when the body is to be removed, but it’s rare that they do anything other than gather information for their notes and discuss possibilities and evidence with the police investigators. In many cases, the local M.E.’s will simply tell the calling detective to have EMS transport the body to the hospital morgue and they’ll take a look when they have a chance. They’ll sometimes ask to speak to the EMS person in charge of their crew. This, the instruction to transport the body, is especially so when the call comes during the overnight hours.
The pay for local M.E’s in Virginia is a “whopping” $150 per case, if the case is referred to the state is one that falls under their jurisdiction. They receive an extra $50 if they actually go to a crime scene. Again, many do not.
The requirements to become a local M.E. in Virginia are:
- A valid Virginia license as a doctor of medicine or osteopathy, Nurse Practitioner, or Physician Assistant
- An appointment by Virginia’s chief medical examiner
- A valid United States driver’s license
The four district offices, however, employ forensic pathologists who conduct all autopsies. Obviously, a physician’s assistant is not qualified to conduct an autopsy, nor are they trained as police/homicide investigators.
Keep in mind, things are never the same/uniform across the country. It’s always best, if you’re going for 100% realism, to check with someone in the area where your story is set. The rules and regulations on one side of the country may not be the same on the other. And the middle of the country may also be totally different. For example, in one Ohio county, a coroner there mandated that autopsies be performed for all deaths that occurred as results of vehicle crashes. This is not so in other areas of the country, or even in other locations in Ohio. By the way, at the time, his office received $1,500 per autopsy performed, with $750 of the sum going to the pathologist performing the exam.
*Thanks to the good folks at crimescenewriter for the idea for today’s article.