In some locations, typically rural, a medical examiner does not always go to the scene of a homicide. Instead, as is the case of many areas within in the Commonwealth of Virginia, EMS or a funeral home is responsible for transporting the body to a local hospital where a doctor or local M.E. examines the victim. If an autopsy is to be performed, though, it is not the local medical examiner who’d conduct it. Instead, the body is transported to a state morgue which could be hours away.

In Virginia, 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.

Breaking Bread with Kay Scarpetta

The Office of the Chief Medical Examiner (OCME) 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.

She, in fact, and one of her assistants, joined Denene and me at dinner at the Commonwealth Club in Richmond the night Denene received her PhD in pathology from Virginia Commonwealth University. Ironically, it was this very assistant to the real-life Kay Scarpetta who months later performed the autopsy on a bank robber who engaged me in a shootout. And it was she who, in explicit detail, informed me that four of the five rounds I’d fired were fatal rounds. The fifth, she told me, entered the skull at an angle that would not have resulted in death.

There are several local M.E.’s in Virginia (somewhere around 160, 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, but many do not. Mostly, they have a look at the bodies brought to  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. Again, some do, but not all.

An example (one of many) was a drug-related execution where I was called on by a nearby county sheriff to assist his department in the investigation. Following the evidence, I and his detectives located the killers. After interrogating one of the suspects he led me to the crime scene where we located the deceased victim. The suspects carried and dragged the body several yards, deep into a wooded area. The local medical examiner did not attend. Instead, he requested that the body be delivered to a local hospital.

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, no sleep, 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.

Take Two Bodies and Call Me in the Morning!

In many cases, the local M.E.’s will simply instruct 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 referred to the state is one that falls under their jurisdiction. The local M.E.s receive an extra $50 if they actually go to a crime scene. Again, many do not. Interestingly, funeral homes pay the local medical examiner $50 for each cremation he or she certifies.

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

Once someone is appointed as a local medical examiner their term is for three years, beginning on October 1 of the year of appointment.

The four district offices employ full-time 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 from the other localities.

For example, in one Ohio county, a coroner there mandated that autopsies be performed for all deaths that occurred during 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.

1 reply
  1. Cathy Akers-Jordan
    Cathy Akers-Jordan says:

    Lee, I have a few questions about the “nonstop, no sleep, 36-hour investigation.” I understand the need to solve murders as quickly as possible, but don’t LEOs (like doctors) make more mistakes when they’re exhausted? If catching the bad guys led to a shoot out, wouldn’t your exhausted reflexes be slower or does adrenalin cancel that out? Finally, after the close of the investigation, do you get a day to catch up on your sleep or do you continue to work in exhaustion until the weekend (which would put you at risk of making dangerous mistakes when driving, shooting, etc.)? Thanks!

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