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The Medicolegal Death Investigator
An Evolution in Crime Scene Investigations Relating to Unexpected Deaths

(Released October 2008)

  by Emil Moldovan  


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Who are these forensic professionals that conduct complex scene investigations? As mentioned above, he/she can be an elected or appointed county coroner; an appointed medical examiner; a medical doctor without forensic pathology training; a forensic pathologist; a forensic odontologist, forensic botonist, forensic anthropologist, criminalist, police officer or a specialty trained forensic death investigator. In smaller more rural communities, it might be the elected or appointed county coroner who responds to death scenes and conducts an investigation. In metropolitan areas where the death statistics are much higher per capita, it is seldom the actual elected or appointed coroner or medical examiner who responds. The scene investigation is usually conducted by a medicolegal death investigator who receives training in manner and causes of death, as well as crime scene investigation and evidence collection.

Any of the above may have a role in death investigation. But it is usually the death investigator, representing the interests of a county coroner or medical examiner, who responds to a death scene to perform vital tasks and begin the process in making determinations as to the manner and cause of death.

body laid out
Mannequin at a Radford University mock crime scene

Some critics of the investigative process refer to the medicolegal death investigator as a "lay person." (Hanzlick, 1996; Haglund & Ernst, 1997) Webster's II New College Dictionary defines layman as: "A man who is not a member of a particular profession or specialty" (1995). The definition of the death investigator as a "lay person" should be corrected. While it often is used to differentiate between a non-medical investigator and a physician-pathologist, scene death investigation requires trained, qualified people performing this important forensic function. Today's MDIs are usually college educated in either criminal justice or one of the physical sciences. They undergo extensive on-the-job training in different aspects of investigative techniques, and are often asked to be the first contact and make notification to the family of decedents. MDIs process crime scenes, identify decedents, collect physical and trace evidence and provide expert testimony in courts of law. They are the link between many law enforcement agencies and other medical establishments and the public at large; as such, they must possess an advanced level of expertise and professionalism. The use of the term "lay person" attributed to the medicolegal death investigator seems inappropriate given the level and sophistication of work performed.

There has been considerable discussion on the merits of having a coroner or medical examiners conduct the death investigation. (Hanzlick, 1998) While the historical attributes of the coroner system have been traditionally accepted as a bona fide law enforcement tool in death investigations, it was discovered early in the field of forensic death investigation that medical knowledge could establish causes of death based on a sound scientific principle. (Spitz, 2006)

Many of the first medicolegal death investigators were funeral home employees or licensed embalmers. Their responsibilities at the death scene were to remove the body from the scene to the morgue or a mortuary, where a more thorough investigation might be conducted.1 More thorough and expert scene investigation was identified as important in the findings of the cause and manner of death. Along with that recognition, the need for more qualified scene investigators, with greater medical and anatomical knowledge, became paramount in legal proceedings.

Coroners and medical examiners began hiring investigators with law enforcement experience to respond and conduct a scene investigation. Their knowledge in the identification and collection of physical and trace evidence added an expertise to the death scene investigation. However, that did not resolve the issues of conducting a proper body examination to document post mortem changes that contribute to the cause and manner of death. Experience in law enforcement varied greatly from area to area, depending on the population, budget, availability of workforce and training of the investigator. Consequently, the integrity of death scene investigations was often in question. (Hanzlick, 1996)

Richard C. Harruff, M.D., Associate Medical Examiner for Seattle/King County, Washington stated "A competent and thorough death-scene investigation provides the basis for a comprehensive medicolegal autopsy, and together the scene investigation and autopsy provide the basis for an accurate determination of cause and manner of death." (U.S. Guide, 1999)

There were no standard practices or procedures in place to help guide investigators in making decisions whether the death fell under the auspices of the coroner or the medical examiner. (Committee, 2003) Cases were sometimes accepted that were unnecessarily autopsied. A thorough investigation may have produced medical documentation revealing a probable cause of death that could have alleviated the need for an autopsy. This added expense which consumed much of the operational budget of the medical examiner or coroner. It also contributed to delays in burial adding to the grieving of many decedents' families. On the flip side, cases were often declined that should have had an autopsy to determine the cause and manner of death. (Di Maio, 2003) The actual numbers of undetected or unsolved homicides is unknown, but could be significant when considered on a national scale. A need for a more consistent and standardized death investigation was identified as far back as the early part of the 1900s. Training for death investigators was often left to the agency employing them. Budgetary concerns often placed medicolegal death investigation training on a low priority and that training, if any, was often left up to the individual investigator to obtain on his or her own. (Ernst, 2003)

American Board of Medicolegal Death Investigators

ABMDI seal
In 1974 under the auspices of the St. Louis University, a one-week course in medicolegal death investigation was offered. In February 1998, the American Board of Medicolegal Death Investigators (ABMDI) was founded. Prior to 1995, there was no in-depth study that evaluated the essential tasks and the body of knowledge required to perform competent medicolegal death investigations. (Howe, 2008) Dr. Jeffrey Jentzen, then Chief Medical Examiner of Milwaukee, Wisconsin, found that only 7 of the 28 coroner-served states mandated any formal training for death investigators. He spearheaded a project (The Milwaukee Task Force) to develop a pre-employment test for death investigators, which produced an in-depth analysis of the skills needed to perform the job. (Howe, 2008)

After 1998, ABMDI tested, registered and certified investigators on a national basis. Today, medicolegal death investigators may also be affiliated with the National Association of Medical Examiners (N.A.M.E.), or American Academy of Forensic Sciences (AAFS) and certified as medical investigators (Certified Medical Investigator, Levels I, II or III) through the American College of Forensic Examiners International. (Ernst, 2003) These professional affiliations, training, registration and certification programs have increased the level of proficiency and professionalism of medicolegal death investigators in general. However, many agencies still do not require their medicolegal death investigators to affiliate or become registered by any of the above professional organizations.

Classification, education and training requirements vary greatly. While some agencies classify their MDIs as law enforcement personnel, most classify them as civilian employees without law enforcement authority. Some Sheriff/Coroner agencies use sworn deputies as a combination law enforcement officer/death investigator. Other sheriff/coroners hire specially trained MDI's and classify them as law enforcement officers with limited law enforcement responsibilities (e.g. in San Bernardino, California.)

Education and training requirements vary from state-to-state. Most require a minimum training period that may include academy classroom training, one-on-one training with an experienced MDI for a specific time period, and continued education on an annual basis. Training can range from a few short weeks to a full year or more. Some colleges and universities offer Medicolegal Death Investigation as part of the Criminal Justice or Forensic training programs. These courses are gaining in popularity and certification or completion of this type of training will often enhance opportunities for many MDI job candidates.2

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