Discuss the role of the medical examiner, including determination of the cause and mode (manner) of death. (<250 words) The office of the medical examiner is charged with investigating all deaths in the state which are of an unnatural mode--accidents, homicides, suicides, and undetermined categories. Deaths which must be reported include: all accidental deaths, including those in the workplace (excepting vehicular accidents on highways in Utah), suspected sudden infant death syndrome, drug overdoses and poisonings, deaths from infections threatening public safety, and deaths occurring under suspicious circumstances. The medical examiner can use injury patterns to help resolve the mode of death. In addition, natural deaths may be reported to the OME for investigation when there was a sudden and unexpected death in apparent health or in cases where no physician (or other healer) attended the patient for the previous 30 days. Determination of the mode of death is important to determine potential civil or criminal charges. The medical examiner must determine the cause of death, particularly the underlying cause--the disease or event that started the chain of events leading to death. In order to do this, the medical examiner may perform an autopsy, but in Utah only about 600 to 700 cases in 2600 reported deaths go to autopsy. In other cases, gross examination, investigation of the scene of death, interview of family or friends, toxicologic data, or review of medical records may suffice to resolve the cause of death. The statistical data collected by the OME can be useful to determine how to prevent future premature deaths. |
A baby dies at 1 month of age. Describe how you would determine the mode (manner) of death. (<250 words) A natural mode of death may be the result of illnesses such as infections, congestive heart failure from congenital heart defects, or failure to thrive following premature birth that suggest a natural disease. An autopsy may be done to confirm the presence of anomalies or infections and determine a diagnosis helpful in explaining the death to the family. If there was no significant medical history, then a non-natural mode of death may be suspected and the case referred to the medical examiner for investigation. Parents, relatives, and babysitters who were involved in care of the baby should be interviewed to determine the circumstances surrounding the death. The scene of death can be investigated to corroborate explanations of events at the time of death. The body of the baby must be examined with autopsy and radiographs to look for signs of trauma. If a single recent injury, such as a blow to the head with a subdural hematoma, is present, then an accidental mode of death is possible if the stated mechanism of injury (e.g., dropping the baby) makes sense. However, multiple injuries of different ages suggest abuse, and findings such as retinal hemorrhages suggest shaken baby syndrome, which implies homicide as the manner of death. In some cases, there are no significant autopsy findings and sudden infant death syndrome may have occurred. However, smothering or other subtle forms of injury may not be ruled out, and the mode of death undetermined pending further investigation. |