How deaths are investigated in Washington state

Feb 8, 2011

In Washington state, if someone dies under suspicious circumstances or suddenly with no obvious cause, an investigation is required. But just how that investigation is conducted depends on where the person dies. It varies county by county.

In King County, Medical Examiner Dr. Richard Harruff has a full staff of forensic pathologists who respond quickly to conduct autopsies and other post mortem investigations.  On a recent morning, he described the bodies that had been brought in over night.

"It's the usual assortment of drug overdoses, motor vehicle collisions, suicides, no murders today, but there was one yesterday.”

Dr. Haruff, who was appointed to his position by the King County Executive, oversees a staff of forensic pathologists who respond quickly to conduct autopsies and other post mortem investigations when there’s a homicide, a drowning, a fatal overdose or an elderly person who falls and dies.

Every year, about 15,000 people die in King county.  Of those, nearly two thousand deaths are investigated by the Medical Examiner’s office.

But Medical Examiners are the exception rather than the rule in the state.  Most counties rely on coroners or prosecutor/coroners who are elected.  There’s no requirement they have medical expertise. Debbie Wilke, who works with the Washington Association of Medical Examiners and Coroners, says there’s a reason for that.

"You couldn’t put a forensic pathologist in every county in the state. You couldn’t afford to and it wouldn’t make sense because they'd have so much down time.”

She says there just aren’t that many deaths in the smaller counties.  She points out those counties do hire forensic pathologists to do autopsies or contract with Medical Examiners in the larger counties. And, she says, if needed, coroners can access a state fund for things such as investigations of double homicide deaths or plane crash fatalities.

Wilke says people who are critical of the coroner system don’t always realize that much of the job isn’t medical.  It’s administrative and about dealing with the living.

“I’ve had family members die in a prosecutor/coroner county and I think the degree of care and concern was exceptional.

There is no movement in Washington to centralize the system and set up a state medical examiner office as some states have done.  But, county based coroners and Medical Examiners point to improvements that have been made in recent years.  State law now requires that all infant deaths be investigated in Washington. This in response to the number of  babies dying from Sudden Infant Death Syndrome or SIDS.  6 counties, including King, require death investigations before a body is cremated.  And, as of the first of the year,  King county now requires a review before every burial as well.

Whether it’s a county coroner investigating a death or a Medical Examiner,  the mission is the same--to find answers.

Medical Examiner Harruff says he provides something the families of the deceased need.

"They have to have a story that explains the death of their loved one and puts that death in the context of that person's life.

Harruff says he helps them write that final chapter.

Link to NPR series on death investigations in the United States.