Appendix G: Office of Chief Medical Examiner: Investigations and Autopsies

C.G.S. Secs. 19a-400 through 19a-415

State Statute and Regulations

· By state statute, "all law enforcement officers, state's attorneys, prosecuting attorneys, other officials, physicians, funeral directors, embalmers and other persons shall promptly notify" the OCME of any death "coming to their attention which is subject to investigation by the OCME."

· The OCME must investigate the death of anybody, including a DMR client, in the following categories:

o violent deaths, whether apparently homicidal, suicidal or accidental;

o sudden or unexpected deaths not caused by a readily recognizable disease;

o deaths under suspicious circumstances;

o deaths of persons whose bodies will be cremated;

o deaths related to disease resulting from employment or to accident while employed; and

o deaths related to disease that might constitute a threat to public health.

· A threshold question, then, is whether the circumstances of the death fit under one of the mandatory categories requiring investigation. The OCME ultimately makes that decision. If OCME accepts jurisdiction, and determines an autopsy is necessary, the OCME makes arrangements for transportation of the body.

· The main purpose of an OCME investigation is to determine cause and manner of death, and certify that on a death certificate. It is up to the OCME to decide whether an autopsy is needed to make that determination. Other sources of investigatory information include the findings at the death scene and any laboratory analysis (e.g., toxicologic, serologic). Sometimes the circumstances of the death and an external examination of the body "allow a medical examiner to conclude with reasonable certainty that death occurred from natural causes or obvious traumatic injury."

· By regulation, all deaths in institutions have to be reported to the OCME by phone immediately by regulation if the death occurs:

o in one of the categories above;

o within 24 hours of admission;

o in a sudden and unexpected fashion;

o during or related to a therapeutic or diagnostic procedure;

o in an operating room or recovery room; or

o there is evidence of abuse or neglect in causing the death.

· By regulation, when any death subject to OCME investigation occurs, the police having primary responsibility for the death investigation are to immediately telephone the OCME and give information.

· In cases of apparent homicide or suicide, or of accidental death, the cause of which is obscure, the scene of the event is not to be disturbed until authorized by the CME or his authorized representative. In these cases, the chief medical examiner, or his representative, shall view and take charge of the body without delay.

· Operationally, the OCME has six physicians located at its Farmington offices, where autopsies are actually performed. The OCME also uses the services of approximately 80 physicians, called assistant medical examiners, around the state. While deaths may be reported directly to the Farmington office, these assistants often are the initial contact for the OCME from local police, hospitals, and others, and make the determination whether a particular death requires the OCME to take jurisdiction.