What is it?
When a death occurs in a hospital, nursing home, prison or one of any number of other institutions, health care or treatment facilities where a person’s health and well-being are under the direct custodial responsibility or authority of someone other than oneself, and family members or loved ones believe that the death is the result of the care provider’s (i.e. nurse, certified nursing assistant, physician) mistake, abuse, medical misadventure, negligence or intention, and creditably and/or legally asserts such a claim, a Medicolegal Death Investigation occurs. Medicolegal death investigations conducted by certified American Board of Medicolegal Death Investigators (ABMDI) professionals trained to conduct death investigations, recognize pertinent evidence, collect evidence, conduct directed interviews, take statements, obtain and analyze medical records and prepare credible investigative reports, as well as provide Court testimony, in conjunction with the performance of an autopsies, are all critical factors to be considered and performed when conducting a medicolegal death investigation.
Who does it?
Medicolegal Death Investigations: Every time someone dies, there is a person charged with the primary responsibility of determining why the person died (i.e. what caused death). In apparent natural deaths where the decedent has remained under the care and authority of a hospital and a physician, the hospital's treating physician or pathologist is primarily responsible for certifying the death, unless someone questions the care and treatment received. If questions or suspicions arise surrounding the death, a medicolegal death investigation is conducted. The individual or entity assigned the death investigation is often determined by the circumstances surrounding the death, where the precipitating event occurred or based upon the next of kin's determination that their loved ones' death warrants a medicolegal death investigation. In the event of potential medical misadventure, injury, suspicion, foul play, abuse, neglect or if the death is otherwise unexplainable, a medicolegal death investigation is conducted by a AMBDI certified Medicolegal Death Investigator.
Who needs it?
The Federal, State and County government; however, their medicolegal death investigations are conducted by Federal, State or County Medical Examiner Centers. Non metropolitan areas tend to have a Coroner system and their medicolegal death investigations are conducted by a County Coroner or Assistant County Coroner. However, when someone has lost a loved one and suspects or believes that foul play, abuse, malpractice, medical misadventure or negligence is a contributing factor in the death, but their suspicion or evidence does not rise to such a level to warrant involvement by a Medical Examiner or Coroner system, a private medicolegal death investigation is needed. Private medicolegal death investigations are typically initiated by the legal next of kin, family members and loved ones with the right or interest in doing so. The legal next of kin, at their own expense, may secure the services of a professional (ABMDI certified medicolegal death investigator to conduct a death investigation in conjunction with a privately contracted forensic pathologist.
What does a Medicolegal death investigation consist of?
When death occurs that is not reasonably explainable, a forensic pathologist is typically charged with determining the cause of death. The word pathologist is derived from the word pathology, which deals with the study of suffering. Typically, physical suffering is due to disease or injury. A pathologist is a physician who has received special training in the field of anatomic or clinical pathology. A forensic pathologist is an anatomic pathologist who has received additional specialized training in medicolegal death investigation. The forensic pathologist is trained to understand the inter-relationship of multiple medical and law enforcement disciplines that are helpful in determining cause and manner of death as it relates to and in conjunction with a medicolegal death investigation.
A medicolegal death investigation involves the combined elements of both a medical and criminal investigations. A quality medicolegal death investigation should consist of establishing a decedent profile, which should include, obtaining information and evidence relative to the decedent’s condition several hours prior to death, the pre-terminal circumstances surrounding the death, as well as the discovery of the decedent’s body, medical intervention, etc. Conducting interviews to include taking witness statements, reviewing previously obtained evidence, reports, statements, reviewing and/or taking scene photographs, performing an external examination of the decedent’s body to include written and photographic documentation, as well as notation of post mortem changes relative to time. A retro scene visit may be necessary to fully understand the circumstances surrounding the death and should involve written and photographic documentation pertinent to the death. A medical and social history of the decedent should be generated to include the location of any injuries or illnesses that may have contributed to the death. A final medicolegal death investigation report containing all information obtained should be generated and discussed with a pathologist to make a determination as to whether an autopsy is warranted.