Sunday, June 17, 2007

Making Texas crime labs come clean

Following up on an independent investigator's revelation of dangerously flawed inner workings in Houston PD's forensic labs, University of Houston law prof Ellen Marrus suggests in today's Houston Chronicle "How to make the crime lab come clean." Marcus identifies some of my main criticisms of modern forensic science - mainly that it's a goal-oriented instead of truth seeking. She proposes making crime labs independent from law enforcement in a column in today's Houston Chronicle:

Across the country, two primary factors loom as the culprits behind this epidemic of ersatz evidence. The first is severe underfunding that makes it difficult to hire or retain competent technicians. The second is the way many jurisdictions place crime labs within law enforcement agencies — an arrangement that prompts lab technicians to view themselves as "advocates for the prosecution" rather than the impartial scientists they need to be.

Added together, these two factors help foster police crime labs that are run by technicians with relatively weak scientific backgrounds who believe their job has a single objective: to generate testimony that will produce convictions. These factors are at the root of police lab fiascos not only in Houston, but also in cities throughout the country. ...

When lab technicians view themselves as part of a law enforcement "team," they may feel compelled to falsify or exaggerate testimony to support the prosecution's case. A previous investigation into shenanigans in the HPD crime lab documented how a supervisor had interpreted similar scientific evidence in opposite ways in two rape cases — and graciously changed their testimony to fit the prosecution's needs. Forensic Science Communications has noted that when forensic scientists have a close relationship with law enforcement, scientific objectivity can be "hindered."

That's been my point in the series of Grits posts where I've ruefully declared that accuracy has become optional in forensic science. Marrus described a case from her own experience where faulty crime lab evidence accused an innocent person, and suggests a structural solution worth considering:

The problem of compromised test results is not new, and almost every criminal attorney has first-hand experience with poorly managed forensic labs and the "conclusions" they can generate. When I served as a public defender in California more than a decade ago, one of my juvenile clients faced assault charges based on blood found on his clothes. My client claimed the blood was from his dog and the police lab asserted it was human blood. When a second test by an independent source confirmed the serum was canine rather than human, the charges were dismissed and an innocent child was set free. Others are not so lucky, and the problems associated with flawed evidence strike across all races, genders and ages.

There's an easy, albeit expensive, way to fix the national crisis in forensic crime labs. Lawmakers should find a way to allocate more funding for these labs, and they should remove these facilities from the control of law enforcement agencies.

I think that'd be a great start, to make crime labs relied upon by the prosecution independent from law enforcement. If I had my way, though, I'd also expand indigent defendants' access to independent lab testing to let the adversarial system work like it's supposed to.

In every other field of human endeavor, science isn't valid unless the results are replicable by others. In the criminal justice system, though, for the most part whatever the police lab says, goes. And for them, too often, getting the right results isn't as important as being a part of the "team."

Paying for defense experts would be expensive, but the alternative, in economists' jargon, is for innocent defendants to pay the "externalities" for avoided costs, as well as the courts themselves, not in money but in lost credibility.

Those prices are too steep to bear.

Here's the final report from the independent investigator. Elsewhere, Kuff is underwhelmed at official reactions, and Bigjolly at the Lone Star Times is incredulous that Houston spent $5.3 million on the report and now refuses to enact its recommendations. That's certainly a startling aspect of official reaction. See also recent Grits coverage:


Anonymous said...

Charges not filed in child's death
Cause of death either accidental or natural
By Blanca Cantu /
September 21, 2006
No criminal charges will be filed against the parents of a 1-month-old Abilene boy who died in July, Abilene Police Department officials said Wednesday.
According to an autopsy report, Rephayah Isaac Lindsay died from protein-calorie malnutrition and terminal asphyxiation. Abilene Police Department Sgt. Roger Berry said the baby's death was either by accident or natural causes. The boy was then buried in an undisclosed location. The parents did not report the boy's death or burial to authorities, citing religious beliefs. The department's investigation of the boy's death officially closed, he said. Rephayah's parents, whose names have not been made public by police, told investigators that the boy was not feeling well, so they took him for a ride in a car. At some point, the boy stopped breathing. After the boy's father retrieved the body and turned it over to police, the body was sent to Tarrant County Medical Examiners office for an autopsy. Berry said Tuesday that he wanted to speak with Marc Krouse, the medical examiner who performed the autopsy, before he made a decision on how to move forward with the case. The autopsy report released Monday did not list a ruling on the death as either a homicide or an accident. After speaking to Krouse on Wednesday, Berry said he closed the case on the death and noted that the baby either died by accident or of natural causes. Police said the boy's parents told them taking their child to a doctor is against their religious beliefs. Police would not elaborate on the family's religion. Child Protective Services alerted Abilene authorities after an anonymous caller reported the death.


Sat, Oct. 04, 2003

Doctor's autopsies probably unlawful
By Jack Douglas Jr. and Amie Streater

Tarrant County Medical Examiner Nizam Peerwani suspended his top deputy
Friday and ordered a review of his forensic cases after learning that the
deputy had performed autopsies despite an expired license.

Marc Krouse, second in command at the medical examiner's office, had his
state license revoked July 1. The revocation came after Krouse neglected
to pay an annual license fee and to show that he had completed mandatory
continuing medical training, said Jill Wiggins, spokeswoman for the Texas
State Board of Medical Examiners.

The lapse could be a violation of state law and could lead to legal
challenges of the forensic evidence that Krouse collected for criminal
cases, legal experts said.

Krouse, a 22-year veteran medical examiner for the county, could not be
reached Friday at his home or office.

Peerwani said Krouse told him late Friday that his failure to keep his
license valid was an "oversight" and that he had fulfilled all
continuing-education requirements.

Krouse plans to meet with officials of the medical examiners board Monday
in Austin "to sort this out," Peerwani said. When Krouse became aware that
his license had lapsed is unclear.

Peerwani expressed confidence in his chief deputy Friday and said he
expects state officials to reinstate him promptly.

"Dr. Krouse is a superb examiner, and he has a very good reputation as a
court witness," Peerwani said. "I'm just mystified he let his license

Krouse missed a May 30 deadline to reregister for his state license, and
the license became delinquent after a 30-day grace period, Wiggins said.

"Delinquent means ... he shouldn't practice," she said.

Records obtained by the Star-Telegram show that Krouse performed dozens of
autopsies after his license expired, including cases involving suicides,
accidents, natural deaths and homicides.

Of the 14 homicides that Fort Worth police have investigated since the
beginning of July, Krouse conducted the autopsies in five cases, according
to medical examiner records.

Peerwani ordered the suspension after the Star-Telegram informed him of
the license lapse.

"Dr. Krouse's privileges are suspended. ... He will not do any autopsies
until future notice," he said.

Peerwani said he is "pretty confident" that the expired license will not
undermine the forensic evidence Krouse gathered in any homicide
investigation. Such cases, he said, are "signed off on" by other medical

Prosecutors and law enforcement officers, who have often relied on Krouse
to help prove their cases, expressed surprise at the development. They
said they were uncertain how it might affect pending criminal

"We've never had this happen before ... and we're going to have to see
what the consequences are," said Mike Parrish, chief of the felony
division for the Tarrant County district attorney's office.

District Attorney Tim Curry, when asked whether Krouse's predicament
concerns him, said: "Well, sure it does. And it may be a needless concern,
depending on what the state's rules are."

Sheriff Dee Anderson, when told that Krouse's medical license had expired,
had a different response.

"Yikes," he said.

Cynthia Orr, president of the Texas Criminal Defense Lawyers Association,
said a lapsed medical license could make a doctor's expert testimony
"highly suspect" in a trial.

A doctor's failure to meet continuing-education requirements could also be
grounds for dismissing a criminal case, said Orr, a San Antonio defense

"Autopsies are unlike any other science because, in most cases, you have a
one-shot deal," she said. "After that, you start losing evidence with

Wiggins, the spokeswoman for the medical examiners board, said performing
autopsies without a license is illegal. But she said she could not comment
on whether the board will investigate Krouse.

Wiggins said Krouse could be reinstated by paying a $335 annual
registration fee plus late fines and proving that he fulfilled at least 24
hours of continuing medical training within the past year.

To keep their licenses active, doctors must also swear that they are
mentally competent and are not dependent on chemicals or other substances,
she said.

Reinstatement is not retroactive, Wiggins said.

"Even if he renews next week, he still was practicing without a license
during the time that he was delinquent," she said.

County commissioners said they are confident that Peerwani will do
everything necessary to resolve the problem.

"We would certainly look to him for all of the people involved in that
entity to be licensed and [to] function at the highest standards
possible," Precinct 1 Commissioner Dionne Bagsby said.

Wiggins said the state board investigated a similar case in Houston
involving autopsies performed in 1997 and 1998 by an assistant medical
examiner who had never been licensed in Texas.

A Harris County grand jury declined to indict him on charges of illegally
practicing medicine.

The state board did not discipline the doctor but took action against the
county's chief medical examiner, Joye Carter, fining her $1,000 for
allowing the assistant to perform autopsies without a license.

Carter has since stepped down from the Houston job.


Source : Fort Worth Star-Telegram__________________

"It would become harder to execute men one after another, as is done in our country today, if those executions were translated into vivid images in the popular imagination."
~ Albert Camus (in "Reflections on the Gillotine")

Questions linger in 2006 infant death
Independent pathologists say son of sect members was murdered
By Blanca Cantu Sunday, June 10, 2007
Almost a year ago, baby Rephayah Isaac Lindsay died.
Exactly when and where the 1-month-old infant perished remains unclear, although his father gave Abilene police his version of those particulars.
The ambiguity surrounding Rephayah's death has hampered police investigations.
Law enforcement officers in two counties - Callahan and Taylor - acknowledged concerns about jurisdiction. And his parents, the two people who are believed to have been with Rephayah at the time of his death, weren't charged with any crime. Rephayah was the couple's only child. No one has been held responsible for Rephayah's death despite the fact that two pathologists - independent from the case - reviewed the medical examiner's report and concluded the child was murdered. According to police, Rephayah's parents said the boy wasn't feeling well, so they decided to take him for a car ride in hopes of making him feel better.
While riding in the car - somewhere in Callahan County, Abilene police believe - Rephayah stopped breathing. Little Rephayah was then buried in a grave at an undisclosed site in Callahan County, according to Abilene police.
Rephayah's parents have never been identified by police. However, Shaun Lindsay, who was 31 at the time, was identified as the boy's father, according to a court-ordered autopsy requested by Taylor County Justice of the Peace Bryan Smith. The boy's mother was 24 at the time of Rephayah's death. Rephayah's parents didn't report his death or burial. The Child Protective Services hotline received an anonymous call July 10 by someone reporting that a child died July 7 and was buried somewhere. Abilene police began investigating the death after the department was notified by CPS. Lindsay told police his son died July 7 and cited his family's religious beliefs for why the boy's death and burial weren't reported.
It is believed that the family belonged to the House of Yahweh - a religious group that many refer to as a cult. The group's headquarters is in Abilene. A compound, where many members live, is located in Callahan County. According to court documents, the couple lived on property owned by Yisrayl Hawkins, the House of Yahweh founder and leader. Abilene investigators talked to Lindsay for several hours before they were able to convince him to bring the baby's body to the police station. The father was allowed to return to the unmarked burial site unescorted - an occurrence Abilene police now say was highly unusual, but the only way possible to get evidence. Police said they do not know the exact location where the boy was buried. When Lindsay returned with the body, it was wrapped in a yellow and white blanket. Rephayah's body was sent to the Tarrant County Medical Examiner's office for an autopsy, which was performed by Dr. Marc Krouse, the deputy chief medical examiner. According to the autopsy, at the time of examination, the body was wrapped in two blankets and enclosed in a plastic bag. Rephayah was wearing only a knit cap, covering his short straight dark brown hair A preliminary autopsy indicated the boy died of protein malnourishment and of ''terminal'' asphyxiation, which does not mean death was caused by another human. Later, the medical examiner's Web site described the death as being caused by ''traumatic'' asphyxiation, or sudden or severe compression of the chest or upper abdomen that prevents breathing. ''Traumatic'' could mean that the child was purposely suffocated. ''If we had known 'traumatic' was the description, we might have approached the investigation differently,'' said Taylor County District Attorney James Eidson. An online public access database of the files from the medical examiner's office lists the cause of death as ''traumatic'' asphyxiation, rather than ''terminal'' asphyxiation. ''If we had known that at the time we were investigating, it might have made a difference in how the case was handled,'' Eidson said. ''Traumatic'' asphyxiation implies the death was caused by an outside force while ''terminal'' asphyxiation does not.
At 4.6 pounds, Rephayah's body was malnourished with almost no fat under the skin and poorly developed muscle, according to the report. His stomach was empty and it was noted that he had ''virtually no contents'' within any part of the bowel. Board certified forensic pathologist Dr. Linda E. Norton, who is based in Dallas and practices privately, said after reviewing the autopsy report that Rephayah's death ''clearly is a homicide. ''When you starve a child to this degree, I don't see how you can't call this a homicide,'' she said. She also said there is evidence, based on the autopsy report, that Rephayah was suffocated, ''actually smothered to death.'' A local medical pathologist who asked not to be identified said basically the same thing. Neither pathologist is involved with the case. Their independent opinions were sought by the Reporter-News because of their expertise. Abilene police declined to file criminal charges against Rephayah's parents after Krouse, who performed the autopsy, told investigators the baby's death was either accidental or of natural causes. APD Assistant Chief Ken Merchant said the medical examiner's report ''carries a lot of weight'' in police's decision to file charges or not. Police said the boy's parents told them taking their child to a doctor is against their religious beliefs. ''They might have been doing what they thought was right, what the midwives had told them to do with the sick child,'' Eidson said. Eidson said if he were prosecuting the case, he would have a hard time proving the couple's intent was homicide.
''Intent is important,'' Eidson said.
Besides the issue of determining whether Rephayah's death was accidental or murder, law enforcement agencies have been faced with the challenge of determining jurisdiction. Abilene police had been the sole agency investigating Rephayah's death, but then they determined the death occurred in Callahan County. Judge Smith said he turned the case over to Justice of the Peace Roy Chapman, whose office is in Callahan County. Abilene police closed their investigation, but not without offering investigative help to Callahan County officials, according to APD Chief Melvin Martin. Chapman, however, doesn't remember the offer.''I just feel that it was thrown at us,'' Chapman said. ''There was never an investigation in Callahan County.'' Callahan County Sheriff Eddie Curtis said his office hasn't and isn't investigating the death. With agencies in both counties stalemated, the investigation of Rephayah's death should be carried forward to the Texas Attorney General or the U.S. Attorney General, according to an investigator who works for Norton, the Dallas forensic pathologist who has a private practice.
''The thing to do in a case like this is to bring in a special prosecutor,'' Norton said.
Ken Ellsworth contributed to this article.
Headline and copy editor: Beverly Butman; Editor: Loretta Fulton

Flinger said...

The institutional structure probably has a lot to do with it, but institutional culture is probably also implicated. Don't forget that the criminalists will have worked for a long time under the old regime, that they will have been educated at law enforcement schools, and that, even long after they are gone, their in court experience will 99% of the time be being put on as direct witnesses for the state and being crossed by the defense. And they will have repeated contact with the detectives and CSU and the DA's office, but only sporadic contact with any one defense attorney.

Anonymous said...

I like the idea of crime labs being independent of the police -- perhaps under the judicial branch rather than the executive.

But why stop there? After all, all police officers, too, ought to be giving everyone the benefit of any doubt rather than assuming that anybody they encounter on their patrols is probably a criminal.

What I'd like to see is periodic, tricky attitude surveys of all police officers, at new hire and once or twice a year thereafter, designed to weed out "cowboys" who like to intimidate and bully people. Only "guardians" have any business being cops.

fisher said...

KJDL 1420 News Radio Lubbock

Fisher Accuses Lbk County: Fraud, Falsifying Documents
May 21, 2008

By: James Clark

Did Lubbock County cause the current and past Medical Examiners to break the law and do illegal autopsies? A written complaint says yes.

An Austin man accuses the Lubbock County Medical Examiner of fraud and falsifying government documents. David Fisher filed a complaint to the Texas Medical Board in late March. Fisher admits Dr. Thomas Beaver is medically qualified to be Medical Examiner. But his complaint says Beaver is not legally qualified because of a mistake by the Lubbock County Commissioner’s Court.

By the way, Fisher is a document analyst who is sometimes hired by defense attorneys in criminal cases. He became passionate about this issue (on a statewide level) when he concluded that a defendant in a Tarrant Count case was getting railroaded.

The Texas Code of Criminal Procedure says a Medial Examiner “shall serve at the pleasure of the commissioner’s court.” Texas law also says, “The commissioners court shall establish and pay the salaries and compensations of the medical examiner and his staff.” But in Lubbock County that’s not how it works. Lubbock County pays the Texas Tech Health Sciences Center and in turn Texas Tech employs the M.E.

Texas Tech pays for and supervises the Medical Examiner.
NR 1420 Extra Coverage

The county looked for a way to make University Medical Center responsible for the M.E. more than 10 years ago. A 1995 Attorney General opinion written to John T. Montford specifically to address Lubbock County, says, “The commissioners court shall establish and pay the salaries and compensations of the medical examiner and his staff.” And two years later the A.G.’s office repeated that same idea. So instead of putting it under UMC they hired the Health Sciences Center.
Fisher says that every time Dr. Beaver testifies in court that he is the Medical Examiner, it is tantamount to perjury. The title “Medical Examiner” is a legal term, not a ceremonial term, “... which does not allow him to claim it as him being that legally. And that’s what he’s claiming when he testifies in a court of law. That’s a legally conferred title, which it’s not.”

Fisher also says every autopsy Dr. Beaver has done without consent of the dead person’s family is illegal. And he says that also goes for Dr. Natarajan, Dr. Spencer, Dr. Frost, and Dr. Hoblit. “He … [is supposed to have] the legal authority that is conferred to him by law, where a doctor in a hospital can only do an autopsy with permission of next of kin.”

This sounds like a small harmless technicality. Not in Fisher’s opinion. “You have such a massive conflict of interest, that nobody can trust any of these autopsies.”

Texas law does draw a line in the sand between hospital autopsies and forensic autopsies. A.G. opinions written specifically for Lubbock County confirm that. Fisher says Lubbock County crossed the line. “So the medical examiner is under the absolute thumb of the Texas Tech Health Science Center regents who are politically appointed. Basically, your medical examiner office is a political appointed position. And we know what happens in political appointed positions. You do what you’re told or you’re gone.”

News Radio 1420 asks, “Who is Dr. Beaver’s boss?” “You’re speaking with him,” says Dr. Dale Dunn at the Texas Tech Health Sciences Center. He says Texas Tech HSC will look at the legal issues raised by Fisher’s complaint. But he absolutely defends Dr. Beaver’s medical credentials. Dunn says, “He’s a board certified forensic pathologist. He’s fellowship trained and is very experienced and has been involved in many cases.”

News Radio 1420 noticed that according to the Texas Medical Board website Dr. Beaver has a temporary faculty medical license. Dr. Dunn says the temporary license isn’t so temporary anymore because of new rules from the Texas Medical Board. “Previously, there was a four year limit on the ability to hold an institutional license. Now, it can be renewed annually indefinitely. So as far as the temporary aspect of it, it can be as temporary as you want it to be.”

Dunn says Texas Tech provides a valuable and credible service. Not even Fisher denies that. It’s Lubbock County’s application of Texas Penal Code 49.25 that Fisher questions.

News Radio 1420 also made brief contact with Lubbock County civil attorney John Grace. He says Fisher has blown the whole thing way out of proportion. We’ve sent Grace an email with some questions. With any luck we’ll be able to get back to you tomorrow morning with more information.

* cosmetic changes made, 8:32 am.

Story Posted: Wed May 21 06:30:00 CDT 2008
Created: Wed May 21 04:54:23 CDT 2008

Lubbock KJDL News Radio 1420

Dead People Used By TTUHSC Without Family’s Permission

By: James Clark
May 22, 2008

“Autopsies can be used for teaching purposes,” says Texas Tech HSC. Some autopsies have the blessing of the family. Others don’t. Audio added 8:40 am.

Texas Tech admits dead people’s bodies are being used as teaching tools without the permission of family members. News Radio 1420 learned this information as we were researching an Austin man’s complaint of the medical examiner’s office.

Autopsies Can Be Used For Teaching

“Well, as part of a teaching organization, autopsies can be used for teaching purposes,” says Dr. Dale Dunn at the Texas Tech Health Sciences Center. We asked if students are allowed to do forensic autopsies. He says it depends on what you mean by students. Texas Tech has both medical students and residents. Medical students, he says, are confined to hospital autopsies. A hospital autopsy is done with the full knowledge and permission of the family.

However, forensic autopsies are a different matter altogether.

“Yeah, we do have residents that may be involved with a forensic case, but these would be a case, for instance, that in all likely-hood would not end up with any prosecution whatsoever,” says Dunn.

A forensic autopsy is required in certain circumstances by law. It does not require notifying next of kin nor does it require their permission. Some forensic autopsies involve murder or manslaughter. However, most forensic autopsies involve people who might have died of natural causes but perhaps they died alone; And so, there’s some question about it.

There’s Always Oversight

“For instance, hypothetically, an individual who died at home while in their sleep could be investigated, and could turn out to be a acute myocardial infarction.” Dr. Dunn says under such circumstances a resident might do the autopsy as part of his or her training. In other words a lot of people who die in Lubbock or the surrounding counties become teaching cadavers.

“But, a resident never, ever functions autonomously. There’s always oversight, and a resident never signs out a case on their own,” says Dunn.

Dr. Dunn spoke to News Radio 1420 for about 4 minutes on this specific issue as part of a much longer conversation about the office of Medical Examiner.

Follow THIS LINK to hear a 3:45 portion of the Dale Dunn interview (opens a new window). It is a 1.1 mb audio file.

Part of David Fishers complaint against the Lubbock County Office of M.E. was an article from Archives of Pathology and Laboratory Medicine: Vol. 123, No. 5, pp. 375–376. We have copied and pasted the article from his complaint and posted it below.

Using Forensic Autopsies to Supplement Training for Residents
Jeffrey W. Oliver, MD; Glen R. Groben, MD
Department of Pathology, Texas Tech University School
of Medicine, Lubbock, TX 79430
Deputy Medical Examiner, Lubbock County Medical
Examiner, Lubbock, TX 79430

To the Editor.—We read with great interest the article “Forensic Autopsy in a Pathology Training Program,” by Djabourian et al, which appeared in the August 1998 issue of Archives of Pathology and Laboratory Medicine.1 In this article, the authors describe a system in which hospital staff pathologists have been deputized by the county coroner’s office to perform autopsies on in-house patients whose deaths fall under forensic jurisdiction. These autopsies are used to supplement the declining number of general medical and perinatal autopsies available for resident training at their institution.

Paralleling the national trend, our institution has also noted a decrease in the number of general medical autopsies during the past several years. To increase the caseload for resident training, we have initiated contracts with other community hospitals to perform autopsies there, in addition to trying to bolster autopsy requests from our own hospital by greater communication with nursing and house staff. However, by far the most successful measure we have taken is contracting with the county medical examiner’s office. Our residents spend 6 months dedicated to full-time autopsy training, during which time they perform all of the general medical and perinatal autopsies available, as well as forensic cases from a large number of surrounding counties. The forensic pathologists determine which cases are appropriate for residents to perform and are responsible for supervising these cases. In addition, residents are allowed to watch and learn from homicides and other high-profile cases that they do not actually perform themselves.

As the authors noted, forensic autopsies provide good training material for aspects of pathology that are important, but for which many residency programs offer minimal instruction. The pathology of blunt and sharp force injuries, gunshot wounds, traumatic neuropathology, sudden infant death syndrome, asphyxia, and toxicology are just a few of the topics that would be very difficult for us to teach without our contract with the medical examiner.

There are currently 7 residents in our program, and during the 20-month period from January 1997 through August 1998 they performed 151 forensic autopsies. We reviewed the manner of death for each of these cases, revealing 82 (54%) natural deaths, 53 (35%) accidental deaths, 15 (10%) suicides, and 1 (0.7%) undetermined manner of death. These data underscore another important aspect of using forensic autopsies for training: there is a tremendous wealth of natural pathology to be learned from forensic autopsies. Natural deaths account for more than half of all forensic cases our residents perform, and include cases in which a person died suddenly without a previously diagnosed illness, infectious cases where public health is a concern, and in-custody natural deaths. These cases have provided our residents great experiences with such pathologic processes as sudden cardiovascular deaths, widespread metastatic disease, acquiredimmunodeficiency syndrome and other infectious diseases, genetic diseases and congenital malformations, cirrhosis, chronic pulmonary diseases, etc. Importantly, these cases would in other circumstances be considered standard hospital-type autopsies, and residents can learn as much from them as they would from standard hospital autopsies if they perform similar clinical investigation, microscopic study, and clinicopathologic correlation. Even the unnatural deaths very often have fascinating incidental findings from which to learn general pathology.

fisher said...

Lubbock Avalanche Journal

Tech to end medical examiner role

By Elliott Blackburn

August 07, 2008

Lubbock and roughly 80 South Plains counties must find a new medical examiner by the end of next year.
The Texas Tech Health Sciences Center will stop managing the county's medical examiner by fall 2009 after deciding the forensic work poorly fit the medical school's overall mission.
County Judge Tom Head said HSC President John Baldwin informed him last week of the center's intent to end its contract to operate the Lubbock County Medical Examiner's Office; a certified letter explaining the decision was dated August 5.
There was no ill will between the county and the HSC, but the decision was a surprise, Head said.
"It's just kind of in limbo right now," he said. "We can't do away with it; we need it, for our cases and for the South Plains."
Lubbock County years ago contracted operation of the county medical examiner's office to the HSC, following problems with autopsies performed by the county in the 1980s and with a privately contracted firm in the late 1990s.
Four forensic pathologists - three working under medical teaching permits secured through Tech and a fourth licensed to practice independently - perform civil and criminal death investigations for counties across the region.
Amarillo, Plainview, Big Spring and Lubbock all contract for autopsies through the Lubbock County Medical Examiner's Office.
Commissioners reasoned a medical school could better recruit and monitor the specialists required to perform death investigations.
As recently as July, medical school officials said the office was an important service that brought top talent in a rare field to Lubbock.
But with a large patient load, ambitious research program and other goals, the office no longer fit well with HSC goals, said Dr. Steven Berk, dean of the medical school.
"As you know, this is a very specialized, very high-profile, very expensive program," Berk said. "And it's really a program that we all agree has to go back to the county."
Berk said the decision had nothing to do with a complaint filed last spring by David Fisher, a document consultant out of Elgin.
Fisher argued the organization of the office and the chief medical examiner's faculty license violated state laws describing how such an office may be formed.
County attorneys have said the argument has no merit. Both the county and the HSC have noted no filed complaint that takes issue with the quality of the pathologists' work.
The Texas Medical Board does not confirm the existence of complaints, but a letter provided earlier this week by Fisher from the board said officials considered the matter out of their jurisdiction and forwarded the accusations to the Texas Attorney General's Office.
Complaints on such a high-profile area of medicine were to be expected, with or without merit, Berk said.
"If it's not one issue, it will be another," he said. "This is a very high-profile area of medicine, and, you could say, probably an area that the county would be more suited to deal with in the future."
Commissioners will decide how to handle the contract's end in October, after the budget season, Head said - he was still in the process of informing the other elected officials. Berk offered to assist the county in finding pathologists to staff the office.
"What we want to do is have a very good transition program, because it is very difficult to recruit medical examiners and forensic pathologists," Berk said.
Fisher said he continues to pursue the complaint against the medical examiner's office in Lubbock and in other cities because the justice system must be held to a high standard.
"You're talking about people's lives, both the victims and the defendants, and any time you can do a shortcut around the law, the whole system falls apart," Fisher said.
The change will not be as simple as swapping letterhead and who issues the paychecks.
Tech owns the morgue and the current forensic building; the county would need to lease or purchase it. Three of the forensic pathologists currently working in Lubbock would need to secure a different medical license to allow them to work independent of the university.
The HSC also will need to make changes. Counties contract directly through the center for forensic services, worth more than $1.6 million. The pathologists are associate professors paid indirectly from autopsy income - Tech would have had to find new funding if it had chosen to keep the program.
To comment on this story: 766-8722 766-8706