Frequently Asked Questions

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Medical Examiner

Investigations

What happens during an investigation?

A death investigation is multidisciplinary in scope.  It may involve not only the county medical examiner investigator and forensic pathologists, but also other agency personnel such as law enforcement, crime scene technicians, criminalists, and prosecutors. Most investigations follow similar protocol: the investigator evaluates the scene upon arrival, documents and evaluates the body, establishes a decedent profile, and completes the investigation. If the body is sent for autopsy, the county medical examiner investigator will arrange for transport and convey the family’s funeral preferences to the State Medical Examiner’s Office. In all Mississippi medicolegal cases, the county medical examiner investigator is responsible for certifying the death and furnishing copies of whatever documentation is requested by the case Forensic Pathologist. Although the length of the investigation will vary, the investigation enters its final stages once the body is removed from the scene. Therefore, it is imperative that the investigator conducts a thorough examination of the body at the scene

How are the bodies identified?

If we receive a patient for which the identity is unknown or cannot be positively confirmed, the SMEO will not release the decedent until we make a scientific identification. The forensic identification methods employed by our office include DNA, fingerprinting, forensic odontology, and forensic radiography. Forensic radiography relies on the analysis of antemortem and postmortem x-rays and medical records in order to demonstrate unique characteristics and surgical implants. An identification based on personal effects or body modifications is not a scientific identification, but may be acceptable under certain circumstances.  

Can a medicolegal investigation case still be an organ or tissue donor?

Yes. When a death falls under the jurisdiction of the State Medical Examiner or county medical examiner investigator, official clearance must be received before proceeding with the donation. This clearance must be obtained by the organ procurement agency from the next-of-kin and from the State Medical Examiner. In rare cases the State Medical Examiner’s Office may deny an organ recovery request when there is a concern for the loss of valuable evidentiary material or lack of appropriate forensic examination. However, in most cases, including homicides, the forensic pathologist can determine cause of death and manner of death to a reasonable degree of certainty despite the occurrence of organ recovery procedures.

What is a forensic odontologist?

A Forensic odontologist is a dentist who applies his or her knowledge of the dental profession to matters of legal concern. A forensic dentist typically uses his or her background to assist in the identify of unknown individuals, including those involved in mass fatality incidents, but may also be involved in assessment of injury patterns found in human abuse, the analysis of bitemark evidence, and involvement in matters of civil litigation. Odontologists compare antemortem dental radiographs and records to postmortem information from unknown individuals to determine if they are from the same individual. If they are determined to be the same, the odontologist will recommend that a determination of positive identification be made.

Odontologists normally receive their initial training in forensics during their pre-doctoral training in dental school with additional training in postgraduate settings. Odontologists who meet the lengthy educational and experiential requirements are eligible to sit for certification examinations with the American Board of Forensic Odontology. Successful completion of these examinations confers diplomate status.  

What is a forensic pathologist?

Forensic pathologists are physicians are board-certified in Anatomic and Clinical Pathology and certified in Forensic Pathology by the American Board of Pathology. These physicians are trained in traditional medicine, but also possess significant education and training in various forensic subspecialties. They are experts in determining cause and manner of death, and are specifically trained to identify the presence or absence of disease or injury, to evaluate investigative information and medical records, and to reconstruct how a person received his or her injuries. The forensic pathologist must have a working knowledge of numerous scientific disciplines in order to accurately assess all evidentiary information presented on the body. Some forensic pathologists further specialize in areas such as cardiac pathology, neuropathology, and pediatric pathology.

An individual choosing Forensic Pathology as a career should plan on receiving a Bachelor’s degree before spending the next four years in medical school earning an M.D. or D.O. degree. After medical school, there are several routes the doctor may follow in order to become a forensic pathologist. All options involve rigorous training in anatomic pathology followed by at least one year of additional training in forensic pathology and death investigation. A qualified physician may become board-certified in forensic pathology by passing the appropriate examination administered by the American Board of Pathology.

How are findings of the investigation made available?

On cases referred to the SMEO for further postmortem examination, the forensic pathologist will finalize the case after the investigation is complete. The final report will be made available to the county medical examiner investigator who, in turn, will make the document available to the next-of-kin. Final reports on all homicide cases are sent directly to the District Attorney representing the jurisdiction in which the crime will be prosecuted.

What is a coroner?

The definition of the term “coroner” - and the position’s associated duties - differs from state to state. Pursuant to Mississippi statutes (§19-21-103), “coroner” is an elected office. Each candidate for office must, as a minimum, possess a high school graduation diploma or its equivalent, be twenty-one years of age or older, and be a registered voter of the county in which he or she is elected. A coroner has no statutory authority to investigate deaths until he or she has successfully completed the state sponsored death investigation training school. 

What is a county medical examiner/investigator?

Mississippi’s 82 counties and one reservation are represented by county medical examiner investigators. A county medical examiner investigator is a non-physician who, at a minimum, possesses a high school graduation diploma or its equivalent. The county medical examiner investigator is, in fact, a coroner who has successfully completed the state’s death investigation training school, received certification from the State Medical Examiner, and taken the oath of office (see Miss. Code Ann. §19-21-105). A county medical examiner must be a physician (M.D. or D.O.) licensed in the State of Mississippi. Although this physician does not necessarily need to be a specialist in death investigation, he or she will bring medical expertise to the evaluation of the medical history and physical examination of the deceased.

County medical examiners/investigators are responsible for investigating the body, while law enforcement and other entities or individuals are responsible for scene investigation should a crime be suspected. The county medical examiner/investigator must be the most medically knowledgeable person at the scene of a crime to determine if further investigation (e.g., autopsy) is necessary based on information developed from the decedent. The CMEI is also responsible for: gathering all medical records and other information requested by the forensic pathologist, certifying the death, filing the Death Certificate in a timely manner, and providing a final autopsy report to the next-of-kin.

What is a forensic anthropologist?

Forensic anthropologists are scientists who specialize in Physical Anthropology and assist in the identification of human skeletal remains. They are trained to distinguish human vs. animal remains, and to estimate a decedent’s sex, age, stature, and ancestral affiliation (i.e., “race”). They also look for indicators of trauma or occupational stress. Some anthropologists are trained in facial reconstruction methods, which can assist in the development of a biological profile and eventual identification. Other anthropologists have experience in archaeological recovery methods, biochemical/geochemical methods, and other subspecialties.

Anthropologists who specialize in forensic analysis generally have a Ph.D. in Physical Anthropology or Biological Anthropology. Many anthropologists are affiliated with universities and supplement their teaching schedules with forensic casework. Some scientists are employed in government or offer private consulting services. Anthropologists who meet the lengthy educational and post-doctoral experience requirements are eligible to sit for certification examinations with the American Board of Forensic Anthropology. Successful completion of these examinations confers diplomate status.    

Missing Persons and Unidentified Human Remains

What role does the SMEO play in such cases?

The State Medical Examiner’s Office has an obligation to scientifically identify unidentified human remains before releasing a decedent for final disposition. One or a combination of the following methods may be used to achieve this goal: fingerprinting, DNA, forensic odontology, and forensic radiography. The method(s) employed will depend on a variety of factors, but the identity will be confirmed by one of our Forensic Pathologists or by our Forensic Odontologist. The State Medical Examiner’s Office relies on numerous resources in order to make identifications, including the state’s forensics laboratory, a private DNA lab, in-house forensic anthropology and odontology services, and NamUs, a national information clearinghouse and resource center for missing, unidentified and unclaimed persons cases in the United States.  If the SMEO cannot identify a decedent within several months following intake, the case information will be entered into NamUs.