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1. What cases should be reported to the Medical Examiner Office?

These guidelines are intended to assist in determining what constitutes a Coroner/Medical Examiner Death Case and how to report a case. Reporting Guidelines

2. Who is a Medical Examiner?

A Medical Examiner is a medical doctor, usually a Forensic Pathologist. The Medical Examiner certifies the cause and manner of death, based on his/her expert opinion following an investigation and medical examination. This examination may include an autopsy and laboratory tests such as toxicology. The medical examiner also completes a report and creates a file for each decedent to document his/her findings in a lasting way. The Medical Examiner's team consists of many other individuals, who assist in various ways with the investigation, administrative tasks, and autopsies. These individuals include Forensic Technicians, Investigators, Office Specialists, Transcriptionists, and Managers.

3. What is the difference between a Medical Examiner and a Coroner?

Medical Examiners and coroners are two different groups that meet a similar need in their communities. Coroners are part of an older system dating back many centuries, to a time when the job of the "Crowner" was to make sure a decedent's taxes had been paid to the King. Today, the coroner's main duties are to inquire into the cause and manner of a death, and to complete the death certificate. Coroners are usually elected laypersons who may or may not have medical training, depending on local statutes. Coroners contract with pathologist or forensic pathologist who provides autopsies and medical expertise to support the coroner's investigations.

In contrast, the Medical Examiner system is a modern invention, a streamlined system for medicolegal death investigation. Medical Examiners are almost always appointed to their positions rather than elected, are always physicians, and should have specialized training in forensic pathology. The Medical Examiner system is the trend of the future in death investigation in the United States, with over half of the states using this system.

In rare circumstances, the terminology may become complex, as a Forensic Pathologist may also be the elected Coroner.

In the state of Missouri, larger urban counties operate under Medical Examiner jurisdiction, while smaller counties, by statute, operate under coroner jurisdiction. Coroners from several rural Missouri counties contract with the Jackson County Medical Examiner's Office for autopsy services when needed. Medical Examiner

4. What is Forensic Pathology?

Forensic Pathology is a subspecialty of pathology that studies disease and injury and how they interface with legal issues. Forensic Pathologists conduct specialized forensic autopsies, provide expert testimony in courts of law, and are at the leading edge of surveillance for new patterns of disease and injury. The modern practice of Forensic Pathology contributes to the public health and public safety of our communities.

5. Who is a Forensic Pathologist?

A Forensic Pathologist is a physician -- a licensed medical doctor who has received specialized training in Anatomic Pathology and Forensic Pathology. This training process lasts for up to an additional six years after graduation from medical school. After completion of the training period, a pathologist can sit for examinations offered by the American Board of Pathology. If a passing grade is achieved on the examination, the board confers certification on the tested areas.

The Jackson County Chief Medical Examiner and Deputy Medical Examiners are board-certified in Anatomic and Forensic Pathology. Some of our medical staff are also board-certified in other areas of pathology, such as Clinical Pathology.

Newly hired Medical Examiners must become board-certified within two years of employment.

6. How is jurisdiction determined?

The Jackson County Medical Examiner’s Office will retain jurisdiction for those deaths that are medical examiner cases in Jackson and Cass counties. Death certificates will be issued from the Jackson County Medical Examiner’s Office for those deaths that are medical examiner cases, including deaths from injury or who die suddenly and unexpectedly while in apparent good health, suspicious deaths, or deaths when there is no doctor to sign the death certificate. Jackson County currently provides complete forensic services to Jackson and Cass Counties under contract for death investigations, autopsy and lab testing as well as court testimony when necessary. Over 20 other Missouri counties utilize the Medical Examiner’s Office on a referral basis. Autopsies services and other tests are performed to determine cause and manner of death for these counties on a fee for service basis. The death certificates are issued by the referral county coroner/medical examiner based upon the autopsy findings. Local authorities in the referral county will conduct their own scene investigations and share their information with the Jackson County Medical Examiner’s Office.

Medical Examiner

7. What is an autopsy?

Also called a post-mortem examination, an autopsy is a systematized, intricate surgical procedure performed after death. It involves external and internal examination of a body, organs and tissues, and often subsequent laboratory testing to determine cause and manner of death. The body is examined both externally and internally, with examination of all major organs to document injury or disease. Small samples of internal organs are retained for microscopic examination and body fluids are obtained and tested for drugs and alcohol.

8. Can I stop an autopsy?

The state statue gives jurisdiction and authority to the Medical Examiner / Forensic Pathologist to decide if an autopsy is needed to determine cause and manner of death. Family permission is not required, unlike a hospital autopsy.

Autopsies are performed to answer medicolegal questions that are deemed in the “public’s interest" or to address a question of law. However, we recognize that an individual's religious or personal beliefs may be contrary to the performance of an autopsy. In the event of a homicide or suspicious circumstances of death, the Medical Examiner WILL perform an autopsy. If the death is not a homicide, the Jackson County Medical Examiner's Office is open to discussion to try to accommodate the families wishes while still meeting our mission and fulfilling the legal obligation presented by an individual's death. If a family wishes for an autopsy not to be performed, they may request so by phone with the on-duty investigator at 816-881-6600.

9. Is there a charge for an autopsy?

No. There is no charge for an autopsy performed under the jurisdiction of the Medical Examiner’s Office (Jackson, Cass, Clay and Platte Counties) when it is determined by the Medical Examiner that an autopsy is warranted. The Jackson County Medical Examiner’s Office does not perform private autopsies.

10. Under what circumstances is an autopsy performed or not performed?

Visit our Autopsy Circumstances page to find a list of reasons why we require an autopsy. Autopsy Circumstances

11. How do I request an autopsy report?

If a party is requesting an autopsy report, we must receive that request in writing. Autopsy Request

12. How do I request a death certificate?

The Medical Examiner’s Office does not issue death certificates. Once our portion of the death certificate is completed, the original is sent to the funeral home for finalization and then forwarded to the Bureau of Vital Records to be filed with the State of Missouri. Obtaining A Death Certificate Copy

13. How can I request a correction to a death certificate?

Corrections on a death certificate require an affidavit to be filed with the State of Missouri. The party responsible for the mistake is responsible for correcting the mistake. For more information on the process after the Bureau of Vital Statistics receives the affidavit, please call them at 573-751-6387 or visit their website. Missouri Department of Health and Senior Services

14. May I view my loved one at the Medical Examiner's Office?

The deceased may be viewed at the funeral home following release from the Medical Examiner's Office.

15. What is the process for claiming my loved one’s body?

The legal next of kin is responsible for determining disposition of the body. If no next of kin can be located, a friend or organization may make arrangements. The body is available to be claimed after the medical examiner approves the release, which occurs following examination and identification. To claim a body, call the on-duty investigator (816-881-6600) and provide the name of the chosen funeral home. Our investigator will then contact the funeral home that will obtain the body from our office. Funeral homes may not call to state that the family wishes to use their services. The next of kin/friend must personally notify the MEO that an individual is to go to a specific funeral home.

16. How can I retrieve my loved one’s personal property?

Except for evidence, any personal items transported to the Medical Examiner's Office are released to the funeral home along with the body at the time he/she is transported. In case of an emergency in which an item (such as a key) is immediately needed, you can contact the on-duty investigator at 816-881-6600.

All evidence collected is released to the investigating agency. Family should contact the investigating police agency for recovery of those items.

17. What is the Medical Examiner's Office role in organ and tissue donation?

At the Jackson County Medical Examiner’s Office, one of our goals is to facilitate organ and tissue donation for the benefit of the family and the community. Organ and Tissue Donation

18. What if a decedent has no next-of-kin or the body is not claimed?

The Jackson County Medical Examiner’s Office seeks the assistance of the public to help locate next of kin and/or friends to claim the remains. Efforts are made to locate next of kin to claim the body. Short newspaper notices are posted locally to look for next of kin and/or friends. If no responses have been generated, the process of county burial will begin for the county to take jurisdiction and begin county disposition procedures. View a list of unclaimed decedents at the medical examiners office. If you have any information, please call 816-881-6600 and speak with an on-duty investigator.