Unattended death investigations in Washington County’s rural areas will soon no longer be the sole responsibility of the sheriff’s office, with a new requirement for a medically trained person to be on scene.
Washington County/Johnson City EMS Executive Director Dan Wheeley said the new rule implemented by the Tennessee Medical Examiner’s office is geared toward recognizing unattended deaths that should or should not be sent for autopsy.
Also part of the new death investigator’s duties will be to specifically look for overdose deaths. Those are now required to be sent for an autopsy.
“Basically, the county approached us because of the new rule that came from the state medical examiner’s office that requires the death scene investigation to be done by a licensed EMT, paramedic, nurse or certified death investigator through the American Board of Medical Legal Death Investigators,” Wheeley said. “One of those four have to do the death scene investigations now, and Washington County does not have a certified death investigator.”
Currently, there is one sheriff’s deputy on each platoon designated as a coroner. When there is an unattended death in the county, that officer is dispatched to investigate and determine if there is foul play.
If the officer detects signs of foul play, the criminal investigation division is dispatched to the scene. Otherwise, it’s up to the responding officer to call in a medical person, generally Dr. Vince Pinyard, a local physician appointed by the county mayor as the local medical examiner, to make the determination about sending the body for an autopsy.
“With the new rule, obviously we have lots of paramedics and EMTs to meet that requirement,” Wheeley said. “Tentatively we have agreed to assist the sheriff’s office with those duties right now until we can get a funding source approved by our board.”
That could come as early as next week. Wheeley said the resolution for county funding has already passed the Finance Committee and will be presented to the full County Commission on Monday. The EMS board will meet Tuesday and discuss accepting the resolution.
Startup costs for the remainder of the 2013-14 fiscal year is $78,400, which includes training, salary, office equipment, a radio and a coroner vehicle. Recurring costs for the fiscal 2014-15 fiscal year will be $80,870, Wheeley said.
“I’ll present the request to our board and the (startup) funding for it. ... I don’t foresee our board having a problem doing it as long as the funding is there,” Wheeley said.
Paramedics have already been accompanying sheriff’s deputies on coroner calls, but “it’s still their responsibility. We’re going with them to help them with the medical part of the paperwork,” he said.
It used to be that death investigation reports were two pages long, but Wheeley said those are now seven pages long and “a lot of that is medically driven terminology and information.”
Wheeley said the paramedic’s role will be to determine if the death is natural or by some unknown reason.
“The state has a campaign where they’re really trying to crack down on misuse of prescription drugs and physicians who may be prescribing too many drugs for the patients,” Wheeley said.
“There are a lot of overdose deaths and now all overdose deaths have to go for an autopsy. That’s where the death investigator will look at their medical history ... if our death investigator can’t determine a cause of death, then (the body) will go for an autopsy,” he said.
If there is suspicion of a criminal act, it would be up to law enforcement to order an autopsy, Wheeley said.
The new duties will also require new employees for EMS.
“Right now, we’re going out with the sheriff’s office and tying up resources that are for emergencies. We just can’t do that,” Wheeley said. “We can’t have a paramedic who’s normally answering 911 calls tied up for two hours on a death investigation.”
Death investigations can take as little as an hour if there are no problems with the determination, or three to four hours if there are issues.
“These take time. Even a natural causes death that we’re not going to order an autopsy on will take a minimum of an hour for the paperwork and we have to wait on the funeral home to come out,” Wheeley said.
He plans to move shift lieutenants to a more administrative role, including duties of the death investigator, and hire three new people to replace them on each shift.
The new vehicle — likely to be a pickup truck with windowless camper cover — is something EMS had needed for body transports anyway, Wheeley said.
“We’ve needed that for a long time. Right now we’re taking an ambulance out of service for body transports, which is not ideal.”