Chapter 8: Miscellaneous information

The Medical Examiner's jurisdiction begins at death. The office has no jurisdiction over living persons. Jurisdiction is determined by the location where death occurs or where the body is found--not where the injury occurred. The Medical Examiner's geographic jurisdiction falls within the borders of King County, Washington.

Deaths that occur on federal property, which include military bases or Veteran's Administration Hospital are not strictly within the jurisdiction of the Medical Examiner.

If the death occurs on non-military federal property and there is some suspicion of homicide or other criminal activity, the death may be primarily investigated by the Federal Bureau of Investigation.

The Medical Examiner may investigate any death occurring on federal property if invited to do so by the respective federal authorities. In practice, nearly all deaths on federal property in King County are investigated by the Medical Examiner. This applies to deaths of both military and civilian personnel.

All human remains, regardless of their state of preservation, will be handled with the dignity befitting what they represent. An autopsy examination is required by the Medical Examiner to accurately certify the cause and manner of death -- this will be done in a timely manner.

Once the examination is complete, the funeral home that has been designated by the surviving family as the responsible agent for disposal of the human remains will be notified.

There are instances where criminal action is responsible for the death and a defendant's attorney appeals to the Medical Examiner to retain the body; this shall only be contemplated after consultation with the Prosecuting Attorney's Office.

Any and all personal property that accompanies the decedent to the Medical Examiner's Office will be released to the next of kin or other person authorized in writing by the next of kin, (unless such property is to be used as evidence in a criminal proceeding).

Generally, personal property can be picked up during normal working hours at the Medical Examiner's Office. In those cases in which personal property is used in criminal proceedings, the property can be obtained from the police department, which has jurisdiction over the case.

If next of kin cannot be located, the personal property will be turned over to the King County Finance Director. The finance director holds the property for periodic auction.

If the property owned by the deceased is in excess of $2,500, the property is turned over to an attorney to institute probate proceedings. The Medical Examiner's Office maintains a list of interested attorneys who are assigned probate cases on a 6-month rotating basis. Probate proceedings follow the appropriate Washington State laws.

The King County Medical Examiner's Office is required by law to make available for public inspection all public records maintained by this office. Public records include the final report prepared by the investigator of every death investigated by this office. Specifically exempt from disclosure are all preliminary records and notes of the investigators. Additionally, all autopsy reports are confidential, by state statute.

According to RCW 68.50.300, the Chief Medical Examiner has the authority to release information publicly, concerning the death of an individual, if this information will aid in the timely identification of the deceased.

The Chief Medical Examiner, under the same statute, may also withhold information for a period up to 48 hours if the identity of the decedent is known but the next of kin have not yet been notified.

This gives the Medical Examiner a period of time to make a good faith effort to locate and notify next of kin before any public announcements are made.

The Chief Medical Examiner has no authority or right to disclose any documents, including medical records, which have not originated from this office. Such documents must be requested from their original source. These include the police and traffic reports, which may or may not be released by law enforcement agencies and certified copies of death certificates which will be released by the Vital Statistics Office of the Public Health Department, Seattle & King County. Medical or hospital records are not public records and therefore not disclosed to the public. Suicide notes are personal property and not a public record-- consequently their content is not disclosed.

By statute (RCW 68.50.105) the reports and records of autopsies are confidential and not available for public inspection. These reports are available only to the family , attending physician, prosecuting attorney, and investigating law enforcement agencies, public health officials and the Department of Labor and Industries if they have an interest in the death.

The family of the decedent may request to discuss the autopsy report with either the attending physician or the investigating Medical Examiner. Any other person, who seeks a copy of the autopsy report, must obtain a court order to do so. There is a fee, payable to the King County Medical Examiner, for duplication of the autopsy report.

A certificate of death must be filed with the Vital Statistics Office of the Public Health Department, Seattle & King County, before burial or other disposition of a body. A certificate of death contains personal information about the decedent, (name, age, marital status, parents and spouse's name, etc.) time, location, cause, and manner of death.

The Office of the Medical Examiner certifies or approves the certification of all deaths over which jurisdiction is assumed. This is ordinarily completed within three days following death. Occasionally completion of the death certificate by the Medical Examiner's Office will be delayed due to various circumstances surrounding the death.

If there is uncertainty as to the cause or manner of death following autopsy, investigation by the Medical Examiner's Office continues. Investigators may continue to search for more information regarding the circumstances of death. Laboratory tests may be done on samples taken from the body at the time of autopsy. Toxicological tests may be done on body fluids. Tissue samples are examined microscopically. All this is done in order to accurately determine the cause and manner of death and may result in a delay in the completion of the death certificate.

This does not mean that burial will be delayed until the death certificate can be completed. A certificate of death is filed at the Vital Statistics Section of the Seattle-King County Public Health Department with certain sections of the certificate incomplete until the results of the follow-up activities are complete. A certified copy can be obtained from the Vital Statistics Office of the Public Health Department, Seattle & King County (206-296-4768.)

Nursing home personnel should be familiar with all of the types of deaths to be reported to the Medical Examiner, (pp. 1:1 - 1:4).

The most frequent types of nursing home deaths that are reported to the Medical Examiner's Office are deaths where a fracture is present. If there is any doubt whether to report a death, please report the death and let the Medical Examiner make determination of jurisdiction. A report should be made to the Medical Examiner's Office at 206-731-3232,
ext. 1. The investigator will assess jurisdiction. Information concerning the deceased's medical history will be obtained at this time.

If the Medical Examiner assumes jurisdiction, an investigator will speak with the physician to assess the nature of the injury. He/she will then validate the information surrounding the death.

If the determination is made that the Medical Examiner will not assume jurisdiction, the case will be assigned a "No Jurisdiction Assumed" (NJA) number, (See pg. 1:1 - 1:4) and will be processed accordingly.

The King County Medical Examiner is authorized under RCW 70.02.050, to obtain all applicable medical Records. The medical records of the deceased are frequently an integral element in determining the cause and manner of death. In conjunction with the investigation of sudden, unexpected, or violent death, the Chief Medical Examiner has the power to issue subpoenas for medical and dental records, documents, and/or specimens that are necessary for the full investigation of any case (King County Ordinance #5057).

In the vast majority of Medical Examiner cases, the investigator in charge will request and be given a copy of the records. Ordinarily, the investigator will call the hospital, doctor or nursing home, request a copy of the deceased's records and inquire as to when the copies will be available. A subpoena for records will be issued only if the custodian of the records fails to respond to the original request, or requests that a subpoena be issued.

Presumptive certificates are normally issued where no body has been recovered but all information including law enforcement agency reports, affidavits of eye witnesses, newspaper clippings, and statistical information of the alleged deceased indicates a death has occurred. Family members or attorneys representing a family that wish to obtain a presumptive death certificate, should present all relevant case information to the King County Medical Examiner's Office.

Law enforcement officials, as well as prosecuting attorneys; may also request a presumptive death certificate. The Chief Medical Examiner will review all pertinent information and a presumptive certificate will be issued depending on the circumstances of the individual case.

The statute that permits the Medical Examiner to issue presumptive death certificates is RCW 70.58.390. Other laws relevant to the presumptive death certificates include RCW 70.58.160, RCW 70.58.170, and RCW 70.58.180.