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  Cook County Hospital fills more outpatient prescriptions every day than are filled at 26 Walgreen's drug store combined.

Medical examiner halts autopsies in drug, alcohol abuse deaths

Wednesday, May 16, 2012
Chicago Sun-Times

A staffing shortage has prompted the Cook County medical examiner’s office to halt full autopsies in some cases where a person died from drug or alcohol abuse.

“Due to the impending shortage of staff Pathologists, there will be a temporary suspension of the requirement to perform a full autopsy examination” of those involved in “[d]elayed fatal deaths due to drug overdoses received from hospitals,” Chief Medical Examiner, Dr. Nancy Jones wrote in a May 12th memo to staff.

In addition, the autopsy requirement will be temporarily suspended on those with “documented histories of a natural disease” — such as heart disease — “who are also known to abuse drugs and/or alcohol,” Jones wrote.

The memo provides guidelines for staff including an ongoing requirement to conduct an external examination on these bodies and ordering toxicology tests to be conducted on those who died, perhaps, days — or longer — after a drug overdose.

If staff has questions about any given case, Jones writes, “error on the side of caution and perform an autopsy to rule out potential contagious disease or other threat to public health and safety.”

And, she advises, consent to any family’s request for an autopsy.

A full autopsy in such cases would include internal and external exams, X-rays and toxicology tests. For now, there will be what is known as a “post-mortem” exam involving everything except the internal exam, explained County spokeswoman Mary Paleologos.

The staffing shortage comes weeks after Dr. Mitra Kalelkar — who as chief deputy medical examiner was second in charge of the office — retired after 33 years with the office.

The county is working to fill that post as well as five vacant “assistant medical examiner” positions. That means half of the 10 assistant medical examiner positions are empty.

“We’re moving as fast as we can to fill the positions and we’re hoping in one to two months to have them filled,” said Paleologos, a spokesman for the County Board President Toni Preckwinkle’s Bureau of Administration, which oversees the medical examiner’s office.

Paleologos said that while these types of autopsies are typically required under medical examiner office policy, such exams are not required under state law.

“It’s part of the medical examiner’s policy and they have the authority to temporarily suspend the policy and still be within state statute,” she said. “Dr. Jones feels confident they can do an effective job with post-mortem examinations for the time being.”

The staffing shortage goes back several months, Paleologos confirmed, including earlier this year when medical examiner’s staff complained the body storage cooler was overcrowded and that conditions were unsanitary. At the time, Preckwinkle said that there were any number of problems — including unfilled positions — that needed to be shored up.

Liane Jackson, a spokeswoman for Cook County Board President Toni Preckwinkle, said Jones personally notified the president of the temporary measures last week.

“She defers to the expertise of the doctors at the medical examiner’s office and approved of the decision based on the current limited resources and the fact that it’s a temporary measure,” Jackson said.

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