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Broward Medical Examiner Report

Broward Medical Examiner Report

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01/22/2013

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FLORIDA
BERTHA W.HENRY,
County Administrator
115 S.Andrews Avenue.Room 409 •Fort Lauderdale.Florida333
01
954-357-7362• FAX954-357-7360
MEMORANDUM
DATE:
April4,2012 
TO:
Board
of
County
C o r n m i s s i
~
. 
FROM:
Bertha Henry, County
A
~~
SUBJECT:
Medical Examiner Review·
As you recall, in responseto theissue regardinghandling
of
medicationattheMedical Examiner's Office, I enlistedtheassistance
of
anindependentconsultantto review theoperationsand procedures of theMedical Examiner'sOffice.County Administrationhas received theconsultant'sreportand
is
working withstaff
to
addresstherecommendations andtimelineforimplementation.A copyofthe report
is
attached for your information.Iam alsoevaluatingretaining additional resources to assist with the implementation
of
therecommendations. Thisimplementation can bedone simultaneouslywithour searchforaMedical Examine
r.
Whilethereport recommends a number
of
changes to policies and procedures
in
ordertoachieve efficienciesand implement be
st
practices,it doesnotnoteany significantdeficiencies in the quality
of
thework or product producedby theOffice. The search fortheMedicalExaminer iscoming to a close. Theinterviewcommittee convenedlast week to conduct interviews. Thecommitteecomposition included Pam Madison, KevinKelleherand a representative
of
the BrowardShe
riffs
Office, StateAttorney'sOffice, PublicDefender,the Broward Police Chiefs Association, the Florida Cemetery, Cremation and Funeral Association,aswellas Miami- Dade MedicalExaminerDr. Bruce
Hyma,
who also servesasthe Chair
of
theFloridaMedical Examiner's Commission.Iamcurrently working with the executive search firm to finalize the remainingdue diligenceissues with thefinalists and expect to announce anew ChiefMedicalExaminernextweek. Pam Madison willbecontacting your offices to offer abriefingshould youwish to discuss thefindings inmoredetail.cc:PamMadison, Deputy County AdministratorJoni ArmstrongCoffey, County AttorneyEvanLukic,County Auditor John
W.
Scott,InspectorGeneral
Broward County Board
of
CountyCommissioners 
Sue Gunzbur
ger
• DaleV.C.HolnessKristinJacobs •ChipLaMarca• IleneLiebermanStacy
Ritter·
John E.Rodstrom,Jr.• Barbara ShariefLoisWexler 
 
10900
Ulmerton Road
MEDICAL EXAMINER
Largo,
FL
33778
District Six
727-582-6800(Fax 727-582-6820)
Pasco
&
Pinellas Counties
March 13, 2012
Evaluation
of
the Practices and Needs
of
the
District
17
Medical Examiner
As
the
District Six Medical Examiner
and
Executive Director
of
the
Pinellas County ForensicLaboratory, I would like to thank Broward County for allowing us to help with
the
Medical ExaminerOffice's efforts
in
improving
the
quality
of
death investigations
forthe
citizens
of
Broward County. Ouragency
is
the
second largest Medical Examiner Office employer
inFlorida
and
the
only Florida MedicalExaminer District
that
administrates
the
local crime laboratory. Our Medical Examiner operation
is
accredited
by
the
National Association
of
Medical Examiners and the Forensic Laboratory
is
accredited
by
ASCLAD-LAB
to
thenewest
ISO
standards. We used our collective experience
in
7
Florida MedicalExaminer Districts
and
years
of
service to accrediting bodies
and
commissions
in
this evaluation.
We
began the evaluation
of
the office on December
B'h.
We
approached this evaluation
of
the
BrowardCounty Medical Examiner Office as knowledgeable fact finders for Broward County Administration. Wevisited
the
office, interviewed
and
met
with
staff
members, and discussed our findings withrepresentatives
of
Broward County Administration. The implementation
of
any
of
our recommendations
is
beyond
the
scope
of
this assessment.
-Jon
R.
Thogmartin,
M.D.
 
Executive summaryThe District
17
(Broward) Medical Examiner Office
is
tasked
with
the determination
of
cause andmanner
of
death pursuant to
Ch.
406
of
the Florida Statutes. Despite being one
of
the
largerjurisdictions
in
Florida, the District 17 Office
is
not
accredited by the National Association
of
MedicalExaminers (NAME). Neighboring District Offices
of
similar
sizepossess
such accreditation.
As is
typical
for
most jurisdictions, decedent transport
is
handled by a contracted body transport company.
The
office
is
one
of
a minority
of
Medical Examiner Offices
that
manages the county's indigent/unclaimeddecedent disposition program.
The
Medical Examiner Office
is
one
of
only
two
offices
that
perform local
DUI
testing
for
law enforcement, and
it
is
the only Medical Examiner Office
that
is
tasked
with
a localtrauma management service.
The
District
17
Medical Examiner Office determines
the
cause
andmanner
of
death appropriately
in
the
vast majority
of
cases
but lacks a coherent operational philosophy.The death investigations
that
the office
is
obligated to perform by Florida Statutes suffer greatly due to
the
performance
of
multiple tasks and functions
that
fall outside
of
their
official duties.
The
DUI
program, management
of
Trauma Services, the indigent/unclaimed body program, frequent autopsyobservers, and acceptance
of
cases
that
fall outside
of
their
official duties have significant negativeimpacts on the statutory function
of
the office.
After
examinations, the decedents are
not
released
in
a
timely
fashion.
The
Medical Examiner Office (MEO) takes possession
of
property and evidence
that
fallsoutside
of
their
statutory duties and retains such property and evidence
for
a longer period thannecessary. At the time
of
our
initial evaluation, the office had numerous (almost daily meetings) whichtake significant
time
away from official duties.
The
office
possesses
standard operating procedures
for
many tasks and comprehensive
job
descriptions, yet the procedures are often
not
followed, and thetasks
in
the
job descriptions are often
not
performed.
The
MEO
needs
an
experienced OperationsManager. The Forensic Investigators need to
be
more involved in independent
case
decisions.
The
office lacks a consistent, systematic approach
to
death investigations.
Such
a consistent philosophyshould
be
applied office-wide, and
not
based
on the individual pathologist's desire
for
that
particularday.
The
pathologists have chronically lacked intellectual leadership and severely overuse technicalforensic diagnostic tools
such
as
histology and toxicology
to
the
detriment
of
the office.
The
backlog
of
toxicology
is
primarily the result
of
overuse
of
service by the pathologists, and this
is
one
of
the office'smany obstacles
to
accreditation.
The
office would benefit from more efficient placement
of
employees
within
the facility.
2

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