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The medical examiner is an official in some American Jurisdiction who is trained in pathology and investigates deaths that occur under unusual or suspicious circumstances, to perform post-mortem examinations, and in some jurisdictions to initiate .
In the US, there are two death investigation systems: first, the coroner system based on English law; and second, the medical examiner system, which evolved from the coroner system during the latter half of the 19th century. The type of system varies across jurisdictions, with over 2,000 separate jurisdictions for investigating unnatural deaths. In 2002, 22 states had a medical examiner system, 11 states had a coroner system, and 18 states had a mixed system. Since the 1940s, the medical examiner system has gradually replaced the coroner system and serves about 48% of the US population. The largest medical examiner's office in the United States is located in Baltimore, Maryland.
The coroner is not necessarily a Physician. They may be a lawyer or a layperson. In the 19th century, the public became dissatisfied with lay coroners and demanded that the coroner be replaced by a physician. In 1918, New York City introduced the office of the Chief Medical Examiner and appointed physicians experienced in the field of pathology. In 1959, the medical subspecialty of forensic pathology was formally certified.
The types of death reportable to the system are determined by federal, state, or local laws. Commonly, these include violent, suspicious, sudden, and unexpected deaths, death when no physician or practitioner was present or treating the decedent, inmates in public institutions, those in custody of law enforcement, deaths during or immediately following Therapy or Diagnosis procedures or deaths due to neglect.
In some jurisdictions, a coroner performs these and other duties. It is common for a medical examiner to visit or to testify in court. Medical examiners specialize in Forensic science knowledge and rely on this during their work. In addition to studying , they are also trained in toxicology, DNA technology and forensic serology (blood analysis). Pulling from each area of knowledge, a medical examiner is an expert in determining a cause of death. This information can help law enforcement solve cases and is crucial to their ability to track criminals in the event of a homicide or other related events.
Within the United States, there is a mixture of coroner and medical examiner systems, and in some states, dual systems. The requirements to hold office vary widely between jurisdictions.
Pilot studies in Sheffield and seven other areas, which involved medical examiners looking at more than 27,000 deaths since 2008, found 25% of hospital death certificates were inaccurate and 20% of causes of death were wrong. Suzy Lishman, president of the Royal College of Pathologists, said it was crucial there was "independent scrutiny of causes of death".
To become experts in pathology, specifically, additional training is required after medical school. The first step is to complete pathological forensic training. This usually consists of anatomic and clinical pathology training which takes anywhere from four to five years to complete. After this, the physician may complete an anatomic pathology residency or a fellowship. Before practicing as a medical examiner, the physician must also become board certified through the American Board of Pathology.
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