Change in medical examiners pitched to county commission
MOUND CITY – Todd Schneider, funeral director of Schneider Funeral Homes, met with the Linn County Commissioners on Monday, April 4, to present options to them regarding medical examiners for Linn County.
Schneider said he had been checking into some options for post-mortem examinations for the coroner’s cases in the county. He said that last Friday, he toured the new Johnson County Medical Examiner’s Office and had a meeting with Chief Medical Examiner Diane Peterson, met other staff, and toured the entire facility.
“It is state-of-the-art,” said Schneider.
Schneider said that he liked how they do things. The office would give Linn County access to take a deceased into their care anytime night or day. The turn-around time on autopsies is faster – a deceased person delivered to the office by 8 a.m. will have a post-mortem exam that day.
The county’s current provider does autopsies seven days a week, but currently Johnson County is just doing them five days a week. If they get busier, they will do them on a Saturday or Sunday or both, but quite often now our autopsies post mortem are not done for a day or maybe two or three days. It just depends on the caseload at the current provider, said Schneider.
Schneider said at Johnson County the cost for a full autopsy is $2,283, which is higher than the county is paying now. But the cost for an external examination is $685 and for a partial autopsy is $1,027. That is how the county can save money.
The funeral director said that every person that is taken in for a post-mortem examination gets a post-mortem computed tomography (CT) scan and what they call Lodox statscan, which is a high-speed x-ray machine. They can x-ray a 6 foot person in less than 20 seconds.
Schneider gave examples of the different costs and reasons why. He said that they have only had two autopsies this year that have been billed.
One of the cases this year was a cerebral hemorrhage, he said. This individual would have gotten a CT scan, and they would have seen the cerebral hemorrhage. They would have also taken toxicology – every deceased person that goes has toxicology drawn – a CT and a Lodox. That post-mortem would have cost the county $685.
Another deceased person that Schneider’s company worked on had a toxicology test drawn, an external examination and a partial autopsy that would have been $1,027. If it had been a full autopsy, it would have been about $400 higher.
County Counselor Gary Thompson asked if Schneider was saying was that many times a full autopsy is not necessary.
Schneider said that they only do a full autopsy if the case warrants it. He said that last year there were a lot of autopsies, 28, but the average year there are about 14.
Schneider said if it is more than 25 percent that do not require a full autopsy, then it is going to be a money savings for the county. In addition, the transportation mileage is reduce for the county, and it turns out to be a wash with the other company’s fees.
The funeral director said he was hesitant to promote using the Johnson County office as a money-saving solution, because several of the county’s autopsies are drug related. He said he sees a lot of fentanyl in the county.
If that is the cause of death, the medical examiner has to do a full autopsy because they often have to prove that it is accidental or intentional in court. That was the only apprehension he had about it saving considerable money for the county.
Something else that is going to come down the pike and the reason Schneider said he was coming to commissioners now is that, at the end of the year, the county is going to lose its district coroner. Paola physician Donald Banks is going to be retiring.
He said he has been visiting with some doctors who would consider being the coroner and deputy coroner.
In a later interview, Thompson explained that there is one coroner for each judicial district and the county with the most population picks that coroner. When it is decided that a deceased person needs a post-mortem examination, they are sent to a medical examiner who is chosen by the coroner. Coroners usually take into consideration who the county wants to use since the county is paying for the costs.
Thompson said that coroners do not go out to the death scene, but a county death scene investigator does and reports to the coroner.
At the commission meeting, Schneider said that he would like to visit with Miami County, the most populous county in the Sixth Judicial District, to update them on his findings about possible candidates for coroner and also about the Johnson County Medical Examiner.
Schneider pointed out that James Akes, the lead death scene investigator in Linn County, has been attending classes for his American Board of Medicolegal Death Investigators (ABMDI) certification.
He told the commissioners that the Johnson County Medical Examiners Office will conduct classes for the death scene investigators from Linn County.
He gave some more examples of why death scene investigators and autopsies are important.
He said that the medical examiners at Johnson County had given some classes to hospice nurses. One nurse said that she had never seen a hospice patient die of an accident. But some patients do.
They may have had a fall that either brought them to hospice or a fall at hospice. According to their insurance, their family might receive the double indemnity amount if they died from an accident, Schneider said.
He told about another incident that the medical examiners presented. A person dies in bed at hospice and a law enforcement officer says they died of natural causes and signs the death certificate.
But if the patient had been examined by a death-scene investigator, they would have seen the ligature marks on their neck that were either caused by an assisted suicide or a murder.
Schneider told the commissioners that between now and first of the year the county could realize if there were savings.
The funeral director also pointed out that the death certificate turnaround would be a lot faster. One case that he worked on with Johnson County had the death certificate to the family in two weeks, while the company they are now using often takes 16 to 20 weeks.
Schneider told how this affects the families, using an example of a young mother with children who really needed the death certificate of her husband to get his benefits.
The question came up about whether Linn County had a contract with their present medical examiner.
Thompson said that the statute read that the coroner decides where the autopsy is done.
The commissioners felt that change would be beneficial for residents of the county.