L.A. County coroner's office workloads could threaten accreditation, sources say

The embattled Los Angeles County Department of Medical Examiner-Coroner met all accreditation standards at the time of its last annual review in August, but showed some signs of potential problems because of a staffing shortage, according to the president of the National Assn. of Medical Examiners.

The department was short two medical examiners at the time of its last review, said David Fowler, president of the association, in an interview Saturday. If the department lost more staff or caseloads increased substantially, he said, workloads could threaten its accreditation.

The Medical Examiner's office, which handles more than 8,500 cases a year, has been under scrutiny for substantial backlogs in processing cases. Currently, there are about 180 bodies in the county morgue waiting for processing, and toxicology tests can take more than six months to complete.

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On Thursday, the county’s top medical examiner, Mark Fajardo, abruptly announced his plans to resign, saying that his office had not been given the resources it needed to do the job. County sources speaking on condition of anonymity have said there were concerns that the office could be in danger of losing its accreditation.

The National Assn. of Medical Examiners looks at a variety of factors, including safety issues, the sufficiency of equipment and facilities, workload and staffing levels in assessing a department’s accreditation.

Accreditation is not legally required for a coroner’s office to operate, but loss of accreditation can have ramifications for victims’ families and law enforcement investigators, Fowler said.

“It means the job’s not being done properly,” he said.

That can have serious ramifications for members of the public, he said, as it affects the credibility of autopsy reports and other work done by the coroner’s office in civil and criminal cases, as well as for purposes of insurance claims and closure for loved ones, he said.

Fowler – who is also chief medical examiner for the state of Maryland – noted that there is a shortage of forensic pathologists in agencies around the nation, in part because rates of pay are higher for private pathologists. Only about 40 new forensic pathologists are trained each year, so there is tough competition among agencies looking to hire, he said.

“It’s difficult to recruit, so you need resources to be able to recruit,” he said.

Fajardo has argued that his agency’s budget, currently about $35.5 million, is insufficient to do the job properly. The budget has increased modestly since he joined the office in 2013. At that time, it was about $32 million.

The average funding for offices around the nation is about $3.36 per resident, Fowler said, which puts the Los Angeles County office’s funding around the average, based on the county’s 10 million residents. But he noted that because of the high cost of living in L.A., the funding might have been expected to be significantly higher than the average.

Fowler said medical examiner’s offices around the nation have seen their caseloads increase in the past year. In particular, he said, drug overdoses have increased, as have car crashes, possibly as a result of people driving more as the economy has improved.

A 2010 Los Angeles County audit of the Medical Examiner's office projected it could run into physician shortages in the coming years that would result in autopsy backlogs, caused by expected retirements and the slow rate of filling positions.

“By the year 2014, the agency is likely to experience a severe shortage of physicians, which could threaten the agency’s ability to meet the [National Assn. of Medical Examiners] standard of 250 autopsies per physician per year and may result in autopsy backlogs and loss of ... accreditation,” the auditors wrote.

About 60,000 people die each year in Los Angeles County, and the county coroner physically examines about 8,500 cases per year, county officials said. The coroner is responsible for investigating sudden, violent or suspicious deaths. Other deaths are handled by hospitals and mortuaries.

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