Coroner Gets Boost in Staff, Equipment : County Rejects Medical Examiner System but Approves Hiring of 6 Pathologists

A massive infusion of people and equipment for the San Diego County coroner’s office was approved Tuesday by the county Board of Supervisors, but the board stopped short of converting the much-criticized operation to a medical examiner system.

The 40% boost in the coroner’s annual budget and a dramatic change in administrative philosophy are expected to help the office improve the quality of its autopsies and shorten the time it takes to complete investigations of sudden or suspicious deaths.

“We’re catching up,” said Coroner David Stark, who has blamed budget shortfalls for problems in his office. “We’re doing five years’ worth this morning. That’s what we did.”

Stark said he had proposed in past years many of the changes the board approved Tuesday. Those proposals, he said, were always deleted before former Chief Administrative Officer Clifford Graves submitted his proposed county budgets to the supervisors.

“It’s a matter of priorities,” Stark said. “When we were studied alone outside the normal budget process, it became very obvious that these deficiencies were there.”

The major change approved Tuesday will allow Stark to hire six full-time pathologists, including one supervisor, to perform autopsies. The employees will replace the current system of paying contract pathologists $100 per case to do the work, a system that was criticized because it encouraged the doctors to do large numbers of autopsies at the expense of quality.

Also approved was the hiring of a toxicologist and a laboratory assistant to shorten the turnaround time on lab work. A new X-ray machine, a machine for analyzing the presence of chemicals in human cells and a tripling of refrigerated space for corpses were also authorized.

The changes are expected to add about $800,000 a year to the coroner’s $2-million annual budget.

Supervisors George Bailey and Susan Golding said their willingness to spend more money on the coroner’s office came in part from a desire to avoid another series of crises like those that plagued the county’s Department of Health Services this year.

“If you don’t give a person the tools he needs to work with, he’s going to have trouble building the house,” Bailey said.

Golding, whose questions about the quality of work in the coroner’s office helped prompt the changes, added: “This is just another department that hasn’t been paid a lot of attention.”

Golding said she intends to pursue with newly appointed Chief Administrative Officer Norman Hickey the idea of creating a medical examiner’s office, which a doctor, rather than a layman such as Stark, would head. Golding failed to win any support for such a change from her board colleagues Tuesday.

“I think it’s time we look at this link in the criminal justice system and say this ought to be a first-class county, it ought to be treated in a first-class way,” Golding said.

Dr. Stephen Baird, president of the county Pathology Society and an advocate of a medical examiner’s system, said he was impressed by the changes.

“I think they made a lot of progress,” Baird said. “While I didn’t get everything I wanted, they definitely made improvements, and I’m pleased with that. We’re happy we got what we got.”

Baird was among those who complained earlier this year that Stark’s overworked staff of contract pathologists, using outmoded techniques and equipment, often produced shoddy autopsies that failed to fully or accurately explain the cause of death.

Many San Diego County defense attorneys relate horror stories about dealings with the coroner’s office. They contend the office’s slipshod work too often forces them to import costly expert witnesses to offer second and, usually, conflicting opinions.

In one case, charges against a woman accused of murdering her child were dropped after a second, private autopsy performed at the request of the defense attorney concluded that the child died of chronic heart disease, not a traumatic heart injury, as was determined by the coroner’s office.

Coroner’s office determinations have been reversed in other cases, defense attorneys contend, because the coroner’s pathologists failed to visit the scene of suspected homicides, and thus rarely see bodies in the condition or position in which they are found.

Local pathologists and attorneys as well as medical examiners from across the country who were familiar with San Diego said the county should change its coroner’s office to a medical examiner’s office.

But Stark and David Janssen, the county’s acting chief administrative officer, said many of the benefits of a medical examiner system could be obtained without the extra expense such an operation would require.