Massachusetts Medical Examiner Will Head New Office in San Diego

San Diego County has hired the chief medical examiner of Massachusetts to establish and head the county’s new medical examiner’s office.

The department, to be directed by Dr. Brian Blackbourne, 51, will replace the existing coroner’s office, which in recent years has been accused of conducting faulty autopsies, and, as a result, jeopardizing law enforcement and criminal justice.

David Janssen, assistant chief administrative officer for the county, said the hiring “is the culmination of efforts . . . undertaken since 1985 to convert the county’s coroner system into a medical examiner system.” Blackbourne’s hiring was announced Thursday.

Blackbourne, who was appointed Massachusetts’ chief medical examiner in 1983 by Gov. Michael Dukakis, is just completing a seven-year term, which ends Jan. 4. Scheduled to start his new job Feb. 9, he will receive an annual salary of $125,000 to manage a 55-member staff and a $3.5-million budget.

Critics of the coroner system have long called for a conversion to a medical examiner system in which a physician oversees autopsies and laboratory work, signs all death certificates and provides the final say on cause of death.

A coroner system need not employ a medical doctor. For example, in San Diego, David Stark, a licensed embalmer and mortician, has been serving as county coroner since 1978. Stark, who joined the coroner’s office in 1962 as an examining room technician, is retiring early next year.

Without a pathologist in charge, critics--often attorneys and pathologists--have cited cases in which the coroner’s office failed to notice bullet wounds, lost evidence and misinterpreted injuries in autopsy reports. Those reports are crucial documents that can often help decide a person’s guilt or innocence in court.

“You need a trained pathologist to make the correct diagnosis--there’s often a lot at stake,” said Dr. Paul Wolf, a professor of pathology at UC San Diego School of Medicine and medical director of autopsy pathology at the VA Medical Center in La Jolla. “And these days there is an enormous number of forensic cases and that number is growing even more with the boom in the population. It has been pitiful that a county as large as San Diego has not had a medical examiner.”

Such mistakes, however, were curtailed when the county hired Dr. Ronald Rivers, a nationally known forensic pathologist, in April, 1987, as the county’s first chief of forensic pathology, according to Wolf.

Rivers’ position was established by the county as the first step in converting the coroner system into one headed by a medical examiner. At the time Rivers was hired, county officials and Wolf said Rivers was the “leading candidate” to become the county’s first medical examiner.

But Rivers resigned in November, citing personal reasons, and did not apply for the new post, Wolf and county officials said.

“Dr. Rivers had done a wonderful job during the last two years,” Wolf said. “I had reviewed many of his cases and found them to be accurate. I was disappointed to hear that he was stepping down, but we have recruited an excellent medical forensic examiner with an outstanding reputation in Dr. Blackbourne.

“I’m extremely happy that we have finally changed the system,” said Wolf, who as program director and past president of the San Diego County Society of Pathologists played an instrumental role in persuading the Board of Supervisors to seek a medical examiner.

San Diego becomes the fifth county in the state to adopt a medical examiner system. Los Angeles, Ventura, Santa Clara and San Francisco counties also have medical examiners.

Although Blackbourne said he doesn’t have immediate plans for the new department, he said in a telephone interview Friday that he was excited to start his new job.

“In my application for the post, I actually wrote that I have often wondered why I ever left California in the first place,” said Blackbourne, a native Canadian, who first moved to the state in 1963 to do his residency at Santa Barbara Cottage Hospital in Santa Barbara.

“But there are some staff vacancies which have been left open in anticipation of a new chief to arrive,” Blackbourne said. “So (filling those vacancies) will be one of my first priorities. But otherwise I have a policy of not changing things unless they’re broken. If things are not working in an optimal way, I’ll change them, but I think the office is operating very well right now.”

The timing of the San Diego job offer and the prospect of steep budget cuts in his department because of Massachusetts’ slumping economy spurred Blackbourne to move West.

Blackbourne’s duties will include supervising six full-time forensic pathologists. Since 1985, under the direction of Supervisor Susan Golding, the board has increased the number of full-time staff pathologists and relied less on fee-for-service independent pathologists.

Golding has also led efforts to augment other department personnel in a gradual attempt to transform the coroner’s office into one led by a medical examiner.

Blackbourne will also be in charge of 10 forensic technicians--autopsy assistants--who work in the examining room, and 10 lab workers who specialize in histology and toxicology. In addition, he will manage a clerical staff and oversee 15 deputy coroners who serve as medical investigators at the scene of the death. The coroner’s office currently investigates 3,000 deaths annually.

County officials began the search for a chief medical examiner in October by sending out applications to nearly 400 pathologists nationwide who had the credentials needed to fulfill the post. The field was narrowed to 29 candidates last month and four finalists were interviewed in mid-December.

Blackbourne received his M.D. from the University of Alberta in Edmonton, Canada, in 1962. Before working as the chief medical examiner of Massachusetts, Blackbourne served as the deputy chief medical examiner for the District of Columbia and as assistant medical examiner of Dade County, Fla.

He has also taught pathology at George Washington University School of Medicine, Howard University College of Medicine and the University of Miami.