Mississippi, like most U.S. states, is experiencing a forensic pathologist shortage, reported the ABA Journal.
Although autopsies are performed in a timely manner out of necessity, reports are taking months—and in some instances years—to finalize. For example, Carolyn Green, the coroner for Mississippi’s Lee County, said in October that one natural death from 2016 still doesn’t have a finalized autopsy report.
The pandemic—which also precipitated a backlog in cases—has only exacerbated the shortage. In the last two years, forensic pathologists across the country also have been burdened by COVID-19 deaths, a spike in homicides and an increase in accidental drug overdoses.
With the time between the autopsy and the finalized report stretching months or even years, both prosecutors and defense attorneys are waiting longer than usual to bring criminal cases to trial, raising due process concerns.
The forensic pathologist shortage has been decades in the making, building since the practice became board-certified in 1959.
Few medical school graduates choose pathology residencies, and even fewer opt to work in forensic pathology, where the pay is lower than in other practice areas.
There are currently 500 board-certified forensic pathologists working full time. These pathologists are tasked with determining the cause of death for anyone who does not die in a hospital or in hospital cases involving homicide, according to Dr. James Gill, chief medical examiner for the state of Connecticut. Gill is also chair of the National Association of Medical Examiners’ board of directors and the group’s immediate-past president.
In a normal year, Gill says, the U.S. has needed more than double the number of forensic pathologists to keep up with the number of cases sent to their offices. Increasing cases in the past two years have only made the problem worse.
“There have been reports of national increases in homicides, motor vehicle deaths and drug intoxication deaths,” Gill says. “For example, the latest numbers from the CDC show a 30% increase in drug intoxication deaths in 2020: There were 93,000 of these deaths. Each of these needed an autopsy.”
In Chicago, the county medical examiner’s office saw almost triple the cases in 2020. The office typically sees about 6,000 to 6,500 cases a year; in 2020, it saw 16,049. According to spokeswoman Natalia Derevyanny, half of those deaths were COVID-19-related. Opioid deaths increased by 40% from the previous year, and homicides increased by 50%.
“Homicides are the most labor-intensive autopsies that we do,” Gill says. “It can take more than a day to do an autopsy on someone who was shot 15 times. All those wounds need to be photographed; all those bullets need to be dissected.”
Forensic pathologists prioritize conducting autopsies so the remains can be transferred to funeral directors. Reports are completed when the pathologists have time, and they are further delayed when forensic pathologists are called to testify in court.
“When you are overwhelmed with autopsies, those can’t wait. You can’t say, ‘I’ll wait until next week.’ Those have to take a priority,” Gill says.
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