FARMINGTON >> The Office of the Chief Medical Examiner has been told it will lose its full accreditation and will be placed on a probationary term from the national medical examiner’s association following reductions in the office’s budget and an increase in drug overdoses in the state.
Connecticut Chief Medical Examiner Dr. James Gill said in a release Wednesday that the National Association of Medical Examiners informed his office in a letter dated Oct. 13 that the office will lose full accreditation and be demoted to provisional accreditation for one year. The letter is signed by Dr. Barbara C. Wolf, chairwoman of NAME’s inspection and accreditation committee.
NAME’s opinion is based on the review of materials ahead of the medical examiner’s scheduled five-year accreditation, according to the letter. Gill said his agency will have an on-site inspection in January, at which point it will lose full accreditation unless its deficiencies are addressed.
“I think loss of name accreditation is a serious thing,” Gill said Wednesday.
A loss of accreditation could reduce the ability of the medical examiner’s office to assist law enforcement efficiently with homicide investigations, reduce prosecutors’ ability to bring charges, and affect family members attempting to address insurance concerns or those seeking emotional closure. It could also affect how quickly donor tissue can be delivered, according to NAME’s letter.
The probationary period allows the office time to correct its deficiencies. Failure to do so will result in the complete loss of accreditation.
Gill said the accreditation is also a barometer measuring the office’s funding from the state. The lack of “appropriate funding” and “budget cuts” are mentioned in the NAME letter as reasons for the office’s struggles.
“An office that loses accreditation means the office is not meeting minimum requirements,” Gill said Wednesday. An office that doesn’t meet minimal requirements could lead to mistakes, such as an improper death investigation or even releasing the wrong body, he said.
NAME’s letter said the requirements Gill’s office failed to meet are considered “essential,” with any deficiencies in those requirements potentially presenting a serious impact on its work.
Figures provided by a spokesman for the state’s Office of Policy and Management Chris McClure show Gill’s office has a fiscal 2017 estimated expenditure line of $5.8 million, down from $6.5 million in fiscal 2016. The current fiscal year expenditure was roughly $700,000 more than in fiscal 2015.
“Dr. Gill and his staff have the unenviable duty of facing the worst of the opioid crisis which has increased the number of autopsies the Chief Medical Examiner must perform,” McClure said in a statement Wednesday. “We will strongly consider the requests of OCME in developing the Governor’s budget proposal and we will continue working with [the state Department of Mental Health and Addiction Services] and first responders across the state to fight opioid addiction and prevent overdose deaths.”
Gill said he sent a copy of the letter to the state’s executive and legislative branches. State Senate Minority Leader Len Fasano, R-North Haven, said in a release that a loss of full accreditation is a result of budget cuts from a Democrat-approved state budget. Fasano said this showed a lack of “well-thought-out policies” from Democrats.
“This is sadly another consequence of a failed state budget and a problem that went ignored and unaddressed by those in control of the legislature,” Fasano said in the statement. “While Democrat lawmakers claim they want to make Connecticut a bioscience capital, their budget didn’t even properly fund a core and basic public health function.”
The increase in fatal drug overdoses has played a role in the struggles of Gill’s office. While there are more autopsies to do, budget cuts mean there is a smaller staff capable of properly addressing them.
NAME had recommended Gill’s office hire two additional pathologists to ensure accreditation, though Gill said in May his office was under a hiring freeze. McClure said Gil’s office is not under a hiring freeze, with OPM approving the hiring of two positions, including a laboratory assistant and a principal physician.
According to NAME’s letter, each pathologist performed an average of 276 autopsies in 2010 while Gill took a case load of about 50 percent of the average because of his administrative duties. However, the most recent data showed the office’s seven pathologists were exceeding 325 autopsies each, which would trigger a deficiency. This also translated to Gill taking on a 100 percent autopsy caseload, in addition to his administrative duties.
NAME’s letter notes Gill’s office is legally mandated to perform its duties. Gill said not all states have a state medical examiner, and unlike other medical care facilities, his office cannot simply turn away bodies. Some jurisdictions have a coroner’s office that would not meet NAME standards, Gill said in an email.
“Unfortunately, without resources, even the best pathologists cannot fulfill their office’s mission appropriately, which will result in suboptimal service for the citizens of Connecticut and the multiple stakeholders of the OCME,” the NAME letter says.
Gill’s office also doesn’t meet national standards developed under the direction of the National Institute of Standards and Technology, which NAME’s letter said is attempting to create certification standards for forensic science labs such as medical examiner’s offices. While these standards are not mandated, NAME suggests it’s likely that medical examiner’s offices will soon be expected to comply with them.
However, McClure cited a 2016 NIST report that said most offices in the U.S. responsible for death investigations are not accredited. That report showed only 25 states have a state medical examiner’s office.
Gill said there are 168 million people in the U.S. living in a jurisdiction that has “quality death investigations,” but the loss of accreditation in Connecticut would reduce that number by 3.6 million, referring to Connecticut’s population. Gill added the state should address his office’s deficiencies like they did the state’s Forensic Science Laboratory, which lost accreditation in 2011 before having it restored in 2012.
“I hope that government officials will take this as seriously as they did the loss of the crime lab accreditation,” Gill said.
Gov. Dannel Malloy’s office on Wednesday responded to a request to comment but has yet to release a statement. The office later clarified McClure’s statement represented a response from the governor’s office.
Reach Esteban L. Hernandez at 203-680-9901