Connecticut medical examiner seeks more staffing as fatal drug overdoses surpass 900

This story was originally published in the New Haven Register and was written by Esteban L. Hernandez 

HARTFORD >> The number of overdoses just keeps rising.

Fatal drug overdoses in Connecticut topped 900 last year, marking the fifth straight year that accidental drug intoxications continue rising. Connecticut Chief Medical Examiner Dr. James Gill said Thursday that 917 people died of overdoses in 2016, which surpassed his own initial estimate of 888.

Last year’s figures represent a 25 percent jump from 2015, Gill said, when 729 people died.

Gill disclosed the figures while testifying before the General Assembly’s Appropriations Committee during a hearing at the Legislative Office Building. Gill said he will release the 2016 drug data Friday.

Fatal overdose figures played a central role in Thursday’s hearing.

Apart from painting an increasingly harrowing picture of the state’s opioid crisis, the uptick in overdoses has led Gill’s office to reach something of a crossroads. It lost full accreditation from the National Association of Medical Examiners, and without changes to its budget to address deficiencies caused partially by the increase in overdoses, it will lose accreditation altogether this fall.

The loss of accreditation means Gill’s office isn’t meeting minimal standards for death investigations.

“During the past three years, we’ve been faced with record high numbers of deaths requiring investigations, coupled with record low staffing levels,” Gill said Thursday. “This is resulting in the delay and backlogs in completed, final death certificates and autopsy reports.”

Gill needs to add two additional pathologists, or medical examiners, to help complete autopsies. The national accreditation agency pulled the agency’s full accreditation and placed it on provisional accreditation partially because the office has too many bodies and not enough medical examiners to inspect them. The agency is the only state agency performing legal and medical death investigations.

While Gill’s office requested additional money to cover the roughly $190,000 annual salary for the two positions for the 2018 and 2019 fiscal year budgets, Gov. Dannel Malloy’s recommended plan eliminated the two positions. Gill is hoping the appropriation committee will recommend adding those two positions back to ensure the office’s accreditation. The medical examiner’s office has four vacancies.

Autopsy have increased by 60 percent over the past three years, Gill said. This leaves the office with two options: Get more medical examiners or conduct fewer autopsies, the latter which could compromise the office’s death investigations.

“Our current medical examiner staff is simply insufficient (in) size for (the) number of deaths that we investigate,” Gill said. “Even if drug deaths start to decrease, our autopsy numbers are unlikely to fall dramatically.”

Gill said on average, a medical examiner from the OCME office testifies about twice a week in a homicide trial. Losing accreditation could leave the office vulnerable.

“It means that our opinions on causes of death are more likely to be challenged or doubted in court,” Gill said.

Committee Co-Chairwoman Rep. Toni Walker, D-New Haven, asked Gill about the office’s refrigeration requirements, which was another deficiency NAME said needs to be addressed. Gill said his office is expanding its storage space to increase capacity, which he said should be completed soon.

State Rep. Whit Betts, R-Bristol, said he couldn’t help but think that there was a “deliberate” effort to allow OCME to lose accreditation. Bettes asked Gill if there was any effort to eliminate his office and how confident Gill was that full accreditation will be restored. He, too, questioned how losing accreditation could impact prosecutions.

Fatal overdoses involving opioids such as heroin and fentanyl have largely driven the recent increase. Gill said last year, fentanyl, an opioid that can be 50 times more potent than heroin, was involved in more than 479 fatal overdoses — a 155 percent increase from 2015. Overdoses involving this opioid nearly surpassed the number of deaths involving heroin. There were 504 deaths involving heroin in 2015.

According to the state’s Office of Fiscal Analysis, OCME is requesting $7.3 million for the 2018 fiscal year and $7.4 million for the 2019 fiscal year. The governor’s recommended plan for 2018 and 2019 fiscal year is significantly less, at $6.2 million each year. OCME had $6.5 million budgeted for the 2016 fiscal year and $5.9 million appropriated for its 2017 budget.

The OCME has until September to address its deficiencies, though Gill said NAME could extend the deadline if OCME proves it’s working toward addressing its deficiencies.

“Loss of accreditation is a red flag to you, the government, that our office is having a problem,” Gill said during his testimony. “I need your help to fix that.”

Reach Esteban L. Hernandez at 203-680-9901

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