title: Detection of medical examiner cases from review of cremation requests.
abstract: Title 9, Chapter 19, Article 3 of the Arizona Administrative Code requires all bodies that are to be cremated must have the death certificate reviewed by a county medical examiner. In Tucson, AZ, and surrounding Pima County, all cremation requests are submitted to the Forensic Science Center, where the death certificates are reviewed by one of 5 board-certified forensic pathologists. In 2002, there were 5557 cremation requests, and in 2003 there were 5662 cremation requests. Of these requests, 670 (12.1%) and 447 (7.9%) death certificates were flagged for further investigation in 2002 and 2003, respectively. Eventually, 47 cases (0.8% of total, 7.0% of flagged cases) were accepted as medical examiner cases in 2002, and 43 cases (0.8% of total, 9.6% of flagged cases) were accepted as medical examiner cases in 2003. In 2002, the majority of cases were handled as a records review; however, 4 cases were brought in for autopsy and 1 was certified after an external examination only. In 2003, all cases were certified via a records review. The manner of death in all but 3 of these deaths was certified as accident, with complications of remote trauma being the most common proximate cause of death. The 3 most common injuries were complications of fractured pelvis or femur (15 in 2002, 22 in 2003), head injury due to fall (18 in 2002, 8 in 2003), and complications of remote motor vehicle accident (3 in 2002, 6 in 2003). The other 3 deaths included 2 homicides, 1 in each year, and 1 suicide in 2003.
authors.affiliation: Department of Pathology, University of Arizona College of Medicine, Tucson, Arizona 85724, USA. craign@email.arizona.edu
authors.forename: Craig L
authors.initials: CL
authors.lastname: Nelson
authors.forename: David C
authors.initials: DC
authors.lastname: Winston
mesh_terms: D000059:Accidents / Q000401:mortality; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001130:Arizona / Q000453:epidemiology; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D003334:Coroners and Medical Examiners; D003644:Death Certificates; D005260:Female; D005554:Forensic Medicine; D006708:Homicide / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009027:Mortuary Practice; D013405:Suicide / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000401:mortality