State of South Carolina
Coroner: Margaret W. Fisher (as of 12:13 PM, 11/13/2014)
Death is a fact in everyone's life. Unless the deceased is under official, prescribed Hospice care or official, prescribed Home health Care, 911 must be called when a death is discovered...even if a family expected it. If deceased is with Hospice or Home Health, the family need only call them and they make whatever required calls must be made. Without Hospice or Home Health, 911 will contact the county coroner who is then required to investigate.
The coroner of Lexington County is an elected county official who serves a four-year term, coroner's election coinciding with the election of state governor. Re-elections are unlimited. Though many have law enforcement backgrounds and modern coroners are required to take continuing education annually, there are no strict educational qualifications. As of 2014, this office investigates close to 2000 cases per year. As alluded to below, our group has used corner autopsy info for the benefit of living area citizens since the 1980s, HERE.
In S. C., a county coroner may be the only county official having the authority to arrest the county sheriff. In the event, for whatever reason, the county sheriff cannot fulfill his duties, the county coroner takes over those duties as acting sheriff until either a special election is held or the governor names a new sheriff. Only our state governor can remove any county coroner from office. Should the office be suddenly vacated, the governor may appoint an acting coroner until a special election can be held to elect a new coroner.
The coroner is absolutely empowered to investigate deaths through whatever means are necessary. This may include subpoenaing medical records, making inquests before a coroner's jury, gaining access to law enforcement investigatory information, and the ordering of postmortem examinations of the dead body, autopsies to be primarily performed in Lexington County at Lexington Medical Center by independent cooperating pathologists. The pathologists at Lexington Medical Center are the primary co-operating pathology group, and the group in Newberry are secondary.
Determinations of "cause of death" and "manner of death" often have hugely important legal & monetary implications to a family & to society. The death certificate in S. C. has 3 different possibilities for the "CERTIFIER" of the details of the official, legal death certificate: (1) treating physician, (2) [death] pronouncing and certifying physician [such as an ER doctor], and (3) the coroner in the county in which the death happened. See Dr. Shaw's discussion HERE. As of 2012, a temporary death certificate must be filed with South Carolina's DEHEC within 24 hours of death investigation or completion of the autopsy dissection. The likely legal PR (personal representative...executor of the estate of the deceased) can obtain a copy from DHEC to present to the Probate Court to start Probate. Insurance companies, when an autopsy has been performed, are unlikely to pay on a death until (1) a final death certificate has been issued and (2) they have been able to review a coroner's copy of the completed, final autopsy report.
Community relations: The coroner's office hopefully relates rightly (meshes with) to area Emergency Medical Services (EMS) and Fire Services (FSP) responding to 911 emergency calls, all area medical care providers (family, sitters & caregivers & individuals, hospice & home health nurses and personell, institutional/hospitals), pastors and other religious epresentatives, grief counselors, doctors & their office staff, law enforcement officers & law enforcement departments (including the S.C. SLED), disaster agencies (potentially) such as NTSB, SLED child fatality investigation, and even SCCVC victims assitance advocacy. It must regularly relate to families, citizens, hospital personnel, pathology groups, body/remains/mortuary transport companies (such as PMT), organ donor agencies (such as Lifepoint), and both local and distant funeral homes (and funeral homes have "remains" shipping issues, example comments). Due to deaths being caused by devices and medications, hundreds of different medications may have to be identified in the home and gathered for potential identification (such as HERE), potential lethal side effects found HERE, and could be reported through the pathology group HERE/ISMP if it was the cause of death. Through the Coroner office, citizens, and medical sources, important adverse situations may be reported to various private and governmental sources, HERE. And, this coroner office is a conduit (through Pathology Associates of Lexington) into Lexington Medical Center's "Center for Best Practices" process improvement (PI), quality assurance (QA), and ongoing professional practice evaluation (OPPE) processes which identify ways to provide safer and better care to the living.
The state of New York's Medical Examiner system (their alternative to our coroner system) had a huge role in the aftermath of the Twin Towers disaster of 9/11.
By gone Days: In the history of coroner office activity, "things" were much simpler in bygone times when society had tremendously less mobility; and thiose olden times efforts could be further complicated by financial insufficiency (such as during the Great Depression or world war times (a case example, HERE). In fact, in the early/mid 1900s there were even some blind coroners in S. C., EXAMPLE. As with many S. C. counties up until maybe 1970, funeral home hurses acted in the place of modern ambulances. Some even had sirens as they sometimes sped at high rates of speed to emergencies...which might even be the discovery of a dead body.
Death Certificate: The death certificate is a big issue, and HERE is the process. Why is the autopsy report so delayed? "The death certificate can't be issued because there is not yet any final autopsy report!": A review of 2006 data in 2007 showed that, of the 189 coroner-ordered autopsies, only 15% of cases took over 60 days to finalize (2.2% of coroner's
call volume). Eleven (6%) took over 90 days. Recognizing how complex the process can be at times, the national College of American Pathologists accreditation standards require that autopsy completion rates average at least 90% completed within 90 working days. We pathologists are well aware that (1) financial matters such as life insurance may not be settled until a final
autopsy report allows issuance of a death certificate and that (2) family emotional closure is often delayed until all of these legalities are completed. To the extent that any individual pathologist with a case feels confident in doing so, the group at Lexington goes on written record as to cause and manner of death the day of the autopsy with a preliminary written report to the coroner. Some cases are very complicated. Suppose a preliminary autopsy diagnosis resulted in
a large life insurance payment that allowed a family to buy something very expensive. Then, suppose that subsequent investigative, toxicology
and autopsy findings changed the final autopsy diagnosis & manner of death into one which the life insurance would NOT have paid on.
The result would be demands for return of the money to the insurance company and possibly a nasty law suit against the family which caused large legal expenses. And, the pathology groups, through (1) manpower shortages due to illness among group members or (2) periods of time when external barriers prevent employment of sufficient manpower (the case with the Lexington pathology group, 1996-2011) may just not be able to complete all cases expeditiously.
The coroner not infrequently requests that we do autopsies in cases of deaths which are considered an unquestioned "natural" manner of death. They tend to do this when there is an unexpected death in a patient who is either (1) not under the care of a physician, (2) or a death in circumstances which do not seem straight-forward enough that the patient's physician feels able to assign the cause of death, (3) a death within less than 24 hours following admission to a hospital, (4) or a death within less than 24 hours after an invasive medical operation or procedure. Over the years since Lexington Medical Center opened in 1971, information from these natural deaths has been beneficial to that hospital's medical staff Quality Assurance & Patient Safety system, especially since 1988 and even more directly since 2011. We hope to extend this quality assurance feedback regularly soon into EMS and other area hospitals (because the Lexington Coroner is involved with deaths connected to almost all central S. C. hospitals as well as possible cases related to military or VA hospitals).
Should a citizen come upon information (even many years after a death) which seems important because it might have changed the cause and/or manner of death of a case had it been originally known and they want to notify authorities, here is an opinion: notify an elected official, be it the county coroner or a state senator or representative of the jurisdiction in which the death happened. Ask for their help.
Coroners, from present back to 1805:
|(posted April 2002; latest update 8 August 2016)|