Explanation of what topics need to be updated in the guidebook

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Attorney General Laurie O. Robinson Assistant Attorney General John H. Laub Director, National Institute of Justice This and other publications and products of the National Institute of Justice can be found at:

National Institute of Justice www.nij.gov Office of Justice Programs Innovation • Partnerships • Safer Neighborhoods www.ojp.usdoj.gov JUNE 2011 Death Investigation: A Guide for the Scene Investigator Technical Update Original Guide Developed and Approved by the National Medicolegal Review Panel Executive Director Steven C. Clark, Ph.D.

Occupational Research and Assessment, Inc.

Big Rapids, Michigan Associate Professor Ferris State University November 1999 Technical Update Developed and Approved by the Technical Update Review Committee March 2010 U.S. Department of Justice Office of Justice Programs The original project was supported under grant number 96–MU–CS–0005 by the National Institute of Justice, Office of Justice Programs, U.S. Department of Justice, and by the Bureau of Justice Assistance and the Centers for Disease Control and Prevention. The technical update was supported under grant number 2007–MU–BX– K008 by the National Institute of Justice, Office of Justice Programs, U.S.

Department of Justice.

This document is not intended to create, does not create, and may not be relied upon to create any rights, substantive or procedural, enforceable at law by any party in any matter civil or criminal.

Opinions or points of view expressed in this document are those of the authors and do not necessarily reflect the official position of the U.S.

Department of Justice.

NCJ 234457 iii D E A T H I N V E S T I G A T I O N Original Guide:

National Medicolegal Review Panel The National Medicolegal Review Panel (NMRP) represents a multidisci- plinary group of content area experts, each represent- ing members of his or her respective organization. Each organization has a role— be it active involvement or oversight—in conducting death investigations and in implementing these guidelines.

United States Conference of Mayors The Honorable Scott L. King (Chairman, NMRP) Mayor Gary, Indiana American Academy of Forensic Sciences Joseph H. Davis, M.D.

Retired Director, Dade County Medical Examiner Department Miami, Florida American Bar Association Bruce H. Hanley, Esq.

Partner, Hanley & Dejoras, P.A.

Minneapolis, Minnesota American Medical Association Mary E.S. Case, M.D.

Chief Medical Examiner St. Louis, St. Charles, Jefferson, and Franklin Counties, Missouri St. Louis University School of Medicine, College of American Pathologists Jeffrey M. Jentzen, M.D.

Medical Examiner Milwaukee, Wisconsin International Association of Chiefs of Police Chief Thomas J. O’Loughlin Wellesley, Massachusetts International Association of Coroners and Medical Examiners Halbert E. Fillinger, Jr., M.D.

Coroner Montgomery County, Pennsylvania National Association of Counties Douglas A. Mack, M.D., M.P.H.

Chief Medical Examiner and Public Health Director Kent County, Michigan iv R E S E A R C H R E P O R T / J U N E 2 0 1 1 National Association of Medical Examiners Richard C. Harruff, M.D., Ph.D.

Associate Medical Examiner Seattle/King County Depart- ment of Public Health Seattle, Washington National Conference of State Legislatures Representative Jeanne M. Adkins Colorado State Legislature House Judiciary Committee Denver, Colorado National Governors’ Association Richard T. Callery, M.D., F.C.A.P.

Chief Medical Examiner Wilmington, DelawareNational Sheriffs’ Association Donald L. Mauro Commanding Officer, Homicide Bureau Los Angeles County Sheriff’s Department Los Angeles, California Colorado Coroners’ Association Elaine R. Meisner Logan County Coroner Sterling, Colorado South Dakota Funeral Directors’ Association George H. Kuhler Elected Coroner Beadle County, South Dakota R E S E A R C H R E P O R T / J U N E 2 0 1 1 v D E A T H I N V E S T I G A T I O N Technical Update:

Review Committee American Academy of Forensic Sciences Julie A. Howe, M.B.A.

Medicolegal Death Investigator St. Louis University, Division of Forensic Pathology St. Louis, Missouri American Board of Medico- legal Death Investigators Roberta Geiselhart, R.N.

Supervisor of Investigations Hennepin County Medical Examiner’s Office Minneapolis, Minnesota International Association of Chiefs of Police Major Rustin Price Commander, Criminal Investigation Division Baltimore County Police Department Towson, Maryland International Association of Coroners and Medical Examiners O’dell Owens, M.D., M.P.H.

President Cincinnati State Technical and Community College Cincinnati, Ohio National Association of Medical Examiners Jeff Jentzen, M.D.

Director of Autopsy and Forensic Services University of Michigan Ann Arbor, Michigan National Sheriffs’ Association Sergeant Michael Price DuPage County Sheriff’s Office Wheaton, Illinois vii D E A T H I N V E S T I G A T I O N Acknowledgments NIJ wishes to thank the original Technical Working Group for Death Investigation (TWGDI). This 144-member reviewer network gave of their time to review guide- line content, providing the researcher feedback from a national perspective. Additional thanks to the TWGDI executive board: Mr.

Paul Davison, Kent County M.E. Office, Grand Rapids, Michigan; Mr. Bill Donovan, Jefferson Parish Coroner’s Office, Harvey, Louisiana; Mr. Cullen Ellingburgh, Forensic Science Center, Orange County, California; Ms. Roberta Geiselhart, R.N., Hennepin County M.E. Of- fice, Minneapolis, Minnesota; Dr. Elizabeth Kinnison, Office of the Chief M.E., Norfolk, Virginia; Mr. Vernon McCarty, Washoe County Coroner, Reno, Nevada; Mr. Joseph Morgan, Fulton County M.E.

Office, Atlanta, Georgia; Mr.

Randy Moshos, M.E. Office, New York, New York; Mr.

Steve Nunez, Office of the Medical Investigator, Albu- querque, New Mexico; Ms.

Rose Marie Psara, R.N., St.

Louis County M.E. Office, St. Louis, Missouri; and Mr.

Michael Stewart, Denver City and County Coroner’s Office, Denver, Colorado, whose combined commitment to the field of death investiga- tion is a tribute to the quality of this document. In addition, the offices that employ each member of the group share in this endeavor. Through their support, each mem- ber was given the flexibility they needed to support the project.

NIJ also wishes to thank its technical advisors: John E.

Smialek, M.D., Chief Medical Examiner, State of Maryland; Randy L. Hanzlick, M.D., Centers for Disease Control and Prevention (CDC) and Emory University School of Medicine; Ms. Mary Fran Ernst, Director of Medico- legal Education, St. Louis University Medical School; and Ms. Mary Lou Kearns, Coroner, Kane County, Il- linois. Each made significant contributions to the project’s inception, eventual funding, and timely completion. Their dedication to the science of death investigation and to the members of the investiga- tive community is apparent throughout this document. viii R E S E A R C H R E P O R T / J U N E 2 0 1 1 The former Director of NIJ, the Honorable Jeremy Travis; the Director of NIJ’s Office of Science and Technology, Mr. David G. Boyd; and NIJ’s Forensic Science Program Manager, Richard M. Rau, Ph.D., each share responsi- bility for the success of this project. Credit also goes to R. Gib Parrish, M.D., of CDC, for his support of and com- mitment to the research. R E S E A R C H R E P O R T / J U N E 2 0 1 1 ix D E A T H I N V E S T I G A T I O N Contents Original Guide: National Medicolegal Review Panel ……. iii Technical Update: Review Committee …………………………. v Acknowledgments ……………………………………………………. vii Introduction to Technical Update …………………………………. 1 Introduction to the Original Guide ………………………………… 1 Purpose and Scope of the Study …………………………………. 1 Study Design …………………………………………………………… 2 Notes ………………………………………………………………\ ……… 8 Section A: Investigative Tools and Equipment ……………… 9 Section B: Arriving at the Scene …………………………………. 11 1. Introduce and Identify Self and Role ……………………….. 11 2. Exercise Scene Safety and Security ……………………….. 12 3. Confirm or Pronounce Death ………………………………… 13 4. Participate in Scene Briefing (With Attending Agency Representatives) ……………………………………… 14 5. Conduct Scene “Walk Through” ……………………………. 15 6. Establish Chain of Custody …………………………………… 16 7. Follow Laws (Related to the Collection of Evidence) ……………………………………………………….. 18 Section C: Documenting and Evaluating the Scene ……. 19 1. Photograph Scene ………………………………………………. 19 2. Develop Descriptive Documentation of the Scene ….. 20 3. Establish Probable Location of Injury or Illness ……….. 21 x R E S E A R C H R E P O R T / J U N E 2 0 1 1 4. Collect, Inventory and Safeguard Property and Evidence ……………………………………………………… 23 5. Interview Witness(es) at the Scene ………………………. 24 Section D: Documenting and Evaluating the Body ……… 27 1. Photograph the Body …………………………………………… 27 2. Conduct External Body Examination (Superficial) ……. 28 3. Preserve Evidence (on Body) ……………………………….. 30 4. Establish Decedent Identification ………………………….. 31 5. Document Post-Mortem Changes ………………………… 32 6. Participate in Scene Debriefing …………………………….. 33 7. Determine Notification Procedures (Next of Kin or Interested and Authorized Individuals) ………….. 35 8. Ensure Security of Remains …………………………………. 36 Section E: Establishing and Recording Decedent Profile Information …………………………………………………….. 39 1. Document the Discovery History ………………………….. 39 2. Determine Terminal Episode History …………………….. 40 3. Document Decedent Medical History ……………………. 41 4. Document Decedent Mental Health History …………… 42 5. Document Social History ……………………………………… 43 Section F: Completing the Scene Investigation ………….. 45 1. Maintain Jurisdiction Over the Body ……………………… 45 2. Release Jurisdiction of the Body …………………………… 46 3. Perform Exit Procedures ……………………………………… 47 4. Assist the Family or Authorized Individual(s) …………… 48 R E S E A R C H R E P O R T / J U N E 2 0 1 1 1 D E A T H I N V E S T I G A T I O N Introduction to Technical Update Death investigation has evolved greatly in the years since the 1999 release of Death Investigation: A Guide for the Scene Investigator.

This revised and updated edi- tion is the result of a collab- orative effort to present the most up-to-date information about the issues confronting death investigators today.

The death investigator is the eyes and ears of the forensic pathologist at the scene. It is hoped that these guide- lines, reflecting the best practices of the forensic community, will serve as a national standard.

The following introduction de – scribes the original study that focused on the establishment of guidelines for conducting death investigations.

Introduction to the Original Guide Purpose and Scope of the Study The principal purpose of the study, initiated in June 1996, was to identify, delineate, and assemble a set of inves- tigative tasks that should and could be performed at every death scene. These tasks would serve as the founda- tion of the guide for death scene investigators. The Director of the National Insti- tute of Justice (NIJ) selected an independent review panel whose members represented international and national organizations whose constitu- ents are responsible for the investigation of death and its outcomes. The researcher or- ganized two multidisciplinary technical working groups (TWGs). The first consisted of members representing the investigative community at large, and the second con- sisted of an executive board representing the investigative community at large. 2 R E S E A R C H R E P O R T / J U N E 2 0 1 1 R E S E A R C H R E P O R T / J U N E 2 0 1 1 3 D E A T H I N V E S T I G A T I O N twofold: (a) they represent the diversity of the profes – sion nationally and (b) their members are the key stake – holders in the outcomes of this research. Each organiza – tion has a role in conducting death investigations and in implementing these guidelines.

Technical Working Group for Death Investigation 1. National Reviewer Network Technical Working Group for Death Investigation (TWGDI) members represent a sample of death investigators from across the country. They are the content area experts who perform within the oc- cupation daily. The following criteria were used to select the members of the TWGDI reviewer network:

■Each member was nominated/selected for the position by a person whose name appeared on the most recent (1995) Centers for Disease Con- trol and Prevention (CDC) national database of death investigation. 3 ■Each member had specific knowledge regarding the investigation of death. ■Each member had specific experience with the pro- cess of death investigation and the outcomes of posi- tive and negative scene investigations.

■Each member could commit to four rounds of national surveying over a 6-month period.

A 50-percent random sample (1,512) of death investigators was drawn from the CDC da- tabase. 4 A letter was sent to each member of the sample, inviting him or her to partici- pate in the national research to develop death investiga- tive guidelines or to nominate a person who participates in death investigations. Two hundred and sixty-three individuals were nominated (17 percent). Nominees were contacted by mail and asked to provide personal demo- graphic data, including job title, years of experience, and educational background, in addition to general informa- tion (name, address, etc.) necessary for participation in the research.

The TWGDI national reviewer network consisted of 263 members from 46 states and representing 5 regions, as seen in table 1. 4 R E S E A R C H R E P O R T / J U N E 2 0 1 1 The educational backgrounds of the national reviewer net- work members are presented in table 2.

The types of investigative systems represented in the reviewer network are shown in table 3.

Table 1. Membership of the Technical Working Group on Death Investigation National Reviewer Network Region 1 Northeast Region 2 Southeast Region 3 Midwest Region 4 Southwest Region 5 West RegionLocationNumber of Participants Percentage 1 Northeast 32 12% 2 Southeast 56 21% 3 Midwest 94 36% 4 Southwest 47 18% 5 West 34 13% R E S E A R C H R E P O R T / J U N E 2 0 1 1 5 D E A T H I N V E S T I G A T I O N executive board were as follows:

■Each member had specific knowledge regarding the investigation of death.

■Each member had specific experience with the pro- cess of death investigation and the outcomes of posi- tive and negative scene investigations.

■Each member could com- mit to attend four work- shops held within the grant period.

TWGDI Executive Board DACUM Workshop. In November 1996, the TWGDI executive board met in St.

Louis to begin developing the national Delphi survey. The survey content was to reflect “best practice” for death- scene investigation. DACUM is a process for analyzing an occupation systematically.

The 2-day workshop used the investigative experts on the executive board to analyze job tasks while employing modified brainstorming tech- niques. The board’s efforts resulted in a DACUM chart that describes the investiga- tive occupation in terms of specific tasks that competent investigators must be able to perform “every scene, every time.” 5 A task was defined Table 2. Educational Background of the National Reviewer Network Education NumberPercent Law Enforcement 8231% Medical 15760% Unknown 249% Table 3. Systems Represented by the National Reviewer Network SystemNumberPercent Medical Examiner 4417% Coroner 16161% Mixed ME/Coroner 5822% 6 R E S E A R C H R E P O R T / J U N E 2 0 1 1 as a unit of observable work with a specific beginning and ending point that leads to an investigative product, service, or decision. The DACUM chart served as the outline for the Delphi survey.

This initial process resulted in six major areas of work. In at- tempts to simplify the survey for the members of the na- tional reviewer network, the areas of work were placed into a logical sequence of events (as they might be performed while investigat- ing a case). Within the five major areas of work (Investi- gative Tools and Equipment was excluded at this point because tools and equipment are “things,” not procedural steps), 29 tasks were identi- fied. Within the 29 identified investigative tasks were 149 discrete steps and/or ele- ments. Theoretically, each step and/or element must be performed for the task to be completed “successfully.” The results were placed in survey format for NMRP review and pilot testing. R E S E A R C H R E P O R T / J U N E 2 0 1 1 7 D E A T H I N V E S T I G A T I O N mean scores for each of the task statements presented, as well as their first-round responses. Respondents were asked to compare their original ratings with the median and mean scores and to revise their original evalu – ations as they saw fit. This procedure was repeated for each of the four rounds of the survey.

The Delphi survey was conducted during the first 6 months of 1997. Table 4 provides general TWGDI response data.

As shown in table 4, final membership in the TWGDI national reviewer network was 146. This number represents approximately 56 percent of the originally nominated members.

Guideline Development.

During the 6 months of the Delphi process, both the TWGDI executive board and NMRP met to review survey data (to date) and to begin the process of moving task- based data into guideline format.

In May 1997, the executive board met for a 2½-day working session in New Orleans to begin the guide- line development process.

The consensus of the board was to establish 29 guide- lines based on the national reviewer network data and present them to NMRP for review. Each guideline would have the following content: ■A statement of principle, citing the rationale for performing the guideline.

■A statement of author- ization, citing specific policy empowering the investigator. Table 4. Response Rates to the Delphi Survey Round Surveys SentSurveys ReceivedCumulative Respondent Loss (%) 1 26319924% 2 19916314% 3 163149 5% 4 149146 1% 8 R E S E A R C H R E P O R T / J U N E 2 0 1 1 ■A statement of policy to the investigator regarding guideline performance.

■The procedure for perform- ing the guideline.

■A statement of summary, citing justification for per- forming the procedures.

In June and July 1997, NMRP met for two 1½-day working sessions in St. Louis and Chicago to review the draft guidelines developed by the executive board and offer recommendations and changes based on jurisdic- tional variances and organiza- tional responsibilities. Those sessions resulted in the final draft of the 29 guidelines for conducting death investiga- tions. The 29 guidelines are presented in the next sections. Notes 1. The Ohio State University, Center on Education and Training for Employment, DACUM, 1996.

2. Borg, W.R., and M.D.

Gall, Educational Research:

An Introduction, New York:

Longman Inc., 1983:413–415.

3. Combs, D., R.G. Parrish, and R.T. Ing, Death Investiga- tion in the United States and Canada, Atlanta: U.S. Depart- ment of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, 1995.

4. Ibid.

5. Clark, S.C., Occupational Research and Assessment, Inc., Big Rapids, Michigan, 1996.

6. Borg and Gall, 413–415. R E S E A R C H R E P O R T / J U N E 2 0 1 1 9 D E A T H I N V E S T I G A T I O N Section A:

Investigative Tools and Equipment 1. A lternate light source.

2. B arrier sheeting or tent (to shield body/area from public view). 3. B iohazard plastic trash bags. 4. B lood collection tubes.

5. B ody bags with locks.

6. B ody identification tags.

7. B usiness cards with fax and e-mail address. 8. C amera equipment.

9. C lean body cover (sheet/ drape). 10. C ommunication equipment. 11. C rime scene tape.

12. D epartmental scene forms. 13. D isposable protective suit.

14. E vidence identification markers. 15. E vidence seal/tape. 16. F ace and eye protection.

17. F irst aid kit.

18. F lashlight.

19. H air cover.

20. H and tools (e.g., bolt cutter, hammer, metal detector, paint brushes, pocketknife, rope, shovel, etc.). 21. I nvestigative notebooks.

22 L atent print kit.

23. L atex gloves.

24. M aps, compass and/or GPS. 25. M asks.

26. M easurement instruments. 27. O fficial identification.

28. P ackaging material (e.g., clean unused paper bags, envelopes, metal cans, tape, rubber bands, etc.). 29. P ersonal supplies (e.g., insect spray, sunscreen, hat, raincoat, umbrella, 10 R E S E A R C H R E P O R T / J U N E 2 0 1 1 boots for wet conditions and construction sites, etc.). 30. P hoto identifier (e.g., header frame, placards). 31. P hone lists and contact information. 32. P ortable lighting.

33. R ecording device.

34. R eenactment doll(s).

35. R esource material (e.g., death scene cleanup, grief support, organ pro – curement, etc.) 36. S cene safety equipment (e.g., biological/chemical/ industrial/disaster/fire, hardhat, reflective vest, steel bottom boots, etc.). 37. S harps container.

38. S hoe/boot covers.

39. S pecimen containers.

40. T hermometer (ambient and body temperature). 41. T race evidence recovery equipment (e.g., blades, cotton-tipped swabs, dis – posable syringe, forceps, gunshot residue and hand lens (magnifying glass), large gauge needles, pre – sumptive blood test kit, scalpel handle, tweezers, etc.). 42. W atch.

43. W aterless hand wash/ disinfectant. 44. W riting instruments. R E S E A R C H R E P O R T / J U N E 2 0 1 1 11 D E A T H I N V E S T I G A T I O N Arriving at the Scene Section B:

1. Introduce and Identify Self and Role Principle: Introductions at the scene allow the investi – gator to establish formal contact with other official agency representatives. The inves- tigator must identify the first responder to ascertain if any artifacts or contamination may have been introduced to the death scene. The investigator must work with all key people to ensure command protocol and scene safety prior to his/her entrance into the scene.

Authorization: Medical Examiner/Coroner Official Office Policy Manual; State or Federal Statutory Authority.

Policy: The investigator shall take the initiative to introduce himself or herself, identify essential personnel, establish rapport and determine scene safety and security.

Procedure: Upon arrival at the scene, and prior to enter – ing the scene, the investigator should: A. Identify the lead investigator at the scene and present identification. B. Identify other essential officials at the scene (e.g., law enforcement, fire, EMS, social/child protective services) and explain the investigator’s role in the investigation. C. Identify and document the identity of the first essential official(s) to the scene (first “professional” arrival at the scene for investigative follow-up) to ascertain if any artifacts or contamination may have been introduced to the death scene. 12 R E S E A R C H R E P O R T / J U N E 2 0 1 1 D. Determine the scene safety and security (prior to entry).

Summary: Introductions at the scene help to establish a collaborative investigative effort. It is neces- sary to carry identification in the event of questioned authority. It is essential to estab- lish scene safety and security prior to entry. 2. Exercise Scene Safety and Security Principle: Determining scene safety and security for all investigative personnel is essential to the investigative process. The risk of environ- mental and physical injury must be removed prior to initiating a scene investigation. Risks can include hostile crowds; collapsing struc- tures; traffic; and environmental, chemical, biological, radiological, nuclear and explosive (CBRNE) threats.

Authorization:

Medical Examiner/Coroner Official Office Policy Manual; State or Federal Statutory Authority.

Policy: The investigator shall attempt to establish scene safety and security prior to entering the scene to prevent injury or loss of life, includ- ing contacting appropriate agencies for as- sistance with other scene safety and security issues.

Procedure: Upon arrival at the scene, the investigator should:

A. Assess and/or establish physical boundaries. B. Identify incident command. C. Secure vehicle and park as safely as possible. R E S E A R C H R E P O R T / J U N E 2 0 1 1 13 D E A T H I N V E S T I G A T I O N D. Use personal protective safety devices (physical, biohazard safety). E. Arrange for removal of animals or secure (if present and possible). F. Obtain clearance/authorization to enter scene from the individual responsible for scene safety and security (e.g., fire mar- shal, disaster coordinator). G. While exercising scene safety and se – curity, protect the integrity of the scene and evidence to the extent possible from contamination or loss by people, animals and elements.

Note: Due to potential scene hazards (e.g., crowd control, collapsing structures, poisonous gas- es, traffic), the body may have to be removed before scene investigation can be continued.

Summary: Environmental and physical threats to the investigator must be removed in order to con- duct a scene investigation safely. Protective devices/equipment must be used by investi- gative staff to prevent injury. The investiga- tor must endeavor to protect the evidence against contamination or loss. 3. Confirm or Pronounce Death Principle: Appropriate personnel must make a deter – mination of death prior to the initiation of the death investigation. The confirmation or pronouncement of death determines jurisdic- tional responsibilities.

Authorization: Medical Examiner/Coroner Official Office Policy Manual; State or Federal Statutory Authority.

Policy: The investigator shall ensure that appropri – ate personnel have viewed the body and that death has been confirmed. 14 R E S E A R C H R E P O R T / J U N E 2 0 1 1 Procedure: Upon arrival at the scene, the investigator should:

A. Locate and view the body. B. Check for pulse, respiration and reflexes, as appropriate. C. Identify and document the individual who made the official determination of death, including the date, time and location of determination. D. Ensure death is pronounced, as required. Summary: Once death has been determined, rescue/ resuscitative efforts cease and medicolegal jurisdiction can be established. It is vital that this occur prior to the medical examiner/ coroner’s assuming any responsibilities. 4. Participate in Scene Briefing (With Attending Agency Representatives) Principle: Scene investigators must recognize the vary – ing jurisdictional and statutory responsibilities that apply to individual agency representatives (e.g., law enforcement, fire, EMT, judicial/ legal). Determining each agency’s investiga- tive responsibility at the scene is essential in planning the scope and depth of each scene investigation and official release of informa- tion to the public.

Authorization: Medical Examiner/Coroner Official Office Policy Manual; State or Federal Statutory Authority.

Policy: The investigator shall identify specific re – sponsibilities, share appropriate preliminary information and establish investigative goals of each agency present at the scene. R E S E A R C H R E P O R T / J U N E 2 0 1 1 15 D E A T H I N V E S T I G A T I O N Procedure: When participating in scene briefing, the investigator should:

A. Locate the staging area (entry point to scene, command post, etc.). B. Document the scene location (address, mile marker, building name, latitude and longitude coordinates) consistent with other agencies. C. Determine nature and scope of investiga – tion by obtaining preliminary investigative details (e.g., suspicious versus nonsuspi- cious death, multiple scenes). D. Confirm that initial accounts of incident are obtained from the first witness(es).

Summary: Scene briefing allows for initial and factual information exchange. This includes scene location, time factors, initial witness informa- tion, agency responsibilities and investigative strategy. Note: Since current global position- ing system (GPS) devices may have error, it is important to establish the location using other reference points (permanent landmarks) and distance/bearing from landmarks whenever GPS is used. 5. Conduct Scene “Walk Through” Principle: Conducting a scene “walk through” provides the investigator with an overview of the entire scene. The “walk through” provides the in- vestigator with the first opportunity to locate and view the body, identify valuable and fragile evidence, and determine initial investi- gative procedures providing for a systematic examination and documentation of the scene and body. 16 R E S E A R C H R E P O R T / J U N E 2 0 1 1 Authorization: Medical Examiner/Coroner Official Office Policy Manual; State or Federal Statutory Authority. Policy: The investigator shall conduct a scene “walk through” to establish pertinent scene parameters. Procedure: Upon arrival at the scene, the investigator should:

A. Reassess scene boundaries and adjust as appropriate. B. Establish a path of entry and exit to include scene log. C. Identify visible physical and fragile evidence. D. Document and photograph fragile evidence immediately and collect if appropriate. E. Locate and view the decedent. Summary: The initial scene “walk through” is essential to minimize scene disturbance and to prevent the loss and contamination of physical and fragile evidence. 6. Establish Chain of Custody Principle: Ensuring the integrity of the evidence by es – tablishing and maintaining a chain of custody is vital to an investigation. This will safeguard against subsequent allegations of tampering, theft, planting and contamination of evidence. Authorization: Medical Examiner/Coroner Official Office Policy Manual; State or Federal Statutory Authority. R E S E A R C H R E P O R T / J U N E 2 0 1 1 17 D E A T H I N V E S T I G A T I O N Policy: Prior to the removal of any evidence, the custodian(s) of evidence shall be designated and shall generate and maintain a chain of custody for all evidence collected. Procedure: Throughout the investigation, those respon – sible for preserving the chain of custody should:

A. Document location of the scene and time of arrival of the death investigator at the scene. B. Determine custodian(s) of evidence, deter – mine which agency(ies) is/are responsible for collection of specific types of evidence, and determine evidence collection priority for fragile/fleeting evidence. C. Identify, document, secure and preserve evidence with proper containers, labels and preservatives. D. Document the collection of evidence by recording its location at the scene, time of collection, and time and location of dispo – sition, and by whom. E. Develop personnel lists, witness lists, and documentation of times of arrival and departure of personnel. Summary: It is essential to maintain a proper chain of custody for evidence. Through proper docu – mentation, collection and preservation, the integrity of the evidence can be assured. A properly maintained chain of custody and prompt transfer will reduce the likelihood of a challenge to the integrity of the evidence. 18 R E S E A R C H R E P O R T / J U N E 2 0 1 1 7. Follow Laws (Related to the Collection of Evidence) Principle: The investigator must follow local, state and federal laws for the collection of evidence to ensure its admissibility. The investigator must work with law enforcement and the legal authorities to determine laws regarding col – lection of evidence. Authorization: Medical Examiner/Coroner Official Office Policy Manual; State or Federal Statutory Authority. Policy: The investigator working with other agen – cies must identify and work under appropri – ate legal authority. Modification of informal procedures may be necessary but laws must always be followed. Procedure: The investigator, prior to or upon arrival at the death scene, should work with other agencies to:

A. Determine the need for a search warrant (discuss with appropriate agencies). B. Identify local, state, federal and interna – tional laws (discuss with appropriate agencies). C. Identify medical examiner/coroner statutes and office standard operating procedures (discuss with appropriate agencies). Summary: Following laws related to the collection of evidence will ensure a complete and proper investigation in compliance with state and lo – cal laws, admissibility in court, and adherence to office policies and protocols. R E S E A R C H R E P O R T / J U N E 2 0 1 1 19 D E A T H I N V E S T I G A T I O N Documenting and Evaluating the Scene Section C:

1. Photograph Scene Principle: The photographic documentation of the scene creates a permanent historical record of the scene. Photographs provide detailed corrobo- rating evidence that constructs a system of redundancy should questions arise concern- ing the report, witness statements or position of evidence at the scene.

Authorization:

Medical Examiner/Coroner Official Office Policy Manual; State or Federal Statutory Authority.

Policy: T he investigator shall obtain detailed photograph – ic documentation of the scene that provides both instant and permanent high-quality images.

It is important to document in writing a descrip – tion of each photo so that it can be used for future reference.

Procedure: Upon arrival at the scene, and prior to moving the body or evidence, the investigator should:

A. Remove all nonessential personnel from the scene. B. Obtain an overall orientation photograph of the scene to spatially locate the specific scene to the surrounding area. C. Photograph specific areas of the scene to provide more detailed views of specific areas within the larger scene. D. Photograph the scene from different angles to provide various perspectives that may uncover additional evidence. 20 R E S E A R C H R E P O R T / J U N E 2 0 1 1 E. Obtain photographs with scales to docu – ment specific evidence. F. Obtain photographs even if the body or other evidence has been moved. Note: If evidence has been moved prior to photog – raphy, it should be noted in the report, but the body or other evidence should not be reintroduced into the scene in order to take photographs. Summary: Photography allows for the best permanent documentation of the death scene. It is es – sential that accurate scene photographs are available for other investigators, agencies and authorities to recreate the scene. Photo – graphs are a permanent record of the terminal event and retain evidentiary value and au – thenticity. It is essential that the investigator obtain accurate photographs before releasing the scene. 2. Develop Descriptive Documentation of the Scene Principle: Written documentation of the scene provides a permanent record that may be used to cor – relate with and enhance photographic docu – mentation, refresh recollections and record observations. Authorization: Medical Examiner/Coroner Official Office Policy Manual; State or Federal Statutory Authority. Policy: Investigators shall provide written scene documentation. Procedure: After photographic documentation of the scene and prior to removal of the body or other evidence, the investigator should: R E S E A R C H R E P O R T / J U N E 2 0 1 1 21 D E A T H I N V E S T I G A T I O N A. Diagram/describe in writing items of evidence and their relationship to the body with necessary measurements. B. Describe and document, with necessary measurements, blood and body fluid evidence, including volume, patterns, spat – ters and other characteristics. C. Describe scene environments, including odors, lights, temperatures and other frag – ile evidence. Note: If scene conditions have changed or evidence has been moved prior to written documenta – tion, it should be noted in the report. Summary: Written scene documentation is essential to correlate with photographic evidence and to re-create the scene for police, forensic(s), and judicial and civil agencies with a legitimate interest. 3. Establish Probable Location of Injury or Illness Principle: The location where the decedent is found may not be the actual location where the injury/illness that contributed to the death occurred. It is imperative that the investigator attempt to determine the locations of any and all injury(ies)/illness(es) that may have contrib – uted to the death. Physical evidence at any and all locations may be pertinent in establish – ing the cause, manner and circumstances of death. Authorization: Medical Examiner/Coroner Official Office Policy Manual; State or Federal Statutory Authority. Policy: The investigator shall obtain detailed informa – tion regarding any and all probable locations associated with the individual’s death. 22 R E S E A R C H R E P O R T / J U N E 2 0 1 1 Procedure: The investigator should: A. Document the location where death was confirmed. B. Determine the location from which the decedent was transported and how the body was transported to the scene. C. Identify and record discrepancies between the body and the scene (e.g., rigor mortis, livor mortis and body temperature). D. Check the body, clothing and scene for consistency/inconsistency of trace evidence and indicate the location where artifacts are found. E. Check for drag marks (on body and ground). F. Establish post-injury activity.

G. Obtain dispatch (e.g., police, ambulance) record(s). H. Interview family members and associates as needed. Summary: Due to post-injury survival, advances in emergency medical services, multiple modes of transportation, the availability of special – ized care, or criminal activity, a body may be moved from the actual location of illness/ injury to a remote site. It is imperative that the investigator attempt to determine any and all locations where the decedent has previously been and the mode of transport from these sites. R E S E A R C H R E P O R T / J U N E 2 0 1 1 23 D E A T H I N V E S T I G A T I O N 4. Collect, Inventory and Safeguard Property and Evidence Principle: The decedent’s valuables/property must be safeguarded to ensure proper processing and eventual return to next of kin. Evidence on or near the body must be safeguarded to ensure its availability for further evaluation. Authorization: Medical Examiner/Coroner Official Office Policy Manual; State or Federal Statutory Authority. Policy: The investigator shall ensure that all property and evidence are collected, inventoried, safe – guarded and released as required by law. Procedure: After personal property and evidence have been identified at the scene, the investigator (with a witness) should:

A. Inventory, collect and safeguard illicit drugs and paraphernalia at the scene and office. B. Inventory, collect and safeguard prescrip – tion medication at the scene and office. C. Inventory, collect and safeguard over-the-counter medications at the scene and office. D. Inventory, collect and safeguard money at the scene and office. E. Inventory, collect, and safeguard personal valuables/property at the scene and office. Summary: Personal property and evidence are impor – tant items at a death investigation. Evidence must be safeguarded to ensure its availability if needed for future evaluation and litigation. 24 R E S E A R C H R E P O R T / J U N E 2 0 1 1 Personal property must be safeguarded to ensure its eventual distribution to appropri – ate agencies or individuals and to reduce the likelihood that the investigator will be accused of stealing property. 5. Interview Witness(es) at the Scene Principle: The documented comments of witnesses at the scene allow the investigator to obtain primary source data regarding discovery of the body, witness corroboration and terminal history. The documented interview provides es – sential information for the investigative process. Authorization: Medical Examiner/Coroner Official Office Policy Manual; State or Federal Statutory Authority. Policy: The investigator’s report shall include the source of information, including specific state – ments and information provided by the witness. Procedure: Upon arriving at the scene, the investigator should:

A. Collect all available identifying data on witness(es) (e.g., full name, address, date of birth, contact information). B. Establish the witness’s relationship/ association to the deceased. C. Establish the basis of the witness’s knowledge (how does the witness have knowledge of the death?). D. Obtain information from each witness individually or as appropriate. E. Note discrepancies from the scene brief – ing (challenge, explain, verify statements). F. Record and retain statements as needed. R E S E A R C H R E P O R T / J U N E 2 0 1 1 25 D E A T H I N V E S T I G A T I O N Summary: The investigator’s final report must docu – ment the witness’s identity and must include a summary of the witness’s statements, corroboration with other witnesses and the circumstances of discovery of the death. This documentation must exist as a permanent record to establish a chain of events. 27 D E A T H I N V E S T I G A T I O N Documenting and Evaluating the Body Section D:

1. Photograph the Body Principle: The photographic documentation of the body at the scene creates a permanent record that preserves essential details of the body position, appearance, identity and final move- ments. Photographs allow sharing of infor- mation with other agencies investigating the death.

Authorization:

Medical Examiner/Coroner Official Office Policy Manual; State or Federal Statutory Authority.

Policy: The investigator shall obtain detailed photo – graphic documentation of the body that pro- vides both instant and permanent high-quality images.

Procedure: Upon arrival at the scene, and prior to moving the body or evidence, the investigator should:

A. Photograph the body and immediate scene (including the decedent as initially found). B. Photograph the decedent’s face (never clean face, do not change condition). C. Take additional photographs after removal of objects/items that interfere with pho- tographic documentation of the decedent (e.g., body removed from car). D. Photograph the decedent with and without measurements (as appropriate). 28 R E S E A R C H R E P O R T / J U N E 2 0 1 1 E. Photograph the surface beneath the body (after the body has been removed, as appropriate).

Note: Take multiple photographs if possible. Summary: The photographic documentation of the body at the scene provides for documentation of the body position, identity and appearance.

The details of the body at the scene provide investigators with pertinent information of the terminal events. 2. Conduct External Body Examination (Superficial) Principle: Conducting the external body examination provides the investigator with objective data regarding the single most important piece of evidence at the scene, the body. This documentation provides detailed information regarding the decedent’s physical attributes, his/her relationship to the scene, and possible cause, manner and circumstances of death.

Authorization:

Medical Examiner/Coroner Official Office Policy Manual; State or Federal Statutory Authority.

Policy: The investigator shall obtain detailed pho – tographs and written documentation of the decedent at the scene.

Procedure: After arrival at the scene and prior to moving the decedent, the investigator should, without removing the decedent’s clothing:

A. Photograph the scene, including the decedent as initially found and the surface beneath the body after the body has been removed. R E S E A R C H R E P O R T / J U N E 2 0 1 1 29 D E A T H I N V E S T I G A T I O N B. Photograph the decedent with and without measurements (as appropriate), including a photograph of the decedent’s face. C. Document the decedent’s position with and without measurements (as appropriate). D. Document the decedent’s physical characteristics. E. Document the presence, absence and condition of clothing and personal effects. F. Document the presence or absence of any items/objects that may be relevant. G. Document the presence or absence of marks, scars and tattoos. H. Document the presence or absence of injury/trauma, petechiae, etc. I. Document the presence of treatment or resuscitative efforts. J. Based on the findings, determine the need for further evaluation/assistance of forensic specialists or technologies (e.g., pathologists, odontologists, alternate light sources).

Note: If necessary, take additional photographs after removal of objects/items that interfere with photographic documentation of the decedent.

Summary: Thorough evaluation and documentation (pho – tographic and written) of the deceased at the scene are essential to determine the depth and direction the investigation will take. 30 R E S E A R C H R E P O R T / J U N E 2 0 1 1 3. Preserve Evidence (on Body) Principle: The photographic and written documentation of evidence on the body allows the investiga- tor to obtain a permanent historical record of that evidence. To maintain chain of custody, evidence must be documented, collected, preserved and transported properly. In addi- tion to all of the physical evidence visible on the body, blood and other body fluids present must be photographed and documented prior to collection and transport. Fragile evidence (which can be easily contaminated, lost or altered) must also be collected and preserved to maintain chain of custody and to assist in determination of cause, manner and circum- stances of death.

Authorization:

Medical Examiner/Coroner Official Office Policy Manual; State or Federal Statutory Authority.

Policy: With photographic and written documenta – tion, the investigator will provide a permanent record of evidence that is on the body.

Procedure: Once evidence on the body is recognized, the investigator should:

A. Photograph the evidence. B. D ocument blood/body fluid on the body (e.g., froth/purge, substances from orifices), location and pattern before transporting. C. Secure decedent’s hands and feet in unused paper bags (as determined by the scene). D. Identify and collect trace evidence before transporting the body (e.g., blood, hair, fibers). R E S E A R C H R E P O R T / J U N E 2 0 1 1 31 D E A T H I N V E S T I G A T I O N E. Arrange for the collection and transport of evidence at the scene (when necessary). F. Ensure the proper collection of blood and body fluids for subsequent analysis (if the body will be released from the scene to an outside agency without an autopsy).

Summary: It is essential that evidence be collected, preserved, transported and documented in an orderly and proper fashion to ensure the chain of custody and admissibility in a legal action.

The preservation and documentation of the evidence on the body must be initiated by the investigator at the scene to prevent altera- tions or contamination. In some instances, identification of trace evidence may require al- ternative methods (e.g., alternate light source, presumptive testing). 4. Establish Decedent Identification Principle: The establishment or confirmation of the decedent’s identity is paramount to the death investigation. Proper identification allows no- tification of next of kin, settlement of estates, resolution of criminal and civil litigation, and the proper completion of the death certificate.

Authorization:

Medical Examiner/Coroner Official Office Policy Manual; State or Federal Statutory Authority.

Policy: The investigator shall engage in a diligent effort to establish/confirm the decedent’s identity.

Procedure: To establish identity, the investigator should document use of the following methods:

A. Direct visual or photographic identification of the decedent if visually recognizable (when authorized, a face may be cleaned 32 R E S E A R C H R E P O R T / J U N E 2 0 1 1 to allow for identification after the initial photographic documentation is completed). B. S cientific methods such as fingerprints and dental, radiographic and DNA comparisons. C. Circumstantial methods such as (but not restricted to) personal effects, circum- stances, physical characteristics, tattoos and anthropologic data. Use available technologies to assist in dece – dent identification (e.g., www.namus.gov, National Crime Information Center).

Summary: There are several methods available that can be used to properly identify deceased per- sons. In some cases, the investigator should employ more than one method to confirm the identity of decedents. An autopsy along with authenticated in-dwelling medical devices may also be used to confirm identification.

This is essential for investigative, judicial, fam – ily and vital records issues. 5. Document Post-Mortem Changes Principle: The documenting of post-mortem changes to the body assists the investigator in ex- plaining body appearance in the interval following death. Inconsistencies between post-mortem changes and body location may indicate movement of the body and validate or invalidate witness statements. In addition, post-mortem changes to the body, when correlated with circumstantial information, can assist the investigators in estimating the approximate time and location of death.

Authorization:

Medical Examiner/Coroner Official Office Policy Manual; State or Federal Statutory Authority. R E S E A R C H R E P O R T / J U N E 2 0 1 1 33 D E A T H I N V E S T I G A T I O N Policy: The investigator shall document all post- mortem changes relative to the decedent and the environment.

Procedure: Upon arrival at the scene and prior to moving the body, the investigator should note the presence of each of the following in his/her report:

A. Livor (e.g., color, location, blanchability, Tardieu spots) consistent/inconsistent with position of the body. B. Rigor (e.g., stage/intensity, location on the body, broken, inconsistent with the scene). C. Degree of decomposition (e.g., putrefac – tion, adipocere, mummification, skeletoni- zation, as appropriate). D. Insect and animal activity. E. Scene temperature (document method used and time estimated). F. Description of body temperature (e.g., warm, cold, frozen) or measurement of body temperature (document method used and time of measurement).

Summary: Documentation of post-mortem changes in every report is essential to determine an ac- curate cause and manner of death, provide information as to the time of death, corrobo- rate witness statements, and indicate that the body may have been moved after death. 6. Participate in Scene Debriefing Principle: The scene debriefing helps investigators from all participating agencies to establish 34 R E S E A R C H R E P O R T / J U N E 2 0 1 1 post-scene responsibilities by sharing data regarding particular scene findings. The scene debriefing provides each agency the oppor- tunity for input regarding special requests for assistance, additional information, special examinations, and other requests requiring interagency communication, cooperation and education.

Authorization:

Medical Examiner/Coroner Official Office Policy Manual; State or Federal Statutory Authority.

Policy: The investigator shall participate in or initi – ate an interagency scene debriefing to verify specific post-scene responsibilities.

Procedure: When participating in scene debriefing, the investigator should:

A. Determine post-scene responsibilities (e.g., identification, notification, media relations and evidence transportation). B. Determine/identify the need for a special – ist (e.g., crime laboratory technicians, so- cial services, entomologists, Occupational Safety and Health Administration). C. Communicate with the pathologist about responding to the scene or to determine the autopsy schedule (as needed). D. Share investigative data (as required in furtherance of the investigation), for example, to disclose the possible existence of communicable diseases. E. Communicate special requests to appropri – ate agencies, being mindful of the neces- sity for confidentiality. R E S E A R C H R E P O R T / J U N E 2 0 1 1 35 D E A T H I N V E S T I G A T I O N Summary: The scene debriefing is the best opportunity for investigative participants to communicate special requests and confirm all current and additional scene responsibilities. The debrief- ing allows participants the opportunity to establish clear lines of responsibility for a suc- cessful investigation. Complete processing of the scene may require an extended period of time beyond the initial scene investiga- tion. This should be communicated between agencies beyond the initial scene, and inves- tigators from different agencies need to stay in communication with each other throughout the entire time. 7. Determine Notification Procedures (Next of Kin or Interested and Authorized Individuals) Principle: Every reasonable effort should be made to notify the next of kin or interested and autho- rized individuals as soon as possible. Notifica- tion of next of kin or interested and authorized individuals initiates the disposition of remains and facilitates the exchange of additional information relative to the case.

Authorization:

Medical Examiner/Coroner Official Office Policy Manual; State or Federal Statutory Authority.

Policy: The investigator shall ensure that the next of kin or interested and authorized individuals are notified of the death and that all failed and successful attempts at notification are documented.

Procedure: When determining notification procedures, the investigator should:

A. Identify the next of kin or interested and authorized individuals (determine who will perform this task). 36 R E S E A R C H R E P O R T / J U N E 2 0 1 1 B. Locate the next of kin or interested and authorized individuals (determine who will perform this task). C. Notify the next of kin or interested and authorized individuals (assign person(s) to perform this task) and record time of noti- fication, or, if delegated to another agency, obtain and document confirmation when notification is made. D. Notify interested and authorized agencies of status of the notification.

Summary: The investigator is responsible for ensur – ing that the next of kin or interested and authorized individuals are identified, located and notified in a timely manner. The time and method of notification should be docu- mented. Failure to locate the next of kin or interested and authorized individuals and efforts to do so should be a matter of record.

This ensures that every reasonable effort has been made to contact the family or interested and authorized individuals. When possible, notification should be performed in person. 8. Ensure Security of Remains Principle: Ensuring security of the body requires the investigator to supervise the labeling, packag- ing and removal of the remains. An appropri- ate identification tag is placed on the body to preclude misidentification upon receipt at the examining agency. This function also includes safeguarding all potential physical evidence and property and clothing that remain on the body.

Authorization:

Medical Examiner/Coroner Official Office Policy Manual; State or Federal Statutory Authority. R E S E A R C H R E P O R T / J U N E 2 0 1 1 37 D E A T H I N V E S T I G A T I O N Policy: The investigator shall supervise and ensure the proper identification, inventory, and se- curity of evidence/property and its packaging and removal from the scene.

Procedure: Prior to leaving the scene, the investigator should:

A. Ensure that the body is protected from further trauma or contamination (if not, document) and unauthorized removal of therapeutic and resuscitative equipment. B. Inventory and secure property, clothing and personal effects that are on the body (remove in a controlled environment with a witness present). C. Identify property and clothing to be retained as evidence (in a controlled environment). D. Recover biological samples before releas – ing the remains. E. Place identification on the body and body bag. F. Ensure/supervise the placement of the body into the bag and secure it. G. Ensure/supervise the removal of the body from the scene. H. Secure transportation. Summary: Ensuring the security of the remains facili – tates proper identification of the remains, maintains a proper chain of custody, and safeguards property and evidence. 39 D E A T H I N V E S T I G A T I O N Establishing and Recording Decedent Profile Information Section E:

1. Document the Discovery History Principle: Establishing a decedent profile includes documenting a discovery history and cir- cumstances surrounding the discovery. The basic profile will dictate subsequent levels of investigation, jurisdiction and authority. The focus (breadth/depth) of further investigation is dependent on this information.

Authorization:

Medical Examiner/Coroner Official Office Policy Manual; State or Federal Statutory Authority.

Policy: The investigator shall document the discov – ery history, available witnesses and apparent circumstances leading to death.

Procedure: For an investigator to correctly document the discovery history, he/she should:

A. Establish and record person(s) who discov – ered the body and when. B. Document the circumstances surrounding the discovery (who, what, where, when, how).

Summary: The investigator must produce clear, concise, documented information concerning who discovered the body, what the circumstances of discovery were, where the discovery oc- curred, when the discovery was made and how the discovery was made. 40 R E S E A R C H R E P O R T / J U N E 2 0 1 1 2. Determine Terminal Episode History Principle: Preterminal circumstances play a significant role in determining cause and manner of death. Documentation of medical intervention and procurement of antemortem specimens help to establish the decedent’s condition prior to death.

Authorization:

Medical Examiner/Coroner Official Office Policy Manual; State or Federal Statutory Authority.

Policy: The investigator shall document known cir – cumstances and medical intervention preced- ing death.

Procedure: In order for the investigator to determine terminal episode history, he/she should:

A. Document when, where, how and by whom the decedent was last known to be alive. B. Document the incidents prior to the death. C. Document complaints/symptoms prior to the death. D. Document and review complete EMS records. E. Obtain relevant medical and pharmacy records. F. Obtain relevant antemortem specimens. Summary: Obtaining records of preterminal circumstanc – es and medical history distinguishes medical treatment from trauma. The history, relevant antemortem specimens, and electronic data collected and/or transmitted may assist the medical examiner/coroner in determining cause and manner of death. R E S E A R C H R E P O R T / J U N E 2 0 1 1 41 D E A T H I N V E S T I G A T I O N 3. Document Decedent Medical History Principle: The majority of deaths referred to the medical examiner/coroner are natural deaths. Estab- lishing the decedent’s medical history helps to focus the investigation. Documenting the decedent’s medical signs or symptoms prior to death determines the need for subsequent examinations. The relationship between dis- ease and injury may play a role in the cause, manner and circumstances of death.

Authorization:

Medical Examiner/Coroner Official Office Policy Manual; State or Federal Statutory Authority.

Policy: The investigator shall obtain the decedent’s past medical history.

Procedure: Through interviews and review of the written records, the investigator should:

A. Document medical history, including medications obtained and taken, alcohol and drug use, and family medical history, including alternative practices. B. Document information from treating physi – cians and/or hospitals to confirm history and treatment. C. Document physical characteristics and traits (e.g., left-/right-handedness, missing appendages, tattoos, implanted/indwelling devices, etc.).

Summary: Obtaining a thorough medical history focuses the investigation, aids in disposition of the case, and helps determine the need for a post-mortem examination or other laboratory tests or studies. Potential sources of medical information should include but are not limited to nursing homes, hospice agencies, inter- mediate care, and assisted living facilities. 42 R E S E A R C H R E P O R T / J U N E 2 0 1 1 Electronic media can be a valuable source of information for obtaining a decedent’s medi- cal history. 4. Document Decedent Mental Health History Principle: The decedent’s mental health history can pro – vide insight into the behavior/state of mind of the individual. That insight may produce clues that will aid in establishing the cause, manner and circumstances of the death.

Authorization: Medical Examiner/Coroner Official Office Policy Manual; State or Federal Statutory Authority.

Policy: The investigator shall obtain information from sources familiar with the decedent pertaining to the decedent’s mental health history.

Procedure: The investigator should attempt to:

A. Document the decedent’s mental health history, including behavioral issues, hospi- talizations and medications. B. Document the history of suicidal ideations, gestures and/or attempts. C. Document mental health professionals (e.g., psychiatrists, psychologists, counsel- ors) who treated the decedent. D. Document family mental health history. E. Obtain relevant records. Summary: Knowledge of the mental health history al – lows the investigator to properly evaluate R E S E A R C H R E P O R T / J U N E 2 0 1 1 43 D E A T H I N V E S T I G A T I O N the decedent’s state of mind and contributes to the determination of cause, manner and circumstances of death. 5. Document Social History Principle: Social history includes marital, family, sexual, educational, employment and financial infor- mation. Daily routines, habits and activities, and friends and associates of the decedent help in developing the decedent’s profile. This information will aid in establishing the cause, manner and circumstances of death.

Authorization:

Medical Examiner/Coroner Official Office Policy Manual; State or Federal Statutory Authority.

Policy: The investigator shall obtain social history information from sources familiar with the decedent.

Procedure: When collecting relevant social history infor – mation, the investigator should: A. Document marital/domestic history. B. Document family history (similar deaths, significant dates). C. Document sexual history. D. Document employment history. E. Document financial history. F. Document daily routines, habits, activities, hobbies and unusual behavioral patterns. G. Document Internet activity (e.g., social media sites). 44 R E S E A R C H R E P O R T / J U N E 2 0 1 1 H. Document relationships, friends, caregiv – ers and associates. I. Document religious, ethnic or other perti – nent information (e.g., religious objection to autopsy). J. Document educational background. K. Document criminal history and obtain relevant records.

Summary: Information from sources familiar with the decedent pertaining to the decedent’s social history assists in the determination of cause, manner and circumstances of death. Special attention may be required in dependent popu- lations (e.g., infants, special needs and the elderly). R E S E A R C H R E P O R T / J U N E 2 0 1 1 45 D E A T H I N V E S T I G A T I O N Completing the Scene Investigation Section F:

1. Maintain Jurisdiction Over the Body Principle: Maintaining jurisdiction over the body allows the investigator to protect the chain of custo- dy as the body is transported from the scene for autopsy, specimen collection or storage.

Authorization:

Medical Examiner/Coroner Official Office Policy Manual; State or Federal Statutory Authority.

Policy: The investigator shall maintain jurisdiction of the body by arranging for the body to be transported for autopsy, specimen collection or storage by secure conveyance.

Procedure: When maintaining jurisdiction over the body, the investigator should:

A. Arrange for, and document, secure transportation of the body to a medical or autopsy facility for further examination or storage. B. Coordinate and document procedures to be performed when the body is received at the facility.

Summary: By providing documented secure trans – portation of the body from the scene to an authorized receiving facility, the investigator maintains jurisdiction and protects chain of custody of the body. 46 R E S E A R C H R E P O R T / J U N E 2 0 1 1 2. Release Jurisdiction of the Body Principle: Prior to releasing jurisdiction of the body to an authorized receiving agent or funeral direc- tor, it is necessary to determine the person responsible for certification of the death.

Information to complete the death certificate includes demographic information and the date, time and location of death.

Authorization:

Medical Examiner/Coroner Official Office Policy Manual; State or Federal Statutory Authority.

Policy: The investigator shall obtain sufficient data to enable completion of the death certificate and release of jurisdiction over the body.

Procedure: When releasing jurisdiction over the body, the investigator should:

A. Determine who will sign the death certifi – cate (name, agency, etc.). B. Confirm the date, time and location of death. C. Collect, when appropriate, biological sam – ples and other evidence prior to release of the body (indwelling or implanted devices). D. Document and arrange with the authorized receiving agent to reconcile all death cer- tificate information. E. Release the body to an authorized funeral director, medical examiner/coroner or other authorized receiving agent.

Summary: The investigator releases jurisdiction only af – ter determining who will sign the death certifi – cate; documenting the date, time and location of death; collecting appropriate specimens; R E S E A R C H R E P O R T / J U N E 2 0 1 1 47 D E A T H I N V E S T I G A T I O N and releasing the body to the authorized funeral director or other authorized receiving agent. 3. Perform Exit Procedures Principle: Completion of the scene investigation en – sures that important evidence has been collected and the scene has been processed.

In addition, a systematic review of the scene ensures that artifacts or equipment are not inadvertently left behind and any dangerous materials or conditions have been reported and documented.

Authorization: Medical Examiner/Coroner Official Office Policy Manual; State or Federal Statutory Authority.

Policy: At the conclusion of the scene investigation, the investigator shall conduct a post- investigative “walk through” and ensure the scene investigation is complete.

Procedure: When performing exit procedures, the investi – gator should: A. Identify, inventory and remove all evidence collected at the scene. B. Remove all personal equipment and materials from the scene. C. Report and document any dangerous materials or conditions. D. Alert family or interested and authorized individuals to potential unsafe scene conditions.

Summary: Conducting a scene “walk through” upon exit ensures that all evidence has been collected, 48 R E S E A R C H R E P O R T / J U N E 2 0 1 1 that materials are not inadvertently left be- hind, and that any dangerous materials or conditions have been documented and reported to the proper entities. 4. Assist the Family or Authorized Individual(s) Principle: The investigator provides the family or autho – rized individual(s) with a timetable so they can arrange for final disposition and provides infor – mation on available community and profes- sional resources that may assist the family.

Authorization: Medical Examiner/Coroner Official Office Policy Manual; State or Federal Statutory Authority.

Policy: The investigator shall offer the decedent’s family or authorized individual(s) information regarding available community and profes- sional resources.

Procedure: When the investigator is assisting the family or authorized individual(s), it is important to:

A. Inform them if an autopsy is required. B. Inform them of available support services (e.g., victim assistance, police, social ser- vices, death scene cleanup). C. Inform them of appropriate agencies to contact with questions (e.g., medical examiner/coroner offices, law enforce- ment, SIDS support group, etc.). D. Ensure that the family or authorized individual(s) is not left alone with the body (if circumstances warrant). E. Inform them of the approximate body release timetable. R E S E A R C H R E P O R T / J U N E 2 0 1 1 49 D E A T H I N V E S T I G A T I O N F. Inform them of the information release timetable (e.g., toxicology, autopsy results, as required). G. Inform them of available reports, including cost, if any. H. Inform them that they might be contacted regarding organ and tissue donation. I. Inform them that they may receive in – quiries from the media (this will be case dependent).

Summary: Interaction with the family or authorized individual(s) allows the investigator to assist and direct them to appropriate resources.

It is essential that families or authorized individual(s) be given a timetable of events so that they can make necessary arrangements.

In addition, the investigator needs to commu- nicate what information will be available and an approximate timeline for its release. About the National Institute of Justice The National Institute of Justice — the research, development and evaluation agency of the Department of Justice — is dedicated to improving our knowledge and understanding of crime and justice issues through science. NIJ provides objective and independent knowledge and tools to reduce crime and promote justice, particularly at the state and local levels.

NIJ’s pursuit of this mission is guided by the following principles:

• Research ca n ma ke a di fference in in dividual li ves, in th e safety of communities and in creating a more effective and fair justice system.

• Government-funded re search mu st ad here to pr ocesses of fair and open competition guided by rigorous peer review.

• NIJ’s research ag enda mu st re spond to th e re al wo rld ne eds of victims, communities and criminal justice professionals.

• NIJ must en courage an d su pport in novative an d ri gorous research methods that can provide answers to basic research questions as well as practical, applied solutions to crime.

• Partnerships wi th ot her ag encies an d or ganizations, pu blic and private, are essential to NIJ’s success. Our principal authorities are derived from:

• The Omnibus Crime Control and Safe Streets Act of 1968, amended (see 42 USC §§ 3721-3723) • Title II of the Homeland Security Act of 2002 • Justice For All Act, 2004 To find out more about the National Institute of Justice, please visit:

www.nij.gov or contact:

National Criminal Justice References Service P.O. Box 6000 Rockville, MD 20849-6000 800-851-3420 www.ncjrs.gov The National Institute of Justice is a component of the Office of Justice Programs, which also includes the Bureau of Assistance; the Bureau of Justice Statistics; the Community Capacity Development Office; the Office for Victims of Crime; the Office of Juvenile Justice and Delinquency Prevention; and the Office of Sex Offender Sentencing, Monitoring, Apprehending, Registering, and Tracking (SMART). U.S. Department of Justice Office of Justice Programs National Institute of Justice Washington, DC 20531 Official Business Penalty for Private Use $300 PRESORTED STAN DA RDPOSTAGE & FEES PAID DOJ/NIJ PERMIT NO. G–91 2011 JUNE *NCJ~234457*

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