An emotional run-around after a death

goff@charlotteobserver.com eleland@charlotteobserver.comMay 17, 2014 

The calls come daily to the Iredell County register of deeds. Same voices. Same question. Grieving families seeking death certificates.

Matt McCall’s answer is usually the same: Call back tomorrow.

McCall, who has been register of deeds four years, became so frustrated over the time it takes to get completed death certificates from the state medical examiner’s office that he sent the governor a letter last fall on behalf of one family.

Margaret Glover’s 37-year-old son had been dead six months and still no death certificate. She couldn’t settle Geoffrey’s finances without one, and so every few weeks, she would telephone McCall to see whether it had arrived.

“I just wanted to get things past me,” said Glover, of Mooresville. “You have to have the darn piece of paper to do anything financial.”

If the cause of a person’s death is not an issue, a death certificate is usually processed promptly. Most delays occur in cases referred to medical examiners – about 13 percent of all deaths in North Carolina, including sudden, violent, accidental or suspicious deaths.

The time it takes for a case to be completed has held up life insurance payments. One family came near foreclosure, said Willoree Jobe, register of deeds in Yancey County. She said family members couldn’t afford to pay the mortgage on a trailer without a life insurance payment – and couldn’t get the life insurance without a death certificate.

The National Association of Medical Examiners, which sets standards for the profession, says top-performing systems complete 90 percent of autopsied cases within 60 days. North Carolina closed 33 percent of autopsied cases within that time, according to a Charlotte Observer analysis of state data for 2001 through mid-2013.

The average wait for cases with an autopsy: 97 days.

Peace of mind

Thousands of families are left waiting.

Kathy Ann Parrish-Uherhewar waited a year to find out whether her 36-year-old son’s sudden death in Durham stemmed from an assault five years earlier. An autopsy attributed his death to meningitis but said it could have developed from the head injury.

“No matter the child’s age, we still need answers,” she said. “I wonder now if I will ever have peace of mind again in my lifetime.”

Cindy Warren is still hoping for peace of mind. In May 2012, her 19-year-old daughter Brooke Burgo was rushed to a Rutherford County hospital after days of flulike symptoms and vomiting.

A day later, she died.

It took more than six months for the Office of the Chief Medical Examiner to rule that Burgo died of an “undetermined” cause. It took an additional 5-1/2 months for the state to amend the ruling to genetic metabolism disease – a cause Warren disputes.

The delays burned through half the time North Carolina allows for filing wrongful death lawsuits. Warren said no lawyer would take the case without a cause of death. That prevented her from finding a lawyer and filing a lawsuit over mistakes she believes led to her daughter’s death.

Now it’s too late.

Reason for delays

Dr. Deborah Radisch, the state’s chief medical examiner, sounded remorseful when asked about delays. “I don’t want to say I hate it more than the families, but I’m very close to hating it more than them. It’s my constant tension.”

Each cause of death listed by a local medical examiner must be reviewed by a pathologist in Radisch’s office. Radisch said delays most often occur when cases require toxicology tests at the state lab. Even after tests are done, Radisch said, a case may be further delayed because the pathologist assigned to the case is busy juggling other work.

The state office has historically been short-staffed, Radisch said. She said it has had trouble recruiting and retaining experienced forensic pathologists, who are medical doctors trained to perform autopsies and determine causes of death.

McCall said that when he called the state office in October about Geoffrey Glover’s death certificate, he was told: Dr. Radisch hasn’t gotten to it yet.

Soon afterward, she did.

“It’s for closure,” McCall said. “People want to know what happens, and when you give them an indefinite answer, they don’t have the opportunity to fully mourn.”

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