RALEIGH — Calling the medical examiners system broken, Gov. Pat McCrory asked lawmakers last month for an additional $2 million to improve the way the state investigates suspicious deaths.
McCrory said the new money would be a stopgap measure for shoring up a long-neglected system. He made it clear that the states roughly 350 medical examiners need better training and higher pay.
An Observer series in May reported that untrained medical examiners across the state often fail families and imperil justice with faulty rulings, and that some pathologists juggle autopsy caseloads far above the recommended level.
But the House and Senate budgets that were approved in recent weeks didnt reflect the governors proposal. Each chamber allocated a $1 million increase half of what McCrory requested.
Josh Ellis, spokesman for the governor, said Tuesday that McCrory is still pushing for the extra $2 million for the Office of the Chief Medical Examiner.
The governor stands by his original proposal, Ellis said. Were going to continue to push for the priorities that were in the governors budget.
This week, legislators are trying to agree on a final budget, attempting to reconcile differences between the two chambers. Its unclear if legislators will increase the amount for medical examiners.
A spokeswoman for House Speaker Thom Tillis, R-Mecklenburg, said the Houses recommendation of an additional $1 million to the medical examiners system shows we see this as an important need.
But critics say that the proposed $1 million increase or even twice that, as McCrory has requested isnt enough to fix the problems.
If this is the only step theyre planning on taking, its going to be woefully inadequate, said Dr. Patrick Lantz, a forensic pathologist at Wake Forest Baptist Medical Center.
Last fiscal year, the state provided $4.4 million to the medical examiners office. Counties added $3.9 million more for a total budget of $8.3 million.
A 2007 study found that the average state medical examiner system spent $1.76 per capita on its death investigation system. Last year, North Carolina spent less than half that about 84 cents per capita.
I feel bad for North Carolina, said Dr. Gregory Davis, a Kentucky forensic pathologist who used to work with Lantz in Winston-Salem. It breaks my heart to hear the medical examiners office is not getting what it needs.
The need for change
North Carolina relies on hundreds of appointed medical examiners, most of whom are full-time doctors, to investigate sudden, accidental and violent deaths during their off hours.
The Observers investigation found that medical examiners often fail to follow crucial investigative steps, raising questions about the accuracy of thousands of death rulings.
Medical examiners dont go to the death scene in 90 percent of the cases they review. In 1 in 9 deaths, they violate a state requirement to look at the bodies.
The state performs autopsies in 40 percent of medical examiner cases, fewer than many nationally accredited systems. Despite the low rate, staffing problems have caused 11 pathologists in recent years to perform more than the recommended number of annual autopsies a situation that experts say increases the chances of mistakes.
The worst-case scenario is what we have right now, Lantz said. You have local medical examiners not looking at the body or going to the scene, and you have a low autopsy rate on top of that.
$2 million for more training
Kevin Howell, spokesman for the medical examiners office, said a $1 million increase would pay for supplies, help develop a training program for medical examiners and provide a stable source of funding for regional autopsy centers.
The second million dollars in funding is critical to further develop the training program and to implement it across the state, said Howell, adding that the money would also help support fellowship programs to train new forensic pathologists.
Even though the House and the Senate budgets call for an increase of $1 million, Rep. Becky Carney, D-Mecklenburg, said the amount could increase as the budget heads for final passage.
McCrory told the Observer earlier that he wouldnt be disappointed if legislators added more than his requested $2 million.
Its been ignored for far too long, he said. And were pleased with our first steps, but we also recognize theres more to go.
In an interview last month, Dr. Aldona Wos, head of the N.C. Department of Health and Human Services, said she recognized problems within the medical examiners system after she took office last year. DHHS oversees the medical examiners office.
Wos said she was concerned about a lack of training and funding.
We need greater education, greater oversight, Wos said.
Along with the $1 million increase, the Senate's budget also calls for an independent review of the medical examiners office.
After its investigation, the Program Evaluation Division would make recommendations to lawmakers about how the system could be improved.
Reporters Ann Doss Helm and Ames Alexander contributed