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      MEDICAL EXAMINER   
Frequently Asked Questions

1. How do I contact the MEO? What are the hours of operation, address, phone and fax numbers?

2. What cases should be reported to the MEO?

3. What is a Medical Examiner?

4. What is the difference between a Medical Examiner and a Coroner?

5. How is jurisdiction determined?

6. What is an autopsy?

7. Can I stop an autopsy?

8. Is there a charge for an autopsy?

9. Under what circumstances is an autopsy performed or not performed?

10. How do I request an autopsy report?

11. How do I  request a death certificate?

12. How can I request a correction to a death certificate?

13. May I view my loved one at the MEO?

14. What is the process for claiming my loved one’s body?

15. How can I retrieve my loved one’s personal property?

16. What is the MEO role in organ and tissue donation?

17. What if a decedent has no next-of-kin or the body is not claimed?

 

1. How do I contact the MEO? What are the hours of operation, address, phone and fax numbers?

  • The Medical Examiner Administrative Offices are open from 8:00 a.m. to 4:30 p.m. Monday through Friday.
  • The Medical Examiner Investigations is operational 24 hours, 7 days a week.
  • Mailing Address: 660 E. 24th Street, Kansas City, MO 64108
  • Phone: 816-881-6600
  • Fax: 816-404-1345

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2. What cases should be reported to the MEO?

These guidelines are intended to assist in determining what constitutes a Coroner/Medical Examiner Death Case and how to report a case.

Reportable Deaths:

The medical examiner has direct jurisdiction for Jackson, Clay, Cass and Platte Counties and is empowered by Missouri State Statutes # RSMo 58.720 to investigate deaths as a result of:

  1. Violence by homicide, suicide, or accident;
  2. Thermal, chemical, electrical or radiation injury;
  3. Criminal abortions, including those self-induced;
  4. Disease thought to be of hazardous and contagious nature or which might constitute a threat to public health;
  5. Any person dies suddenly when in apparent good health;
  6. When unattended by a physician, chiropractor, or an Accredited Christian Science Practitioner, during a period of thirty-six hours immediately preceding death;
  7. While in custody of the law, or while an inmate in a public institution;
  8. In any unusual or suspicious manner;
  9. All child deaths, involving individuals below the age of eighteen years
  • These deaths include maternal or fetal deaths that may be caused from illegal interference with the pregnancy or from criminal activity, trauma or illicit drugs.
  • These include deaths caused by rapidly fatal illnesses, such as fulminant meningitis.  Any death caused by highly infections agent capable of causing an epidemic should be reported to the Medical Examiner.  NOTE:  Deaths due to Acquired Immunodeficiency Syndrome (AIDS) are usually not reportable.
  • Deaths that occur during employment or that are related to employment or deaths that occur in public places, such as buildings, streets, parks or other similar areas, must be reported.
  • Sudden and unexpected deaths,
  • Deaths for which the attending physicians cannot supply adequate or reasonable explanations,
  • Persons found dead without obvious causes of death,

There is no 24-hour rule in Missouri:
A death occurring less than twenty-four hours after hospital admission is not necessarily reportable unless:
 
ER and Surgical Deaths:

  • Deaths while under anesthesia, during the post-anesthetic period, or during induction of anesthesia, regardless of the interval between the original incident and the death,
  • Deaths during or following diagnostic or therapeutic procedures, if the death might be related to the procedures or the complications resulting from the procedures.
  • All deaths occurring in correctional institutions, reformatories, or other incarceration or detention areas are reportable.  Deaths of persons under police custody or police hold, regardless of the probable cause and manner, are also reportable.

Reporting Guidelines:

Law enforcement officer,  hospital personnel or any person having knowledge of such a death shall immediately notify the office of the Medical Examiner of the known facts concerning the time, place, manner, and circumstances of the death.  Immediately upon receipt of notification, the Medical Examiner or his designated assistant shall take charge of the dead body and fully investigate the essential facts concerning the medical causes of death.

If an injury occurs outside of Jackson, Platte, Clay, or Cass counties and the victim dies while in transit to a medical facility in Jackson, Platte, Clay or Cass Counties, the jurisdiction of the death belongs to the Medical Examiner or Coroner in the outside county.  The Medical Examiner assumes jurisdiction in any case from an outside county when the subject is institutionalized within Jackson, Platte, Clay, or Cass counties.  The Medical Examiner then is required by law to immediately notify the coroner or Medical Examiner or the county where the injury occurred.  An emergency room admission for emergency room treatment is not considered institutionalization.  
  
Any death suspected of being caused by injury must be reported to the Medical Examiner, even if the injury occurred days, weeks, months or years before the death.  Even if an injury only contributes to an otherwise natural death, the death should still be reported. 

Examples of Reportable Injuries

  • Falls
  • Blunt force or crushing injuries
  • Sharp force (cutting, stabbing or chopping) injuries
  • Injuries from firearms (handguns, rifles, shotguns or other)
  • Explosions
  • Electrocutions and lightning strikes
  • Asphyxia (suffocation, strangulation, hanging, exclusion of oxygen poisoning by gases (carbon monoxide or other), poisoning by cyanide
  • Vehicular accidents (automobile, bus, railroad, motorcycle, bicycle, boat, aircraft, or other craft), including deaths of drivers, passengers, pedestrians, or non-occupants involved in the accidents
  • Drowning
  • Weather-related injuries (lightning, heat exposure, cold exposure, tornado, or other)
  • Drug use, prescription or illicit
  • Poisoning or chemical ingestions, and
  • Burns (chemical, thermal, radiation, electrical, etc.) 

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3. What is a Medical Examiner?

A Medical Examiner is a medical doctor, usually a Forensic Pathologist.  The Medical Examiner certifies the cause and manner of death for certain individuals, based on his/her expert opinion following an investigation and medical examination.  This examination may include an autopsy and laboratory tests such as toxicology.  The medical examiner also completes a report and creates a file for each decedent to document his/her findings in a lasting way.  The Medical Examiner’s team consists of many other individuals, who assist in various ways with the investigation, administrative tasks, and autopsies; these individuals include Investigators, Office Specialists, Transcriptionists, and Managers.

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4. What is the difference between a Medical Examiner and a Coroner?

Medical Examiners and coroners are two different groups that meet a similar need in their communities. Coroners are part of an older system dating back many centuries, to a time when the job of the “Crowner” was to make sure a decedent’s taxes had been paid to the King.  Today, the coroner’s main duty is to inquire into the cause and manner of a death, and to complete the death certificate.  Coroners are usually elected laypersons who may or may not have medical training, depending on local statutes.  Coroners contract with phatologist or forensic phatologist who provide autopsies and medical expertise to support the coroner’s investigations.

In contrast, the Medical Examiner system is a modern invention, and a streamlined system for medicolegal death investigation. Medical Examiners are almost always appointed to their positions rather than elected, are always physicians, and should have specialized training in forensic pathology.

In rare circumstances, the terminology may become complex, as a Forensic Pathologist may also be the elected Coroner.

In the state of Missouri, larger counties operate under Medical Examiner jurisdiction, while smaller counties, by statute, operate under coroner jurisdiction.  Coroners from several rural Missouri counties contract with the Jackson County Medical Examiner’s Office for autopsy services when needed.

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5. How is jurisdiction determined?

The Jackson County Medical Examiner’s Office will retain jurisdiction for those deaths that are medical examiner cases in Jackson, Clay, Platte and Cass counties. Death certificates will be issued from the Jackson County Medical Examiner’s Office for those deaths that are medical examiner cases, including deaths from injury or who die suddenly and unexpectedly while in apparent good health, suspicious deaths, or deaths when there is no doctor to sign the death certificate.

Jackson County currently provides complete forensic services to Jackson, Clay, Platte and Cass Counties under contract for death investigations, autopsy and lab testing as well as court testimony when necessary. Over 20 other Missouri counties utilize the Medical Examiner’s Office on a referral basis. Autopsies services and other tests are performed to determine cause and manner of death for these counties on a fee for service basis. The death certificates are issued by the referral county coroner/medical examiner based upon the autopsy findings.  Local authorities in the referral county will conduct their own scene investigations and share their information with the Jackson County Medical Examiner’s Office.

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6. What is an autopsy?

Also called a post-mortem examination, an autopsy is a systematized, intricate surgical procedure performed after death which involves examination of body tissues and often subsequent laboratory testing to determine cause and manner of death.  The body is examined both externally and internally, with examination of all major organs to document injury or disease.  Small samples of internal organs are retained for microscopic examination and body fluids are obtained and tested for drugs and alcohol.

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7. Can I stop an autopsy?

Autopsies are performed to answer medicolegal questions that are deemed in the "public's interest" or to address a question of law.  However, we recognize that an individual's religious or personal beliefs may be contrary to the performance of an autopsy.  In the event of a homicide or suspicious circumstances of death, the Medical Examiner WILL perform an autopsy.  If the death is not a homicide, the Jackson County Medical Examiner’s Office is open to discussion to try to accommodate the family's wishes while still meeting our mission and fulfilling the legal obligation presented by an individual's death.  If a family wishes for an autopsy to not be performed, they may request so by phone with the on-duty investigator at 816-881-6600.

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8. Is there a charge for an autopsy?

There is no charge for an autopsy performed under the jurisdiction of the Medical Examiner’s Office (Jackson, Cass, Clay and Platte Counties) when it is determined by the Medical Examiner that an autopsy is warranted.  The Jackson County Medical Examiner’s Office does not perform private autopsies.

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9. Under what circumstances is an autopsy performed or not performed?

As a facility accredited by the National Association of Medical Examiners, a forensic autopsy will be performed when:

1. the death is known or suspected to have been caused by apparent criminal violence.
2. the death is unexpected and unexplained in an infant or child.
3. the death is associated with police action.
4. the death is apparently non-natural and in custody of a local, state, or federal institution.
5. the death is due to acute workplace injury.
6. the death is caused by apparent electrocution.
7. the death is by apparent intoxication by alcohol, drugs, or poison.
8. the death is caused by un-witnessed or suspected drowning.
9. the body is unidentified and the autopsy may aid in identification.
10. the body is skeletonized.
11. the body is charred.
12. the forensic pathologist deems a forensic autopsy is necessary to determine cause or manner of death or collect evidence.

An autopsy is not normally required when the death is known to be the result of natural causes, adequate medical history exists and there are no signs of foul play.  In some cases, a detailed external examination may be sufficient to document injuries in cases with no pending legal issues associated.

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10. How do I request an autopsy report?

If a party is requesting an autopsy report, we must receive that request in writing.    Accepted methods of request include faxing or mailing to the address listed following this paragraph.  The request must include the decedent’s full name and date of death.  Be sure to include a fax number or address to which the autopsy report should be sent.  There is no charge to request an autopsy report as this information is a matter of public record.  Note, if a case is pending litigation or is an open criminal investigation, the records are not available.  In general, it takes a minimum of 4-6 weeks to complete an autopsy report.  In certain cases, additional tests may need to be performed which will delay completion of the report for several additional weeks.

Fax: 816-404-1345

Mail requests to:
Jackson County Medical Examiner’s Office
660 E. 24th Street
Kansas City, MO 64108

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11. How do I request a death certificate?

The Medical Examiner’s Office does not issue death certificates.  Once our portion of the death certificate is completed, the original is sent to the funeral home for finalization and then forwarded to the Bureau of Vital Records to be filed with the State of Missouri.

When a family makes funeral arrangements, the funeral home will ask how many copies of the death certificate the family needs.  The funeral home will then provide that number of death certificates to the family.  If the family or another entity requires more copies or needs a copy at a future date, then they should contact the Bureau of Vital Records, which is part of the Missouri Department of Health and Senior Services:

Missouri Department of Health and Senior Services
Bureau of Vital Records
P.O. Box 570
930 Wildwood Dr.
Jefferson City, MO 65102
573-751-6387
http://www.dhss.mo.gov/BirthAndDeathRecords/

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12. How can I request a correction to a death certificate?

Corrections on a death certificate require an affidavit to be filed with the State of Missouri.  The party responsible for the mistake is responsible for correcting the mistake.  For more information on the process after the Bureau of Vital Statistics receives the affidavit, please call them at 573-751-6387 or visit http://www.dhss.mo.gov/BirthAndDeathRecords/ .

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13. May I view my loved one at the MEO?

Our facilities are not set up to accommodate viewing requests.  The deceased may be viewed at the funeral home shortly after arriving there.

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14. What is the process for claiming my loved one’s body?

Only a family member can claim the body.  “Family member” is defined as spouse, child, parent, sibling, or grandparent; the legal next of kin is responsible for determining disposition of the body.  The body is available to be claimed after it has been properly identified and the autopsy (if performed) is complete.  The way a body is claimed is for the family member to call the on-duty investigator and provide the name of the funeral home.

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15. How can I retrieve my loved one’s personal property?

Except for evidence, any items transported to the Medical Examiner's Office are released to the funeral home along with the body at the time it is transported.  In case of an emergency in which an item (such as a key) is immediately needed, you can contact the on-duty investigator at 816-881-6600.

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16. What is the MEO role in organ and tissue donation?

At the Jackson County Medical Examiner’s Office, one of our goals is to facilitate organ and tissue donation for the benefit of the family and the community. 

For example, if an individual has a serious head injury and meets brain death criteria, he/she may be a candidate for organ donation.  Examples of current organ recoveries are whole hearts, lungs, kidneys, pancreas, and liver.

If an individual has died, they are eligible for tissue donation only within 24 hours after the time death.  Examples of tissues recovered are skin (split and full thickness) for burn patients, long bones (tibia, fibula, femur, humerus, and pelvic bones) for total and partial bone replacement surgery, tendons (achilles, anterior and posterior tibialis, and knee ligaments) for reconstruction of torn tendons, vascular tissues (heart valves, saphenous and femoral veins) for vascular repair, and corneas for whole cornea replacement.

In hopes of facilitating this lifesaving contribution to society, it is our policy at the Jackson County Medical Examiner to call an organ procurement organization on every death reported to our jurisdiction. 

After the organ/tissue procurement organization receives the information about the individual who has recently died, they then may approach the family about donation.  If an individual has a signed driver’s license indicating that he wishes to be a donor, surprisingly this is not the final say.  The decision of organ and tissue donation is up to a first generation family member (husband, wife, children, or parents – i.e., next of kin). 

If the family decides to donate, the organ/tissue procurement organization then will ask about a medical-social history. These questions will help to determine if the individual has possible infectious diseases.  If the individual meets the organization’s criteria for donation, the Medical Examiner will be asked to grant permission for donation on cases under our jurisdiction.  In all but the rarest of cases, donation does not interfere with the Medical Examiner’s duties.  In those cases, extraordinary measures (such as the Medical Examiner attending the organ procurement to directly observe any pathology) will be taken to facilitate the family’s wishes to make the gift of life.

Please refer to the following Web sites for further information on donation.

American Association of Tissue Banks www.AATB.org
Midwest Transplant Network www.mwtn.org
Musculoskeletal Transplant Foundation www.mtf.org  

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17. What if a decedent has no next-of-kin or the body is not claimed?

The Jackson County Medical Examiner’s Office seeks the assistance of the public to help locate next of kin and/or friends to claim the remains. Efforts are made to locate next of kin to claim the body. Short newspaper notices are posted locally to look for next of kin and/or friends. If no responses have been generated, the process of county burial will begin for the county to take jurisdiction and begin county disposition procedures. Click on the link to view a list of unclaimed decedents at the medical examiners office. If you have any information, please call 816-881-6600 and speak with an on-duty investigator.  

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