The pathology division includes four board-certified forensic pathologists. The division is directed by the Chief Medical Examiner who oversees the general operation of the office, in addition to the clinical forensic training program.
The pathologists determine and certify the cause and manner of death through review of the circumstances of the death, review of medical records if applicable, and examinations of the individuals. Additional duties include education and training sessions with external agencies, teaching courses at local medical schools, and providing court testimony.
All individuals who are brought to the Medical Examiner’s Office for examination will, at a minimum, be examined externally and have representative body fluids and/or tissue collected for toxicology. Fingerprinting, if applicable, and blood samples for DNA are also obtained on every individual.
In accordance with RSMo 58.725, the Medical Examiner or Deputy Medical Examiner will have the sole discretion in determining whether or not an autopsy, or an internal examination of the body and organ systems, will be performed. According to the (NAME) Forensic Autopsy Standards, the forensic pathologist shall perform a forensic autopsy on the following cases:
- The death is known or suspected to have been caused by apparent criminal violence.
- The death is unexpected and unexplained in an infant or child.
- The death is associated with police action.
- The death is apparently non-natural and in custody of a local, state or federal institution.
- The death is due to acute workplace injury.
- The death is caused by apparent electrocution.
- The death is by apparent intoxication by alcohol, drugs or poison.
- The death is caused by unwitnessed or suspected drowning.
- The body is unidentified and the autopsy may aid in identification.
- The body is skeletonized.
- The body is charred.
- The forensic pathologist deems a forensic autopsy is necessary to determine cause or manner of death, or to document injuries/disease, or to collect evidence.
- The deceased is involved in a motor vehicle incident, and an autopsy is necessary to document injuries and/or determine the cause of death.
In cases where an autopsy is not mandatory under NAME standards, the medical examiner can decide, based on circumstances and case specifics, to perform a limited dissection (partial autopsy) or an external examination. The pathologist may perform an external examination in cases involving non-suspicious natural deaths or delayed traumatic deaths. The pathologist may also perform an external examination in well-documented gunshot suicide cases if there is no projectile to recover and in traumatic deaths wherein the cause of death is evident from external examination and/or radiographs.