Murphy Signs Law to Update NJ’s Sorely Outmoded System for Investigating Deaths

Lilo H. Stainton | July 9, 2018 | Health Care
State’s medical examiner operation has been falling apart for years but major reforms are about to begin

New Jersey will begin later this summer to reform its beleaguered medical examiner system in an effort to modernize the state’s death investigation process, reduce the chance for conflicts of interest, and make it more responsive to the families of those who have died.

Gov. Phil Murphy signed legislation early last week to overhaul the current system, bringing it under the Department of Health’s management and requiring far more coordination and stricter standards at facilities throughout the state. The changes, under discussion for years, will replace the current system of 10 regional and county offices, all but a few of which operate largely independently and without adequate resources, according to those involved.

Some reforms are already under way. In June, Rutgers University announced that its New Jersey Medical School had signed a first-of-its-kind agreement with the Bergen County Medical Examiner’s Office to share two board-certified forensic pathologists, one of whom will serve as the county medical examiner. The office will also serve as a research site for students in the pathology program.

Although concerns about the current system are not new, the operation became the target of public attention following an investigation by late last year. The reporting drew Murphy’s attention and led to a January hearing on the issue by the Senate health committee, in which the current state medical examiner, Dr. Andrew Falzon, described a system that was underfunded and essentially overwhelmed.

Falzon said the statewide system investigated more than 21,000 suspicious or undetermined deaths in 2017, as required by law, and conducted full autopsies on nearly 5,000. The system has been further stressed by the rising number of opioid overdoses, he said, which claimed nearly 2,000 people in New Jersey last year. Critics said the current system is stressed in ways that at times lead to autopsies backing up, with bodies stored in temporary facilities, and families waiting months for answers.

No idea of final cost

Murphy has emphasized efforts to improve data collection, including around drug addiction and other health-related concerns. He included an additional $500,000 to begin improvements to the medical examiner system in his budget plan for fiscal year 2019, which he signed into law on July 1. While the reform will add to the state’s cost for this work, a nonpartisan analysis by legislative staff was not able to determine the full price, based on the information available.

The reform law, championed by health committee chairman Sen. Joseph Vitale (D-Middlesex), Sen. Christopher “Kip” Bateman (R-Hunterdon) and Assemblywoman Valerie Vainieri Huttle (D-Bergen), calls for a unified medical examiner system, not like the current patchwork effort.

“I welcome the governor’s actions in signing these long-overdue and desperately-needed reforms to a medical examiner system that’s been fragmented, mismanaged, under-resourced and overworked,” said Vitale, who led the years-long battle for change.

“Today’s enactment will empower the medical examiner with the capability for central oversight, adequate staffing, sufficient funding, higher standards and enhanced quality control, and will bring closure and comfort to families who have been mourning without answers,” he added.

Under the law, which will begin to take effect in August, each county can host its own office or coordinate with other counties on a joint initiative. But all facilities will report to the state medical examiner, who will set protocols and procedures and be responsible for ensuring each program has adequate staff and budgets. As it is, examiners make as little as $35,000 annually and some buildings need boiler repairs and other upgrades, according to testimony.

Avoiding conflicts of interest

In addition, the system will be moved to the DOH from under the purview of the Office of the State Attorney General, which currently oversees the network. This will allow it to be overseen by medical experts and will reduce the likelihood of any conflict of interest among the pathologists, who now investigate cases for an agency that also pays their salaries.

Bergen County seems to have gotten a jump on reforms by signing a five-year agreement with Rutgers Medical School earlier this year; the county is now one of five that runs its own medical examiner program. The deal, the first of its kind in the state, will improve medical examiner services and benefit the county overall, said county executive James J. Tedesco III.

“Our physicians will serve Bergen County, families mourning the untimely loss of loved ones, and victims of violent crime with professionalism, compassion, and excellent skill in forensic pathology,” added Dr. Robert L. Johnson, dean of the Rutgers New Jersey Medical School. “In addition, the benefit of a teaching site for our residency program will enhance our ability to produce highly-skilled physician graduates.”