Bureau of Justice Statistics

Special Report

June 2007, NCJ 216756

U.S. Department of Justice

Office of Justice Programs

Medical Examiners and Coroners’ 

Offices, 2004

Matthew J. Hickman, Ph.D.

Kristen A. Hughes, MPA

Bureau of Justice Statistics

Kevin J. Strom, Ph.D.

Jeri D. Ropero-Miller, Ph.D., DABFT

RTI International

About 2,000 medical examiners and coroners' (ME/C) 

offices provided death investigation services across the 

United States in 2004. These offices were responsible for 

the medicolegal investigation of death. They may conduct 

death scene investigations, perform autopsies, and determine the cause and manner of death when a person has 

died as a result of violence, under suspicious circumstances, without a physician in attendance, or for other reasons.

As of 2004, 16 States had a centralized statewide medical 

examiner system (see map). Fourteen States had a county 

coroner system, 7 had a county medical examiner system, 

and 13 had a mixed county medical examiner and coroner 

system. Eight States with decentralized death investigation 

systems also had a State medical examiner office performing medicolegal duties (Alabama, Arkansas, Georgia, Iowa, 

Kentucky, Montana, North Dakota, and Tennessee). The 

District of Columbia reported a city medical examiner office, 

which functioned similar to a statewide system. 

ME/C offices employed an estimated 7,320 FTE employees. Estimated annual budgets for these offices totaled 

$718.5 million, an average of $387,000 per office.The 

majority of ME/C offices in 2004 were county coroners’ 

offices (1,590 or 80%), most of which served small jurisdictions (less than 25,000 persons).

Nearly one million human death cases were referred by 

medical and law enforcement personnel to the Nation's 

ME/C offices in 2004, accounting for approximately 40% of 

all deaths in the United States that year.1 Depending on the 

circumstances of the death, characteristics of the death 

scene, the decedent's medical history, and other factors, 

death cases may be cleared without the medical examiner 

or coroner accepting jurisdiction and conducting an additional investigation to determine the cause and manner of 

death. Overall, ME/C offices in 2004 accepted about half of 

all referred cases for further investigation.

The 2004 Bureau of Justice Statistics’ (BJS) Census of 

Medical Examiner and Coroners' Offices represented the 

Bureau’s first effort to describe the medicolegal investigation of death in the United States. The census also gathered detailed information on unidentified human decedents 

handled by ME/C offices because they represent a critical 

component in the Nation's effort to resolve missing persons 

cases. In a typical year ME/C offices reported that they 

handled about 4,400 unidentified human decedents of 

which about 1,000 remained unidentified after one year. 

1For more information about the total number of deaths in the United 

States, see the Center for Disease Control’s website on “Deaths/Mortality” 

at <http://www.cdc.gov/nchs/fastats/deaths.htm>.

Death investigation systems in the United States, 2004

Centralized State Medical Examiner System

County Coroner System

County Medical Examiner System

Mixed County Medical Examiner and Coroner System
2 Medical Examiners and Coroners’ Offices, 2004

Sixteen States in 2004 had centralized, statewide 

medical examiner systems

Although the specific title and duties of medicolegal officials 

varied, each State had one of three basic types of death 

investigation systems: medical examiner, coroner, or mixed 

systems. States varied in the degree to which death investigation was centralized. Some States had a statewide medical examiner system with no independently functioning 

county entities, while other States had independent medical 

examiner or coroner offices in each county or in other political or geographic subdivisions, such as judicial districts. 

Some ME/C offices were responsible for a specific city, a 

county, multiple counties, or larger regions within a State.

Caution should be exercised when making comparisons by 

the type of office. States differed in selection and qualification standards for medicolegal officials. The distinction 

between coroner and medical examiner systems varied by 

jurisdiction; and the qualifications, skills, and activities of 

medicolegal personnel cannot necessarily be inferred from 

the title attached to the office.

In general, coroners were elected officials while medical 

examiners were appointed. Coroners may be lay persons 

while medical examiners were generally required to be 

physicians and may have specialized training (such as 

forensic pathology). Among many exceptions, there were 

forensic pathologists who had been elected to the position 

of coroner and served in a coroner’s office. In addition, 

some medicolegal officials held the title of medical examiner or coroner, while the title of the office was the opposite. 

These factors complicate comparisons by type of office. 

Two-thirds of the nearly 2,000 ME/C offices in the 

United States served populations of less than 50,000 

persons

A total of 1,998 ME/C offices were enumerated in the BJS 

census, including offices in the District of Columbia and in 

each State except Louisiana. Due to Hurricane Katrina, 

data collection was temporarily suspended in affected gulfcoast States and ultimately canceled in Louisiana. Sixtyfour offices were operating in Louisiana at the time of the 

census. In the aftermath of Hurricane Katrina, Louisiana 

created a centralized State medical examiner office.

Most ME/C offices served relatively small jurisdictions. 

About two-thirds of the offices in the BJS census (1,361 

offices, or 68%) served populations of less than 50,000 

persons. Nearly 1 in 5 served populations of less than 

10,000 persons. Of the 57 offices that served jurisdictions 

with populations of 1 million or more, 12 were centralized 

medical examiner offices serving an entire state.

County coroners’ offices accounted for 80% of all 

ME/C offices in the United States 

The majority of ME/C offices in the United States were 

county coroner offices (1,590 offices, or 80%), most of 

which serve relatively small jurisdictions (table 1). County 

medical examiner offices were the next most common type 

of office (316 offices, or 16%), the majority serving mediumsized jurisdictions (25,000 to 249,999 persons). The 

remainder consisted of State medical examiner offices, district or regional medical examiner and coroner offices, and 

city medical examiner offices.

ME/C offices employed an estimated 7,320 full-time 

personnel nationwide; over half worked in offices 

serving 500,000 or more persons.

ME/C offices employed an estimated 7,320 full-time equivalent (FTE) personnel in 2004. Most of the personnel were 

employed in offices serving jurisdictions of 500,000 or more 

persons. While only 6% of all offices served populations of 

500,000 or more persons, these offices employed over half 

of all FTE personnel.

ME/C offices

Estimated FTE

salaried positions

Population served Number Percent Number Percent

Total 1,998 100.0 % 7,320 100.0 %

1,000,000 or more 57 2.9 % 2,900 39.6 %

500,000 to 999,999 68 3.4 1,000 13.7

250,000 to 499,999 80 4.0 570 7.8

100,000 to 249,999 192 9.6 540 7.4

50,000 to 99,999 240 12.0 440 6.0

25,000 to 49,999 428 21.4 700 9.6

10,000 to 24,999 542 27.1 780 10.7

2,500 to 9,999 326 16.3 320 4.4

Less than 2,500 65 3.3 60 0.8

Table 1. Number of medical examiners and coroners’ offices in 

the United States, 2004

Total number 

of offices

National estimate*

Type of office FTEs Percent

Total 1,998 7,320 100.0%

County coroner office 1,590 3,520 48.1%

Large jurisdiction (250,000 or more) 82 1,100 15.0

Medium jurisdiction (25,000 to 249,999) 660 1,360 18.6

Small jurisdiction (Less than 25,000) 848 1,060 14.5

County medical examiner office 316 2,040 27.9%

Large jurisdiction (250,000 or more) 69 1,700 23.2

Medium jurisdiction (25,000 to 249,999) 172 240 3.3

Small jurisdiction (Less than 25,000) 75 100 1.4

District or regional medical examiner 

office 35 500 6.8%

District or regional coroner office 29 60 0.8%

State medical examiner office 24 680 9.2%

City medical examiner office 3 520 7.1%

Other 1 1 --

Note: Detail may not add to total due to rounding. Excludes offices 

in Louisiana.

*Estimates based on 1,547 offices reporting 6,540 FTEs. See Methodology

for details on estimation procedures.

--Less than 0.5%.
Medical Examiners and Coroners’ Offices, 2004 3

Offices serving 100,000 or more persons, representing 

20% of all offices, employed more than two-thirds (69%) of 

all FTE personnel. County coroner offices employed nearly 

half (48%) of all FTE personnel in 2004, and county medical examiner offices employed 28%.

ME/C offices serving large jurisdictions had an average of 

over 20 FTE personnel, while those serving medium and 

small jurisdictions averaged about 1 to 2 FTE positions. 

Offices serving jurisdictions of 1 million or more persons 

had an average of about 50 FTE personnel.

Among offices serving large jurisdictions (250,000 or more 

persons), most of the FTE salaried employees (40%) were 

categorized as ancillary death investigation personnel, 

such as medical death investigators, autopsy technicians, 

and photographers (figure 1). Forensic pathologists (13%) 

and other medical examiners and coroners (7%) comprised 

20% of all FTE employees. Thirteen percent were laboratory support personnel, such as lab technicians, analysts, 

and toxicologists. Forensic specialists, such as odontologists, entomologists, and anthropologists, comprised less 

than 1% of all FTE employees.

Some ME/C offices did not have FTE salaried personnel 

and the individuals performing medicolegal duties were 

compensated on a per case, per diem, fee-for-service, or 

other “as needed” basis. ME/C offices may also use full- or 

part-time consultants and contractors, including pathologists, forensic specialists, on-call field investigators, and 

others. 

Nearly 1 million human death cases referred in 2004; 

about 500,000 accepted

In general, when a human decedent is discovered by law 

enforcement, medical personnel, or other persons, the 

decedent case is referred to the ME/C office that has jurisdiction. An estimated 956,000 cases were referred to the 

Nation’s ME/C offices during calendar year 2004 (table 2).

Referred cases were generally screened to determine if 

they can be cleared based on death scene characteristics, 

medical history, and other factors, or if it was necessary to 

assume jurisdiction and conduct additional investigations, 

including toxicological screens, autopsies, and specialized 

procedures. About 487,000 cases, or 51% of all cases 

referred in 2004, were accepted, meaning that the office 

conducted additional investigations and completed the 

death certificate or otherwise determined the cause of 

death. These cases represented about a fifth of all human 

deaths in 2004 (figure 2).

Jurisdiction size Average number of FTEs

Large (250,000 or more) 22

Medium (25,000 to 249,999) 2

Small (Less than 25,000) 1

Percent of full-time employees in medical examiners and 

coroners’ offices serving large jurisdictions (250,000 or 

more persons), by personnel category, 2004

Figure 1

0 5 10 15 20 25 30 35 40

Percent of FTE employees

Ancillary death investigation

Administrative

Forensic pathologists

Other MEs or coroners

Laboratory support

Forensic specialists

Other personnel

Note: Excludes offices in Louisiana.

Table 2. Number and percent of cases referred and accepted, 

and total percent accepted, by size of population served, 2004

National estimates* Total percent 

Population served Referred Percent Accepted Percent accepted

Total 955,870 100.0% 486,680 100.0% 50.9%

1,000,000 or more 404,160 42.3% 192,040 39.5% 47.5%

500,000 to 999,999 189,540 19.8 69,620 14.3 36.7

250,000 to 499,999 110,460 11.6 49,150 10.1 44.5

100,000 to 249,999 102,580 10.7 61,140 12.6 59.6

50,000 to 99,999 55,510 5.8 40,850 8.4 73.6

25,000 to 49,999 54,660 5.7 40,570 8.3 74.2

10,000 to 24,999 32,290 3.4 27,400 5.6 84.8

2,500 to 9,999 6,230 0.7 5,540 1.1 89.0

Less than 2,500 430 -- 370 -- 84.8

Note: Detail may not add to total due to rounding. Excludes offices 

in Louisiana.

*Estimates based on 1,348 offices reporting 780,760 referred cases and 

1,568 offices reporting 436,673 accepted cases. See Methodology for 

details on estimation procedures.

--Less than 0.5%.

In 2004 medical examiners and coroners’ offices conducted 

investigations for about 1 in 5 deaths in the U.S.

Figure 2

956,000

referred to

ME/C offices

487,000 accepted

for investigation

2,398,000

human

deaths

Note: Excludes offices in Louisiana.
4 Medical Examiners and Coroners’ Offices, 2004

About three-quarters (74%) of all referred cases in 2004 

were handled by ME/C offices serving jurisdictions of 

250,000 or more persons. These offices handled about 

two-thirds (64%) of all accepted cases.

The percentage of referred cases accepted for further 

investigation was higher in smaller jurisdictions. About 85% 

or more of referred cases were accepted in jurisdictions 

serving less than 25,000 persons, compared to less than 

half of referred cases in jurisdictions serving 250,000 or 

more. These differences may be due to variations in referral and screening practices, workload, and other factors. 

Overall an average of about 480 cases were referred to 

ME/C offices in 2004. About 240 of the referred cases were 

accepted. The average number of cases referred in 2004 

ranged from 40 to 70 among county coroner and medical 

examiner offices serving small jurisdictions to over 3,500 

among county medical examiner offices serving large jurisdictions. State medical examiner offices averaged about 

4,800 referrals.

Accepted cases in 2004 ranged from an average of 30 to 

50 in county coroner and medical examiner offices serving 

small jurisdictions to more than 1,200 in large jurisdictions. 

State medical examiner offices accepted an average of 

about 3,000 cases.

Completed autopsy in nearly half of accepted cases; 

autopsy more likely in large jurisdictions

Accepted cases may involve a variety of procedures 

related to the medicolegal investigation of death. Among 

1,087 offices reporting details on accepted death case procedures performed in 2004, about 62% of accepted cases 

included a death scene investigation (not shown in table). 

Other common procedures included toxicology analysis 

(51%), complete autopsy (48%), and review of medical 

records (45%). Less common were radiology (13%), microbiology (7%), crime scene processing (5%), partial autopsy 

(4%), metabolic screen (3%), and characterization of skeletal remains (1%).

ME/C offices serving jurisdictions of less than 250,000 conducted death scene investigations in a greater percentage 

of accepted cases (72%), compared to jurisdictions serving 

250,000 or more (42%) (figure 3). This difference may be 

due to variation in screening practices; for example, death 

scene investigations may be part of the screening process 

prior to accepting a case in jurisdictions of 250,000 or more 

persons, but after accepting a case in jurisdictions of less 

than 250,000.

ME/C offices serving jurisdictions of 250,000 or more conducted toxicology analyses (57%) in a greater percentage 

of accepted cases, compared to offices serving smaller 

jurisdictions (34%). Similarly, offices serving large jurisdictions conducted complete autopsies in a greater percentage of accepted cases (45%), compared to offices serving 

smaller jurisdictions (23%).

Estimated mean

number of cases

Type of office Referred Accepted

Total 480 240

County coroner office 250 150

Large jurisdiction (250,000 or more) 2,490 1,220

Medium jurisdiction (25,000 to 249,999) 250 170

Small jurisdiction (Less than 25,000) 40 30

County medical examiner office 910 380

Large jurisdiction (250,000 or more) 3,520 1,270

Medium jurisdiction (25,000 to 249,999) 240 160

Small jurisdiction (Less than 25,000) 70 50

District or regional medical examiner office 3,200 960

District or regional coroner office 250 90

State medical examiner office 4,780 3,060

Percent of accepted cases in which listed procedures were 

performed, by size of jurisdiction, 2004

Figure 3

Complete autopsy

Toxicology analysis

Death scene investigation

0% 10% 20% 30% 40% 50% 60% 70% 80%

Percent of accepted cases

Type of procedure

250,000 or more

Less than 250,000

Note: Number of offices reporting in large jurisdictions (153 of 205) 75%;

small jurisdictions (934 of 1,793) 52%. Excludes offices in Louisiana.

Average workload about 130 referred cases and 

70 accepted cases per FTE employee in 2004

Overall, ME/C offices in 2004 were referred an 

estimated 131 cases per FTE employee and 

accepted 67 per FTE (not shown in figure). 

Workload generally increased with jurisdiction size. 

ME/C offices serving populations of 250,000 or more 

received 158 referred cases per FTE and 70 

accepted. Among offices serving under 10,000 

persons, 17 cases were referred and 15 accepted.

 Cases referred and accepted, per FTE employee, 2004

Under 10,000

10,000 - 49,999

50,000 - 249,999

250,000 or more

0 20 40 60 80 100 120 140 160 180

Cases per FTE

Population served

Referred

Accepted

Note: Excludes offices in Louisiana.
Medical Examiners and Coroners’ Offices, 2004 5

4,400 unidentified human decedents reported in an 

average year; 1,000 remained unidentified after 1 year

Medical examiners and coroners are occasionally faced 

with a human decedent that cannot be identified. ME/C 

offices estimated that a total of about 4,400 unidentified 

human decedents were reported in an average year (figure 

4). Ninety percent of these estimated annual unidentified 

decedents were reported by offices serving jurisdictions of 

250,000 or more persons (not shown in figure).

After one year an estimated 1,000 (or 23%) remained unidentified and became “cold cases.” Seventy percent of 

these estimated annual cold cases were reported by offices 

serving jurisdictions of 250,000 or more persons (not 

shown in figure).

ME/C offices reported that a total of about 600 cold cases 

underwent final disposition (such as burial, cremation, or 

other means of disposition) in 2004. Seventy-one percent 

of these cases were reported by offices serving jurisdictions of 250,000 or more persons (not shown in figure).

Nearly 13,500 unidentified human decedents presently on record; total number affected 

by variation in record keeping practices

ME/C offices reported a total of 13,486 unidentified 

human decedents currently on record, with the largest 

jurisdictions (those serving 250,000 or more) 

accounting for 87% of all cases. Overall, an estimated 

23% of ME/C offices reported one or more 

unidentified decedents on record (not shown in table). 

Both jurisdiction size and record keeping practices of 

offices affected the number of unidentified human 

decedents on record.

An estimated half (49%) of ME/C offices in 2004 had a 

policy for retaining records on unidentified human 

decedents, such as x-rays, fingerprints, or DNA. ME/C 

offices serving larger jurisdictions were more likely to 

have such a policy. More than 90% of those serving 

250,000 or more persons had a policy to retain 

records of unidentified human decedents. In 

comparison, 29% of ME/C offices serving jurisdictions 

of less than 2,500 persons reported such a policy. 

A forthcoming BJS report will compare the information 

on unidentified human decedents obtained in the BJS 

census with data available in theFederal Bureau of 

Investigation’s National Crime Information Center. The 

report will also explore different methods for 

generating national estimates of the total number of 

unidentified human decedents. Understanding the 

number and distribution of unidentified human 

decedents is critical to improving national databases, 

particularly regarding missing persons investigations. 

Unidentified human decedents on recorda Percent of offices 

with record

retention policiesb Population served Number Percent

Total 13,486 100.0 % 49 %

1,000,000 or more 10,667 79.1 % 95 %

500,000 to 999,999 1,108 8.2 94

250,000 to 499,999 450 3.3 94

100,000 to 249,999 571 4.2 66

50,000 to 99,999 201 1.5 47

25,000 to 49,999 229 1.7 49

10,000 to 24,999 105 0.8 38

2,500 to 9,999 144 1.1 31

Less than 2,500 11 -- 29

Note: Detail may not add to total due to rounding. Excludes offices 

in Louisiana.

--Less than 0.5%.

aData represent 1,624 ME/C offices reporting human decedents on 

record.

bData represent 1,638 ME/C offices reporting retention policies.

Five offices account for about 54% of all unidentified human 

remains on record nationally

Population of 

jurisdiction 

served

Unidentified decedents on record

City State Number Percent

Year of 

earliest case

New York NY 8,085,000 3,612 26.8 % 1996

Cleveland OH 1,363,000 2,184 16.2 1900

Los Angeles CA 9,900,000 800 5.9 1968

Houston TX 3,644,000 411 3.0 1957

San Bernardino CA 1,900,000 307 2.3 ...

Note: Excludes offices in Louisiana.

...Data not available.

About a fifth of reported unidentified human decedents 

remain unidentified after 1 year

Figure 4

1,000 remain

unidentified

after one year

600 undergo

final disposition

4,400

unidentified

human

decedents in

an average

year

Note: 4,400 estimate based on 1,398 offices reporting 4,281

cases; 1,000 estimate based on 1,439 offices reporting 926

cases; 600 estimate based on 1,446 offices reporting 577

cases. See Methodology for details on estimation

procedures. Excludes offices in Louisiana.
6 Medical Examiners and Coroners’ Offices, 2004

Eighty percent of ME/C offices reported they “rarely or 

never” used NCIC

An estimated 20% of ME/C offices reported they used the 

FBI’s National Crime Information Center (NCIC) “somewhat 

often” or “very often,” while 80% said they used the NCIC 

“rarely or never” (table 3). Frequent use of NCIC was more 

common among offices serving larger jurisdictions, including 59% of those serving 1,000,000 or more persons.

Direct access to NCIC by ME/C offices was not permitted at 

the time of the census. Typically, information on unidentified human remains was entered by law enforcement agencies on behalf of ME/C offices. In May 2006 direct access 

to NCIC was granted to ME/C offices by the FBI. Greater 

use of NCIC might be expected as a result, but increased 

workload and the cost of access remain obstacles.

As of February 2005 the NCIC Unidentified Person file contained about 5,800 unidentified human decedent records. 

Twenty-seven percent of these unidentified persons were 

determined to be homicide victims. The cause of death for 

more than half of the victims could not be determined.

California was the only State that mandated information 

about the unidentified be reported to NCIC within a specified period. About 42% of all records in the NCIC unidentified persons file were from California.

Estimated annual budgets totaled $718.5 million or 

about $387,000 per office

ME/C offices had estimated overall annual budgets of 

nearly $718.5 million, an average of $387,000 per office 

(table 4). The median budget was $37,000. 

County medical examiner budgets averaged $715,000, 

ranging from an average of $2.5 million among those serving large jurisdictions to $18,000 among those serving 

small jurisdictions.

County coroner budgets averaged $225,000, ranging from 

an average of about $1.4 million among those serving large 

jurisdictions to $41,000 among those serving small jurisdictions.

Overall, ME/C offices had annual budgets equivalent to 

about $99,000 per FTE employee. Among county coroner 

and medical examiner offices, per FTE amounts were 

higher in medium jurisdictions and lowest in small jurisdictions. County medical examiner offices serving small jurisdictions had the lowest per FTE budget, at $11,400. County 

coroner offices serving medium jurisdictions had the highest per FTE budget, at $143,400.

Table 4. Estimated average operating budget of medical examiners and coroners’ offices 

in the United States, by type of office, 2004

Type of office Total Mean Median Per FTE

Total $718,450,000* $387,000 $37,000 $99,000

County coroner office $335,959,000 $225,000 $31,000 $96,900

Large jurisdiction (250,000 or more) 112,010,000 1,366,000 796,000 101,800

Medium jurisdiction (25,000 to 249,999) 192,381,000 302,000 64,000 143,400

Small jurisdiction (Less than 25,000) 31,569,000 41,000 16,000 30,800

County medical examiner office $200,303,000 $715,000 $69,000 $98,600

Large jurisdiction (250,000 or more) 173,064,000 2,508,000 1,270,000 101,600

Medium jurisdiction (25,000 to 249,999) 26,159,000 173,000 66,000 112,000

Small jurisdiction (Less than 25,000) 1,079,000 18,000 10,000 11,400

District or regional medical examiner office $55,830,000 $1,595,000 $1,025,000 $111,000

District or regional coroner office $3,723,000 $155,000 $21,000 $62,000

State medical examiner office $65,311,000 $2,721,000 $2,161,000 $96,600

Note: Includes city and other types of offices. Does not include offices reporting zero annual budget (such as offices 

compensated on a per case, per diem, fee-for-service, or other “as needed” basis). Detail may not add to total due to 

rounding. Excludes offices in Louisiana.

*Estimates based on 1,570 offices reporting $674,678,583 for total operating budgets. See Methodology

for details on estimation procedures.

Table 3. Use of the FBI's NCIC unidentified persons file 

by medical examiners and coroners’ offices, by size 

of jurisdiction

Percent of offices using the 

FBI's NCIC — 

Population served

Number of offices 

reporting

Very or somewhat often Rarely or never

Total 1,655 20% 80%

1,000,000 or more 56 59% 41%

500,000 to 999,999 61 41 59

250,000 to 499,999 70 39 61

100,000 to 249,999 166 21 79

50,000 to 99,999 196 20 80

25,000 to 49,999 343 16 85

10,000 to 24,999 439 14 86

2,500 to 9,999 271 17 83

Less than 2,500 53 30 70

Note: Detail may not add to total due to rounding. 

Excludes offices in Louisiana.
Medical Examiners and Coroners’ Offices, 2004 7

Methodology

Data collection for the 2004 Census of Medical Examiner 

and Coroner Offices was conducted by RTI International 

(RTI) on behalf of BJS under cooperative agreement 2005-

MU-MU-K011. BJS provided an initial draft questionnaire 

and respondent list to RTI. RTI reviewed the draft questionnaire for general content and design and coordinated a 

forensic expert panel review of the instrument to obtain 

feedback on specific items.

The initial list of ME/C offices operating in the United States 

was provided to BJS by the Centers for Disease Control 

and Prevention, U.S. Department of Health and Human 

Services. RTI updated the list and conducted telephone 

verification of contact information for each office.

Data were collected by mixed mode. In addition to mail-out 

packages, RTI created a web site on which respondents 

could access the questionnaire and provide responses 

electronically. Follow-up efforts included Computer 

Assisted Telephone Interviewing (CATI) and e-mail. Seventy-one percent of respondents used mail or facsimile 

transmission of data, 13% responded via the Internet, and 

16% responded by telephone.

A total of 1,998 ME/C offices were enumerated in the census. Despite extensive follow-up efforts, 281 ME/C offices 

did not respond to the request for information, yielding an 

overall response rate of 85.9%. By population served, the 

response rate was lowest among ME/C offices serving 

10,000 to 49,999 persons (83.9%), and generally higher 

among those serving 100,000 or more.

By type of office, the response rate was lowest among 

county medical examiner offices serving small jurisdictions 

(77.3%). Response rates for other types of offices were as 

follows: State medical examiner offices (100.0%); city medical examiner offices (100.0%); district or regional medical 

examiner offices (94.3%); county coroner offices (85.9%); 

county medical examiner offices (84.2%). 

Five States had overall response rates below 80%, including Kansas (79.4%), Wyoming (78.3%), Tennessee 

(77.4%), Arizona (64.3%), and Illinois (60.4%). In counties 

in Texas, justices of the peace are not death investigators 

or coroners. They may make cause and manner of death 

determinations but were out of scope for this census.

Imputations were made for missing continuous data elements including FTEs, budgets, and workload items (cases 

referred and accepted, and unidentified decedents handled 

in an average year). Imputation cells were based on the 

State in which an ME/C office was located, type of office, 

and population served.

For FTE data the median ratio of FTEs to population served 

was calculated within imputation cells and multiplied by the 

population for offices with missing data to produce the 

imputed values. Imputations for FTE data in sheriff-coroner 

offices were based on agency employment data from the 

BJS Law Enforcement Management and Administrative 

Statistics (LEMAS) program. 

For budget data the median ratio of budget to FTEs was 

calculated within imputation cells and multiplied by the total 

FTEs in offices with missing data to produce the imputed 

values. 

For referred cases, accepted cases were divided by the 

median ratio of cases accepted to those referred. For 

accepted cases, referred cases were multiplied by the 

median ratio of cases accepted to those referred. If both 

elements were missing, the median ratio of cases referred 

to population served was multiplied by the population for 

offices with missing data to impute referred cases. The 

median ratio of cases accepted to those referred was multiplied by the number of referred cases to impute accepted 

cases.

For unidentified decedents reported annually, remaining 

unidentified after 1 year, and undergoing final disposition, 

the median value within imputation cells was used as the 

imputed value.

Population served Total Response rate

Total 1,998 85.9 %

1,000,000 or more 57 98.2 %

500,000 to 999,999 68 94.1

250,000 to 499,999 80 88.8

100,000 to 249,999 192 88.5

50,000 to 99,999 240 86.3

25,000 to 49,999 428 83.9

10,000 to 24,999 542 83.9

2,500 to 9,999 326 85.6

Less than 2,500 65 86.2

Type of office Total Response rate

Total 1,998 85.9%

County coroner office 1,590 85.9%

Large jurisdiction (250,000 or more) 82 89.0

Medium jurisdiction (25,000 to 249,999) 660 86.4

Small jurisdiction (Less than 25,000) 848 85.3

County medical examiner office 316 84.2%

Large jurisdiction (250,000 or more) 69 94.2

Medium jurisdiction (25,000 to 249,999) 172 83.1

Small jurisdiction (Less than 25,000) 75 77.3

District or regional medical examiner office 35 94.3%

District or regional coroner office 29 82.8

State medical examiner office 24 100.0

City medical examiner office 3 100.0

Other 1 100.0
U.S. Department of Justice

Office of Justice Programs

Bureau of Justice Statistics

Washington, DC 20531

Official Business

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Permit No. G-91

*NCJ~216756*

8 Medical Examiners and Coroners’ Offices, 2004

The Bureau of Justice Statistics is the statistical 

agency of the U.S. Department of Justice. Jeffrey L. 

Sedgwick is director.

This Special Report was written by Matthew J. 

Hickman and Kristen A. Hughes of BJS, under the 

supervision of Steven K. Smith, and Kevin J. Strom 

and Jeri D. Ropero-Miller of RTI International. Tracey 

Kyckelhahn provided statistical review. Data 

collection for the 2004 Census of Medical Examiner 

and Coroners’ Offices was conducted by RTI 

International on behalf of BJS under cooperative 

agreement 2005-MU-MU-K011.

The National Association of Medical Examiners 

(NAME) and the International Association of 

Coroners and Medical Examiners (IACME) provided 

valuable assistance in development of the data 

collection instrument and in encouraging participation 

in the study. (See <http://thename.org> and <http://

www.theiacme.com> for more information.)

Carolyn C. Williams edited the report, with assistance 

from Joanna S. Bradford, and Jayne Robinson 

prepared the report for final printing, under the 

supervision of Doris J. James.

June 2007, NCJ 216756

This report in portable document format and in ASCII 

and its related statistical data and tables are available 

at the BJS World Wide Web Internet site: <http://

www.ojp.usdoj.gov/bjs/abstract/meco04.htm>.

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