# Bureau of Justice Statistics 

# Special Report

June 2007, NCJ 216756 U.S. Departmentof 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 conductdeath scene investigations, perform autopsies, and determine the cause and manner of death when a person hasdied 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 coun ty medical examiner system, and 13 had a mixed county medical examiner and coroner system. Eight States with decentralized death investigationsystems 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 pe r office.The majority of ME/C offices in 2004 were county coroners’ offices (1,590 or 80%), most ofwhich 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 examineror 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 theBureau’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.

1 For 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 System2 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 medicalexaminer or coroner offices in each county or in other political or geographic subdivisions, such as judicial districts. Some ME/C offices were respon sible for a specific city, a county, multiple counties, or larger regions within a State. Caution should be exercised when making comparisons bythe 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 qualificat ions, 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 weregenerally 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 ju risdictions (table 1). County medical examiner offices were the next most common typeof office (316 offices, or 16%), the majority serving mediumsized jurisdictions (25,000 to 249,999 persons). The remainder consisted ofState 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 nearlyhalf (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 deat h investigation personnel, such as medical death investig ators, autopsy technicians, and photographers (figure 1). Forensic pathologists (13%) and other medical examiners and coroners (7%) comprised20% of all FTE employees. Thirteen percent were laboratory support personnel, such as lab technicians, analysts, and toxicologists. Forensic specialists, such as odontologists, entomologists, and an thropologists, 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- orpart-time consultants and contractors, including pathologists, forensic specialists, on-call field investigators, and others. Nearly 1 million human deat h 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 referredto 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 weregenerally 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 cond uct additional investigations, including toxicologica l 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 accepted Population served Referred Percent Accepted Percent

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 sm aller jurisdicti ons. 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 ju risdictions 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 offi ces 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. Among1,087 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 medicalrecords (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 jurisdicti ons 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 ju risdictions 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 re cord 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 record s on unidentified human decedents, such as x-rays, fingerprints, or DNA. ME/C offices serving larger jurisd ictions 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 of fices 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 record a Percent of offices with record retention policies b 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%.

a Data represent 1,624 ME/C offices reporting human decedents on record.
b Data represent 1,638 ME/C offi ces 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 BernardinoCA 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 morecommon 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 atthe 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 repo rted 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 amongthose 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 m illion among those serving largejurisdictions 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 FTEbudget, at $11,400. Countycoroner 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 questionnaireand 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 ef forts included ComputerAssisted 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 (8 3.9%), and generally higher among those serving 100,000 or more.

By type of office, the resp onse rate was lowest among county medical examiner offices serving small jurisdictions (77.3%). Response rates for other types of offices were asfollows: 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 ce lls 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 acceptedto those refe rred. 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. Themedian 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 1 100.0U.S. Department of Justice Office of Justice Programs Bureau of Justice Statistics

Washington, DC 20531

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### *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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