OSAC 2022-N-0027 Medicolegal Death Investigation 

Response to Death Locations and Incident Scenes: 

Best Practice Recommendations

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OSAC 2022-N-0027

Medicolegal Death Investigation 

Response to Death Locations and 

Incident Scenes: 

Best Practice Recommendations

Medicolegal Death Investigation Subcommittee

Medicine Scientific Area Committee

Organization of Scientific Area Committees (OSAC) for Forensic Science
OSAC 2022-N-0027 Medicolegal Death Investigation 

Response to Death Locations and Incident Scenes: 

Best Practice Recommendations

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Draft OSAC Proposed Standard

OSAC 2022-N-0027

Medicolegal Death Investigation 

Response to Death Locations and Incident 

Scenes: Best Practice Recommendations

Prepared by 

Medicolegal Death Investigation

Version: 1.0

March 2022

Disclaimer:

This OSAC Proposed Standard was written by the (subcommittee) of the Organization of Scientific Area 

Committees (OSAC) for Forensic Science following a process that includes an open comment period. 

This Proposed Standard will be submitted to a standards developing organization and is subject to 

change.

There may be references in an OSAC Proposed Standard to other publications under development by 

OSAC. The information in the Proposed Standard, and underlying concepts and methodologies, may be 

used by the forensic-science community before the completion of such companion publications.

Any identification of commercial equipment, instruments, or materials in the Proposed Standard is not a 

recommendation or endorsement by the U.S. Government and does not imply that the equipment, 

instruments, or materials are necessarily the best available for the purpose
OSAC 2022-N-0027 Medicolegal Death Investigation 

Response to Death Locations and Incident Scenes: 

Best Practice Recommendations

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1 OSAC 2022-N-0027

2 Medicolegal Death Investigation Response to Death Locations and Incident 

3 Scenes: Best Practice Recommendations

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5 FORWARD 

6 A medicolegal death investigation (MDI) should be an independent investigation with a scope 

7 and focus of establishing cause and manner of death. The MDI is parallel but separate to that 

8 conducted by any other agency, including the law enforcement investigating agency. The 

9 investigation should be conducted by MDI personnel with specialized training in death scene 

10 investigation. This investigation should focus on postmortem changes, injury documentation, 

11 circumstances of death, and collecting any pertinent investigative or medical history to assist 

12 with determining the cause and manner of death. 

13

14 A MDI begins when a death is reported to the MDI authority. Initial decisions about the extent 

15 of involvement and investigation by the MDI authority are important to ensure a thorough and 

16 complete death investigation. One of the initial investigative decisions is whether the MDI 

17 authority will respond to the location of death or incident scene to perform an investigation. 

18 Recognizing that a response by the MDI authorities varies by state and local jurisdictions, best 

19 practice is for a Medicolegal Death Investigator, credentialed by the American Board of 

20 Medicolegal Death Investigators, or a Forensic Pathologist (FP), certified by the American Board 

21 of Pathology or American Osteopathic Board of Pathology, to respond to the location where the 

22 body was found, as well as to the incident scene (when it still exists) as specified in this 

23 document.

24

25 Medical examiner/coroner offices should be adequately resourced with funding, supplies, and 

26 qualified personnel to ensure adherence by the office to respond at a minimum to the types of 

27 incidents, decedents and locations specified in this document.

28

29

30 KEYWORDS 

31 coroner, death investigation, decedent, medical examiner, medicolegal death investigation, 

32 medicolegal death investigator, scene response

33

34 ABSTRACT 

35 This document presents best practice recommendations for the medicolegal death investigation 

36 (MDI) authority, as when to examine decedents at the location of death and when to document 

37 the incident scenes, when different than the location of death. General topics highlighted include 

38 to which types of deaths the MDI authority should respond, to what types of scene and locations 
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39 the MDI authority should respond, and which decedents should be examined at the location of 

40 death. 
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41 TABLE OF CONTENTS

42

43 1 Scope

44 2 Normative References

45 3 Glossary

46 4 Recommendations

47 4.1 Background

48 4.2 Considerations for scene response based on initial presumptive case type

49 4.3 Considerations for scene response based on the decedent(s)

50 4.4 Considerations for scene response based on the type of location of death

51 5 Bibliography
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52 1 SCOPE

53 Medicolegal death investigation (MDI) personnel may not respond to the death location or 

54 incident scene for every death investigated or for which jurisdiction is assumed. This document 

55 provides guidance for which death locations and/or incident scenes require a scene investigation. 

56 Not only does scene investigation allow for in situ preliminary body evaluation, it provides an 

57 opportunity to document and collect property and evidence (in accordance with jurisdictional 

58 laws and regulations) and to collect important medical history and contextual information from 

59 family and witnesses. Responding to these locations and scenes may also provide important 

60 information to help triage cases, to assist with the decision whether or not a complete autopsy is 

61 necessary, to request toxicology or other analyses, to document and collect evidence to help 

62 determine the manner of death, and to document suspicious circumstances that necessitate 

63 further investigation. Information gathered at the death location and/or incident scene may also 

64 play an important role in public health, such as identifying emerging diseases, epidemics, or 

65 novel drug trends. 

66

67 The need for scene investigation depends on multiple factors such as decedent demographics, 

68 location of death and suspected type of death. As such, a case may fall under multiple categories 

69 specified in this document and should be analyzed from various angles to see if the best practice 

70 is to respond to that scene and/or incident location. For purposes of this document, all deaths are 

71 categorized by the initial suspected type of death, recognizing that until a complete investigation 

72 (often with autopsy) is concluded, the type (or manner) of death is not finalized and is subject to 

73 change. Personnel deciding if they should respond to a scene or incident location should always 

74 err on the side of caution, and when in doubt should respond.

75

76 Notwithstanding any conflicting state statutory issues, decedents should be left at the death 

77 location to allow the MDI personnel to respond to that location and examine the remains in situ. 

78 Exceptions to this may be discussed with the MDI authority due to issues such as the remains 

79 possibly being lost or in danger of being damaged (e.g. in a structure fire or being washed out to 

80 sea by rising tides). MDI offices should have personnel available 24 hours a day for a timely 

81 response, preferably being en route to the scene within an hour. 

82

83 This document does not take into account taking custody of the remains and/or transporting the 

84 remains, nor does it account for the specifics of the location and scene investigations, just best 

85 practices for the MDI authority to respond to initially evaluate the body, location and scene. 

86

87

88

89

90
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91 2 NORMATIVE REFERENCES

92

93 Department of Justice, Office of Justice Programs, National Institute of Justice. Death 

94 investigation: A guide for the scene investigator (technical update). Washington, DC. 2011. 

95 Available from: https://www.nij.gov/pubs-sum/234457.htm

96

97 3 TERMS AND DEFINITIONS 

98

99 certified medicolegal death investigator

100 Medicolegal death investigator who has completed the requirements for Certification (Registry 

101 or Board) by an accredited credentialing body, currently American Board of Medicolegal Death 

102 Investigators

103

104 cause of death

105 Medical opinion of the disease or injury that resulted in a person’s death

106

107 coroner

108 Elected or appointed official whose duty is to oversee medicolegal death investigations, usually 

109 for a single county, and ensure certification of cause and manner of death; duties vary based on 

110 local enabling statutes

111

112 death scene

113 Location or site at which a death is pronounced, and at which the decedent’s body is 

114 located. This may or may not be the same location as the incident scene 

115

116 decedent

117 Deceased person or any suspected human remains

118

119 forensic pathologist

120 Physician who is board-certified in forensic pathology by an accredited credentialing body, 

121 currently American Board of Pathology and American Osteopathic Board of Pathology

122

123 incident scene 

124 Location at which a fatal injury or fatal sequence of events happened. This may or may not be 

125 the same location as where the death was pronounced 

126

127 jurisdiction
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128 (1) Legal authority to make legal decisions and judgments regarding a death, including 

129 performance of autopsy, as well as investigation and certification of cause and manner of 

130 death.

131 (2) Geographic area in which a medical examiner or coroner’s authority applies.

132

133 manner of death

134 Classification system based on the circumstances under which death occurred; includes accident, 

135 homicide, natural, suicide, and undetermined

136

137 medical examiner

138 Appointed forensic pathologist whose duty is to oversee medicolegal death investigations, 

139 perform postmortem examinations, and certify cause and manner of death. In some jurisdictions, 

140 individuals with other qualifications hold the title “Medical Examiner”, but for purposes of this 

141 document those individuals are considered medicolegal death investigators 

142

143 medicolegal death investigation

144 Formal inquiry into the circumstances surrounding the death of a human being; investigative 

145 information is considered with autopsy findings and adjunctive studies (if performed) to 

146 determine the cause and manner of death

147

148 medicolegal death investigation authority

149 Person or persons whose duty it is to perform medicolegal death investigations for a 

150 designated jurisdiction, and ensure certification of cause and manner of death; duties vary 

151 based on local enabling statutes 

152

153 medicolegal death investigation system

154 Varied jurisdictional structures used for medicolegal death investigations

155

156 medicolegal death investigator

157 Individual who has completed the requirements for Certification (Registry or Board) by an 

158 accredited credentialing body or performs medicolegal death investigations

159

160 on scene 

161 When the location at which a death is pronounced and at which the decedent’s body is 

162 located is the same as the incident scene

163

164 organ procurement organization (OPO)

165 Organization responsible for recovering organs from donors 

166
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167 tissue procurement organization (TPO)

168 Organization responsible for recovering tissues from tissue donors

169

170 4 Recommendations

171

172 4.1 Background

173 After an MDI authority has initially determined jurisdiction based on local and state statutes and 

174 office policy, a thorough medicolegal death investigation often continues with response to the 

175 death location and/or incident scene. This includes a preliminary body evaluation to document 

176 findings that may be useful in aiding the determination of cause and manner of death, 

177 identification of the decedent, or to help identify and locate next of kin. The principles of the 

178 National Institute of Justice’s Death investigation: A guide for the scene investigator (technical 

179 update) should be followed once at the location(s). This includes providing written 

180 documentation of all findings, as well as photographs and/or video to become part of the MDI 

181 authority case file. 

182

183 There are several factors to consider when determining if a scene or incident response by the 

184 MDI personnel is necessary. These include the initial presumptive case manner/circumstances 

185 (as described below in section 4.2) the category of decedent (as described below in section 4.3) 

186 and the type of location of the death (as described below in section 4.4). Guidance for each of 

187 these categories are presented in this section to be used to determine if a scene response is 

188 warranted in that particular case. 

189

190 Recognizing at times that a death is not reported proximal to the death and/or injury, and the 

191 body may have been moved and/or evidentiary issues are no longer a concern, the following 

192 caveats apply as exceptions to the procedures described below193

194 Delayed deaths (days to years following release from the initial hospitalization) –

195 Evaluate case-by-case, but generally unless in a long-term medical facility, MDI 

196 personnel should respond to evaluate and ensure no competing issues; also applying the 

197 guidelines in sections 4.2 and 4.3.

198

199 Cases with a delay in reporting to the MDI authority, often after the body has been moved to a 

200 mortuary or funeral home (sometimes called backwards cases) –

201 Evaluate case-by-case, depending on the need to collect evidence (i.e. sexual assault kit), 

202 but generally response is not necessary.

203

204 Nothing in this document is intended to prohibit the MDI authority from allowing the staff of an 

205 operating room to move a decedent to another secure location within the hospital in order to 

206 utilize that operating room for additional procedures. The MDI authority should have 

207 agreements with hospitals that establish guidelines for this to happen, and should consider 

208 formalizing the agreements. 

209
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210 In jurisdictions where law enforcement personnel at the incident scene do not permit access to it 

211 by the MDI personnel, the MDI authority should develop MOUs with these jurisdictions to gain 

212 this access, as it can provide valuable information for the death investigation.

213

214 The decision to respond or not does not relieve the MDI authority of responsibility to respond to 

215 collect admission blood samples when available. MDI authorities should consider developing 

216 MOUs with their local hospitals to address retention of admission blood samples. 

217

218 4. 2. Considerations for scene response based on initial presumptive case manner or 

219 circumstances

220 Once an MDI authority has determined case jurisdiction, one of the next steps in a death 

221 investigation is to determine if a scene response is needed. A scene response should occur in a 

222 timely manner due to concerns of postmortem changes, as well as concerns of loss of evidence or 

223 changes in the scene environment. The timeliness of response will be affected by resources and 

224 geography, but offices should take steps to attempt to minimize response times. This section will 

225 provide best practice recommendations for evaluating MDI personnel response based on the 

226 suspected type of death. 

227

228 4.2.1 Deaths by homicide or with suspicious circumstances

229 4.2.1.1 MDI personnel should respond to all deaths that are on scene. 

230 4.2.1.2 MDI personnel should respond to the location of death in an emergency department (ED), 

231 and to the incident scene if it has not been cleared.

232 4.2.1.3 MDI personnel should respond to the location of death in the operating room (OR) for 

233 acute trauma or proximal to coming to the hospital, and to the incident scene if it has not been 

234 cleared.

235 4.2.1.4 MDI personnel need to evaluate deaths of Inpatients (IP) or the OR in conjunction with 

236 an extended stay on a case-by-case basis, depending on the need to collect evidence from the 

237 decedent (i.e. sexual assault kit).

238 4.2.1.5 This would include anytime other involved agencies express a concern that the death 

239 might have been related to homicidal violence.

240

241 4.2.2 Deaths by suicide 

242 4.2.2.1 MDI personnel should respond to all deaths that are on scene. 

243 4.2.2.2 MDI personnel should respond to the location of death in an ED, and to the incident 

244 scene if it has not been cleared.

245 4.2.2.3 MDI personnel should respond to the location of death in the operating room (OR) for 

246 acute trauma, or proximal to coming to the hospital, and to the incident scene if it has not been 

247 cleared.

248 4.2.2.4 MDI personnel need to evaluate deaths of Inpatients (IP) or the OR in conjunction with 

249 an extended stay on a case-by-case basis, depending on the need to collect evidence from the 

250 decedent but generally response is not necessary. 

251

252 4.2.3 Accidents, to include drowning and electrocution

253 4.2.3.1 MDI personnel should respond to all deaths that are on scene. 
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254 4.2.3.2 MDI personnel should respond to the location of death in an ED, and to the incident 

255 scene if it has not been cleared.

256 4.2.3.3 MDI personnel should respond to the location of death in the operating room (OR) for 

257 acute trauma or proximal to coming to the hospital, and to the incident scene if it has not been 

258 cleared.

259 4.2.3.4 MDI personnel need to evaluate deaths of Inpatients (IP) or the OR in conjunction with 

260 an extended stay on a case-by-case basis, depending on the need to collect evidence from the 

261 decedent but generally response is not necessary. 

262

263 4.2.4 Traffic related incidents

264 4.2.4.1 MDI personnel should respond to all deaths that are on scene. 

265 4.2.4.2 MDI personnel should respond to the location of death in an ED, and to the incident 

266 scene if it has not been cleared.

267 4.2.4.3 MDI personnel should respond to the location of death in the operating room (OR) for 

268 acute trauma or proximal to coming to the hospital, and to the incident scene if it has not been 

269 cleared.

270 4.2.4.4 MDI personnel need to evaluate deaths of Inpatients (IP) or the OR in conjunction with 

271 an extended stay on a case-by-case basis, depending on the need to collect evidence from the 

272 decedent but generally response is not necessary. 

273

274 4.2.5 Work related incidents

275 4.2.5.1 MDI personnel should respond to all deaths that are on scene. 

276 4.2.2.5 MDI personnel should respond to work-related deaths that occur in an (ED), and to the 

277 incident scene if it has not been cleared, unless they are a clearly witnessed event consistent with 

278 a natural death and the decedent has history to support the natural death.

279 4.2.2.5 MDI personnel should respond to the location of death in the operating room (OR) for 

280 deaths with trauma that is acute or proximal to coming to the hospital, and to the incident scene 

281 if it has not been cleared.

282 4.2.2.5 MDI personnel need to evaluate deaths of Inpatients (IP) or the OR in conjunction with 

283 an extended stay on a case-by-case basis, depending on the need to collect evidence from the 

284 decedent but generally response is not necessary. 

285

286 4.2.6 In Custody and/or during law enforcement interaction

287 4.2.6.1 MDI personnel should respond to all deaths that are on scene. 

288 4.2.6.2 MDI personnel should respond to the location of death in an ED, and to the incident 

289 scene if it has not been cleared.

290 4.2.6.3 MDI personnel should respond to the location of death in the operating room (OR) for 

291 acute trauma or proximal to coming to the hospital, and to the incident scene if it has not been 

292 cleared.

293 4.2.6.4 MDI personnel need to evaluate deaths of Inpatients (IP) or the OR in conjunction with 

294 an extended stay on a case-by-case basis, depending on the need to collect evidence from the 

295 decedent but generally response is not necessary. 

296

297 4.2.7 Suspected overdose or drug related

298 4.2.7.1 MDI personnel should respond to all deaths that are on scene. 
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299 4.2.7.2 MDI personnel should respond to the location of death in an ED, and to the incident 

300 scene if it has not been cleared.

301 4.2.7.3 MDI personnel should respond to the location of death in the operating room (OR) for 

302 acute trauma or proximal to coming to the hospital, and to the incident scene if it has not been 

303 cleared.

304 4.2.7.4 MDI personnel need to evaluate deaths of Inpatients (IP) or the OR in conjunction with 

305 an extended stay on a case-by-case basis, depending on the need to collect evidence from the 

306 decedent but generally response is not necessary.

307

308 4.2.8 Fire related deaths

309 4.2.8.1 MDI personnel should respond to all deaths that are on scene. 

310 4.2.8.2 MDI personnel should respond to the location of death in an ED, and to the incident 

311 scene if it has not been cleared.

312 4.2.8.3 MDI personnel should respond to the location of death in the operating room (OR) for 

313 acute trauma or proximal to coming to the hospital, and to the incident scene if it has not been 

314 cleared.

315 4.2.8.4 MDI personnel need to evaluate deaths of Inpatients (IP) or the OR in conjunction with 

316 an extended stay on a case-by-case basis, depending on the need to collect evidence from the 

317 decedent but generally response is not necessary. 

318

319 4.2.9 Surgical misadventures

320 4.2.9.1 Generally an incident or scene response is not necessary in a hospital setting, but MDI 

321 personnel should respond to the incident location if it is in an outpatient setting.

322

323 4.2.10 Contagious diseases

324 4.2.10.1 Generally an incident or scene response is not necessary except for other reasons stated 

325 in this document. These decisions should be coordinated with relevant public health agencies in 

326 cases of outbreaks or new/emerging diseases. 

327

328 4.2.11 Natural deaths

329 4.2.11.1 MDI personnel should respond to all deaths in public view.

330 4.2.11.2 MDI personnel should respond to the location of death in the ED If there is not a 

331 physician to certify the death and a witnessed terminal event consistent with natural disease 

332 process, and to the incident scene if it has not been cleared.

333 4.2.11.3 It is generally not necessary to respond to the operating room (OR) or for in-patient (IP) 

334 death except for other reasons stated in this document.

335

336 4.2.12 Multiple deaths

337 4.2.12.1 MDI personnel should respond to all deaths where two or more are deceased, regardless 

338 of the circumstances, unless unrelated and in different rooms of a care facility.

339

340 4.2.13 Suspicious deaths

341 4.2.13.1 MDI personnel should respond to the location of the decedent anytime other involved 

342 agencies (such as law enforcement or hospital staff) have a concern that the death might be due 

343 to other than natural causes 
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344 4.3 Considerations for scene response based on the decedent(s)

345 A case may not fall under one of the above listed types of cases but still should have MDI 

346 personnel respond. This section will provide best practice recommendations for evaluating MDI 

347 personnel response based on the type or profile of the decedent.

348

349 4.3.1 Child/infant (through age 17) unless the child is under hospice care for a natural 

350 disease or has fatal health conditions and a physician is able to certify the death certificate.

351 4.3.1.1 MDI personnel should respond to all on scene deaths in this classification.

352 4.3.1.2 MDI personnel should respond to all deaths in this classification in the emergency 

353 department (ED), and respond to the incident scene if it has not been cleared.

354 4.3.1.3 MDI personnel should respond to all deaths in this classification in the Operating room 

355 (OR) if it is proximal to just coming to the hospital.

356 4.3.1.4 MDI personnel need to evaluate deaths of Inpatients (IP) or the OR in conjunction with 

357 an extended stay on a case-by-case basis, depending on the need to collect evidence from the 

358 decedent and/or interview family. Best practice includes still responding to the home for a doll 

359 reenactment and scene visit, even if delayed, on infants.

360

361 4.3.2 Persons in custody

362 4.3.2.1 MDI personnel should respond to all deaths in which the decedent was in either direct or 

363 indirect contact with law enforcement such as during incarceration, apprehension, or pursuit.

364

365 4.3.3 Bones/specimens

366 4.3.3.1 MDI personnel, which may include a forensic anthropologist, should respond to all found 

367 bones/specimens, unless by looking at clear photographs with a scale it is obviously non-human 

368 (e.g. tail, wing, not biologic material).

369

370 4.3.4 Decomposed or charred remains

371 4.3.4.1 MDI personnel should respond to all decomposed and charred decedents.

372 4.3.4.1.1 The standard for the level of decomposition that requires a response is if visual 

373 identification of the decedent is questionable or they are visually unidentifiable.

374

375 4.3.5 Unidentified remains

376 4.3.5.1.MDI personnel should respond to all unidentified decedents.

377 4.3.5.1.1 On Hospital IP, only if hospital social workers/personnel have been unable to make 

378 positive identification (such as through property/evidence or law enforcement assistance with 

379 fingerprints).

380

381 4.3.6 Organ donor/OPO or TPO involvement (pre procurement)

382 4.3.6.1 MDI personnel should respond to document the remains prior to procurement if it is a 

383 case where the office will be accepting jurisdiction of the remains.

384 4.3.6.1.1 Arrangements may be made with OPO/TPO that their personnel may obtain 

385 photographs and specimens on behalf of the MDI authority in lieu of a response.

386

387 4.3.7 High profile circumstances
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388 4.3.6.1 MDI personnel should respond to the death location and to the incident scene if it has not 

389 been cleared. 

390 4.3.7.1.1 The definition of high profile may differ by jurisdiction, but consideration should be 

391 given to high level government officials, and high profile political, entertainment, athletic or 

392 controversial figures, or scene circumstances. 

393

394 4.3.8 Multiple decedents 

395 4.3.8.1 MDI personnel should respond when there are two or more decedents at a location, other 

396 than a hospital or long term care facility. 

397 4.3.8.2 MDI personnel should respond to the ED when there are two or more decedents brought 

398 in from the same location.

399 4.3.8.3 If there are multiple victims known, even if only a single fatality, best practice should 

400 still be for MDI personnel to respond to the death location and to the incident scene if it has not 

401 been cleared.

402

403 4.3.9 Hospice patients

404 4.3.9.1 MDI personnel should respond to all unnatural deaths if the event was not the reason for 

405 their admission to hospice (i.e. hospice patient dies by suicide, has a fall or other traumatic event, 

406 or suspected euthanasia if not legal and medically supervised), or if hospice personnel has 

407 concerns the death is not directly related to the condition for which they are on hospice care.

408

409 4.3.10 Without an independent physician

410 4.3.10.1 MDI personnel should respond to all deaths if the decedent is not under the care of a 

411 non-related healthcare provider; either by blood, marriage, or intimate friendship. 

412

413 4.3.11 Unattended deaths

414 4.3.11.1 When a death is outside of a healthcare setting, the scene response should be handled 

415 according to established office policy, which may be dictated by jurisdiction & state mandates, 

416 assuming no other category in this best practice recommendation applies.

417

418 4.4 Considerations for scene response based on the type of location of death

419 A case may not fall under one of the above listed types of cases but still should have MDI 

420 personnel respond. This section will provide best practice recommendations for evaluating MDI 

421 personnel response based on the type of location of the death.

422

423 4.4.1 Emergency Department (ED)

424 4.4.1.1 In the case of suspected unnatural death, MDI personnel should respond to all deaths in 

425 the ED and also respond to the incident scene, if any evidence remains and it has not been 

426 cleared. For natural deaths, MDI personnel should respond if there is not a physician to certify 

427 the death and a witnessed terminal event consistent with natural disease process.

428

429 4.4.2 Operating Room (OR)

430 4.4.2.1 For natural deaths and/or surgical misadventures, there is generally no need for MDI 

431 personnel to respond to the OR. For non-natural deaths, if proximal to initial presentation to the 

432 hospital, then MDI personnel should respond to the death scene, as well as respond to the 
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433 incident location, if potential evidence remains. If, after an extended stay, there is an OR death, 

434 it is only necessary to respond if there is potential evidence to be collected or the location to be 

435 assessed.

436

437 4.4.3 Inpatient (IP)/Outpatient (OP) following IP stay 

438 4.4.3.1 It is generally unnecessary for MDI personnel to respond to these deaths, unless there is 

439 evidence to be collected, such as admission blood, or it is believed that the injury (such as 

440 overdose or fall) occured at the hospital, and was proximal to the death. An example of 

441 evidence that would necessitate a response would be if a sexual assault kit is indicated but not 

442 already collected, or any other evidence necessary to be collected in a timely manner or any 

443 evidence not securely contained within the body itself (i.e., a screwdriver in the head that might 

444 need to be examined in case it is dislodged during transportation, and as part of the examination 

445 can also be better secured to protect it during transportation). 

446

447 4.4.4 Residential

448 4.4.4.1 MDI personnel should respond when someone dies alone at a residence.

449 4.4.4.2 Transitional or supportive residences would be handled accordingly

450

451 4.4.5 Assisted living/board & care/hospice

452 4.4.5.1 MDI personnel should respond to all unnatural deaths, no matter how remote the death 

453 from the incident, when there are potential criminal implications or if there are any concerns 

454 about care provided to the decedent.

455

456 4.4.6 Jail, prison or other incarceration settings

457 4.4.6.1 MDI personnel should respond to all deaths within a custodial setting.

458

459 4.4.7 Sober living and/or drug/alcohol rehabilitation facilities

460 4.4.7.1 MDI personnel should respond to all deaths within sober living and/or drug/alcohol 

461 rehabilitation facilities.

462

463 4.4.8 Hotels/Motels

464 4.4.8.1 MDI personnel should respond to all deaths in hotels/motels.

465

466 4.4.9 In Vehicles

467 4.4.9.1 MDI personnel should respond to all deaths in vehicles and other forms of transportation. 

468

469 4.4.10 In Public View

470 4.4.10.1 MDI personnel should respond to all deaths in public view.

471

472 4.4.11 Child Day Care Settings

473 MDI personnel should respond to all deaths in children’s day care settings

474

475 4.4.12 Other Locations

476 4.4.12.1 Assuming no other category in this best practice recommendation applies,
OSAC 2022-N-0027 Medicolegal Death Investigation 

Response to Death Locations and Incident Scenes: 

Best Practice Recommendations

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477 when a death is in another type of location, handle the scene response according to established 

478 office policy, which may be dictated by jurisdiction & state mandates. 

479

480 5 Bibliography

481

482 Centers for Disease Control and Prevention (CDC). Death Scene Investigation After Natural 

483 Disaster or Other Weather-Related Events Toolkit: First edition. Atlanta (GA): CDC; 2017. 

484

485 Davis, G., National Association of Medical Examiners Position Paper: Recommendations for the 

486 Investigation, Diagnosis, and Certification of Deaths Related to Opioid Drugs. 2019

487

488 Department of Health and Human Services, Centers for Disease Control and Prevention, Sudden, 

489 Unexplained Infant Death Investigation; Guidelines for the Scene Investigator. Atlanta, GA. 

490 2007. Available at: https://www.cdc.gov/sids/pdf/curriculumguide_tag508.pdf

491

492 IACME. Accreditation Standards. International Association of Coroners and Medical 

493 Examiners. https://theiacme.com/page/accreditation. 2021

494

495 Melinek, J., Thomas, L., Oliver, W., Schmunk, G., Weedn, V., and the National Association of 

496 Medical Examiners Ad Hoc Committee on Medical Examiner Independence. National 

497 Association of Medical Examiners Position Paper: Medical Examiner, Coroner, and Forensic 

498 Pathologist Independence. Acad Forensic Pathol. 2013 3 (1) 93-98 

499

500 Mitchell Jr., R., Diaz, F., Goldfogel, G., Fajardo, M., Fiore, S., Henson, T., Jorden, M., Kelly, S., 

501 Luzi, S., Quinn, M., Wolk, D. National Association of Medical Examiners Position Paper: 

502 Recommendations for the Definition, Investigation, Postmortem Examination, and Reporting of 

503 Deaths in Custody. 2017

504

505 NAME Policies and Procedures, Inspection and Accreditation Policy. 

506 https://name.memberclicks.net/assets/docs/NAME%20Accreditation%20Autopsy%20Facilities

507 %20Checklist%202019%20-%202024.pdf. Accessed Nov 22, 2021

508

509 National Center for Health Statistics. A reference guide for certification of deaths in the event of 

510 a natural, human-induced, or chemical/radiological disaster. Hyattsville, MD. 2017. 

511

512 Rocha LA, Fromknecht CQ, Redman SD, Brady JE, Hodge SE, Noe RS. Medicolegal Death 

513 Scene Investigations After Natural Disaster- and Weather-Related Events: A Review of the 

514 Literature. Acad Forensic Pathol. 2017 Jun 1;7(2):221-239.