But some prosecutors, police, families and the state's own medical examiners say fixes are needed in a system that breaks down in dangerous places. Some medical examiners order autopsies infrequently, even in suspicious deaths. Statewide from 1993 to 1998, medical examiners did not order autopsies in almost 70 percent of accidental deaths. No autopsies were performed in 66 percent of suicides and 41 percent of fire-related deaths, even though crimes can be covered up. Even when medical examiners opt for autopsies, some send cases to pathologists trained in the study of natural death, not violent death.
Autopsies help pinpoint the cause of death and reveal foul play.
But he says as North Carolina grows and becomes more urban, the state must find new ways to investigate deaths. Some potential changes likely will spark heavy debate. Officials in counties with regular access to forensic pathologists worry that creating several regional medical examiner centers could limit their access to the specialists, because the forensic pathologists would be serving more counties. Asking counties to foot a bigger bill for death investigations also raises concerns. When a county resident dies there, the county pays for any medical examiner investigation or autopsy.