Deathly Dealings 

When coroners collide

When coroners collide

Inside Politics

Metro’s forensic pathologist has the job of investigating “suspicious deaths” in Nashville. Over the past four years, however, Metro has had a hard time keeping anybody in the job. In fact, Nashville has had four forensic pathologists in the past four years.

According to sources in the Bredesen administration, each of the four pathologists departed, in part, because of “political interference,” either from Metro Council members, employees of the Medical Examiner’s Office, or other public officials.

Thus, Mayor Phil Bredesen has proposed that Metro get out of the pathology business and turn the supervision of the medical examiner’s office over to a private firm. If that plan gains final approval from Metro Council next week, Davidson County will more than double what it now spends to operate its Medical Examiner’s Office.

The agreement to hire the Brentwood-based Associated Pathologists (AP), the firm Bredesen has handpicked for the job, is not a done deal. Just last week, the proposal passed a second reading in Metro Council—but only by two votes. Thus far, Council has raised a host of concerns about the deal, ranging from its cost to the reluctance of handing over the office’s duties.

Meanwhile, the Scene has learned that the AP deal may not rid the office of political problems. As it turns out, AP has already asked Dr. Emily Ward, a controversial forensic pathologist now on the faculty of the University of Mississippi Medical Center in Jackson, Miss., to accept one of the positions in the newly privatized Medical Examiner’s Office. Under AP’s plan, Ward would be second in command to Dr. Bruce Levy, a young New Yorker who recently became a board-certified forensic pathologist.

Ward, the divorced mother of three, was appointed to the post of medical examiner for Mississippi in 1993 by the state public safety commissioner, Jim Ingram. She resigned two years later, in 1995, just a few weeks after she had made an enemy of one of the state’s elected county coroners, says Ingram, who still serves as Mississippi’s public safety commissioner.

According to Ingram, Ward “became embroiled, or involved, I should say, in a political situation that turned into a passionate difference of opinion. She eventually said, ‘I’ve had enough of this.’ ”

In Mississippi, Ingram says, “The elected county coroners were split” in their opinion of Ward. “Some used the services of the state medical examiner—Dr. Ward—and others wanted to use other pathologists. She ended up with some who disliked her with a passion.”

Ingram cautions that Ward’s experience in Mississippi “should not detract from the job she would do [in Nashville]”; he also describes her as a talented pathologist. On the other hand, Ingram says that Ward’s forthright personality has sometimes gotten her into trouble. “She speaks her mind, but what the hell, she’s skilled,” he says. “She didn’t get where she was by being a nice girl.

“This sounds bad, I know, but you have to be tough to deal with dead bodies all the time.”

AP, through its spokesman Dr. Ed Pierce, refused to talk to the Scene about Ward’s background. According to Pierce, until the contract between his company and Metro is passed by Council, “this is not a public event for us.” Ward did not return a phone call to her office in Jackson, Miss.

Sources in Mississippi say Ward got into trouble when she frequently spoke out against the common practice of “double-dipping” among the state’s county coroners. Many of the coroners elected to run county medical examiner’s offices also work at funeral homes, a practice that can lead to serious conflicts of interest.

Ward’s final confrontation with a double-dipping coroner came when she dared to oppose Karl Oliver, who is now in his second term as coroner for Montgomery County and who also serves as president of the Mississippi Coroner Medical Examiner’s Association. Oliver says that, after a jail inmate died, he and Ward fought over his right to use another state-designated pathologist, instead of Ward, to perform the autopsy.

Ward, then the state’s top forensic pathologist, had advised all county coroners that she was to perform all autopsies in cases of unexplained prisoner deaths. Oliver balked at the order and hired another pathologist. When Ingram, who was Ward’s boss, learned what Oliver had done, he called Oliver and ordered him to send the body to Ward.

Oliver did as he was told, but he also asked Ingram if he could make the drive to Jackson—a 90-mile trip from Montgomery County—to be present for the autopsy. Both Ingram and Ward agreed to the request, but, when Oliver showed up on time for the autopsy, Ward had already finished the procedure.

Ingram agrees with Oliver’s account of the incident. “It happened. It was one of those things that, regrettably, happened,” he says, “although it didn’t happen again.” A few weeks later, Ingram says, Ward left the medical examiner’s office of her own accord.

Habeas corpus

Medicine and pathology have come a long way since the 18th century, when each of the 13 American colonies set up its own coroner system. In those days, coroners—who weren’t necessarily doctors—brought in juries to view bodies and to help them determine cause of death. An autopsy was little more than a haphazard guessing game.

As the nation developed, coroners became elected county officers, much like sheriffs, but the system was still woefully inadequate.

In 1877, Massachusetts became the first state to establish a system which required that the governor appoint physicians as medical examiners. Nevertheless, those doctors were not required to have experience in death investigation, and they were beholden to the district attorneys who ordered the autopsies.

Massachusetts’ system created its own problems. Case in point: the 1969 death of Mary Jo Kopechne, who drowned after her companion, Sen. Edward Kennedy, drove a car off a bridge at Chappaquiddick Creek on Martha’s Vineyard Island. “The local medical examiner was so overwhelmed by the authority of the representatives and advisors [involved] that he signed the case out without autopsy,” according to the respected forensic pathologist Dr. Milton Helpern in his 1977 memoir, Autopsy.

These days, a medical examiner’s office is mostly staffed by board-certified forensic pathologists, who, for the most part, only conduct examinations when the cause of death is in some question. In states such as Mississippi, elected coroners serve only as death investigators and administrators. Autopsies are farmed out to qualified professionals, such as forensic pathologists.

Nashvillians may have heard more than they want to hear about the problems of the Davidson County Medical Examiner’s Office. Autopsies, after all, seem to be one of the least glamorous functions of local government.

But the Medical Examiner’s Office performs a highly important function, particularly in murder cases, and continuity in the Medical Examiner’s Office is vital. Local prosecutors need to know that, when they require testimony concerning a particular autopsy, the same pathologist who performed that autopsy will be readily available.

In Nashville, Metro Council and the mayor’s office have convincingly argued that the Davidson County Medical Examiner’s Office is uniquely troubled. The office’s problems came to light several years ago, when Bredesen asked pathologist Dr. Charles Harlan to resign. Harlan’s abilities as a forensic pathologist were never questioned. His downfall was the result of poor administration and several accusations of sexual harassment.

Since Harlan’s departure, three other pathologists have come and gone. The latest, Dr. Miles Jones, commuted regularly from out of state, charging Metro $600 per autopsy. Jones’ contract expired last week; he had earned $287,000 for only 10 months of work—$137,000 more than the permanent medical examiner before him had made in a year. Like Harlan, Jones was dogged by an accusation of sexual assault from an employee in the Medical Examiner’s Office.

Nashvillians may find some consolation in the fact that medical examiners’ offices all over the country are plagued by political interference, internal strife, and unusual personalities.

New York City’s former forensic pathologist once provided Playboy magazine readers with instructions for committing the perfect murder. The article, based on scientific and technical data, stirred up a firestorm of controversy. Before Ward joined the state medical examiner’s office in Mississippi, one of her predecessors had been fired for allegedly offensive behavior toward some of the female employees in the office.

Nationwide, the list of irregularities goes on and on.

Getting stiffed

As if the Davidson County Medical Examiner’s Office hadn’t already had enough problems, the debate about how to reform it has also grown nasty.

Bredesen clearly wants nothing more to do with the office’s problems. Making a $2.2 million deal with AP, a large pathology group doing business throughout the Southeast, is an expeditious way of passing the problem along to someone else or eliminating it altogether.

But the issue has divided Metro Council. Council members want to satisfy the concerns of bereaved families and the local district attorney’s office, but they don’t want to be criticized for approving a plan that would more than double the medical examiner’s office budget. To make matters worse, Council is being heavily lobbied by another private firm, the Institute of Forensic Medicine, which entered final contract negotiations with Metro last fall before it was tossed aside in favor of Associated Pathologists.

The Institute said it could take over the Medical Examiner’s Office for about $1 million, about the same amount Metro now spends on the office. The Institute also proposed offering training and education in forensic pathology to public employees such as policemen and district attorneys. Members of the Institute’s advisory committee include some of the top forensic pathologists in the country.

The Institute of Forensic Medicine was never formally notified that it wasn’t going to get the Metro job. However, when Bredesen’s proposal to hire AP was made public, the Institute lobbied hard to convince Council members to vote against the mayor’s plan. In turn, two weeks ago, Bredesen sharply attacked the Institute because it had not officially hired the doctors whom it said it would be bringing to work here.

Metro Council members and others did the right thing in alerting Bredesen to the need for change in the Medical Examiner’s Office, but not much else about the debate has been admirable. The focused-to-a-fault mayor has launched unnecessary attacks against the Institute, and AP’s spokesman, Ed Pierce, has been tight-lipped and defensive.

To make matters even worse, until July 1, when the proposed contract with Associated Pathologists is scheduled to begin, Nashville will have a non-board-certified physician for its medical examiner. Meanwhile, if the necessity arises, Metro will consult with a board-certified pathologist in Kentucky, who will be able to view photos of bodies via modem.

“In a perfect world, we would prefer a board-certified pathologist,” says Metro’s top prosecutor, District Attorney Torry Johnson. “But we’ve put up with so much other stuff that this doesn’t seem like that big a deal.”


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