A toxicology lab that helps look into unexplained deaths in North Carolina for the first time has received national accreditation for the quality of its operations, state officials said Tuesday.
The milestone represents a reversal for the state medical examiner’s office, which has been criticized for conducting flawed investigations, including the 2013 carbon monoxide deaths of three people at a Boone hotel.
An audit by the American Board of Forensic Toxicology, a major accrediting organization, found that procedures and staffing in the agency’s lab meet its standards for testing blood samples. Only about 30 forensic toxicology labs in the United States and Canada have obtained accreditation from the group.
State officials and outside experts said the accreditation validates moves to strengthen death investigations, particularly the construction of a $52 million building in Raleigh – unveiled in 2012 – that houses the medical examiner’s office and its lab. The old facility on the UNC-Chapel Hill campus was so cramped and outdated it would not qualify for accreditation, officials said.
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“You’re not going to fix a 40-year-old system on the ropes overnight, but this is definitely a plus,” said Dr. Patrick Lantz, a longtime forensic pathologist at Wake Forest Baptist Medical Center in Winston Salem. “They made a giant step with this.”
Medical examiners, mostly doctors and nurses who look into deaths in their spare time, determine the cause of suspicious and violent deaths, such as shootings, suicides and auto wrecks. Their findings are used to help solve crimes, identify public health threats and settle life insurance payouts.
They collect blood samples from corpses that go to the toxicology lab where testing can reveal the presence of illegal drugs, alcohol, poisons or hazardous chemicals. The state lab handles more than 9,000 cases a year.
Lawmakers have vowed to remake the medical examiner system in response to a Charlotte Observer investigation, which found that medical examiners often skip basic investigative steps, casting doubt on the accuracy of thousands of their rulings.
North Carolina has one of the most poorly funded medical examiner offices in the nation. The state spends only about 93 cents per capita on its system compared with average of $3 per capita for leading offices.
That left the toxicology lab with growing caseloads and little money to make repairs to needed equipment, said Dr. Ruth Winecker, chief toxicologist for the state medical examiner’s office.
The toxicology lab endured criticism in 2013 after an elderly couple died in a Boone hotel on the same night. The local medical examiner didn’t warn the lab about the unusual circumstances or request a rush for tests.
It took almost six weeks to determine that carbon monoxide killed the couple and even then no one alerted the public about the danger. A short time later, the deadly gas leaked into the hotel room again, killing an 11-year-old boy.
Complicated cases requiring more testing still typically take anywhere from two weeks to 60 days, Winecker said. But the state now requires that examiners include a description of death circumstances with blood samples sent to the lab.
Dr. Deborah Radisch, state chief medical examiner, said obtaining national accreditation affirms how the toxicology lab overcame difficult circumstances to produce high-quality work.
“I am not surprised because we’ve been doing wonderful toxicology for years,” Radisch said. “The science was never the problem.”
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