N.C. Medical Examiners

An emotional run-around after a death

The calls come daily to the Iredell County register of deeds. Same voices. Same question. Grieving families seeking death certificates.

Matt McCall’s answer is usually the same: Call back tomorrow.

McCall, who has been register of deeds four years, became so frustrated over the time it takes to get completed death certificates from the state medical examiner’s office that he sent the governor a letter last fall on behalf of one family.

Margaret Glover’s 37-year-old son had been dead six months and still no death certificate. She couldn’t settle Geoffrey’s finances without one, and so every few weeks she would telephone McCall to see if it had arrived.

“I just wanted to get things past me,” said Glover, of Mooresville. “You have to have the darn piece of paper to do anything financial.”

If the cause of a person’s death is not an issue, a death certificate is usually processed promptly. Most delays occur in cases referred to medical examiners – about 13 percent of deaths in North Carolina, including sudden, accidental or suspicious deaths.

The time it takes for a case to be completed has held up life insurance payments. One family came near foreclosure, said Willoree Jobe, register of deeds in Yancey County. She said family members couldn’t afford to pay the mortgage on a trailer without a life insurance payment – and couldn’t get the insurance without a death certificate.

“I hear heartbreaking stories,” said Susan Lockridge, register of deeds in Gaston County, “relatives giving their family members money because they can’t get into the decedent’s insurance or bank accounts, power getting shut off, losing their home.”

The National Association of Medical Examiners, which sets standards for the profession, says top-performing systems complete 90 percent of autopsied cases within 60 days. North Carolina closed 33 percent of autopsied cases within that time, according to an Observer analysis of state data for 2001 through mid-2013.

The average wait for cases with an autopsy: 97 days.

Thousands of families are left waiting.

It took a year before Diane Wactor knew that her father died of alcohol poisoning in Cumberland County in 2012. She repeatedly called Raleigh and was asked to be patient because the office had lost two employees.

“It was terrible,” she said. “I thought he might be a victim of homicide.”

Cindy Warren is still hoping for peace of mind. In May 2012 her 19-year-old daughter Brooke Burgo was rushed to a Rutherford County hospital after days of flu-like symptoms and vomiting.

A day later, she died.

It took more than six months for the state medical examiner’s office to rule that Burgo died of an “undetermined” cause. It took another five months for the state to amend the ruling to genetic metabolism disease – a cause Warren disputes.

The delays burned through half the time North Carolina allows for filing wrongful death lawsuits. Warren said no lawyer would take the case without a cause of death.

Now it’s too late.

“I feel like I can’t do anything for her,” Warren said. “It cost me being able to have time to find anybody. That takes months.”

Dr. Deborah Radisch, the state’s chief medical examiner, sounded remorseful when asked about delays. “I don’t want to say I hate it more than the families, but I’m very close to hating it more than them. It’s my constant tension.”

Each cause of death listed by a medical examiner must be reviewed by a pathologist in Radisch’s office. Radisch said delays most often occur when cases require toxicology tests. Even after tests are done, Radisch said, a case may be further delayed because the pathologist assigned to the case is busy juggling other work.

The state office has historically been short-staffed, Radisch said. She said it has had trouble recruiting and retaining experienced forensic pathologists, who are medical doctors trained to perform autopsies and determine causes of death.

McCall, the Iredell County register of deeds, said that when he called the state in October about Glover’s death certificate, he was told that Radisch hadn’t gotten to it. Soon afterward, she did.

“It’s for closure,” McCall said. “People want to know what happens, and when you give them an indefinite answer, they don’t have the opportunity to fully mourn.”

Staff writers Ames Alexander and Fred Clasen-Kelly contributed.