Untrained medical examiners fail families, imperil justice

Anyone who has enrolled in school or applied for a passport knows the value of a birth certificate.

This is a special series of stories tied to the piece of paper at the other end of life -- your death certificate.

No, you won’t need the certificate, but trust me, it will be very important to the people you leave behind.

That’s because death certificates do more than just certify your death. They also explain what took your life.

The stated cause of death affects the ability of loved ones to collect on insurance, hold others liable for your death if warranted, and ultimately come to some peace of mind about what killed you.

And that’s just about you. Compiled and studied as vital statistics, death certificates reveal public health threats ranging from disease to environmental hazards.

But none of this works unless the facts are right. And as you will learn from this five-part series, titled "Fatally Flawed," that’s a big problem in North Carolina.

Our team of reporters documented many troubles. But the bottom line is this: Our state stands out nationally for trying to investigate unexplained deaths on the cheap.

Each year about 75,000 North Carolinians die. A medical examiner is called in to investigate about 10,000 of those deaths because the circumstances are suspicious, violent, accidental or unattended.

That’s where the trouble begins. The state requires no training for its medical examiners. And it pays them a paltry $100 per case. As a result, many deaths get little attention.

The effects on surviving loved ones can be devastating. We found case after case of grieving relatives forced to launch their own inquiries into how a family member died. Forget all you’ve seen on CSI. These circumstances were DIY (do it yourself).

The disgrace to our state doesn’t stop there. We found an eastern N.C. county conducting an earnest campaign to fight heart disease. Its inspiration: state statistics suggesting that residents were up to 10 times more at risk of dying of a heart ailment. Experts say it’s more likely that the county’s medical examiners simply chose heart disease as a catch-all explanation in processing death certificates.

While all of this may surprise you, there are people in Raleigh who have been in the know for a long time.

Our Legislature was first warned about problems with the medical examiner system 13 years ago, through another Observer series called “Grave Secrets.” Those stories triggered a 2001 commission that recommended improvements. A handful of suggestions were adopted, but many others were ignored.

Now, a new team of Observer journalists has burrowed into the system. They examined more than 130,000 deaths investigated by medical examiners since 2001. Their work is the most comprehensive analysis of state death rulings ever conducted.

And while matters have only grown worse, it doesn’t have to be this way. We’ll show you how another state helps families get to the truth about causes of death, bringing them the closure they desperately need.

I hope you’ll read the entire series and support something better for North Carolina. Both you and your descendants deserve it.

An autopsy suite in Raleigh at the Medical Examiner's labs.