NYC stops doing autopsies in Queens as more medical examiners leave
Faced with an exodus of medical examiners, New York City has stopped doing autopsies at the city medical examiner's office in Queens and has consolidated those services in Brooklyn and Manhattan. The worsening staff shortage has also affected courtroom testimonies and how the city handles investigations into drug deaths.
The city currently has 18 medical examiners, a little more than half the number of staff in 2021, according to Doctors Council SEIU, the union that represents city medical examiners.
City officials said the recent changes to autopsy protocols have helped improve efficiency without undermining the agency's standards. Some Queens funeral directors said traveling to Brooklyn to pick up bodies can take longer — and one director said he was raising funeral prices as a result — but they added that the changes are unlikely to delay families' memorials.
Still, representatives with the Doctors Council said what they called a "staffing crisis" wasn't letting up and could have real consequences for New Yorkers. The medical examiners are responsible for investigating the cause of violent or unexpected deaths and are frequently called to testify in court.
City medical examiners over the summer stopped conducting autopsies as part of the investigation into some suspected overdose deaths. Medical examiners said that as more of their peers leave, substitutes have to testify in the criminal cases they left behind — a practice known as "surrogate testimony" that is under growing scrutiny in the courts.
The union said another three medical examiners were expected to retire or quit by the end of the year.
At the same time, the agency's caseload continues to grow. Drug overdose deaths still make up a significant part of that caseload, despite the number of overdose fatalities dipping slightly last year, according to the latest Mayor's Management Report .
The Doctors Council is negotiating with the city over a new contract and said the city must boost its pay to compete with other jurisdictions across the country amid a national shortage of medical examiners.
"We are demanding the city provide [the Office of the Chief Medical Examiner] with the resources it desperately needs to ensure public health and safety for all New Yorkers," said Dr. Frances Quee, the union's president.
Julie Bolcer, a spokesperson for the medical examiner's office, said the recent changes have gone smoothly. "The realignment does not impede the process of claiming decedents and the agency's relationships with funeral directors remain strong," Bolcer said.
She added that the Queens office was still being used to store bodies.
The Mayor's Office of Labor Relations declined to comment on the ongoing negotiations, other than to say it hoped for an "agreement that is fair to both the workers and city taxpayers."
Despite the staffing challenges, the city is starting to reduce the turnaround time for autopsy reports, which have been taking longer to complete in recent years. In the first four months of fiscal year 2024, the median turnaround time was more than four months. That declined to 91 days by the end of June, according to the Mayor's Management Report.
"This improvement is largely attributed to financial investments in the Forensic Toxicology Laboratory as well as new workflow efficiencies put in place by the agency for the medical examiners," the report said.
Still, legal experts said there were other issues to consider as medical examiners leave.
"Their opinions about the cause or manner [of death] have significant implications for how someone might be charged [in a criminal case], what the evidence might be against them, how a case is being presented to the jury," said Elizabeth Daniel Vasquez, an attorney who serves as director of the Brooklyn Defender Services' Science and Surveillance Project.
She said sometimes the original medical examiner who investigated a death will come back to testify in court, but often another medical examiner will have to take their place, reviewing their notes, photographs and other available evidence. Recent court rulings, including a U.S. Supreme Court decision in June, have weighed in on what types of statements can be used in surrogate testimony and when it can be permitted.
Although Vasquez said surrogate testimony was expected to be unavoidable sometimes as medical examiners retire, she added that she has noticed a growing number of cases where the original medical examiner no longer worked in New York City. "It severely complicates the calculus on being able to bring forward evidence that exists in the case," said Vasquez.
Nationwide, there are about 800 certified forensic pathologists working full time, and it's estimated that at least twice as many are needed to serve the entire country, said Dr. J. Keith Pinckard, president of the National Association of Medical Examiners. He said not enough doctors are choosing this specialty.
"The reasons are multifactorial but largely economic," Pinckard said. "Jobs tend to be in the government sector and as physicians, they are not paid as well as what they could earn in other specialties in hospital or private practice."
As a result, medical examiner's offices are raising salaries to attract new candidates. Medical examiners in New York said some colleagues have been enticed to leave the city with the promise of higher pay. Current base salaries for medical examiners in New York range from about $157,000 to $239,000 a year, according to the Doctors Council.
