el paso county coroner’s office · the el paso county coroner’s office 05 2017 revenue for el...

THE EL PASO COUNTY CORONER’S OFFICE

EL PASO COUNTYCORONER’S OFFICE

2017 ANNUAL REPORT

THE EL PASO COUNTY CORONER’S OFFICE 01

The Coroner’s Office (EPCCO) serves El Paso County by investigating all sudden, unexpected, and non-natural deaths. While many natural deaths can be certified by the decedent’s physician, approximately one quarter of deaths require further investigation to determine cause and manner of death and ensure public health and safety. In addition to performing 902 autopsies on El Paso County Deaths, the office performed 313 autopsies for a fee for 19 surrounding counties

In 2017, the Coroner’s Office staff consisted of four board certified forensic pathologists including the county’s elected Coroner Robert Bux, M.D., Deputy Chief Medical Examiner Leon Kelly, MD and Associate Coroners Dan Lingamfelter, D.O., and Emily Berry, M.D., as well as three full-time and two part-time administrative staff, eight full-time death investigators, four full-time toxicologists, one full-time histologist, and three full-time and two part-time morgue technicians.

TOTAL DEATHS INVESTIGATED

4968AUTOPSIES

PERFORMED

1215


Colorado Revised Statute 30.10.606 describes the roles and responsibilities of the coroner in investigating deaths. A complete forensic investigation provides the cause and manner of how an individual died. The investigation can assist in settling insurance and estate claims as well as the implementation of civil and criminal actions. Identifying cause and manner of death is a critical component of ensuring public health and safety. The surviving family and general public can have peace of mind that a thorough investigation was completed.

It is the responsibility of the Coroner’s Office to identify the decedent and notify next-of-kin. In many cases, identification and next-of-kin notification can be quickly achieved. However, in cases of burns, extensive injury, or decomposition this can prove more challenging. Our office ensures all leads have been exhausted in pursuit of identification and notification. At the time of this report, 1 body from 2017 is still awaiting positive identification. Any identified but unclaimed bodies are released to the Public Administrator.

02

MEANS OF IDENTIFICATION

Visual – 854

Fingerprints – 40

Dental – 7

X-ray – 1

No individuals were identified using DNA during 2017

Why Perform an Autopsy?


What is an Autopsy?

An “autopsy” can encompass several levels of examination:

307 cases in 2017 were “external only” examinations, in which the cause and manner

are well established by the external examination* and a

thorough medical history.

*External Examination – Every autopsy includes a thorough examination of the outside of the decedent’s body documenting changes of natural disease, identifying marks and scars, medical treatment, injuries, and an inventory of clothing and property.

307 56 85256 of the 2017 examinations were partial autopsies and

typically consisted of “head only” examinations to ensure that head trauma didn’t cause or

contribute to death.

852 Examinations included a full internal exam in which each organ and

body cavity is examined and is considered a complete autopsy.

87% of cases had toxicology testing performed. Samples

are always collected, but testing is performed at the discretion of the physician.

87%El Paso County Coroner’s Office does not perform Hospital Autopsies.

640El Paso County

Coroner’s Office did not perform any

exhumations in 2017.

03

640 autopsies required death scene investigations.

0

⌧

Average number of days from autopsy to report completion during 2017 is 25 days.

59 cases (<5%) took greater than 60 days to complete due to their complexity or ongoing investigation.

Average time to completion


What Deaths are Investigated?

// Sudden, unexpected, or non-natural // No physician available to certify the death // Industrial accidents // Deaths in the custody of law enforcement or in the care

of a public institution // Deaths due to contagious diseases // All unexplained deaths

// Pronounce death // Determine cause and manner of death // Identify human remains // Notify next-of-kin // Perform an investigation into a death independent of

law enforcement // Collect evidence on or in the body // Secure a decedent’s property for next-of-kin // Provide expert testimony // Grant tissue/organs for donation

04

The responsibility of the Coroner:

Colorado Revised Statutes (C.R.S) 30-10-606 mandate that the following deaths are reported and investigated by the coroner:


2017 Revenue for El Paso County Coroner’s Office

Grant for Violent Death Reporting $3,825Out-of-County Autopsy Fees $435,100Out-of-County Toxicology Fees $89,730Miscellaneous Fees $2,063.75

$530,718.75El Paso County Citizen Cost Breakdown

Total Revenue for 2017

2017 Population* 699,232$2,474,619Total 2017 Budget

$2,474,619.00 (Budget)

(Revenue)- $530,718.75

$1,943,900.25 Overall Cost to Citizens

÷ 699,232 (Population)

= $2.78 Annual cost to each El Paso County Citizen

*US Census Bureau ( July, 2017)


ALAMOSABACABENTCHAFFEECONEJOSCOSTILLACROWLEYCUSTEREL PASOELBERT

1898

321610

212

90222

FREMONTHUERFANO

KIOWAMINERAL

OTEROPARK

PROWERSRIO GRANDE

SAGUACHE

491258141681517

1,215 – TOTAL CASES

06

Overall Breakdown of Autopsies Performed by the El Paso County Coroner’s Office

TELLER40


Manner of Death

There are five manners of death that can be listed on a Colorado Death Certificate.

Natural - Deaths due solely to disease or aging

Accident - Deaths due to unintentional injury

Suicide - Deaths due to an intentional self-inflicted injury

Homicide - Deaths due to the intentional injurious action of another individual

Undetermined - Deaths in this category may or may not have a determined cause of death, or may have several different possible manners.

07

Natural (34%)

Accident (42%)

Suicide (18%)

Homicide (5%)

Undetermined (.6%)

Unclassified - Death of a fetus in utero (in the uterus) does not receive a manner determination

Unclassified (.4%)

2017 El Paso County Breakdown


Deaths Due to Natural Diseases

Cardiovascular

Chronic Alcohol

Pulmonary Embolism

Infections

Pulmonary Disease

Global Geriatric Decline

Diabetes

Significant Contributing Causes – These are diseases that are most commonly listed as significant contributing factors in death alongside those causes listed above.

Gastrointestinal

Congenital

Cancer

Cerebrovascular

Liver Disease

Cardiovascular Obesity Diabetes Pulmonary Disease

308171

33

15

15

7

6

8

5

4

6

9

2

21483221

Total

Complications of Pregnancy

3

Morbid Obesity 9

Epilepsy 5

Other 10

Chronic Alcohol 18Smoking 18


Blunt Force Injuries Breakdown

Deaths Due to Accidents

378 Total Motor Vehicle Accidents

Drugs

Falls

Pedestrian Injury

Fires/Burns

Carbon Monoxide

Choking

Others

Wind

Train

Asphyxias

Bicycle Injuries

Drowning

Acute Alcohol Intoxication

60

147

106

15

5

3

6

2

2

2

12

7

9

2

Falls

Motor Vehicle (Cars)

Motorcycle

Pedestrian

Wind

Train

Bicycle

106210250215


Motor Vehicle Crashes

Type of VehicleSedan

Mini Van

Motorcycle SUV

Other/Unknown

Truck

261010527

Use of Restraint/seatbelt

Yes

Unknown No

Motorcycle

11

301010

Type of Collision

Front

Unknown

Rear Side

Rollover

23121159

*In every crash that the decedent was ejected there was failure to use a seatbelt

Suspected Primary Cause of CrashOperator Error

Asleep

Unknown Reckless Driving/Excessive Speed

Natural Event

Drugs/Alcohol

Road Hazard

*Of the 34 fatal crashes where the decedent was the “at fault driver” 22 had drugs or alcohol in their autopsy


Drug Related Accidental Deaths

147 Total Cocaine

Heroin

Heroin + Fentanyl

Methamphetamine

Cocaine + Methamphetamine

Methamphetamine + Prescription Opioids

Heroin, Cocaine + Methamphetamine

Prescription Opioids

Non-Opioid Prescription Drugs

Heroin + Methamphetamine

MDMA

Cocaine + Heroin

Cocaine + Non-Opioid Prescription Drugs

7

24

1

38

3

3

2

5

1

32

29

1

1

Opioids 92 Total HeroinOxycodone HydrocodoneFentanylMorphineTramadolOxymorphineMethadone

Mixed Rx Opioids with Methamphetamine

Mixed Rx Opioids


v

12

Of medication used in the overdose was prescribed by the decedent’s physician.

18%The average age at death (range of 19 - 88 years)

old)

2017 Drug Related Death Facts

Percentage of the accidental deaths

that were male

65%

v Have a prior history of

substance abuse or addiction

71%

42 YEARS

Death scene investigations

revealed drugs, drug paraphernalia or

medications of abuse

63%

Percentage of the accidental opioid deaths that were

heroin

62%

Have a history of mental illness

29%

20%Deaths of all causes that have marijuana metabolites present

at autopsy

v Total number of opioid related deaths (suicide and accidental)

102


Apparent Circumstances of the Homicides

13

Deaths Due to Homicide

42 Total

Firearms

Sharp Force Injuries

Blunt Force Injuries

Neglect

Physical restraint

30

5

5

1

1

AltercationDomestic Violence UnknownWhile committing another crimeOfficer involvedAbuse/NeglectHit + run motor vehicle collisionGang Related

513

1

4

68

2 2

Reckless use of firearm 1


Deaths Due to Suicide

164 Total

Drugs Used in SuicideOther

Anti-convulsants Benzodiazepines

OpioidsAnti-depressants

Mixed alcohol and non-opioids

1023

21

4

43Average age

at death (Range of 12 -

99 years)

25% 50% 54% 23%Notes or social

media posts indicating suicidal

intentions

Have a reported history of prior mental illness

Intoxicated with drugs or alcohol

at the time of death

Have a history of prior suicide

attempts

2017 Suicide Facts

of completed suicides were male75%of firearm deaths used their personal weapon76%

Three most common risk factors: recently ended relationship, financial struggles, and personal health crisis

Firearms

Ligature

Sharp Force Injury

Asphyxia

Other

Fall

Drugs

91

33

5

6

6

1

22


Gender

15

El Paso County Coroner’s Office investigated the deaths of 53 children (below the age of 18 years old). These cases are individually reviewed by the El Paso County Child Fatality Review Team to identify strategies to prevent these types of deaths in the future.

Child Fatalities

53 Total

Fetus

<1 Year

13-17

1-4 Years

5-12 Years

4

9

19

6

15

Age

Male: 9

Hanging

Drugs

Firearms

Asphyxia

Female: 4

5

2

4

2

Teen Suicides (Ages 12-17 Years)

Breakdown

NaturalHomicides SuicidesPedestrian struck by motor vehicleInfant unsafe sleep/asphyxiaUndeterminedDrowningMotor vehicle accident

OtherFetal death

69133

622543

When the Suicides Occurred

JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC

Infant Asphyxias – 6 Total

Deaths due to an unsafe sleep surfaceDeaths due to bed sharing with adults

4

2

0 0 0 0 0 0


7 of the 10

El Paso County donors had organs recovered for transplantation10

There were no refusals of requests

55

Organ Donation

Were coroner jurisdiction cases and all were approved for

donation

Organs were transplanted from El Paso County donors

29

In 2017:

El Paso County tissue donor cases fell under the coroner’s jurisdiction

⌧Cases resulted in

tissue harvest

35

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