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Deschutes Co. M.E. Asks For Full Time Staff Amid Increase In Death Investigations

BEND, OR -- With major changes at the state Medical Examiner’s office, Deschutes County’s M.E. is pushing for more money and full-time staff. "The state Medical Examiner’s office is completely inundated with cases and volume, and they are incredibly short-staffed," Dr. Annie Onishi told Deschutes County Commissioners Monday, "They need about 10 more pathologists to be a fully functional state office. They’re out of morgue space, they’re out of morgue techs. It’s sort of dire straits over there."

Dr. Onishi contracts with Deschutes and Crook counties. But, she says, more than a dozen other counties that previously relied on the state M.E. for coroner services have to take on those services themselves. "As of July one of this year, the State Medical Examiner’s Office is no longer covering 14 of the 36 counties of Oregon," Onishi said, "They were serving as the county medical examiner for quite a few counties and they are no longer doing that." And there are other service cuts, "There was a - I’ll say - a pretty shocking email from the state M.E.’s office and Oregon State Police of the things that they are not going to be investigating anymore. So, it used to be that anybody who died of a suspected overdose would get an autopsy. They’re not doing that anymore. So, from Deschutes or Crook County, if there’s a suspected overdose, all we do is send tox - so either a blood or a urine sample. And that goes to the lab; and that’s a six month delay." She added, "They, on a state level, are going to be investigating homicides and child and infant deaths, and that’s about it. Everything else is going to fall on the counties."

Dr. Onishi's full time job is as a trauma surgeon for St. Charles Bend. And, she says, her staff, including eight nurse investigators, are also independent contractors. They conduct exams, review medical records of the deceased, collect fluids and prepare reports, all on their days off from full-time nursing jobs. She doesn't believe it's a sustainable operating model for such a fast-growing county, "We are doing double the amount of case investigations that we were 10 years ago. We get phone calls for 1,200 people that die a year in this county, and we investigate 600-700 of those. So, you can already sort of get a sense of how much leg work that is for our investigators and how many death certificates Maureen and I are signing." She told Commissioners, "Especially with all the drug use in the area, all the sort of problems that go along with that. That is where the vast majority of our case volume comes from, as well as visitors to the area. If a visitor passes away while they’re visiting Deschutes County, that becomes our jurisdiction." They also sign every death certificate for accidental deaths.
"My educated guess would be, as Deschutes County’s population continues to grow, and as we continue to sort have these lifestyle plights - the homelessness issue, the drug issue," Onishi said, "I can only see those numbers going up and I can only see the state continuing to say, ‘we just don’t have the capacity to help with that sort of thing’." 

She says it’s time for the county to consider bringing the office in-house, including a licensed pathologist. Onishi is not a pathologist and does not perform autopsies - right now, those are done by the state Medical Examiner.

In response to KBND's request for information on changes at the State Medical Examiner's Office (SMEO), an Oregon State Police spokesperson said in an email, "For many years, the SMEO has assisted about one-third of Oregon’s counties with some of their county tasks. Unfortunately, staffing challenges and several years of dramatic and compounding increases in SMEO workload have made it impossible for the State to continue doing so much of the county portion of the M.E. work." Capt. Kyle Kennedy went on to say, "The SMEO is invested in the success of every county partner and our overall system, so we are continuing to help where needed, as needed. Such determinations vary depending on our capacity at the moment and the needs of the county, but we’re committed to helping when we can."  

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