Manistee/Benzie medical examiner explains requirements for autopsies

BENZIE COUNTY — The Benzie County Board of Commissioners heard a report from the county’s medical examiner explaining the increased number of autopsies being performed.

Dr. Lois Goslinoski, the medical examiner for Benzie and Manistee county’s regional medical examiner’s office, spoke at a March 28 meeting.

Goslinoski said since she began working for the county in 2017, she has been following requirements for when autopsies must be performed.

“Case management (prior to my employment with the county) was different from how I was trained,” she said.

Goslinoski outlined when autopsies are suggested and when they are required. Autopsies must be performed in the event of sudden and unexpected death, accidental death, violent death and deaths

Dr. Lois Goslinoski, medical examiner for Benzie County, tells the Benzie County Board of Commissioners under what circumstances autopsies must be done. (Colin Merry/Pioneer News Network)

under suspicious circumstances.

There also were cases in which infant deaths and cases where inmates in custody died and needed autopsies performed.

Attorneys could also order them to be performed

“Suspicious deaths are when somebody is found dead, and there is no clear reason for their death,” Goslinoski said. “There are also cases when the police are called and there is something odd about the death, even if there is a substantial medical history.”

Goslinoski also said deaths in which the deceased shows no signs of what might have killed them and seem perfectly healthy can be investigated.

She told commissioners that death certificates are legal documents, and that she couldn’t write down her best guess as cause of death.

Goslinoski presented the board with charts showing how many cases were reported to the county’s medical examiner, and how many had full autopsies done.

In 2015, when the county was using medical examiners in Kalamazoo and Grand Rapids, 14 cases resulted in four autopsies. The rest involved external examinations and a toxicology report or scene investigations and medical record reviews. Several did not have sufficient information in the case file to determine what was done after a report was made.

In 2016, 14 cases again resulted in four autopsies. The rest, again, involved external examinations and scene investigations.

During 2017, the first three months of the year saw seven cases, none of them resulted in autopsies. For the rest of 2017, after Goslinoski started working for the county, 23 cases resulted in nine autopsies. The rest were external examinations and medical record reviews or scene investigations.

In 2018, 34 cases were referred and 25 autopsies were performed, the rest were scene and external exams with medical record reviews.

In 2019, seven cases have resulted in four autopsies.

Goslinoski stated there had been a rise in the number of accidental deaths involving drug overdose. She also explained that death from trauma, such as car accidents and recreational vehicles, often need to be investigated to satisfy consumer protection groups.

“In the past, I think the guidelines weren’t always followed,” Goslinoski said. “I’m not saying there was anything wrong with how cases were handled, but I would have handled them a bit differently. I can’t pretend I don’t know the rules.”

Commissioner Art Jeannot said the purpose of requesting the information from Goslinoski was to address why spending on autopsies has increased over the past few years.

“We look at the budget and the activity is much higher than what I anticipated, so I started asking questions,” Jeannot said. “Why are we doing more autopsies? Are they needed? Are there situations we should have been doing them in the past? Could there be liability consequences of not doing them when we should have been?”

In an interview outside of the meeting, Jeannot said a financial report from the county’s first quarter shows a significant increase in autopsy spending from previous quarters, and said the county was on track to exceed the money budgeted for the activity.

Mitch Deisch, administrator for Benzie County, said the county should factor the cost of more autopsies in future budgets.

The next Benzie County Board of Commissioners meeting will be held at 9 a.m. on April 9.

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