STATE OF MICHIGAN

FRANK J. KELLEY, ATTORNEY GENERAL

Opinion No. 6565

January 30, 1989

COUNTY MEDICAL EXAMINER:

Performance of autopsy upon body of nonresident deceased person

Authority to seek reimbursement from county of residence or place where injuries were sustained for performance of autopsy upon body of deceased person

A county medical examiner is obligated to perform all the duties and functions imposed by law with respect to the body of a deceased person in the county, including the performance of an autopsy, irrespective of the county of residence of the deceased person or the county of the place where the deceased person may have sustained injury.

A county medical examiner is not authorized to restrict the performance of complete medical examinations and/or autopsies to the bodies of deceased persons within the county based upon residence of the deceased person in the county or the place of injury of the deceased person within the county.

The Legislature has not authorized a county medical examiner, either prior or subsequent to performing an examination or autopsy upon the body of a deceased person, to seek financial reimbursement for the cost of such services from the county in which the deceased person either resided or sustained injuries which were causally connected with the death.

Honorable William Van Regenmorter

State Representative

The Capitol

Lansing, MI 48909

You have requested my opinion on three questions relating to the scope of the authority and duties of a county medical examiner with respect to the performing of autopsies on nonresident individuals who die within the county. Your first question is:

In your letter you state "that it is common practice for a seriously ill or injured person to be transported to a neighboring county which may have more sophisticated health care services and which may serve as a regional medical care center."

In essence, your question asks whether a county medical examiner must either make a determination as to cause of death or perform an autopsy on the body of a person found dead in the county, regardless of residence or place of injury in another county or state.

1953 PA 181, MCL 52.201 et seq; MSA 5.953(1) et seq, provides for the duties of the county medical examiner. Act 181, Sec. 3, provides:

In Act 181, Sec. 5, the Legislature has provided:

Where the language of a statute is clear and unambiguous, the plain and ordinary meaning is controlling. People v Love, 425 Mich 691, 701; 391 NW2d 738 (1986); Metropolitan Life Ins Co v Church, 150 MichApp 539, 544; 389 NW2d 124 (1986).

The language in Act 181, Sec. 5(1), is clear and unambiguous. When the body of a deceased person "has been found within his or her county or district" the medical examiner "shall take charge of the body ... [and make] personal inquiry into the cause and manner of death ... [and if necessary] a further examination [i.e., autopsy] ...." The language makes no reference or distinction with respect to bodies of deceased nonresident persons or those that may have sustained their injuries outside the county. The duty of the medical examiner applies to every deceased body that "has been found within his or her county or district ...."

It is my opinion, in answer to your first question, that the county medical examiner of a county in which an individual dies is obligated to perform all of the statutory duties with respect to the body of that deceased person, including an autopsy, irrespective of the county or state in which the deceased person had resided or may have sustained his or her injury.

Your second question is:

The answer to your question is contained in Act 181, Sec. 5(1). The language in that subsection states that the county medical examiner "shall take charge of the body, and if ... [he or she] considers a further examination necessary, the county medical examiner or a deputy may cause the body to be removed to the public morgue [for an autopsy]."

The phrase "shall take charge of the body" mandates the county medical examiner to assume control and/or jurisdiction over the deceased body. After having assumed that control, the county medical examiner has both the authority and the duty, under the provisions of Act 181, Sec. 5(1), to conduct a "personal inquiry into the cause and manner of the death ...." If, at the completion of the inquiry the county medical examiner has been unable to establish these facts, then he or she has the authority to determine that "a further examination [is] necessary ...," i.e., conduct an autopsy in order to establish the facts as to the cause and manner of the death.

Stated differently, the purpose of the autopsy is to obtain the necessary facts that were not ascertainable through personal inquiry into the matter by the county medical examiner in order to establish the cause and manner of death. Adoption of a policy not to perform complete examinations and/or autopsies with respect to certain classes of deceased persons would constitute an arbitrary limitation, regardless of the completeness of the findings on the facts of the particular death, on the scope of the investigation of the cause and manner of death.

Such a policy would thwart the statutory duties of the county medical examiner, i.e., to establish the cause and manner of death of a person who died either suddenly, unexpectedly, accidentally, violently, or as the result of any suspicious circumstances or without medical attendance during the 48 hours prior to the hour of death.

The statutory duty for establishing the cause and manner of death has been imposed by the Legislature upon the county medical examiner of the county in which the deceased body has been found. Act 181, Sec. 5(1). Assuming that there was a need for an autopsy in order to establish the cause and manner of death, and that solely upon the basis of a policy regarding nonresident deceased persons found in the county a complete autopsy was not performed, there would be no other county medical examiner, not even the one in which the deceased person had resided, that would have the statutory duty to conduct an examination and/or autopsy necessary to establish the cause and manner of death. Thus, the duty lies exclusively with the medical examiner in the county where the deceased body has been found.

OAG, 1975-1976, No 4999, p 415, 418 (April 21, 1976), considered whether a county medical examiner is empowered to exercise control over a deceased body even if it is transported beyond the county, and concluded "that a county medical examiner does have the authority to order that an autopsy be performed at an out-of-state facility but he continues to be responsible for the duties imposed upon him by law."

If a county medical examiner remains responsible for a deceased body sent out of the county for an autopsy, it follows that a county medical examiner cannot be relieved of responsibility by transporting a deceased body beyond the county, to the county in which the deceased person had resided or sustained fatal injury, without having conducted the necessary autopsy. The duties imposed by law are to establish the cause and manner of death, which if required, includes performing an examination or autopsy.

In most instances, an autopsy may not be conducted on a deceased person except by written consent of a person interested in or charged with the disposition of the body. The Public Health Code, 1978 PA 368, as amended, MCL 333.1101 et seq; MSA 14.15(1101) et seq, Sec. 2855 provides, in pertinent part, as follows:

Thus, an autopsy would typically be performed only if either a parent, surviving spouse, guardian, next of kin or a person charged with the responsibility of burial first gave written consent to perform it.

A county medical examiner who conducts an autopsy, without either the request or permission of the relative or person responsible for burial, does so in the discharge of a governmental function. Burse v Wayne County Medical Examiner, 151 MichApp 761, 766-767; 391 NW2d 479 (1986). But, the county medical examiner can exercise that authority only if the deceased dies suddenly, violently, accidentally, or unexpectedly, or without having received medical attendance within 48 hours prior to death, and then only when the body has been found within the county. Act 181, Sec. 5(1).

It is my opinion in answer to your second question, that if a complete autopsy is necessary in order to establish the cause and manner of death, the county medical examiner in the county where the body of the deceased person has been found cannot relieve himself or herself of that duty imposed by law by implementing a policy not to perform complete examinations and/or autopsies on the bodies of deceased persons who resided and/or sustained injuries in a neighboring county.

Your third question is:

There are several sections of Act 181, which are pertinent in answering your third question.

Section 1e of Act 181, provides:

Act 181, Sec. 6, provides:

The thrust of these two sections is that the compensation and expenses of the office of the county medical examiner, including those incurred from private morgues, must be defrayed from appropriations made therefor by the county board of commissioners. 1 OAG, 1955, No 1954, p 95 (March 4, 1955).

Act 181 is devoid of any language that either specifically or by implication authorizes the county medical examiner to either charge or seek reimbursement for the cost of services from any source other than the appropriations of the county board of commissioners of the county where the medical examiner serves.

It is my opinion, in answer to your third question, that the Legislature has not authorized a county medical examiner, either prior or subsequent to performing an examination or autopsy upon the body of a deceased person as to the cause and manner of death, to seek financial reimbursement from the county in which the deceased person either resided or sustained injuries which were causally connected with the death.

Frank J. Kelley

Attorney General