Each case starts with a phone call to my office of someone reporting a death. The call starts with basic questions, where is the body, were they on hospice care, any recent surgeries, falls, injuries, suspicious circumstances, unusual amounts of body fluid – vomit, diarrhea, blood and is it near the body or through-out the scene? Is family present? Any drugs, alcohol, open or empty prescription pill bottles? Was anybody home? Was their death witnessed? Did paramedics respond to the scene? Did they do any treatment? If no one was home, was the residence locked? Why did police/fire respond if no one else was home – who called and why?
These are just SOME of the questions we ask when we receive the initial phone call in order to determine what else needs to be done and where to take the investigation next. If the person has a significant medical history, no recent injuries, is at least 65 years old, has been seen by a doctor on a regular basis, no signs of medication abuse, no blood, no contacts for APS (adult protective services), no recent falls, etc… that it appears to be a natural death and the primary care physician is willing to sign the death certificate, then in those cases the person can go to the mortuary and we do NOT need to go out there. Usually in these cases I will send an email or fax to the primary care physician and advise them of the circumstances of the death and why we did not respond. Sometimes they need a little direction in how to word the death certificate so I assist with that too.
If someone is on hospice care it pretty much goes the same. However even a hospice case can warrant further investigation if there are signs of abuse or neglect such as bedsores that are not being cleaned and bandaged, unusual bruises or cuts, dirty bedding, lack of food, apparent dehydration, clogged feeding tube, missing medications, and odd incriminating spontaneous statements by family or caregivers. Then it goes from a medical-natural to something else.
As for the “something else” types of cases, I will get into those on a more individual format. Stay tuned!!!!