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Florida medical examiners no longer required to certify, investigate COVID-19 deaths

An Aug. 14 ruling approved by the Florida Medical Examiners Commission states that medical examiners are no longer required to certify death certificates listing COVID-19 as the cause of death.
These six refrigerated containers were delivered to the Hillsborough County Medical Examiner's Office on North 46th Street in Tampa in late June. The containers are a contingency for hurricane season, not coronavirus, said Harrison Cowan, the office's manager of operations.
These six refrigerated containers were delivered to the Hillsborough County Medical Examiner's Office on North 46th Street in Tampa in late June. The containers are a contingency for hurricane season, not coronavirus, said Harrison Cowan, the office's manager of operations. [ LUIS SANTANA | Times ]
Published Aug. 26, 2020|Updated Aug. 26, 2020

The number of fatalities attributed to the novel coronavirus in Florida will no longer be verified by the forensic pathologists who investigate causes of death.

A new ruling approved by Florida’s nine-member Medical Examiners Commission on Aug. 14 states that Florida’s medical examiners are no longer required to sign off on death certificates listing COVID-19 as the cause or a contributing cause of death.

Instead, any attending physician with a valid medical license in the state of Florida can now determine the official cause of death for those who die after testing positive for the coronavirus.

Medical examiners would still be allowed to assume jurisdiction over COVID-19 cases at their own discretion, the motion states. But since most people who die from the virus are living in an assisted living facility or are hospitalized with severe symptoms, the small procedural change could have huge ramifications for the way Florida records, reports and researches the deaths of its coronavirus patients.

Ever since the first cases in Florida’s coronavirus outbreak were announced March 1, medical examiners have been required by law to investigate the deaths of anyone known to be infected by the virus, often testing for the virus posthumously before certifying that coronavirus was or was not the cause.

But this summer brought on a surge in coronavirus testing, diagnoses, and - eventually - deaths. According to Wednesday’s update from the Florida Department of Health, 10,872 people have died the past six months due to COVID-19.

The commission’s ruling was meant to alleviate backlogs in Florida’s hardest hit communities, where some medical examiners offices reported gruesome accounts of cadavers piling up while awaiting testing.

“In support of the motion, the Commission cited the knowledge gained of the disease during the past five months, delay in obtaining medical records and the overwhelming number of cases that have resulted in insurmountable and growing backlogs for many districts throughout the state,” the commission’s meeting minutes said.

According to the commission’s report, the Palm Beach County medical examiner’s office said it faced a backlog of nearly 500 cases, while the medical examiner in Miami-Dade County — the epicenter of the state’s COVID-19 pandemic - reported a backlog of more than 650 potential COVID-19 deaths.

“There’s a squeeze point and I think most of the offices are beyond that squeeze point,” Commission Chairman Stephen J. Nelson, chief medical examiner in Polk, Highlands and Hardee counties, told the Miami Herald.

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No Central Florida counties have reported a backlog in cases.

Despite the new ruling, the Pinellas-Pasco Medical Examiner’s Office will continue investigating — and provide a detailed report to the commission — on every suspected COVID-19 death, said Bill Pellan, director of investigations for the Pinellas-Pasco Medical Examiner’s Office.

“The reason why medical examiners exist is to document how people are dying so you can identify trends and put things in place to prevent as many deaths from happening as possible,” Pellan said. “And at this point - in the middle of a pandemic with kids going back to school - we felt like bowing out of that responsibility just wouldn’t be the right thing to do.”

He added: “It’s not like they teach you how to fill out death certificates in medical school. The cause of death is a professional opinion based on your knowledge and experience in the practice of medicine, just like how three different physicians can have three different diagnoses for the same patient.”

The Hillsborough County Medical Examiner’s Office is supportive of the decision by the Florida Medical Examiners Commission, Manager of Operations Harrison Cowan said in an emailed statement to the Tampa Bay Times on Wednesday.

“Although the majority of our COVID-19 death investigations have been conducted over the telephone, the process was laborious, time-consuming, and involved much after-hours work,” Cowan’s statement read. “The change in process will significantly reduce the amount of additional hours and paperwork which our staff have taken on without relief since the start of the pandemic, and provide families with a quicker resolution and turnaround for death certificates.”

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