HB 225-MEDICAL EXAMINERS & AUTOPSIES 3:09:17 PM CHAIR WILSON announced that the first order of business would be HOUSE BILL NO. 225, "An Act relating to medical examiners and medical death examinations." REPRESENTATIVE MCGUIRE, speaking as the sponsor, expressed her belief that the duty of the state medical examiner is of immense responsibility and importance to the citizens of Alaska. She explained that autopsies are performed by the state coroner for various reasons, including suspicious death and possible communicable disease outbreaks. There is one state medical examiner in Alaska, she related, manages over 1,000 cases, annually. She further explained that Alaska law divides autopsies into two different categories, which include suspicious, unusual or public health related deaths in the first category and leaves other cases to the discretion of the medical examiner. REPRESENTATIVE MCGUIRE said that HB 225 would require that a deputy medical examiner be appointed to assist the state medical examiner in Alaska. She explained that the state medical examiner has been so overworked in past years, that some deaths have not been properly investigated, due to the lack of resources. She pointed out that the deputy medical examiner would provide respite for the state medical examiner and allow for the development and training of the position. If the state medical examiner became ill, needed to take time off, or decided to leave the position, there would be someone to take over, she related. REPRESENTATIVE MCGUIRE stated that there is a zero fiscal note attached to HB 225 because the governor's office decided to fund the [deputy commissioner] position. She explained that this position was funded in recognition that this is a critical state responsibility, and a matter of public trust. 3:14:37 PM DR. ROGERS said that he was the state medical examiner for 27 years in Alaska. He explained that he resigned and retired when the policy in Juneau shifted requirements to complete only 25 percent of deaths reported to the state medical examiner. He continued: I couldn't see doing that because we have to sign a death certificate, we have to certify that somebody died of something. And the word certify, I take seriously, ... the word certify is equivalent to being under oath. So, I didn't want to do what they call a walk by autopsy and just make a guess at the cause of death and sign it out .... One of the reasons that the present situation is unsatisfactory is nothing more that death certificate statistics. The Department of Epidemiology ... thought that our autopsy records were the best in the country because we did autopsies on about 98 percent of all the coroner's cases and that includes the unattended natural deaths, and there are a lot of things to die of besides a coronary, which is what most of them get signed out as now. Our death certificate statistics have become relatively worthless ... for people who die outside of the hospital .... I was at a meeting a while back where a group from Pittsburgh tried an experiment, they would bring a body in, the duty pathologist would decide whether or not to do an autopsy and write down what he would sign it out as; ... if he decided he didn't need to do one, then one of the other pathologists in the group would do an autopsy .... And they found that they were wrong 25 percent of the time and I think that a 25 percent error rate is really not very acceptable. I think it's a responsibility of the state to know what its citizens die of, and therefore I think this bill will at least provide more people for them to do the work. Right now, one guy just simply can't do it all ... my partner and I, used to do about 1,000 cases a year and it can be done if the time is utilized efficiently .... I really applaud this bill and hope that it will make a difference in the policies that come out of the "department"; I assume that they come from the commissioner .... When they made us change it came through Dr. Nakamura, I think is Dr. Mandsager's predecessor, and it was his view that we should do only an average job compared to the rest of the country. And I wanted to do a better job than the rest of the country, not because we're any better at it, but because there are few enough cases that we could do them all. So, I think we should go back to doing them all, again. REPRESENTATIVE SEATON moved to report HB 225 out of committee with individual recommendations and the accompanying zero fiscal note. There being no objection, HB 225 was reported from the House Health, Education and Social Services Standing Committee.