Maryland

Is medical death investigation system centralized, county-based, or district-based?
Centralized. Md. Code Ann., Health–Gen. § 5-306.

If centralized, in which department or agency is the system housed?
Department of Health and Mental Hygiene. Md. Code Ann., Health–Gen. § 5-302.

Does the state system have a coroner, medical examiner, or coroners and medical examiners?
Medical examiner. Md. Code Ann., Health–Gen. § 5-305.

“In practice” notes
None.

Is there a state medical examiner?
Yes. Md. Code Ann., Health–Gen. § 5-305.

If so, what is the state medical examiner’s role?
Unspecified.

In what department or agency is the state medical examiner’s office located?
Department of Health and Mental Hygiene. Md. Code Ann., Health–Gen. § 5-302.

Are there deputies?
The staff shall include . . .

(ii) 2 deputy chief medical examiners;

(iii) Assistant medical examiners

Md. Code Ann., Health–Gen. § 5-305.

(b)(1) The Commission may appoint one or more deputy medical examiners . . . for each county . . . Md. Code Ann., Health–Gen. § 5-306.

If so, what are the deputies’ roles?
Unspecified.

What are the qualifications for deputies?
(b)(1) [D]eputy chief medical examiners shall be board certified in anatomic and forensic pathology by the American Board of Pathology.

(2) Assistant medical examiners appointed on or after October 1, 2008, shall be certified by the American Board of Pathology in anatomic and forensic pathology or obtain that certification within 3 years of appointment . . .

Md. Code Ann., Health–Gen. § 5-305.

(c) Each deputy medical examiner appointed under subsection (b) of this section shall be a physician. Md. Code Ann., Health–Gen. § 5-306.

Is the coroner or medical examiner position elected?
No. Md. Code Ann., Health–Gen. § 5-305.

If so, how many years is the term of office?
Not applicable.

What are the qualifications specified by law?
(b)(1) The Chief Medical Examiner . . .  shall be board certified in anatomic and forensic pathology by the American Board of Pathology. Md. Code Ann., Health–Gen. § 5-305.

What types of deaths are required to be investigated?
(a)(1) A medical examiner shall investigate the death of a human being if the death occurs:

(i) By violence;

(ii) By suicide;

(iii) By casualty;

(iv) Suddenly, if the deceased was in apparent good health or unattended by a physician; or

(v) In any suspicious or unusual manner.

(2) A medical examiner shall investigate the death of a human fetus if:

(i) Regardless of the duration of the pregnancy, the death occurs before the complete expulsion or extraction of the fetus from the mother; and

(ii) The mother is not attended by a physician at or after the delivery.

Md. Code Ann., Health–Gen. § 5-309.

An individual dying in Maryland as a result of a homicide, poisoning, suicide, criminal abortion, rape, drowning, or dying in a suspicious or unusual manner, or an unattended death of an apparently healthy individual shall be examined by the medical examiner in the Office of the Chief Medical Examiner in Baltimore, or in any other place as may be approved by the Chief Medical Examiner. Md. Code Regs. 10.35.01.03.

“Medical examiner’s case” means a death that a medical examiner is required by law to investigate. Md. Code Ann., Health–Gen. § 5-301.

(a) “Medical examiner case” means any death which is the result, wholly or in part, of a casualty or accident, homicide, poisoning, suicide, criminal abortion, rape, therapeutic misadventure, drowning, or a death of a suspicious or unusual nature, or of an apparently healthy individual while not under the care of a physician.

(b) “Medical examiner case” does not mean:

(i) A stillbirth or a neonatal death, or accident room or hospital death in which the cause of death has been established by the hospital physician and is due to disease, and free of evidence of criminal or accidental nature;

(ii) A case which is dead on arrival at the hospital and the physician who pronounces death has been in previous attendance on the patient; or

(iii) A death which occurs in a hospital within 24 hours of admission merely because the death occurred within 24 hours.

Md. Code Regs. 10.35.01.01.

What types of deaths are required to be autopsied?
(b)(1) If the medical examiner who investigates a medical examiner’s case considers an autopsy necessary, the Chief Medical Examiner, a deputy chief medical examiner, an assistant medical examiner, or a pathologist authorized by the Chief Medical Examiner shall perform the autopsy . . .

(c)(1) A medical examiner shall conduct an autopsy of any fire fighter and any sworn personnel of the State Fire Marshal’s Office who dies in the line of duty or as a result of injuries sustained in the line of duty.

Md. Code Ann., Health–Gen. § 5-310.

The medical examiner shall perform an autopsy and complete toxicological examination of any fire fighter or sworn personnel of the State Fire Marshal’s Office who dies in the line of duty or whose death appears to have been caused by:

(1) Fire;

(2) Toxic gases;

(3) Toxic fire conditions; or

(4) Fire-related circumstances.

Md. Code Regs. 10.35.01.04.

A. The following types of medical examiner cases may be autopsied by the hospital pathologists with the authorization of the Chief Medical Examiner:

(1) Death from acute or chronic alcoholism without manifestation of trauma;

(2) Death from accidental burns occurring in the home;

(3) Death, or sudden death, associated with a therapeutic procedure;

(4) Death following a fracture in an elderly person and resulting from a simple fall in the home.

B. In the cases listed in Sec. A of this regulation, permission from next of kin is not required since these are under the medical examiner’s jurisdiction and the hospital pathologist is acting pursuant to this jurisdiction.

Md. Code Regs. 10.35.01.07.

Does the state require that pathologists perform the autopsies?
Yes, [i]f the medical examiner who investigates a medical examiner’s case considers an autopsy necessary, the Chief Medical Examiner, a deputy chief medical examiner, an assistant medical examiner [all of whom must be pathologists or receive certification within 3 years], or a pathologist authorized by the Chief Medical Examiner shall perform the autopsy. Md. Code Ann., Health–Gen. § 5-310.