Massachusetts

Is medical death investigation system centralized, county-based, or district-based?
Centralized. Mass. Gen. Laws Ann. ch. 38, § 2.

If centralized, in which department or agency is the system housed?
Executive Office of Public Safety. Mass. Gen. Laws Ann. ch. 38, § 2.

Does the state system have a coroner, medical examiner, or coroners and medical examiners?
Medical examiner. Mass. Gen. Laws Ann. ch. 38, § 2.

“In practice” notes
None.

Is there a state medical examiner?
Yes. Mass. Gen. Laws Ann. ch. 38, § 2.

If so, what is the state medical examiner’s role?
The chief medical examiner, with the approval of the commission, shall establish a comprehensive system to deliver medicolegal investigative services in the commonwealth . . . The chief medical examiner may, subject to the approval of the secretary of public safety, apply for and accept on behalf of the commonwealth any funds, including grants, bequests, gifts or contributions, from any person for the improvement of the system of medicolegal investigative services in the commonwealth. Such funds shall be deposited in a separate account with the state treasurer and received by him on behalf of the commonwealth. All such funds may be expended by the chief medical examiner, in accordance with law. . . . The office of the chief medical examiner shall have custody of all files, reports, photographs and other articles generated by all employees or vendors of the office. The chief medical examiner, with approval of the secretary of the executive office of public safety, shall promulgate rules for the disclosure of autopsy reports, which shall not be deemed to be public records, to those who are legally entitled to receive them . . . The chief medical examiner, with the approval of said secretary, may establish fees for providing autopsy reports to those who are legally entitled to receive them . . . Mass. Gen. Laws Ann. ch. 38, § 2.

In what department or agency is the state medical examiner’s office located?
Executive Office of Public Safety. Mass. Gen. Laws Ann. ch. 38, § 2.

Are there deputies?
The chief medical examiner shall appoint a deputy chief medical examiner who shall perform all of the duties of the chief medical examiner in case of incapacity or absence. The chief medical examiner may appoint such associate chief medical examiners as necessary . . . District medical examiners shall be appointed by the chief medical examiner to conduct appropriate medicolegal investigations within the commonwealth. Mass. Gen. Laws Ann. ch. 38, § 2.

If so, what are the deputies’ roles?
[A] deputy chief medical examiner . . . shall perform all of the duties of the chief medical examiner in case of incapacity or absence . . . District medical examiners shall be appointed by the chief medical examiner to conduct appropriate medicolegal investigations within the commonwealth. Such medical examiners shall serve in areas or districts as determined by the chief medical examiner and for terms of office at his discretion. Such medical examiners shall be responsible, under the direction of the chief medical examiner or the deputy medical examiner or an associate chief medical examiner, for the investigation and certification as to the cause of deaths under their jurisdiction. District medical examiners shall be licensed to practice medicine within the commonwealth and shall reside therein. In areas where such individuals are not available, the chief medical examiner or his representative may appoint other appropriately qualified individuals to conduct medicolegal investigations . . . Mass. Gen. Laws Ann. ch. 38, § 2.

What are the qualifications for deputies?
District medical examiners shall be licensed to practice medicine within the commonwealth and shall reside therein. In areas where such individuals are not available, the chief medical examiner or his representative may appoint other appropriately qualified individuals to conduct medicolegal investigations . . . Mass. Gen. Laws Ann. ch. 38, § 2.

Is the coroner or medical examiner position elected?
No. Mass. Gen. Laws Ann. ch. 38, § 2.

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

What are the qualifications specified by law?
The chief medical examiner shall be a physician who is a diplomat of the American Board of Pathology with certification in anatomic pathology and subspecialty certification in forensic pathology, a graduate of an approved fellowship program in forensic medicine and licensed to practice medicine in the commonwealth and must reside within the commonwealth within six months after his appointment. Mass. Gen. Laws Ann. ch. 38, § 2.

What types of deaths are required to be investigated?
(1) death where criminal violence appears to have taken place, regardless of the time interval between the incident and death, and regardless of whether such violence appears to have been the immediate cause of death, or a contributory factor thereto;

(2) death by accident or unintentional injury, regardless of time interval between the incident and death, and regardless of whether such injury appears to have been the immediate cause of death, or a contributory factor thereto;

(3) suicide, regardless of the time interval between the incident and death;

(4) death under suspicious or unusual circumstances;

(5) death following an unlawful abortion;

(6) death related to occupational illness or injury;

(7) death in custody, in any jail or correctional facility, or in any mental health or mental retardation institution;

(8) death where suspicion of abuse of a child, family or household member, elder person or disabled person exists;

(9) death due to poison or acute or chronic use of drugs or alcohol;

(10) skeletal remains;

(11) death associated with diagnostic or therapeutic procedures;

(12) sudden death when the decedent was in apparent good health;

(13) death within twenty-four hours of admission to a hospital or nursing home;

(14) death in any public or private conveyance;

(15) fetal death, as defined by section two hundred and two of chapter one hundred and eleven, where the period of gestation has been twenty weeks or more, or where fetal weight is three hundred and fifty grams or more;

(16) death of children under the age of 18 years from any cause;

(17) any person found dead;

(18) death in any emergency treatment facility, medical walk-in center, child care center, or under foster care; or

(19) deaths occurring under such other circumstances as the chief medical examiner shall prescribe in regulations promulgated pursuant to the provisions of chapter
thirty A . . .

Mass. Gen. Laws Ann. ch. 38, § 3.

Upon notification of a death in the circumstances enumerated [above], the chief medical examiner or his designee shall carefully inquire into the cause and circumstances of the death. If, as a result of such inquiry, the chief medical examiner or such designee is of the opinion that the death was due to violence or other unnatural means or to natural causes that require further investigation, he shall take jurisdiction. . . The district attorney or his law enforcement representative shall direct and control the investigation of the death and shall coordinate the investigation with the office of the chief medical examiner and the police department within whose jurisdiction the death occurred . . . Mass. Gen. Laws Ann. ch. 38, § 4.

What types of deaths are required to be autopsied?
Either the medical examiner or the district attorney in the jurisdiction where death occurred may order an autopsy . . . Mass. Gen. Laws Ann. ch. 38, § 4.

Does the state require that pathologists perform the autopsies?
No.