New Hampshire

Is medical death investigation system centralized, county-based, or district-based?
Centralized. N.H. Rev. Stat. Ann. § 611-B:2.

If centralized, in which department or agency is the system housed?
Department of Justice. N.H. Rev. Stat. Ann. § 611-B:2.

Does the state system have a coroner, medical examiner, or coroners and medical examiners?
Medical examiner. N.H. Rev. Stat. Ann. § 611-B:2.

“In practice” notes
None.

Is there a state medical examiner?
Yes. N.H. Rev. Stat. Ann. § 611-B:2.

If so, what is the state medical examiner’s role?
The chief medical examiner shall have the authority to adopt rules, pursuant to RSA 541-A, relative to:

(a) The methods and procedures for medico-legal death investigations.

(b) The examination of substances taken from dead bodies or human remains in order to determine the manner of death, provided that such examinations shall be conducted, whenever possible, at existing qualified state facilities.

(c) Training and certification of medical examiners under RSA 611-B.

(d) The fee schedule for medical examiners under RSA 611-B.

(e) Forms, blank returns, and other documents necessary for medical examiners to carry out the provisions of this chapter.

N.H. Rev. Stat. Ann. § 611-B:2.

I. The chief medical examiner shall have the authority to enter into agreements, subject to approval of the attorney general and governor and council, with state departments and with any public or private college or university, school of medicine, or hospital for the use of certain laboratories, morgues, and other technical facilities, and, pursuant to such agreements, shall have authority to make medical examiners available to such educational institutions for the teaching of legal medicine and other subjects closely related to their duties.

II. The chief medical examiner and, at the chief medical examiner’s direction, other medical examiners shall assist in the training of police officers in police training programs authorized by the police standards and training council under RSA 188-F:22 through RSA 188-F:32.

N.H. Rev. Stat. Ann. § 611-B:8.

The chief medical examiner shall have general supervision over the administration of and shall enforce the provisions of this chapter. Medical examiners shall serve under the professional direction and supervision of the chief medical examiner. N.H. Rev. Stat. Ann. § 611-B:7.

In what department or agency is the state medical examiner’s office located?
Department of Justice. N.H. Rev. Stat. Ann. § 611-B:2.

Are there deputies?
There is hereby established within the office of chief medical examiner the position of deputy chief medical examiner. N.H. Rev. Stat. Ann. § 611-B:3.

The chief medical examiner shall appoint assistant deputy medical examiners to perform the duties of medical examiner under this chapter. N.H. Rev. Stat. Ann. § 611-B:5.

If so, what are the deputies’ roles?
The deputy chief medical examiner shall serve under the professional direction and supervision of the chief medical examiner and shall act as the chief medical examiner whenever the latter is absent, or unable to act for any cause. N.H. Rev. Stat. Ann. § 611-B:3.

Assistant deputy medical examiners shall serve without geographic restriction . . . An assistant deputy medical examiner shall possess all the powers granted to medical examiners under this chapter and be sworn in the same manner . . . N.H. Rev. Stat. Ann. § 611-B:5.

What are the qualifications for deputies?

The deputy chief medical examiner . . . shall be a licensed physician, certified by the American Board of Pathology as a qualified pathologist, with training and experience in forensic medicine. N.H. Rev. Stat. Ann. § 611-B:3.

An assistant deputy medical examiner shall be a person educated in the science of medicine and shall serve under the direction and supervision of the chief medical examiner. N.H. Rev. Stat. Ann. § 611-B:5.

Is the coroner or medical examiner position elected?
No. N.H. Rev. Stat. Ann. § 611-B:2; N.H. Rev. Stat. Ann. § 611-B:5.

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

What are the qualifications specified by law?
[T]he “chief medical examiner” . . . . shall be a duly licensed physician and certified by the American Board of Pathology to possess special competence in forensic pathology and who has had experience in forensic medicine. N.H. Rev. Stat. Ann. § 611-B:2.

What types of deaths are required to be investigated?

II. A medical examiner shall make investigations in medico-legal cases. A medico-legal case exists when death is pronounced or remains are found indicating that a human has died and that death is known or suspected to have resulted from:

(a) Any death known or suspected to have occurred during or as a result of any criminal act regardless of the time interval between incident and death and regardless of whether criminal violence appears to have been the immediate cause of death or a contributory factor thereto.

(b) Any death by suicide regardless of the time interval between the incident and death.

(c) Any death due to accidental or unintentional injury regardless of the 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.

(d) Deaths associated with fire or explosion.

(e) Deaths associated with firearms or other mortal weapons.

(f) Any death which occurs in or associated with any public or private conveyance, including but not limited to any motor vehicle, recreational vehicle, bicycle, aircraft, watercraft, motorcycle, bus, train, or the like.

(g) Abortion or the complications thereof if the abortion was known or suspected to have been performed by an unlicensed practitioner.

(h) Poison, illicit drug use, or an overdose of any drug or medication.

(i) Disease, injury, or exposure to a toxic agent resulting from or occurring during the course of employment.

(j) Disease or agent which constitutes a public health hazard or environmental hazard.

(k) Sudden unexpected death when in apparent good health of a person under the age of 60 years.

(l) Death of a person whose medical care has not been regularly followed by a physician.

(m) Death occurring in legal custody, including any death that occurs in any prison or penal institution.

(n) Death associated with diagnostic or therapeutic procedures, including intraoperative and perioperative deaths.

(o) Death in which a body is to be cremated in the state of New Hampshire or buried at sea regardless of the jurisdiction in which the death occurred.

(p) Death occurring less than 24 hours after admission to a health care facility or hospital, except when the decedent was known to have been terminally ill from natural disease and the death is imminent and expected.

(q) Death of a child under the age of 18 years unless the child is known to be terminally ill from natural disease or congenital anomaly and the death is expected.

(r) The death of any child from any cause when such death occurs at a day care facility, or when the child is in foster care, or when the child is in the custody of or being investigated by the department of health and human services.

(s) Fetal deaths that result from intrauterine trauma when the fetus has attained 20 weeks gestation or 350 grams weight.

(t) Death known to have been improperly certified, including but not limited to any remains brought into the state of New Hampshire without proper certification.

(u) Death of any unidentified person regardless of cause and manner.

(v) Discovery of buried remains which are known or thought to be human and which are uncovered other than by an exhumation order.

(w) The discovery of decomposed remains, including partially or completely skeletonized remains.

(x) Suspicious or unusual circumstances surrounding a presumed natural death.

N.H. Rev. Stat. Ann. § 611-B:11.

What types of deaths are required to be autopsied?
I. If the supervising medical examiner, attorney general, or county attorney deems that an autopsy is necessary, he or she shall direct that one be made. The commissioner of the department of health and human services may, pursuant to RSA 126-A:5, V, request an autopsy of any individual who dies while admitted to, a resident of, or receiving care from New Hampshire hospital, Glencliff home, or any other residential facility operated by the department or a contract service provider.

II. The supervising medical examiner shall have the authority to conduct an autopsy and shall comply with any request by the attorney general, a county attorney, or the commissioner of health and human services to perform an autopsy.

N.H. Rev. Stat. Ann. § 611-B:17.

Does the state require that pathologists perform the autopsies?
Yes, [t]he supervising medical examiner shall have the authority to conduct an autopsy . . . N.H. Rev. Stat. Ann. § 611-B:17.

“Supervising medical examiner” means the chief medical examiner, deputy chief medical examiner, or acting chief medical examiner [all of whom must be pathologists]. N.H. Rev. Stat. Ann. § 611-B:1.