Kentucky

Is medical death investigation system centralized, county-based, or district-based?
County-based. Ky. Rev. Stat. Ann. § 72.410.

If centralized, in which department or agency is the system housed?
Not applicable.

Does the state system have a coroner, medical examiner, or coroners and medical examiners?
Coroner. Ky. Rev. Stat. Ann. § 72.410.

“In practice” notes
None.

Is there a state medical examiner?
Yes. Ky. Rev. Stat. Ann. § 72.240.

If so, what is the state medical examiner’s role?
It is the intention of the General Assembly for the office to aid, assist, and complement the coroner in the performance of his duties by providing medical assistance to him in determining causes of death. Ky. Rev. Stat. Ann. § 72.210.

[T]he chief medical examiner . . .  shall administer the Office of the Kentucky State Medical Examiner . . . Ky. Rev. Stat. Ann. § 72.240.

In what department or agency is the state medical examiner’s office located?
Justice and Public Safety Cabinet. Ky. Rev. Stat. Ann. § 72.240.

Are there deputies?
Every coroner shall have the authority to appoint deputy coroners. Ky. Rev. Stat. Ann. § 72.010.

The Justice and Public Safety Cabinet may employ physicians licensed to practice medicine in Kentucky as county or district medical examiners to carry out the provisions of KRS 72.210 to 72.275 within the counties or district to which they are assigned by the medical examiner section. The cabinet may designate county or district health officers as county or district medical examiners . . . Ky. Rev. Stat. Ann. § 72.240.

If so, what are the deputies’ roles?
At the request of the coroner the county or district medical examiner shall assist in the investigation of deaths. Ky. Rev. Stat. Ann. § 72.245.

What are the qualifications for deputies?
Where a duly elected coroner is a physician licensed to practice medicine in Kentucky, he may be authorized by the department to perform the duties of a county or district medical examiner . . . Ky. Rev. Stat. Ann. § 72.265.

No person shall be eligible to hold the office of deputy coroner unless he holds a high school diploma or its recognized equivalent. Every deputy coroner, other than a licensed physician, shall be required as a condition of office to take during every calendar year he or she is in office the training course of at least eighteen (18) hours provided by the Department of Criminal Justice Training or other courses approved by the Justice and Public Safety Cabinet after having completed the basic training course the first year of employment. Ky. Rev. Stat. Ann. § 72.415.

The Justice and Public Safety Cabinet may employ physicians licensed to practice medicine in Kentucky as county or district medical examiners [or] may designate county or district health officers as county or district medical examiners . . . Ky. Rev. Stat. Ann. § 72.240.

Is the coroner or medical examiner position elected?
Yes. Ky. Rev. Stat. Ann. § 72.400.

If so, how many years is the term of office?
Four. Ky. Const. § 99.

What are the qualifications specified by law?
State Medical Examiner: board-certified forensic pathologist. Ky. Rev. Stat. Ann.
§ 72.240.

Coroner: No person shall be eligible to the offices mentioned in Sections 97 and 99 who is not at the time of his election twenty-four years of age . . . , a citizen of Kentucky, and who has not resided in the State two years, and one year next preceding his election in the county and district in which he is a candidate. Ky. Const. § 100.

What types of deaths are required to be investigated?
Coroners shall require a post-mortem examination to be performed in the following circumstances:

(1) When the death of a human being appears to be caused by homicide or violence;

(2) When the death of a human being appears to be the result of suicide;

(3) When the death of a human being appears to be the result of the presence of drugs or poisons in the body;

(4) When the death of a human being appears to be the result of a motor vehicle accident and the operator of the motor vehicle left the scene of the accident or the body was found in or near a roadway or railroad;

(5) When the death of a human being occurs while the person is in a state mental institution or mental hospital when there is no previous medical history to explain the death, or while the person is in police custody, a jail or penal institution;

(6) When the death of a human being occurs in a motor vehicle accident and when an external examination of the body does not reveal a lethal traumatic injury;

(7) When the death of a human being appears to be the result of a fire or explosion;

(8) When the death of a child appears to indicate child abuse prior to the death;

(9) When the manner of death appears to be other than natural;

(10) When human skeletonized remains are found;

(11) When post-mortem decomposition of a human corpse exists to the extent that external examination of the corpse cannot rule out injury or where the circumstances of death cannot rule out the commission of a crime;

(12) When the death of a human being appears to be the result of drowning;

(13) When the death of an infant appears to be caused by sudden infant death syndrome in that the infant has no previous medical history to explain the death;

(14) When the death of a human being occurs as a result of an accident;

(15) When the death of a human being occurs under the age of forty (40) and there is no past medical history to explain the death;

(16) When the death of a human being occurs at the work site and there is no apparent cause of death such as an injury or when industrial toxics may have contributed to the cause of death;

(17) When the body is to be cremated and there is no past medical history to explain the death;

(18) When the death of a human being is sudden and unexplained; and

(19) When the death of a human being occurs and the decedent is not receiving treatment by a licensed physician and there is no ascertainable medical history to indicate the cause of death.

Ky. Rev. Stat. Ann. § 72.025.

What types of deaths are required to be autopsied?
(1) The coroner of each county shall investigate the cause and manner of all deaths that are defined by KRS 72.405 as a coroner’s case.

(2) The coroner may, in his sound discretion, when investigating a coroner’s case, request the assistance of the district medical examiner and the Office of the Kentucky State Medical Examiner, order an autopsy, and hold an inquest.

Ky. Rev. Stat. Ann. § 72.410.

“Coroner’s case” means a case in which the coroner has reasonable cause for believing that the death of a human being within his county was caused by any of the conditions set forth in KRS 72.025 [see above]. Ky. Rev. Stat. Ann. § 72.405.

Does the state require that pathologists perform the autopsies?
Yes, “[c]oroner ordered autopsy” means an autopsy ordered by the coroner having jurisdiction and performed by a pathologist pursuant to such authorization in order to ascertain the cause and manner of death in a coroner’s case. Ky. Rev. Stat. Ann. § 72.405.