New Jersey

Is medical death investigation system centralized, county-based, or district-based?
County-based. N.J. Stat. Ann. § 52:17B-83.

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?
Medical examiner. The office of county medical examiner is hereby created and shall be maintained in each county, except that several counties may jointly maintain the office on a cooperative basis. N.J. Stat. Ann. § 52:17B-83.

“In practice” notes
None.

Is there a state medical examiner?
Yes. N.J. Stat. Ann. § 52:17B-79.

If so, what is the state medical examiner’s role?
The State Medical Examiner shall have general supervision over the administration of and shall enforce the provisions of this act. He shall have general supervision over all county medical examiners. He shall promulgate such rules and regulations as he may deem necessary to effectuate the provisions of this act. N.J. Stat. Ann. § 52:17B-80.

It shall be the duty of any county medical examiner to call upon the State Medical Examiner or an assistant State medical examiner, or other person authorized and designated by the State Medical Examiner, to make an examination or perform an autopsy whenever he deems it necessary or desirable, and it shall be the duty of the State Medical Examiner or assistant State medical examiner to perform such examination, except in such cases as a competent pathologist is so authorized by the State Medical Examiner to perform such autopsy. N.J. Stat. Ann. § 52:17B-88.

In what department or agency is the state medical examiner’s office located?
Division of Criminal Justice in the State Department of Law and Public Safety. N.J. Stat. Ann. § 52:17B-79.

Are there deputies?
The county medical examiner of any county may, subject to the approval of the board of chosen freeholders, appoint such assistant medical examiners of the county . . . as shall be deemed necessary and required . . . N.J. Stat. Ann. § 40A:9-47.

If the county medical examiner is unable to perform any duty imposed upon him as such medical examiner, by law, he may appoint a resident licensed physician to act for and in his behalf. The physician so appointed shall have all the powers of the county medical examiner and shall receive compensation for his services to be paid by the county. N.J. Stat. Ann. § 40A:9-48.

The county medical examiner may, subject to the approval of the board of chosen freeholders, appoint and prescribe the duties of such deputy or assistant county medical examiners and other personnel required for the proper performance of the duties of the office. N.J. Stat. Ann. § 52:17B-84.

The Attorney General shall . . . appoint such other personnel as he may consider necessary for the efficient performance of the work of the [State Medical Examiner office]. He shall prescribe the duties of all such persons thus appointed . . . N.J. Stat. Ann. § 52:17B-79.

If so, what are the deputies’ roles?
The county medical examiner of any county may, subject to the approval of the board of chosen freeholders, appoint such assistant medical examiners of the county . . . as shall be deemed necessary and required, fix their compensation and prescribe their powers, duties and functions. The assistant medical examiners of the county shall have the same qualifications as the county medical examiner. The said personnel shall be under the direction and supervision of the county medical examiner. N.J. Stat. Ann. § 40A:9-47.

If the county medical examiner is unable to perform any duty imposed upon him as such medical examiner, by law, he may appoint a resident licensed physician to act for and in his behalf. The physician so appointed shall have all the powers of the county medical examiner and shall receive compensation for his services to be paid by the county. N.J. Stat. Ann. § 40A:9-48.

The county medical examiner may, subject to the approval of the board of chosen freeholders, appoint and prescribe the duties of such deputy or assistant county medical examiners and other personnel required for the proper performance of the duties of the office. N.J. Stat. Ann. § 52:17B-84.

The Attorney General shall . . . appoint such other personnel as he may consider necessary for the efficient performance of the work of the [State Medical Examiner office]. He shall prescribe the duties of all such persons thus appointed . . . N.J. Stat. Ann. § 52:17B-79.

What are the qualifications for deputies?

The assistant medical examiners of the county shall have the same qualifications as the county medical examiner. N.J. Stat. Ann. § 40A:9-47.

He shall be a licensed physician, a resident of the county, of recognized ability and good standing in his community, with such training or experience as may be prescribed by standards promulgated by the State Medical Examiner by rule or regulation. N.J. Stat. Ann. § 40A:9-46.

The deputy and assistant county medical examiners shall be licensed physicians and shall possess such qualifications as shall be determined by the county medical examiner after consultation with the State Medical Examiner. N.J. Stat. Ann.
§ 52:17B-84.

(a) Any . . . deputy or assistant county medical examiner . . . shall be a physician fully licensed in the State of New Jersey of recognized ability and good standing in his or her community, and shall have met the following standards relating to prior training and experience:

1. Successful completion of a minimum of 30 hours of basic education in death investigation conducted or sponsored by the Armed Forces Institute of Pathology, the American Society of Clinical Pathologists, the College of American Pathologists, the National Association of Medical Examiners, or an institution of higher education or other agency approved by the State Medical Examiner. . .

2. Successful completion of a basic course conducted by the Office of the State Medical Examiner on the laws, rules and regulations relating to the New Jersey Medical Examiner System.

3. Successful completion of seven full days of internship training at the New Jersey State Medical Examiner Office or equivalent approved by said office.

(b) Any . . . deputy or assistant county medical examiner or designated forensic pathologist . . . shall enroll in and complete a program of continuing medical education in the forensic sciences for a minimum of 20 hours of American Medical Association Category I credit, every two years while holding said position.

(c) Any . . . deputy or assistant county medical examiner or designated forensic pathologist . . . shall enroll in and complete a supplemental program conducted by the Office of the State Medical Examiner on amendments to the laws, rules, and regulations relating to the New Jersey Medical Examiner System or for any other necessary training. The State Medical Examiner shall conduct such courses when necessary.

(d) Only those . . . deputy or assistant county medical examiners or forensic pathologists authorized by the State Medical Examiner as competent to perform autopsies pursuant to N.J.S.A. 52:17B-88, shall perform such autopsies. Such person shall be qualified in one of the following categories:

1. Pathologists who shall have completed a two-year program of supervised training in anatomical pathology approved by the Accreditation Council for Graduate Medical Education of the American Medical Association are eligible to conduct death investigations and to perform postmortem examinations and autopsies under the direct guidance and supervision of a designated pathologist who has already been qualified to practice in an unsupervised capacity in the New Jersey Medical Examiner System, pursuant to (d)2 below and under the general supervision of the State Medical Examiner as provided by law. The reports prepared by this person shall be countersigned by the designated pathologist who has supervised the autopsy.

2. Pathologists who qualify as anatomic pathologists as defined in (d)1 above, and who have at least one year of formal supervised training in a forensic pathology program approved by the Accreditation Council for Graduate Medical Education, or two years supervised experience in forensic pathology in a situation comparable with that of a program accredited by the Accreditation Council for Graduate Medical Education are eligible to conduct death investigations and to perform postmortem examinations and autopsies under the general supervision of the State Medical Examiner as provided by law.

3. Physicians of any specialty who, by virtue of their experience in a medical examiner system, are able to produce a portfolio of personal case studies acceptable to the State Medical Examiner and who, further, are able to demonstrate by interview a knowledgeable approach to forensic problems may be declared eligible to conduct death investigations and to perform postmortem examinations and autopsies under the general supervision of the State Medical Examiner as provided by law.

(e) Nothing in this section is intended to prevent a qualified person from serving both as a county medical examiner or deputy or assistant county medical examiner and simultaneously as a designated pathologist authorized by the State Medical Examiner to perform autopsies pursuant to N.J.S.A. 52:17B-88.

N.J. Admin. Code 13:49-7.1.

Is the coroner or medical examiner position elected?
No, [i]n every county the board of chosen freeholders shall appoint a county medical examiner or join in the appointment of an intercounty medical examiner in the manner and for the term provided by law. N.J. Stat. Ann. § 40A:9-46.

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

What are the qualifications specified by law?
The county medical examiner shall be a licensed physician, of recognized ability and good standing in his community, with such training or experience as may be prescribed by standards promulgated by the State Medical Examiner by rule or regulation. N.J. Stat. Ann. § 52:17B-83.

He shall be a licensed physician, a resident of the county, of recognized ability and good standing in his community, with such training or experience as may be prescribed by standards promulgated by the State Medical Examiner by rule or regulation. N.J. Stat. Ann. § 40A:9-46.

State Medical Examiner . . . shall be a duly licensed physician, a graduate of a regularly chartered and legally constituted medical school or college and a qualified forensic pathologist. N.J. Stat. Ann. § 52:17B-79.

(a) Any person appointed or reappointed to the position of county medical examiner pursuant to N.J.S.A. 52:17B-83, deputy or assistant county medical examiner pursuant to N.J.S.A. 52:17B-84, or forensic pathologist authorized by the State Medical Examiner pursuant to N.J.S.A. 52:17B-88, on or after the effective date of this subchapter shall be a physician fully licensed in the State of New Jersey of recognized ability and good standing in his or her community, and shall have met the following standards relating to prior training and experience:

1. Successful completion of a minimum of 30 hours of basic education in death investigation conducted or sponsored by the Armed Forces Institute of Pathology, the American Society of Clinical Pathologists, the College of American Pathologists, the National Association of Medical Examiners, or an institution of higher education or other agency approved by the State Medical Examiner.

i. In addition, all persons appointed or reappointed to the position of county medical examiner pursuant to N.J.S.A. 52:17B-83 on or after the effective date of this subchapter who are to serve in the capacity of “County Medical Examiner”, in addition to the above educational requirement, shall have completed a minimum of 20 hours of advanced education in death investigation conducted or sponsored by the Armed Forces Institute of Pathology, the American Society of Clinical Pathologists, the College of American Pathologists, the National Association of Medical Examiners, or an institution of higher education or other agency approved by the State Medical Examiner.

2. Successful completion of a basic course conducted by the Office of the State Medical Examiner on the laws, rules and regulations relating to the New Jersey Medical Examiner System.

3. Successful completion of seven full days of internship training at the New Jersey State Medical Examiner Office or equivalent approved by said office.

(b) Any person appointed to or holding the position of county medical examiner, deputy or assistant county medical examiner or designated forensic pathologist on or after the effective date of these amendments shall enroll in and complete a program of continuing medical education in the forensic sciences for a minimum of 20 hours of American Medical Association Category I credit, every two years while holding said position.

(c) Any person appointed to or holding the position of county medical examiner, deputy or assistant county medical examiner or designated forensic pathologist on or after the effective date of this subsection shall enroll in and complete a supplemental program conducted by the Office of the State Medical Examiner on amendments to the laws, rules and regulations relating to the New Jersey Medical Examiner System or for any other necessary training. The State Medical Examiner shall conduct such courses when necessary.

(d) Only those county medical examiners, deputy or assistant county medical examiners or forensic pathologists authorized by the State Medical Examiner as competent to perform autopsies pursuant to N.J.S.A. 52:17B-88, shall perform such autopsies. Such person shall be qualified in one of the following categories:

1. Pathologists who shall have completed a two-year program of supervised training in anatomical pathology approved by the Accreditation Council for Graduate Medical Education of the American Medical Association are eligible to conduct death investigations and to perform postmortem examinations and autopsies under the direct guidance and supervision of a designated pathologist who has already been qualified to practice in an unsupervised capacity in the New Jersey Medical Examiner System, pursuant to (d)2 below and under the general supervision of the State Medical Examiner as provided by law. The reports prepared by this person shall be countersigned by the designated pathologist who has supervised the autopsy.

2. Pathologists who qualify as anatomic pathologists as defined in (d)1 above, and who have at least one year of formal supervised training in a forensic pathology program approved by the Accreditation Council for Graduate Medical Education, or two years supervised experience in forensic pathology in a situation comparable with that of a program accredited by the Accreditation Council for Graduate Medical Education are eligible to conduct death investigations and to perform postmortem examinations and autopsies under the general supervision of the State Medical Examiner as provided by law.

3. Physicians of any specialty who, by virtue of their experience in a medical examiner system, are able to produce a portfolio of personal case studies acceptable to the State Medical Examiner and who, further, are able to demonstrate by interview a knowledgeable approach to forensic problems may be declared eligible to conduct death investigations and to perform postmortem examinations and autopsies under the general supervision of the State Medical Examiner as provided by law.

(e) Nothing in this section is intended to prevent a qualified person from serving both as a county medical examiner or deputy or assistant county medical examiner and simultaneously as a designated pathologist authorized by the State Medical Examiner to perform autopsies pursuant to N.J.S.A. 52:17B-88.

N.J. Admin. Code 13:49-7.1.

What types of deaths are required to be investigated?
An investigation shall be conducted in the manner hereinafter described in the case of all human deaths from the following causes:

a. Violent deaths, whether apparently homicidal, suicidal or accidental, including but not limited to death due to thermal, chemical, electrical or radiation injury and deaths due to criminal abortion, whether apparently self-induced or not;

b. Deaths not caused by readily recognizable disease, disability or infirmity;

c. Deaths under suspicious or unusual circumstances;

d. Deaths within 24 hours after admission to a hospital or institution;

e. Deaths of inmates of prisons;

f. Deaths of inmates of institutions maintained in whole or in part at the expense of the State or county, where the inmate was not hospitalized therein for organic disease;

g. Deaths from causes which might constitute a threat to public health;

h. Deaths related to disease resulting from employment or to accident while employed; and

i. Sudden or unexpected deaths of infants and children under 3 years of age and fetal deaths occurring without medical attendance.

N.J. Stat. Ann. § 52:17B-86.

What types of deaths are required to be autopsied?
1. All cases of apparent homicidal deaths;

2. All deaths occurring under suspicious or unusual circumstances;

3. All deaths from causes which might constitute a threat to public health;

4. All deaths of inmates of jail, prison, or penitentiary and all prisoners and suspects who were in the process of being detained, arrested or transported by guards, police and law enforcement or court officers unless the suspected cause of death is a known condition for which the inmate, prisoner or suspect is hospitalized and being treated at the time of death, and the medical examiner’s investigation, review of hospital records, and examination of the decedent’s body permit him or her to determine the cause of death beyond a reasonable doubt without an autopsy, and no other issues of public interest compel his or her conclusion that an autopsy is necessary;

5. All infants and children suspected of having been abused or neglected and children suspected of having died from sudden infant death syndrome (SIDS);

6. In all cases wherein the State Medical Examiner, the Attorney General, any assignment judge of the Superior Court, or the county prosecutor (of the county wherein the injury occurred or where the decedent expired) requests an autopsy;

7. In all cases otherwise under the Medical Examiner’s jurisdiction where the decedent has been identified as a potential donor pursuant to P.L. 1969, c.161 (N.J.S.A. 26:6-57 et seq.), the medical examiner shall perform any necessary examination, autopsy or analysis of any organ or tissue in a manner and within a time period compatible with preservation of the organ or tissue for the purpose of transplantation.

N.J. Admin. Code 13:49-1.1.

[A]utopsies may be performed when it appears in the discretion of the county medical examiner to be in the public interest to do so in all cases of human deaths occurring in the following circumstances:

1. All cases of violent deaths which are apparently suicidal or accidental, including but not limited to deaths due to thermal, chemical, electrical or radiation injury, except as enumerated in N.J.A.C. 13:49-1.1, Mandatory autopsies;

2. All deaths caused by disease, disability or infirmity which are not readily recognizable;

3. All deaths of inmates as defined in N.J.S.A. 52:17B-86(f) occurring in institutions maintained in whole or in part at the expense of the State or county when the inmate was not hospitalized therein for organic disease;

4. All deaths related to diseases resulting from employment or from accidents while employed;

5. All deaths from motor vehicle collisions to include drivers, occupants, and pedestrians.

N.J. Admin. Code 13:49-1.2.

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