North Carolina

Is medical death investigation system centralized, county-based, or district-based?
Centralized. N.C. Gen. Stat. Ann. § 130A-382.

If centralized, in which department or agency is the system housed?
Department of Health and Human Services. N.C. Gen. Stat. Ann. § 130A-377.

Does the state system have a coroner, medical examiner, or coroners and medical examiners?
Coroners and medical examiners. One or more county medical examiners for each county shall be appointed by the Chief Medical Examiner for a three-year term. N.C. Gen. Stat. Ann. § 130A-382.

In each county a coroner shall be elected by the qualified voters thereof in the same manner and at the same time as the election of members of the General Assembly, and shall hold office for a term of four years, or until his successor is elected and qualified. N.C. Gen. Stat. Ann. § 152-1.

“In practice” notes
While most North Carolina counties have appointed medical examiners, a handful of counties still elect coroners.

Is there a state medical examiner?
Yes. N.C. Gen. Stat. Ann. § 130A-378.

If so, what is the state medical examiner’s role?
The Chief Medical Examiner shall perform postmortem medicolegal examinations as provided in this Part. N.C. Gen. Stat. Ann. § 130A-379.

In what department or agency is the state medical examiner’s office located?
Department of Health and Human Services. N.C. Gen. Stat. Ann. § 130A-378.

Are there deputies?
The Chief Medical Examiner may employ qualified pathologists to serve as Associate and Assistant Medical Examiners in the central and district offices. N.C. Gen. Stat. Ann. § 130A-380.

One or more county medical examiners for each county shall be appointed by the Chief Medical Examiner . . . from a list of physicians licensed to practice medicine in this State submitted by the medical society of the county in which the appointment is to be made. If no names are submitted by the society, the Chief Medical Examiner shall appoint one or more medical examiners from physicians in the county licensed to practice medicine in this State. N.C. Gen. Stat. Ann. § 130A-382.

If so, what are the deputies’ roles?
The Associate and Assistant Medical Examiners shall perform duties assigned by the Chief Medical Examiner. N.C. Gen. Stat. Ann. § 130A-380.

What are the qualifications for deputies?
Associate and Assistant Medical Examiners: qualified pathologists . . . N.C. Gen. Stat. Ann. § 130A-380.

County medical examiners: physicians licensed to practice medicine in this State
. . . N.C. Gen. Stat. Ann. § 130A-382.

Is the coroner or medical examiner position elected?
Coroner: elected
Medical examiner: appointed

N.C. Gen. Stat. Ann. § 152-1; N.C. Gen. Stat. Ann. § 130A-382.

If so, how many years is the term of office?
Four. N.C. Gen. Stat. Ann. § 152-1.

What are the qualifications specified by law?
The Chief Medical Examiner shall be a forensic pathologist certified by the American Board of Pathology and licensed to practice medicine. N.C. Gen. Stat. Ann. § 130A-378.

[P]hysicians licensed to practice medicine in this State . . . N.C. Gen. Stat. Ann. § 130A-382.

What types of deaths are required to be investigated?
[T]he death of any person resulting from violence, poisoning, accident, suicide or homicide; occurring suddenly when the deceased had been in apparent good health or when unattended by a physician; occurring in a jail, prison, correctional institution or in police custody; occurring in State facilities operated in accordance with Part 5 of Article 4 of Chapter 122C of the General Statutes; occurring pursuant to Article 19 of Chapter 15 of the General Statutes [execution]; or occurring under any suspicious, unusual or unnatural circumstance . . . N.C. Gen. Stat. Ann. § 130A-383.

When a body is brought into this State for disposal and there is reason to believe either that the death was not investigated properly or that there is not an adequate certificate of death, the body shall be reported to a medical examiner in the county where the body resides or to the Chief Medical Examiner. These deaths may be investigated by the same procedure as deaths occurring in this State under G.S. 130A-383. N.C. Gen. Stat. Ann. § 130A-384.

Whenever it appears that the deceased probably came to his death by the criminal act or default of some person, he shall go to the place where the body of such deceased person is and make a careful investigation and inquiry as to when and by what means such deceased person came to his death and the name of the deceased, if to be found out, together with all the material circumstances attending his death, and shall make a complete record of such personal investigation . . . N.C. Gen. Stat. Ann. § 152-7.

What types of deaths are required to be autopsied?
If, in the opinion of the medical examiner investigating the case or of the Chief Medical Examiner, it is advisable and in the public interest that an autopsy or other study be made; or, if an autopsy or other study is requested by the district attorney of the county or by any superior court judge, an autopsy or other study shall be made by the Chief Medical Examiner or by a competent pathologist designated by the Chief Medical Examiner. N.C. Gen. Stat. Ann. § 130A-389.

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