West Virginia

Is medical death investigation system centralized, county-based, or district-based?
Centralized. W. Va. Code Ann. § 61-12-7.

If centralized, in which department or agency is the system housed?
Department of Health and Human Resources. W. Va. Code Ann. § 61-12-7.

Does the state system have a coroner, medical examiner, or coroners and medical examiners?
Coroners and medical examiners.

3.4. County Coroner. – A person trained and certified by the Office of Chief Medical Examiner (OCME) in the practice of medico-legal death investigation, who is appointed by a county commission and works under the supervision of the OCME.

3.5. County Medical Examiner. – A physician, registered nurse, paramedic, emergency medical technician or physician’s assistant, licensed by the State of West Virginia, who is certified by the Office of Chief Medical Examiner or by the American Board of Medico-Legal Death Investigators to practice medico-legal death investigation under the direction of the Chief Medical Examiner, or his or her designee.

W. Va. Code R. § 64-84-3.

It is the duty of the county commission of every county, from time to time, to appoint a coroner for the county, who shall hold the office during the pleasure of the commission and shall take the oath of office prescribed for other county officers. The county coroners shall be certified in medicolegal investigations . . . W. Va. Code Ann. § 61-12-14.

“In practice” notes
In West Virginia, the office of medical examiner may be held by nonphysicians.

Is there a state medical examiner?
Yes. W. Va. Code Ann. § 61-12-3.

If so, what is the state medical examiner’s role?
The office of chief medical examiner . . . shall be directed by a chief medical examiner . . .

(d) The chief medical examiner shall be responsible to the director of the division of health in all matters except that the chief medical examiner shall operate with independent authority for the purposes of:

(1) The performance of death investigations conducted pursuant to section eight of this article;

(2) The establishment of cause and manner of death; and

(3) The formulation of conclusions, opinions or testimony in judicial proceedings.

(e) The chief medical examiner, or his or her designee, shall be available at all times for consultation as necessary for carrying out the functions of the office of the chief medical examiner.

W. Va. Code Ann. § 61-12-3.

In what department or agency is the state medical examiner’s office located?
Department of Health and Human Resources. W. Va. Code Ann. § 61-12-3.

Are there deputies?
Subject to the approval of the director of the division of health, the chief medical examiner may, in order to provide for the investigation of the cause of death as authorized in this article, employ and pay qualified pathologists and toxicologists to make autopsies and such pathological and chemical studies and investigations as he or she considers necessary, in the several counties or regions of the state and he or she may arrange for the use of existing laboratory facilities for such purposes. W. Va. Code Ann. § 61-12-6.

If the chief medical examiner determines that it is necessary, he or she may appoint any person medically trained and licensed by the state of West Virginia as a physician, registered nurse, paramedic, emergency medical technician or a physician assistant and of good moral character to act as an assistant county medical examiner for a term of three years. W. Va. Code Ann. § 61-12-7.

If so, what are the deputies’ roles?
An assistant shall have the same powers and duties as a county medical examiner and shall perform his or her duties under the supervision of the chief medical examiner . . .

County medical examiners and assistant county medical examiners are authorized to determine the cause and manner of death in any case falling within the provisions of section eight of this article, subject to the supervision of the chief medical examiner, and may exercise any of the powers attendant to the investigation of deaths.

W. Va. Code Ann. § 61-12-7.

What are the qualifications for deputies?
[A]ssistant county medical examiner: any person medically trained and licensed by the state of West Virginia as a physician, registered nurse, paramedic, emergency medical technician or a physician assistant and of good moral character . . . W. Va. Code Ann. § 61-12-7.

Is the coroner or medical examiner position elected?
No. W. Va. Code Ann. § 61-12-7.

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 licensed to practice medicine or osteopathic medicine in the state of West Virginia, who is a diplomat of the American board of pathology in forensic pathology, and who has experience in forensic medicine. W. Va. Code Ann. § 61-12-3.

Qualified pathologists shall hold board certification or board eligibility in forensic pathology or have completed an American board of pathology fellowship in forensic pathology. W. Va. Code Ann. § 61-12-6.

A county medical examiner shall be medically trained and licensed by the state of West Virginia as a physician, registered nurse, paramedic, emergency medical technician or a physician assistant, be certified in the practice of medicolegal death investigation and be of good moral character . . .  any person medically trained and licensed by the state of West Virginia as a physician, registered nurse, paramedic, emergency medical technician or a physician assistant and of good moral character [may be appointed] to act as an assistant county medical examiner . . . W. Va. Code Ann. § 61-12-7.

For this purpose [conducting autopsy], the chief medical examiner may employ any county medical examiner who is a pathologist who holds board certification or board eligibility in forensic pathology or has completed an American Board of Pathology fellowship in forensic pathology to make the autopsies . . . W. Va. Code Ann. § 61-12-10.

4.1. A County Medical Examiner:

4.1.a. If he or she is not already trained and certified in the practice of medico-legal death investigation prior to his or her appointment, the appointee shall be provided the opportunity for training and certification in the practice of medico-legal death investigation by the OCME within one (1) year of the appointment;

4.1.b. Shall qualify to take a state certifying examination administered by the OCME by completing and passing a course of training specific to medico-legal death investigation within one (1) year of the date of the examination. If a person fails the state certifying examination, he or she shall attend another training program that satisfies the requirements in Subdivision 4.1.b. of this Subsection before taking the examination again; and

4.1.c. Shall be certified in the practice of medico-legal death investigation:

4.1.c.1. If he or she passes an examination administered by the OCME, the State of West Virginia, or by an entity recognized by the American Board of Medico-Legal Death Investigators; or

4.1.c.2. If he or she was already practicing as a County Medical Examiner as of January 1, 2001, and has been a County Medical Examiner for three (3) years.

4.2. A County Coroner:

4.2.a. Shall be certified by the OCME or by the American Board of Medico-Legal Death Investigators in the practice of medico-legal death investigation prior to his or her appointment by the county commission. If he or she is already serving as county coroner at the effective date of this rule with no certification, he or she shall seek training and certification in the practice of medico-legal death investigation within two (2) years of the effective date of this rule; and

4.2.b. Shall meet the same requirements as a County Medical Examiner for training and certification, as described in Subsection 4.1. of this rule.

4.3. The OCME shall provide or provide access to a training course that meets the requirements in this rule at least once each year and shall assess reasonable fees, as established by the Chief Medical Examiner, to cover the cost of the training.

4.4. Certification in the practice of medico-legal investigation provided by the State of West Virginia to County Medical Examiner, Assistant County Medical Examiner and County Coroner expires after three (3) years and requires recertification by attendance in any approved training program and passage of any approved certification examination as described in this rule.

W. Va. Code R. § 64-84-4.

What types of deaths are required to be investigated?
When any person dies in this state from violence, or by apparent suicide, or suddenly when in apparent good health, or when unattended by a physician, or when an inmate of a public institution, or from some disease which might constitute a threat to public health, or in any suspicious, unusual or unnatural manner, the chief medical examiner, or his or her designee or the county medical examiner, or the coroner of the county in which death occurs shall be immediately notified by the physician in attendance, or if no physician is in attendance, by any law-enforcement officer having knowledge of the death, or by the funeral director, or by any other person present or having knowledge. W. Va. Code Ann. § 61-12-8.

5.2. When the County Medical Examiner, Assistant County Medical Examiner or County coroner investigates a death where the circumstances fall under criminal investigation:

5.2.a. He or she shall perform all duties related to medico-legal death investigation, under the direction of the Chief Medical Examiner, and also subject to the direction of the county prosecutor and the principal investigative agency of the jurisdiction . . .

W. Va. Code R. § 64-84-5.

6.1. The County Medical Examiner, Assistant County Medical Examiner and County coroner, under authority and supervision of the Office of the Chief Medical Examiner, shall investigate the circumstances of a death when:

6.1.a. A person dies without benefit of a treating physician;

6.1.b. A person who is in apparent good health and is less than fifty (50) years of age, dies suddenly when there is no history or other reliable evidence of serious natural disease so as to be able to reasonably assume death due to natural causes;

6.1.c. An inmate in a public institution such as a jail dies while in the institution, while in police custody, during police intervention, during court-ordered hospitalization, or the death is believed to be in association with receiving public services provided by county, state or federal social service agencies;

6.1.d. A person dies due to, or in association with, environmental conditions suspected to pose a hazard to public health or safety;

6.1.e. A person dies due to or in association with, violence, suspected violence, or by any external cause, regardless of the interval between the injury and death; or

6.1.f. A person dies under any suspicious conditions, or in any unusual or unnatural manner.

W. Va. Code R. § 64-84-6.

What types of deaths are required to be autopsied?
The chief medical examiner, or his or her designee, is authorized to order and conduct an autopsy in accordance with the provisions of this article and this code. The chief medical examiner, or his or her designee, shall perform an autopsy upon the lawful request of any person authorized by the provisions of this code to request the performance of the autopsy. W. Va. Code Ann. § 61-12-3.

If in the opinion of the chief medical examiner, or of the county medical examiner of the county in which the death in question occurred, it is advisable and in the public interest that an autopsy be made, or if an autopsy is requested by either the prosecuting attorney or the judge of the circuit court or other court of record having criminal jurisdiction in that county, an autopsy shall be conducted by the chief medical examiner or his or her designee, by a member of his or her staff, or by a competent pathologist designated and employed by the chief medical examiner under the provisions of this article. W. Va. Code Ann. § 61-12-10.

Does the state require that pathologists perform the autopsies?
Yes. [A]n autopsy shall be conducted by the chief medical examiner or his or her designee, by a member of his or her staff, or by a competent pathologist designated and employed by the chief medical examiner under the provisions of this article. For this purpose, the chief medical examiner may employ any county medical examiner who is a pathologist who holds board certification or board eligibility in forensic pathology or has completed an American Board of Pathology fellowship in forensic pathology to make the autopsies . . . W. Va. Code Ann. § 61-12-10.