Funds help Crime Lab cut backlog by 10,000 cases
Posted on Sunday, June 4, 2006
Over the past year and a half, the Arkansas medical examiner’s office and state Crime Laboratory have cut the wait for autopsy reports in half and chipped away at a backlog of cases once considered unmanageable.
But they still have a long way to go.
In December 2004, the Arkansas Democrat-Gazette reported a backlog of more than 16, 000 cases at the lab and the use of unrefrigerated pickups to transport bodies across the state.
Eighteen months later, the pickups are still on the roads. Infants still are transported in ice chests, and bags of ice are still packed on bodies during hot days to slow decomposition.
And the four pathologists at the state’s morgue, located in the basement of the state Crime Laboratory in west Little Rock, are expected to conduct nearly 1, 500 autopsies among them this year, an unreasonable number by professional standards.
“We’re not where we want to be,” Chief Medical Examiner Charles Kokes said. “But for the first time in a long time, we’re working on current cases.” In 2004, the wait for an autopsy report from Arkansas ’ single, underfunded lab was six to nine months, but some reports took more than a year to complete.
And the state had no immediate way of raising more money.
At the same time, nearby states were looking for and finding money in nontraditional places to build multiple labs, add staff members and keep their backlogs to manageable levels. Oklahoma, for instance, added a $ 3. 25 charge to every moving traffic violation, using the money to build a $ 20 million lab.
Last year, the Arkansas Legislature raised the fee to file circuit cases from $ 100 to $ 125, dedicating the extra money — expected to eventually be about $ 1. 7 million a year — to the lab. The lab’s annual budget is now about $ 8 million.
The lab used the extra money to add staff members and take aim at the backlog.
Now, the average wait for an autopsy report is three months, said Kokes (pronounced KOHkuss ).
The wait is of more than bureaucratic concern.
Delayed autopsy reports mean, for instance, that survivors of someone who died must wait to draw life insurance benefits.
And across Arkansas, the wheels of justice turn only as fast as the Crime Lab allows. All of the state’s 300 police departments and 75 county sheriff’s offices rely on the medical examiner to conduct autopsies on homicide victims, suspected suicides, and prison and jail inmates who die in custody.
Police and attorneys who work in criminal justice say the lab works much faster now than in the past.
Even with Little Rock police sending the bodies of 27 homicide victims to the Crime Laboratory so far this year, a record pace, detectives say the lab has kept up with the demand for autopsy reports needed to handle those cases.
They doubt that would have been possible in years past.
“Three to four months is what we’re seeing,” homicide detective Sgt. Alan Quattlebaum said of the wait for autopsy reports.
“It’s definitely an improvement. It was eight to nine months before.” Prosecuting someone in a homicide is difficult when an exact cause of death isn’t determined until nearly a year after the crime was committed, he said.
In some cases, without test results, police cannot make arrests. In others, judges must postpone trials for lack of test results, and defendants sit in jail. TOXICOLOGY AND TRUCKS Increased efficiency at the medical examiner’s office can be attributed to the infusion of funds that helped the Crime Lab chip away at its backlog, Kokes said. The 16, 000-case backlog had been trimmed to less than 6, 500 by the end of April. After the fee increase, the lab was able to add analysts working in areas such as toxicology and DNA testing, increasing the staff from 103 to 121. “The primary reason the medical examiner’s off ice was behind in getting autopsy reports out was because they were waiting for toxicology,” Crime Lab Director J. R. Howard said. “By dealing with the toxicology backlog, you’re benefiting the medical examiner’s off ice. They’re reaping the results of that.” Defense attorney Lloyd Warford said last week that some evidence from the lab still takes awhile to get, but “I think it’s getting a little better.” “ The two murder cases I have right now, both autopsy reports came in quickly, within two months. ” Howard also says he hopes to hire a fifth pathologist soon. The morgue should have at least six, according to the National Association of Medical Examiners, which sets accreditation standards. But vehicles equipped with refrigeration units won’t be added to the fleet anytime soon. Instead, the lab will try to retrofit pickups with cheaper cooling units. Howard said with limited resources, he had to decide where to focus his dollars.
“If the money was there, we would have gotten the trucks, but we didn’t feel like that was as much of a priority as getting the backlog under control.” Howard said he’s looking into spending up to $ 1, 800 per truck before the end of June to add cooling units so that purchasing ice won’t be necessary. State Sen. Jim Hill, DNashville, a longtime advocate of the lab, said he was shocked to learn in 2004 that the lab was transporting bodies in pickup beds, packed in ice. “People want those bodies to be treated with dignity,” Hill, one of the sponsors of the 2005 legislation to raise money for the lab, said last week. “That’s something that kind of hit me hard.” He said he was surprised that new vans hadn’t been purchased, but he feels confident that the purchase of new vehicles will eventually happen. “I’ve left [Howard ] alone because he knows what his agency needs worst, and it may not be those vans,” he said. “We gave them discretion on how to do that.” Howard said his goal is still to get specially equipped vehicles, when the money is available.
STRIVING FOR FIVE As the trucks deliver bodies to the state morgue, doctors work at a grinding pace trying to keep up with autopsies.
They work shoulder to shoulder on four or five bodies at a time in a sterile space no larger than an average living room.
When results come in, Crime Lab analysts and pathologists spend hours traveling to courthouses then waiting in courthouse halls to testify about their roles in criminal investigations.
During much of 2004 and a portion of 2005, the medical examiner’s office had only three pathologists. And even with four, there’s little time for professional reading, research or even vacation.
Most of the pathologists accumulate more vacation time than they have time to use. And state policy doesn’t allow them to roll all of their unused time over from one year to the next.
It’s important that pathologists keep up with developments and research in the field, Kokes said.
“It’s not a static field,” he said. “There are new things to learn.” Howard said lab leaders have plans to hire a fifth pathologist during the next fiscal year, which starts in July.
With a National Association of Medical Examiners inspection coming in 2008, “we want to be in compliance,” he said.
“Five will have us meeting or exceeding that requirement.” If the medical examiner’s office lost accreditation, it would risk not qualifying for federal grants. Also, the office’s credibility could be diminished when pathologists testify in criminal cases.
The medical examiner’s off ice loses points during inspections if any one of the pathologists handles more than 250 cases in a year.
In 2005, three of the four on staff exceeded that number, but none by more than 30.
Kokes explained that three pathologists, including himself, had to take on extra cases because a fourth pathologist position was vacant for a portion of the year.
Kokes has said the “magic number” for jeopardizing accreditation is 400 cases per pathologist.
The office spent years in what he called “the hand-slap zone” — working too many cases, but not so many that accreditation is in jeopardy.
And he believes it isn’t in jeopardy now.
“I don’t think we’ll be in trouble in that regard, especially since our staffing level is stable now,” he said.
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