Chapter 14. Chief Medical Examiner.
§ 5–1401. Definitions.
For the purposes of this chapter, the term:
(1) "CME" means the Chief Medical Examiner within the OCME.
(1A) “District” means the District of Columbia.
(2) “Legal custody” includes imprisonment, jail, or detention.
(2A) "OCME" means the Office of the Chief Medical Examiner.
(3) “Ward” means any person in the official custody of the District government, on a temporary or permanent basis, because of neglect, abuse, mental illness or intellectual disability.
§ 5–1402. Establishment of the Office of the Chief Medical Examiner; appointments, qualifications, and compensation.
(a) There is established as a subordinate agency in the Executive branch of the District government, the Office of the Chief Medical Examiner.
(b) The Mayor shall nominate, with the advice and consent of the Council, a person to serve as the Chief Medical Examiner within the OCME pursuant to § 1-523.01(a). The CME shall be responsible for the management and operation of the OCME. The CME shall appoint a Deputy CME and any other medical examiners the CME finds necessary to carry out the duties of the OCME.
(c)(1) The CME, the Deputy CME, and any medical examiners appointed pursuant to subsection (b) of this section shall be physicians licensed to practice medicine in the District.
(2) Except as provided in paragraph (3) of this subsection, the CME, the Deputy CME, and any medical examiners appointed after October 19, 2000, shall be certified in forensic pathology by the American Board of Pathology or be eligible for such certification.
(3) The certification requirement of paragraph (2) of this subsection may be waived by the Mayor for the CME appointed to fill the term beginning on May 1, 2007, and ending on April 30, 2013.
(d) The Mayor shall fix the compensation of the CME pursuant to subchapter X-A of Chapter 6 of Title 1 [§ 1-610.51 et seq.]. The Mayor shall fix the compensation of all medical examiners appointed by the CME pursuant to this section.
(e) The CME shall be appointed for a 6-year term.
(f) If a vacancy in the position of Chief Medical Examiner occurs as a consequence of resignation, disability, death, or a reason other than the expiration of the term of the Chief Medical Examiner, the Mayor shall appoint a replacement to fill the unexpired term in the same manner provided in § 1-523.01(a). A person appointed to fill the unexpired term shall serve only for the remainder of the term.
§ 5–1403. Supporting services and facilities.
(a) The CME shall appoint such qualified professional, investigative, technical and clerical personnel as the OCME may require, including administrators, medicolegal investigators, and a General Counsel. The General Counsel shall be appointed pursuant to subchapter VIII-B of Chapter 6 of Title 1.
(b) The Mayor shall provide such facilities and equipment as the OCME shall require. The Chief Medical Examiner may arrange or contract for such services, equipment and facilities as deemed necessary to carry out the duties and responsibilities of the OCME, pursuant to Chapter 3 of Title 2.
§ 5–1404. Former duties of coroner; oaths; teaching; other duties.
(a) The CME shall be responsible for all the medical functions formerly performed by the coroner in the District consistent with the provisions of this chapter. The CME and such other medical examiners as may be appointed may administer oaths and affirmations and take affidavits in connection with the performance of their duties.
(a-1) The CME may provide pathology and toxicology services to other District government agencies, non-District government agencies, and private entities, and may establish fees or require the payment of costs for the provision of such services.
(b) The CME, and OCME employees authorized by the CME, may teach post-secondary, medical, and law school classes, conduct special classes for government personnel, conduct research, and engage in other activities related to their work.
(c) The CME shall inform the Registrar of Vital Records of all deaths of children 18 years of age or younger as soon as practicable, but in any event, within 5 business days.
(d) The CME, or the CME's designee, shall attend all reviews of deaths by District government fatality review committees and fatality review boards. The CME shall coordinate with such committees and boards in their investigations of deaths.
§ 5–1405. Deaths — determinations and investigations; cremations.
(a) The CME, other medical examiners, and medicolegal investigators (physician assistants or advanced practice registered nurses) licensed under subchapter V of Chapter 12 of Title 3, are authorized to make determinations of death.
(b) Pursuant to regulations established by the Mayor, the following types of human deaths occurring in the District shall be investigated by the OCME:
(1) Violent deaths, whether apparently homicidal, suicidal, or accidental, including deaths due to thermal, chemical, electrical or radiation injury and deaths due to criminal abortion, whether apparently self-induced or not;
(2) Sudden, unexpected or unexplained deaths not caused by readily recognizable disease, including sudden infant deaths or apparent sudden infant death syndrome (SIDS) for infants one year of age and younger;
(3) Deaths under suspicious circumstances;
(4) Deaths of persons whose bodies are to be cremated, dissected, buried at sea or otherwise disposed of so as to be thereafter unavailable for examination;
(5) Deaths related to disease resulting from employment or on-the-job injury or illness;
(6) Deaths related to disease which might constitute a threat to public health;
(7) Deaths of persons who are wards of the District government;
(8) Deaths related to medical or surgical intervention, including operative, peri-operative, anesthesia, medication reactions or deaths associated with diagnostic or therapeutic procedures;
(9) Deaths of persons while in the legal custody of the District;
(10) Fetal deaths related to maternal trauma, including substance abuse, and extra-mural deliveries;
(11) Deaths for which the Metropolitan Police Department, another law enforcement agency, or the United States Attorney's Office for the District of Columbia requests, or a court orders investigation;
(12) Dead bodies brought within the District without proper medical certification; and
(13) All maternal mortalities.
(b-1) For the purposes of subsection (b) of this section, the term:
(1) "Maternal mortalities" means pregnancy-associated deaths and pregnancy- related deaths, as those terms are defined in § 7-671.01(4)and (5), and deaths resulting from severe maternal morbidity.
(2) "Severe maternal morbidity" means one of the following outcomes of labor and delivery that results in short-term or long-term consequences to a birthing parent's health:
(A) Acute myocardial infarction;
(B) Acute renal failure;
(C) Adult respiratory distress syndrome;
(D) Air and thrombotic embolism;
(E) Amniotic fluid embolism;
(F) Anesthesia complications;
(G) Aneurysm;
(H) Blood products transfusion;
(I) Cardiac arrest/ventricular fibrillation;
(J) Conversion of cardiac rhythm;
(K) Disseminated intravascular coagulation;
(L) Eclampsia;
(M) Heart failure/arrest during surgery or procedure;
(N) Hysterectomy;
(O) Puerperal cerebrovascular disorders;
(P) Pulmonary edema/acute heart failure;
(Q) Sepsis;
(R) Shock;
(S) Sickle cell disease with crisis;
(T) Temporary tracheostomy; or
(U) Ventilation.
(c) Clearances by the CME shall be required for all deaths occurring in the District for which cremations are requested regardless of where the cremation will occur.
(d) The Mayor shall, by regulation, prescribe procedures for taking possession of a dead body following a death subject to investigation under subsection (b) of this section and for obtaining all essential facts concerning the medical causes of death and the names and addresses of as many witnesses as it is practicable to obtain.
§ 5–1406. Deaths — Notification; penalties for noncompliance.
(a) For all deaths described in § 5-1405(b), the CME shall take charge of the body upon the mandatory and direct notification of the death required by subsection (b) of this section. The CME, or duly authorized representatives of the CME, shall have authority to respond to the scene of the death. The body of the decedent shall not be disturbed unless the CME, or the CME’s designee, grants permission to do so.
(b) All law enforcement officers, emergency medical service personnel, physicians, nurses, health care institutions, nursing homes, community residential facilities, prisons and jails, funeral directors, embalmers and other persons shall promptly notify the OCME of the occurrence of all deaths coming to their attention which are subject to investigation under § 5-1405(b) and shall assist in making the bodies and related evidence available to a medical examiner for investigation and autopsy.
(c) Any person subject to the reporting requirements in subsection (b) of this section who willfully fails to comply with this section shall be guilty of a misdemeanor and upon conviction shall be fined not less than $100 nor more than $1,000.
§ 5–1406.01. Mass fatality management and response.
(a) The OCME shall serve as the lead agency for the District's mass fatality management and mass fatality incident response.
(b) The CME shall create a District mass fatality management response plan.
(c)(1) The CME may enter into, request, or provide assistance under a mutual aid agreement with states or local jurisdictions within the National Capital region or with the federal government for the purpose of mass fatality management or mass fatality incident response; provided, that any financial obligation created by a mutual aid agreement is consistent with the limitations under § 47-355.02, as determined by the General Counsel of OCME after consultation with the Office of the Attorney General and the Office of the Chief Financial Officer.
(2) The CME may enter into a mutual aid agreement that creates a financial obligation for the District if there is clear legal and budgetary authority to do so, as determined by the General Counsel of OCME after a legal sufficiency review by the Office of the Attorney General and a budgetary authority review by the Office of the Chief Financial Officer.
(3) Any requests by the CME for federal assistance shall be coordinated with the Mayor's authorized representative, designated pursuant to 44 C.F.R. § 206.41(d).
(d) For the purposes of this section, the term:
(1) "Mass fatality incident" means a situation resulting in more human remains to be investigated, recovered, and examined than can be managed using District resources, or any other exceptional circumstance that results in the inability to process human remains under routine conditions.
(2) "Mass fatality management" means the training of and cooperation among governmental and nongovernmental agencies, organizations, associations, and other entities to ensure the accomplishment of the following after a mass fatality incident:
(A) The proper recovery, handling, identification, transportation, tracking, storage, and certification of cause and manner of death of victims; and
(B) Facilitating access to mental and behavioral health services to family members, responders, and survivors.
(3) "National Capital region" shall have the same meaning as provided in § 2-1001(b)(1).
§ 5–1407. Subpoena power for access to confidential medical records.
The CME is authorized to issue a subpoena for confidential medical records and relevant information from physicians, hospitals, nursing homes, residential care facilities and other health care providers as in the CME's opinion is necessary for investigating deaths under this chapter. Any such subpoena issued by the CME may be enforced by order of the Superior Court. The Mayor shall, by regulation, prescribe procedures for issuing administrative subpoenas pursuant to this section.
§ 5–1408. Possession of evidence and property.
(a) At the scene of any death subject to investigation under § 5-1405(b), the medical examiner, a medicolegal investigator, or a law enforcement officer shall take possession of any objects or articles which, in the opinion of the medical examiner, medicolegal investigator, or law enforcement officer, may be useful in establishing the cause and manner of death or the identity of the decedent and shall hold them as evidence. The Mayor shall issue regulations concerning the evidence in the possession of the CME and the transfer of that evidence to law enforcement agencies or the United States Attorney’s Office. The regulations shall include requirements on the length of time evidence shall be preserved by the CME, and shall require that toxicology and histology specimens be preserved for periods of time consistent with the accreditation requirements of the National Association of Medical Examiners.
(b) A law enforcement officer, a medical examiner, or a medicolegal investigator may take possession of all property of value found on or in the custody of the decedent. If possession is taken of the property, the law enforcement officer, medical examiner, or medicolegal investigator shall make an exact inventory of the property and deliver it to the Property Clerk of the Metropolitan Police Department; except, that the CME may instead transfer the property to the person with the right to control the disposition of the remains of the decedent under § 3-413 or to the funeral services establishment that has or takes possession of the remains of the decedent. The CME may dispose of, in any reasonable manner, property of no apparent value or property deemed to be a hazard to health or safety. The Mayor shall issue regulations concerning the transfer of any such property from the OCME.
§ 5–1409. Examination; further investigation and autopsy.
(a) If, in the opinion of the CME, the cause and manner of death are established with a reasonable medical certainty, the CME shall complete a report of the medical examination of the decedent.
(b) If, in the opinion of the CME, or the United States Attorney, further investigation as to the cause or manner of death is required or the public interest so requires, a medical examiner shall either perform, or the CME shall arrange for a qualified pathologist to perform, an autopsy on the body of the decedent and to retain tissues and biological specimens deemed necessary to an investigation. No consent of the next of kin shall be required for an autopsy to be performed under this section.
(c) The medical examiner performing the autopsy shall make a complete record of the findings and conclusions of any autopsy and shall prepare a report thereon.
§ 5–1410. Autopsy by pathologist other than a medical examiner.
(a) If an autopsy is performed by a pathologist other than a medical examiner by request of the CME, the pathologist shall furnish to the CME, a complete record of the findings and conclusions of the autopsy. The CME, or assigned medical examiner, shall thereupon prepare a report, indicating the name of the pathologist performing the autopsy, the pathologist’s findings and conclusions, and the CME’s, or assigned medical examiner’s, own comments, if appropriate.
(b) A pathologist other than a medical examiner who performs an autopsy at the request of the CME shall be compensated in accordance with a fee rate established by the Mayor by regulation.
§ 5–1411. Delivery of body; expenses.
(a) Following investigation or autopsy, the CME shall release the body of the decedent to the person having the right to the body for the purpose of burial or other disposition pursuant to law. If after a reasonable time, established by regulation by the Mayor, no authorized person claims the body of the decedent, the CME shall dispose of the body in accordance with the law.
(b) Expenses of transportation of bodies and autopsies performed pursuant to this chapter shall be borne by the District.
(c) Only the CME shall dispose unclaimed bodies in the District without of next of kin or other means of disposition. The Mayor shall prescribe fees and regulations for the storage and disposal of unclaimed bodies.
§ 5–1412. Maintenance of records; annual report.
(a) The CME shall be responsible for maintaining full and complete records and files, properly indexed, giving the name, if known, of every person whose death is investigated, the place where the body was found, the date, cause and manner of death and all other relevant information and reports of the medical examiner concerning the death. The CME shall issue a death certificate in all appropriate cases.
(a-1) Records and files related to an open investigation of a homicide shall be retained for 65 years from the date the CME initiates its investigation of the homicide. Other records and files maintained under subsection (a) of this section shall be retained by the CME for periods of time established by regulations issued pursuant to § 5-1417. For the purposes of this subsection, the term “open investigation” shall have the same meaning as provided in § 5-113.31(10).
(b) Except as provided in subsection (c-2)(3) of this section, the records and files maintained pursuant to subsection (a) of this section shall be open, upon request, to inspection by any person designated by the Mayor, the Office of the United States Attorney for the District of Columbia, the Metropolitan Police Department or another law enforcement agency, a government health or safety organization, or a fatality review committee or board of the District government when such inspection is necessary for the discharge of its official duties. Upon request by such person, the CME shall promptly deliver to such person copies of records relating to the deaths as to which further investigation may be advisable.
(c) Repealed.
(c-1) An external examination or autopsy report of a decedent in the CME's records and files:
(1) Shall be a public record under subchapter II of Chapter 5 of Title 2, only as to the following information:
(A) Name of the decedent;
(B) Race of the decedent;
(C) Sex of the decedent;
(D) Age of the decedent;
(E) Cause of death;
(F) Manner of death;
(G) Place of death;
(H) Case identification number;
(I) Date of examination; and
(J) Name of the examiner performing the external examination or autopsy; and
(2) May be obtained directly from the CME by the following persons, without those persons being required to make a request for records pursuant to § 2-532(a), after written request and payment of such fees as may be prescribed by regulations issued pursuant to § 5-1417:
(A) A person with the right to control the disposition of the decedent's remains pursuant to § 3-413;
(B) A person without the right to control the disposition of the decedent's remains pursuant to § 3-413 if:
(i) The person has the written consent of a person having the right to control the disposition of the decedent's remains pursuant to § 3-413; or
(ii) The person has the authority to receive the external examination or autopsy report under a properly issued subpoena in a matter pending before a court having personal jurisdiction over the CME, if a copy of the subpoena has been properly served on the person with the right to control the disposition of the decedent's remains pursuant to § 3-413; or
(C) A healthcare provider, healthcare facility, or medical peer review committee in furtherance of a review of the decedent's care.
(c-2) A photograph, negative, video, print or other image of a decedent, or any portion of the body of a decedent, in the CME's records and files, shall not be disclosed by the CME except for:
(1) Use or potential use in a criminal action or proceeding that relates to the decedent's death;
(2) Use or potential use in a civil action or proceeding that relates to the decedent's death, pursuant to:
(A) The written authorization of a person with the right to control the disposition of the decedent's remains pursuant to § 3-413; or
(B) A valid subpoena;
(3) A purpose necessary to further an investigation by a person identified in subsection (b) of this section; or
(4) Use in medical or scientific education or research where the identity of the decedent is kept confidential.
(d) The CME shall prepare an annual report to the Mayor which includes information on the number of autopsies performed, statistics as to the causes of deaths, and any other relevant information the Mayor may require. The annual report shall be open to inspection by the public. The annual report shall not identify by name, deceased persons examined.
(e) For the purposes of this section, the term "government health or safety organization" means a state or federal agency responsible for protecting health or safety, including the Centers for Disease Control and Prevention, the Consumer Product Safety Commission, the Federal Aviation Administration, the National Transportation Safety Board, and the Occupational Safety and Health Administration.
§ 5–1413. Records as evidence.
The records maintained pursuant to § 5-1412, or reproductions thereof certified by the CME, are admissible as evidence in any court in the District; except that, statements made by witnesses or other persons and conclusions upon nonmedical matters are not admissible.
§ 5–1414. Autopsies performed under court order.
In the case of unexplained, sudden, violent, or suspicious death, when the body is buried without investigation, or there has been an inadequate investigation, the United States Attorney for the District of Columbia, on the United States Attorney's own motion, or at the request of a medical examiner, the Metropolitan Police Department, or another law enforcement agency, may petition the appropriate court for an order to conduct an inquiry. The court may order the body exhumed and an autopsy performed. In such cases, records and reports shall be filed as if the autopsy were performed prior to burial; except that, a copy of the report shall be furnished directly to the court.
§ 5–1415. Tissue transplants. [Repealed]
Repealed.
§ 5–1416. Personnel, records, functions, and authority transferred.
All positions, personnel, property, records, and unexpended balances of appropriations, allocations, and other funds available or to be available to the Office of the Chief Medical Examiner and all the functions assigned and authority delegated to the Office of the Chief Medical Examiner are hereby transferred to the Office of the Chief Medical Examiner established pursuant to § 5-1402:
(1) Commissioner’s Order 70-83, effective March 6, 1970, vesting the Director of the Department of Human Resources with authority over the Chief Medical Examiner and the operations of the Office of the Chief Medical Examiner under Public Law 91-358;
(2) Commissioner’s Order 71-16, effective January 26, 1971, establishing the Office of the Chief Medical Examiner, headed by the Chief Medical Examiner, in the Department of Human Resources with the functions set forth in Public Law 91-358;
(3) Part IV(B)(2) of Reorganization Plan No. 2 of 1979, effective February 21, 1980, vesting the Commissioner of Public Health, Department of Human Services, with administrative authority over the technical programs and services for medical investigation of all deaths, except clearly natural deaths under Public Law 91-358 and Commissioner’s Order 71-16, as amended;
(4) Part III(K) of Reorganization Plan No. 3 of 1986, effective January 3, 1987, vesting the Director of the Department of Human Services with responsibility for medically investigating and reporting on known or suspected homicides, suicides, medically unattended or accidental deaths and deaths which might threaten public health and safety;
(5) Mayor’s Order 89-62, Establishment of Commission on the Medical Examiner’s Office, effective March 28, 1989;
(6) Part IV(B)(2) of Reorganization Plan 4 of 1996, Establishment of the District of Columbia Department of Health, placing the Office of the Chief Medical Examiner under the supervision of the Director of the Department of Health; and
(7) Department of Health Organization Order No. 15, Office of the Chief Medical Examiner, dated May 30, 1997, establishing the Office of the Chief Medical Examiner in the Department of Health.
§ 5–1417. Regulations and fees.
(a) The Mayor shall promulgate proposed regulations to implement the provisions of this chapter. The proposed regulations shall be submitted to the Council for a 45-day period of review, excluding Saturdays, Sundays, legal holidays, and days of Council recess. If the Council does not approve or disapprove the regulations, in whole or in part, by resolution within the 45-day review period, the proposed rules shall be deemed approved.
(b) The Mayor is authorized to establish fees and rates required by this chapter.
§ 5–1418. Office of the Chief Medical Examiner Management Fund.
Repealed.
§ 5–1419. Impaired driving program; chemical testing.
(a) The CME shall be responsible for ensuring the accuracy of blood and urine testing for the District’s impaired driving program. The CME may test or authorize the testing of specimens, as defined by § 50-1901(18), for the purposes of determining if specimens contain alcohol or a drug.
(b) Until October 1, 2012, and after October 1, 2012 if authorized under § 5-1501.07(d), the CME shall be responsible for testing and certifying the accuracy of any District instrument utilized by District law enforcement personnel to test the alcohol content of breath. A District breath-test instrument shall only be used by District law enforcement personnel if it has been certified by the CME to be accurate. Certification of the accuracy of each breath test instrument must occur at least once every 180 days.
(c) In addition to the requirements under subsection (a) of this section, the CME shall:
(1) Develop a program for District law enforcement personnel to become trained and certified as a breath test instrument operator;
(2) Develop policies and procedures for the operation and maintenance of all breath test instruments utilized by District law enforcement personnel; and
(3) Develop policies and procedures for the maintenance of records demonstrating that the breath test instruments utilized by District law enforcement personnel are in proper operating condition.
§ 5–1420. Office of the Chief Medical Examiner Fund.
(a) There is established as a special fund the Office of the Chief Medical Examiner Fund ("Fund"), which shall be administered by the Mayor in accordance with subsection (c) of this section.
(b) All funds from fees received by OCME for services provided pursuant to § 5-1404(a-1) shall be deposited in the Fund.
(c) Money in the Fund shall be used to support any personnel and non-personnel expenses associated with District fatality reviews, in addition to other agency expenses.
(d)(1) The money deposited into the Fund but not expended in a fiscal year shall not revert to the unassigned fund balance of the General Fund of the District of Columbia at the end of a fiscal year, or at any other time.
(2) Subject to authorization in an approved budget and financial plan, any funds appropriated in the Fund shall be continually available without regard to fiscal year limitation.
