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pdf2017 Medical Examiner/Coroner Office Survey
As the primary agency for enforcing the controlled substances laws and regulations of the United States,
the Drug Enforcement Administration (DEA) strives to develop information sources on the prevalence
and distribution of drugs commonly available and used and of emerging drugs. Since its inception in
1997, the National Forensic Laboratory Information System (NFLIS) has provided a systematic approach
for collecting data on solid-dosage drug analyses conducted by Federal, State, and local forensic
laboratories across the country. NFLIS has provided the DEA with an efficient, reliable, and
comprehensive data resource for monitoring drug schedule actions; tracking drug trends; and
identifying new substances of use, misuse, and abuse. NFLIS also provides the community with midyear,
annual, and special reports on drug seizure data submitted by participating laboratories.
The DEA plans to enhance its efforts to combat diversion and identify new and emerging substances of
misuse and abuse by expanding NFLIS to establish two additional continuous drug surveillance
programs. These programs will provide the DEA with current information on drug-related mortality and
toxicology findings supplied by censuses of medical examiner/coroner offices and toxicology
laboratories to supplement the current drug seizure data from the forensic drug laboratories. To be
effective, any plans to systematically collect this information must reflect a thorough understanding of
the operations and data-reporting capabilities of medical examiner/coroner offices and toxicology
laboratories.
The purpose of this survey is to gather key information from each medical examiner/coroner office in
terms of organizational context, caseload, toxicology requesting practices, capability of collecting and
reporting a set of core data items (e.g., toxicology results, cause and manner of death). All of this
information will be used to help the DEA to develop the aforementioned drug surveillance data system.
Aggregated survey results will be provided in such a manner as the NFLIS periodic Survey of Crime
Laboratory Drug Chemistry Sections.
Instructions for Completing the 2017 Medical Examiner/Coroner Office Survey
1. Refer to the jurisdictions your medical examiner/coroner office serves when answering
questions. If your office jurisdiction includes more than one county, respond for all
counties.
2. Answer all questions based on calendar year 2016 data.
3. In some cases, you will be asked to skip certain questions based on your response.
4. Complete the survey by September 22, 2017, and return it by mail using the postagepaid envelope or using the online survey option at Web site link.
5. If you need assistance to answer any question, please e-mail RTI staff at
DEANFLISSurveys@rti.org or call RTI staff at 1-866-784-7723.
We appreciate your voluntary responses because your participation is needed for the survey's success
which will in turn, provide the information the DEA needs to launch critical national surveillance systems
to combat our Nation’s drug problem.
Section 1. Medical Examiner/Coroner Office Identification
The purpose of this section is to ensure that we have the correct contact information for your medical
examiner/coroner office and to gather a general profile of your office.
1. We have the official name of your office as [NAME]. Is this correct?
o A. YES, this is correct.
o
B. NO, this is not correct. Please provide the corrected name below.
2. Please review the mailing address and contact information for this office as shown below.
Address Line 1: [Medical Examiner/Coroner Office Mailing Address Line 1]
Address Line 2: [Medical Examiner/Coroner Office Mailing Address Line 2]
City: [Medical Examiner/Coroner Office City]
State:
ZIP Code:
Telephone:
Number:
Extension:
[Medical Examiner/Coroner Office State]
[Medical Examiner/Coroner Office City ZIP]
[Medical Examiner/Coroner Office Telephone Number]
[Medical Examiner/Coroner Office Extension]
Is this information correct?
o A. YES, this is correct. →Go to 3
o
B. NO, this is not correct. →Go to 2a
2a. Edit the mailing address and contact information below.
Current Information on File
Address Line 1: [Medical Examiner/Coroner Office Mailing
Address Line 1]
Address Line 2: [Medical Examiner/Coroner Office Mailing
Address Line 2]
City: [Medical Examiner/Coroner Office City]
State: [Medical Examiner/Coroner Office State]
ZIP Code: [Medical Examiner/Coroner Office City ZIP]
Telephone [Medical Examiner/Coroner Office Telephone
Number: Number]
Extension: [Medical Examiner/Coroner Office Extension]
Enter Changes Below
3. We have the chief position (e.g., chief medical examiner/coroner) of the [ME/C NAME] shown
below.
Honorific (e.g.,
Dr., Mr., Ms.):
First Name:
Last Name:
Title:
[Honorific]
[First Name]
[Last Name]
[Title]
Is this correct?
o
o
A. YES, this is correct. →Go to 4
B. NO, this is not correct. →Go to 3a
3a. Edit the contact information below.
Current Information on File
Honorific (e.g., [Honorific]
Dr., Mr., Ms.):
First Name: [First Name]
Last Name: [Last Name]
Title: [Title]
Enter Changes Below
4. Enter the name and title of the chief position in your toxicology laboratory (e.g., chief
toxicologist).
Honorific (e.g., Dr.,
Mr., Ms.):
First Name:
Last Name:
Title:
o
NOT APPLICABLE
4a. Does your office use an off-site toxicology laboratory (e.g., State/local crime or health
laboratory) and/or reference toxicology laboratory (e.g., commercial, academic)?
Off-site toxicology laboratory: A toxicology laboratory that is not located within the
medical examiner/coroner office.
Reference laboratory: An off-site toxicology laboratory that is used by the medical
examiner/coroner office uses in addition to its typically used toxicology laboratory. For
example, an office may use its State toxicology laboratory but may send specimens to a
reference laboratory for synthetic cannabinoid or synthetic cathinone testing.
o
o
A. YES → Go to Question 4a1
B. NO → Go to Question 5
4a1.
Laboratory Name
1
2
3
Laboratory City
Laboratory
State
5. Select the best description of your office. Select only one option. {Respondent may select only
one option}
o
o
o
o
o
o
o
o
A. State medical examiner office
B. District/regional medical examiner office
C. County medical examiner office
D. City medical examiner office
E. District/regional coroner office
F. County coroner office
G. Private autopsy facility serving the medical examiner/coroner community {If respondent
selects “G,” proceed to thank you screen}
H. None of the above {If respondent selects “H,” proceed to thank you screen}
6. {If Option E or F is selected in Question 5, ask Question 6; otherwise SKIP to Question 7} What
are the responsibilities of your coroner’s office? Select all that apply.
o A. Determine the cause and manner of death
o B. Conduct inquests
o C. Assist medical examiners in death investigations
o D. Move the decedent from location of death
o E. Order toxicology testing
o F. Execute arrest warrants and serve process
o G. None of the above {If respondent selects “G,” proceed to thank you screen}
7. What jurisdiction(s) does your office serve (e.g., State of North Carolina; Orange County, Florida;
New York City; First Judicial District )?
8. Enter the total population of the jurisdiction(s) your office serves.
Check this box if the total population is an estimate
□
9. Is your office accredited by any organizations? Select all that apply.
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A. National Association of Medical Examiners (NAME)
B. International Association of Coroners & Medical Examiners (IAC&ME)
C. Other (please specify)
D. NO
Section 2. Caseload and Testing Practices
This section asks about your caseload in calendar year 2016, types of inquiries, turnaround time, and
selected drug and drug class toxicology requests for analysis.
10. Enter the total number of cases referred to your office during calendar year 2016, including all
of the cases in which your office conducted an investigation or documented referral of the case
to your office.
Referred cases: The number of human death cases referred to medical examiner/coroner
offices by medical and law enforcement personnel.
Check this box if referred cases are not documented
□
Check this box if the total number of referred cases is an estimate
□
11. For calendar year 2016, enter the total number of human death cases accepted by your office.
Do not include cremation approval cases or cases in which jurisdiction was declined.
Accepted cases: The number of human death cases for which the medical
examiner/coroner office accepted jurisdiction conducted further investigations to
determine cause and manner of death and completed the death certificate.
Check this box if the total number of accepted cases is an estimate
□
12. Of the total {Number populated from Question 11} cases for calendar year 2016, enter the
number of cases that included any of the following procedures performed by your office or by a
reference laboratory at your request. If data are not available, provide an estimate and mark
the square box to the right.
Reference laboratory: An off-site toxicology laboratory that is used by the medical
examiner/coroner office uses in addition to its typically used toxicology laboratory. For
example, an office may use its State toxicology laboratory but may send specimens to a
reference laboratory for synthetic cannabinoid or synthetic cathinone testing.
Type of Inquiry
Number of Cases
Estimate
A. Death scene investigation
□
B. Autopsy performed
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C. Toxicology analysis
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D. External examination
□
E. Review of medical records
from health care provider
□
13. Are there instances where your office requests toxicology testing for specific drugs based on the
type of case (e.g., more extensive testing requested for homicides vs. suicides; more extensive
testing requested for a gunshot wound vs. a vehicle crash)?
o A. YES (please specify)
o
B. NO, we have a test all policy where every case submitted is tested for the same drugs
14. In the case of novel psychoactive substances (e.g., synthetic cannabinoids), what is the normal
course of action for requesting toxicology analysis? Select only one option.
o A. We submit these cases to a reference laboratory
o B. We do not request analysis of these substances
o C. It is rare that we encounter these substances, but if we do, our normal course of
action is to:
15. In general, what is the average turnaround time, in days, for completing a case (defined here as
completion of a death certificate)?
[NUMERIC FIELD – MAXIMUM 3 CHARACTERS]
16. Does your office typically wait to complete the death certificate until all investigations, autopsy
reports, and laboratory results are completed?
o A. YES
o B. NO
17. In cases where a drug is found as a cause or contributing cause of death, which of the following
best describes what would be listed as the cause of death on the death certificate? Select only
one option.
o A. All of the drug class(es) (e.g., opiates, benzodiazepines) would be listed on the death
certificate.
o B. Some of the drug class(es) would be listed on the death certificate.
o C. All of the specific drug(s) (e.g., oxycodone, lorazepam) would be listed on the death
certificate.
o D. Some of the specific drug(s) would be listed on the death certificate.
o E. A mixture of specific drug(s) and drug class(es) would be listed on the death
certificate.
18. Indicate the request frequency of the following drugs/drug classes that your office requests for
toxicology analysis.
Drug/Drug Class
Toxicology Request Frequency
Always – testing for drug is part of a
standard panel
Sometimes – testing is done on an
individual case basis
Never – testing is never done for the
particular drug or drug class
Quantitative Analysis Frequency
Always – positive results are always
quantitated
Sometimes – positive results are quantitated
on an individual case basis
Never – positive results are never
quantitated for the particular drug or drug
class
Alcohol
Amphetamines
Anticonvulsants
Antidepressants
Antipsychotics
Barbiturates
Benzodiazepines
Buprenorphine
Carisoprodol
Cocaine
Fentanyl
Fentanyl related substances (e.g., acetyl
fentanyl)
Gabapentin
Heroin
Inhalants/volatiles
Ketamine
Marijuana/THC
Muscle relaxants
Opiates/opioids (other than heroin and
fentanyl)
Over-the-counter medications (e.g.,
guaifenesin, ibuprofen)
Phencyclidine (PCP)
Phenethylamines (e.g., 2-CI, 25I-NBOMe)
Piperazines (e.g., BZP, TFMPP)
Synthetic cannabinoids
Synthetic cathinones (e.g., bath salts)
Z-Drugs (e.g., zolpidem, zopiclone)
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Section 3. Information Management System Overview
This section gathers information on whether your office uses an electronic laboratory information
system, whether your office captures the core data items we are interested in collecting, and your
office's reporting capabilities.
19. How would you characterize your office’s records management system? Select only one option.
o A. Computerized, networked system {SKIP to Question 21}
A computerized system that is connected to a network on which personnel can
access the same information from different computers. Networked does not
mean that instrumentation is networked to the case management system so that
toxicology results are automatically imported.
o
B. Computerized, non-networked system {SKIP to Question 21}
A computerized system that is not connected to a network on which personnel
can access the same information from different computers.
o
C. Partially computerized system, some manual record-keeping {SKIP to Question 21}
Some case data are stored in a computerized system, whereas other case data
are stored as paper-based files.
o
D. Manual record-keeping system {Go to Question 20}
All case data are stored as paper-based files and are not accessible by a
computer.
o
E. Other (please describe) {SKIP to Question 21}
Never
Never
Never
Never
Never
Never
20. {If respondent selected “D” for Question 19, ask Question 20} Are there any plans in the next 3
years to transition to a computerized information management system?
o A. YES→{SKIP to Question 24a}
o B. NO→{SKIP to Question 24a}
21. {If A, B, C, or E was selected from Question 19, ask Question 21} Please provide the name of the
information management system you are using.
o A. In-house laboratory information management system
o
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o
o
o
o
o
o
B. Bar Coded Evidence Analysis Statistics and Tracking (BEAST)
C. Forensic Advantage
D. Justice Trax
E. LabHealth
F. Orchard Harvest
G. VertiQ
H. Epic
I. Other (please specify)
22. Does your information management system have the ability to export customized files? Select
all that apply.
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A. Comma-separated values (CSV) file
B. Tab-delimited text
C. XML
D. Database (DBF, SQL)
E. Text (TXT)
F. Excel (XLS, XLSX)
G. Access (MDB, ACCDB)
H. Crystal Reports
I. Other (please specify)
J. NO
K. Don’t know
23. Does your office have the ability to electronically transfer exported files? Select all that apply.
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A. E-mail only
B. FTP upload
□
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C. HTTP upload
D. Other (please specify)
E. NO
F. Don’t know
24a. Indicate whether your office's case records capture the following data items and whether they
are stored electronically.
Core Data Items Collected by the Medical Examiner/Coroner
Office
Case ID/Unique identifier
Submitting agency
Date of death
Date of final death record
Cause of death
Manner of death
Location of injury (county, city, or ZIP Code)
Age of decedent
Sex of decedent
Known prescription drugs decedent was prescribed
Data Item Is Available in Case
Records
○ Yes
○ No
○ Yes
○ No
○ Yes
○ No
○ Yes
○ No
○ Yes
○ No
○ Yes
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○ Yes
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○ Yes
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○ No
○ Yes
○ No
[IF RESPONDENT SELECTS “D” FOR
QUESTION 19, SKIP COLUMN]
Is the Data Item Stored in an
Electronic Information Management
System?
○ Yes
○ No
○ Yes
○ No
○ Yes
○ No
○ Yes
○ No
○ Yes
○ No
○ Yes
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○ No
24b. Indicate whether your office's case records capture the following data items and whether they
are stored electronically.
Core Data Items Collected by the Toxicology Laboratory
Data Item Is Available in Case
Records
Requesting agency name
Date of analysis
Drugs and metabolites confirmed
Concentration with units for confirmed results
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Yes
Yes
Yes
Yes
Sample matrix used for confirmation results
○ Yes
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No
No
No
No
○ No
[IF RESPONDENT SELECTS “D” FOR
QUESTION 19, SKIP COLUMN]
Is the Data Item Stored in an
Electronic Information Management
System?
○ Yes
○ No
○ Yes
○ No
○ Yes
○ No
○ Yes
○ No
○ Yes
Section 4. Participation in a National Data Collection System
In this section, we ask about assistance needed if your office volunteers to participate in this data
collection, potential barriers to participation, and benefits that this data collection could provide to your
office.
25. What types of assistance would ease your participation in NFLIS? Select all that apply.
□
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A. Computer hardware
B. Computer software
C. Assistance with programming
○ No
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D. Direct financial assistance to support data acquisition and reporting
E. Other (please specify)
26. {If the respondent selected more than one response in Question 25, ask Question 26 and provide
to the respondent only the items he or she selected; otherwise, go to Question 27} Of the types of
assistance that you specified in Question 25 that would ease your participation in NFLIS, which one
is the most important. Select all that apply.
□ A. Computer hardware
□ B. Computer software
□ C. Assistance with programming
□ D. Direct financial assistance to support data acquisition and reporting
□ E. Other (please specify)
27. Does your office participate in any other drug-related data collection efforts? Select all that
apply.
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A. National Violent Death Reporting System (NVDRS)
B. Fatality Analysis Reporting System (FARS)
C. State-based drug-related data collection (please specify)
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D. Other (please specify)
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E. NO
28. Generally, what are the main potential barriers for your office to participate in data collection
efforts? Select all that apply.
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A. Lack of electronic records
B. Lack of resources for data conversion to other systems
C. Concerns about privacy
D. Unavailable personnel to work on project
E. Unavailable personnel for software, IT, and so forth needed for this project
F. Unwillingness to share data with Federal agencies
G. Political climate or restrictions
H. Resource limitations
I. Concerns that the effort will not benefit my jurisdiction, office, or laboratory
J. Other barriers (please specify)
□
K. None of the above
29. What information from NFLIS resulting from this project would be most beneficial to your office?
Select all that apply.
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A. Drugs involved in cause of death
B. Levels of drugs involved in cause of death
C. Drug frequency trends
D. New drug trends
E. Practices of other offices
F. Our office does not see a benefit from this project
G. Other benefits (please specify)
30. We would like to collect the contact information of the person who has completed this survey.
Your contact information would be used if there are questions about answers you have provided
and possible future contact related to NFLIS participation.
Honorific (e.g., Dr.,
Mr., Ms.):
First Name:
Last Name:
Title:
Telephone Number:
Extension:
E-mail Address:
Thank you screen
We appreciate your time and responses because your participation will help inform
DEA’s efforts to launch two important national drug surveillance systems.
| File Type | application/pdf |
| File Modified | 2018-09-06 |
| File Created | 2017-04-19 |