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THE EL PASO COUNTY CORONER’S OFFICE
EL PASO COUNTYCORONER’S OFFICE
2017 ANNUAL REPORT
THE EL PASO COUNTY CORONER’S OFFICE 01
The Coroner’s Office (EPCCO) serves El Paso County by investigating all sudden, unexpected, and non-natural deaths. While many natural deaths can be certified by the decedent’s physician, approximately one quarter of deaths require further investigation to determine cause and manner of death and ensure public health and safety. In addition to performing 902 autopsies on El Paso County Deaths, the office performed 313 autopsies for a fee for 19 surrounding counties
In 2017, the Coroner’s Office staff consisted of four board certified forensic pathologists including the county’s elected Coroner Robert Bux, M.D., Deputy Chief Medical Examiner Leon Kelly, MD and Associate Coroners Dan Lingamfelter, D.O., and Emily Berry, M.D., as well as three full-time and two part-time administrative staff, eight full-time death investigators, four full-time toxicologists, one full-time histologist, and three full-time and two part-time morgue technicians.
TOTAL DEATHS INVESTIGATED
4968AUTOPSIES
PERFORMED
1215
THE EL PASO COUNTY CORONER’S OFFICE
Colorado Revised Statute 30.10.606 describes the roles and responsibilities of the coroner in investigating deaths. A complete forensic investigation provides the cause and manner of how an individual died. The investigation can assist in settling insurance and estate claims as well as the implementation of civil and criminal actions. Identifying cause and manner of death is a critical component of ensuring public health and safety. The surviving family and general public can have peace of mind that a thorough investigation was completed.
It is the responsibility of the Coroner’s Office to identify the decedent and notify next-of-kin. In many cases, identification and next-of-kin notification can be quickly achieved. However, in cases of burns, extensive injury, or decomposition this can prove more challenging. Our office ensures all leads have been exhausted in pursuit of identification and notification. At the time of this report, 1 body from 2017 is still awaiting positive identification. Any identified but unclaimed bodies are released to the Public Administrator.
02
MEANS OF IDENTIFICATION
Visual – 854
Fingerprints – 40
Dental – 7
X-ray – 1
No individuals were identified using DNA during 2017
Why Perform an Autopsy?
THE EL PASO COUNTY CORONER’S OFFICE
What is an Autopsy?
An “autopsy” can encompass several levels of examination:
307 cases in 2017 were “external only” examinations, in which the cause and manner
are well established by the external examination* and a
thorough medical history.
*External Examination – Every autopsy includes a thorough examination of the outside of the decedent’s body documenting changes of natural disease, identifying marks and scars, medical treatment, injuries, and an inventory of clothing and property.
307 56 85256 of the 2017 examinations were partial autopsies and
typically consisted of “head only” examinations to ensure that head trauma didn’t cause or
contribute to death.
852 Examinations included a full internal exam in which each organ and
body cavity is examined and is considered a complete autopsy.
87% of cases had toxicology testing performed. Samples
are always collected, but testing is performed at the discretion of the physician.
87%El Paso County Coroner’s Office does not perform Hospital Autopsies.
640El Paso County
Coroner’s Office did not perform any
exhumations in 2017.
03
640 autopsies required death scene investigations.
0
⌧
Average number of days from autopsy to report completion during 2017 is 25 days.
59 cases (<5%) took greater than 60 days to complete due to their complexity or ongoing investigation.
Average time to completion
THE EL PASO COUNTY CORONER’S OFFICE
What Deaths are Investigated?
// Sudden, unexpected, or non-natural // No physician available to certify the death // Industrial accidents // Deaths in the custody of law enforcement or in the care
of a public institution // Deaths due to contagious diseases // All unexplained deaths
// Pronounce death // Determine cause and manner of death // Identify human remains // Notify next-of-kin // Perform an investigation into a death independent of
law enforcement // Collect evidence on or in the body // Secure a decedent’s property for next-of-kin // Provide expert testimony // Grant tissue/organs for donation
04
The responsibility of the Coroner:
Colorado Revised Statutes (C.R.S) 30-10-606 mandate that the following deaths are reported and investigated by the coroner:
THE EL PASO COUNTY CORONER’S OFFICE 05
2017 Revenue for El Paso County Coroner’s Office
Grant for Violent Death Reporting $3,825Out-of-County Autopsy Fees $435,100Out-of-County Toxicology Fees $89,730Miscellaneous Fees $2,063.75
$530,718.75El Paso County Citizen Cost Breakdown
Total Revenue for 2017
2017 Population* 699,232$2,474,619Total 2017 Budget
$2,474,619.00 (Budget)
(Revenue)- $530,718.75
$1,943,900.25 Overall Cost to Citizens
÷ 699,232 (Population)
= $2.78 Annual cost to each El Paso County Citizen
*US Census Bureau ( July, 2017)
THE EL PASO COUNTY CORONER’S OFFICE
ALAMOSABACABENTCHAFFEECONEJOSCOSTILLACROWLEYCUSTEREL PASOELBERT
1898
321610
212
90222
FREMONTHUERFANO
KIOWAMINERAL
OTEROPARK
PROWERSRIO GRANDE
SAGUACHE
491258141681517
1,215 – TOTAL CASES
06
Overall Breakdown of Autopsies Performed by the El Paso County Coroner’s Office
TELLER40
THE EL PASO COUNTY CORONER’S OFFICE
Manner of Death
There are five manners of death that can be listed on a Colorado Death Certificate.
Natural - Deaths due solely to disease or aging
Accident - Deaths due to unintentional injury
Suicide - Deaths due to an intentional self-inflicted injury
Homicide - Deaths due to the intentional injurious action of another individual
Undetermined - Deaths in this category may or may not have a determined cause of death, or may have several different possible manners.
07
Natural (34%)
Accident (42%)
Suicide (18%)
Homicide (5%)
Undetermined (.6%)
Unclassified - Death of a fetus in utero (in the uterus) does not receive a manner determination
Unclassified (.4%)
2017 El Paso County Breakdown
THE EL PASO COUNTY CORONER’S OFFICE 08
Deaths Due to Natural Diseases
Cardiovascular
Chronic Alcohol
Pulmonary Embolism
Infections
Pulmonary Disease
Global Geriatric Decline
Diabetes
Significant Contributing Causes – These are diseases that are most commonly listed as significant contributing factors in death alongside those causes listed above.
Gastrointestinal
Congenital
Cancer
Cerebrovascular
Liver Disease
Cardiovascular Obesity Diabetes Pulmonary Disease
308171
33
15
15
7
6
8
5
4
6
9
2
21483221
Total
Complications of Pregnancy
3
Morbid Obesity 9
Epilepsy 5
Other 10
Chronic Alcohol 18Smoking 18
THE EL PASO COUNTY CORONER’S OFFICE 09
Blunt Force Injuries Breakdown
Deaths Due to Accidents
378 Total Motor Vehicle Accidents
Drugs
Falls
Pedestrian Injury
Fires/Burns
Carbon Monoxide
Choking
Others
Wind
Train
Asphyxias
Bicycle Injuries
Drowning
Acute Alcohol Intoxication
60
147
106
15
5
3
6
2
2
2
12
7
9
2
Falls
Motor Vehicle (Cars)
Motorcycle
Pedestrian
Wind
Train
Bicycle
106210250215
THE EL PASO COUNTY CORONER’S OFFICE 10
Motor Vehicle Crashes
Type of VehicleSedan
Mini Van
Motorcycle SUV
Other/Unknown
Truck
261010527
Use of Restraint/seatbelt
Yes
Unknown No
Motorcycle
11
301010
Type of Collision
Front
Unknown
Rear Side
Rollover
23121159
*In every crash that the decedent was ejected there was failure to use a seatbelt
Suspected Primary Cause of CrashOperator Error
Asleep
Unknown Reckless Driving/Excessive Speed
Natural Event
Drugs/Alcohol
Road Hazard
*Of the 34 fatal crashes where the decedent was the “at fault driver” 22 had drugs or alcohol in their autopsy
THE EL PASO COUNTY CORONER’S OFFICE 11
Drug Related Accidental Deaths
147 Total Cocaine
Heroin
Heroin + Fentanyl
Methamphetamine
Cocaine + Methamphetamine
Methamphetamine + Prescription Opioids
Heroin, Cocaine + Methamphetamine
Prescription Opioids
Non-Opioid Prescription Drugs
Heroin + Methamphetamine
MDMA
Cocaine + Heroin
Cocaine + Non-Opioid Prescription Drugs
7
24
1
38
3
3
2
5
1
32
29
1
1
Opioids 92 Total HeroinOxycodone HydrocodoneFentanylMorphineTramadolOxymorphineMethadone
Mixed Rx Opioids with Methamphetamine
Mixed Rx Opioids
THE EL PASO COUNTY CORONER’S OFFICE
v
12
Of medication used in the overdose was prescribed by the decedent’s physician.
18%The average age at death (range of 19 - 88 years)
old)
2017 Drug Related Death Facts
Percentage of the accidental deaths
that were male
65%
v Have a prior history of
substance abuse or addiction
71%
42 YEARS
Death scene investigations
revealed drugs, drug paraphernalia or
medications of abuse
63%
Percentage of the accidental opioid deaths that were
heroin
62%
Have a history of mental illness
29%
20%Deaths of all causes that have marijuana metabolites present
at autopsy
v Total number of opioid related deaths (suicide and accidental)
102
THE EL PASO COUNTY CORONER’S OFFICE
Apparent Circumstances of the Homicides
13
Deaths Due to Homicide
42 Total
Firearms
Sharp Force Injuries
Blunt Force Injuries
Neglect
Physical restraint
30
5
5
1
1
AltercationDomestic Violence UnknownWhile committing another crimeOfficer involvedAbuse/NeglectHit + run motor vehicle collisionGang Related
513
1
4
68
2 2
Reckless use of firearm 1
THE EL PASO COUNTY CORONER’S OFFICE 14
Deaths Due to Suicide
164 Total
Drugs Used in SuicideOther
Anti-convulsants Benzodiazepines
OpioidsAnti-depressants
Mixed alcohol and non-opioids
1023
21
4
43Average age
at death (Range of 12 -
99 years)
25% 50% 54% 23%Notes or social
media posts indicating suicidal
intentions
Have a reported history of prior mental illness
Intoxicated with drugs or alcohol
at the time of death
Have a history of prior suicide
attempts
2017 Suicide Facts
of completed suicides were male75%of firearm deaths used their personal weapon76%
Three most common risk factors: recently ended relationship, financial struggles, and personal health crisis
Firearms
Ligature
Sharp Force Injury
Asphyxia
Other
Fall
Drugs
91
33
5
6
6
1
22
THE EL PASO COUNTY CORONER’S OFFICE
Gender
15
El Paso County Coroner’s Office investigated the deaths of 53 children (below the age of 18 years old). These cases are individually reviewed by the El Paso County Child Fatality Review Team to identify strategies to prevent these types of deaths in the future.
Child Fatalities
53 Total
Fetus
<1 Year
13-17
1-4 Years
5-12 Years
4
9
19
6
15
Age
Male: 9
Hanging
Drugs
Firearms
Asphyxia
Female: 4
5
2
4
2
Teen Suicides (Ages 12-17 Years)
Breakdown
NaturalHomicides SuicidesPedestrian struck by motor vehicleInfant unsafe sleep/asphyxiaUndeterminedDrowningMotor vehicle accident
OtherFetal death
69133
622543
When the Suicides Occurred
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
Infant Asphyxias – 6 Total
Deaths due to an unsafe sleep surfaceDeaths due to bed sharing with adults
4
2
0 0 0 0 0 0
THE EL PASO COUNTY CORONER’S OFFICE 16
7 of the 10
El Paso County donors had organs recovered for transplantation10
There were no refusals of requests
55
Organ Donation
Were coroner jurisdiction cases and all were approved for
donation
Organs were transplanted from El Paso County donors
29
In 2017:
El Paso County tissue donor cases fell under the coroner’s jurisdiction
⌧Cases resulted in
tissue harvest
35
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