Investigations and Autopsies

Arkansas
Person is in state mental institution and there is no previous medical history to explain the death; a person is admitted to a hospital emergency room unconscious and is unresponsive, with cardiopulmonary resuscitative measures being performed, and dies within twenty-four (24) hours of admission without regaining consciousness or responsiveness, unless a physician was in attendance within thirty-six (36) hours preceding presentation to the hospital, or, in cases in which the decedent had a prediagnosed terminal or bedfast condition, unless a physician was in attendance within thirty (30) days preceding presentation to the hospital. Ark. Code Ann. § 12-12-315.

California
Hanging, stabbing, cutting, exposure, starvation, strangulation, aspiration. Cal. Gov’t Code § 27491.

District of Columbia
Fetal deaths related to maternal trauma including substance abuse, and extra-mural deliveries. D.C. Code § 5-1405.

Idaho
If a death occurs that is not attended by a physician and the cause of death cannot be certified by a physician, the coroner must refer the investigation of the death to the sheriff of the county or the chief of police of the city in which the incident causing the death occurred or, if such county or city is unknown, to the sheriff or chief of police of the county or city where the body was found. The investigation shall be the responsibility of the sheriff or chief of police. Upon completion of the investigation, a written report shall be provided to the coroner of the county in which the death occurred or, if such county is unknown, to the coroner of the county where the body was found. Idaho Code Ann. § 19-4301.

Illinois
Suffocation. 55 Ill. Comp Stat. 5/3-3013.

Kentucky
When the death of a human being occurs while the person is in a state mental institution or mental hospital when there is no previous medical history to explain the death; when the death of a human being occurs at the work site and there is no apparent cause of death such as an injury or when industrial toxics may have contributed to the cause of death; when the body is to be cremated and there is no past medical history to explain the death. Ky. Rev. Stat. Ann. § 72.025.

Louisiana
Any death from natural causes occurring in a hospital under twenty-four hours admission unless seen by a physician in the last thirty-six hours; natural causes, hanging, electrocution, stabs or cutting, lightning, starvation, exposure, tetanus, strangulation, suffocation, smothering. La. Rev. Stat. Ann. § 13:5713.

Maine
During diagnostic or therapeutic procedures under circumstances indicating gross negligence or when clearly due to trauma or poisoning unrelated to the ordinary risks of those procedures. Me. Rev. Stat. tit. 22, § 3025.

Massachusetts
Death where suspicion of abuse of . . . family or household member, elder person or disabled person exists; death in any emergency treatment facility, medical walk-in center, child care center. Mass. Gen. Laws Ann. ch. 38, § 3.

Minnesota
unexplained or unexpected perinatal and postpartum maternal deaths; deaths due to culpable neglect; unexpected deaths of persons notwithstanding a history of underlying disease; deaths in which a fracture of a major bone such as a femur, humerus, or tibia has occurred within the past six months; deaths of persons not seen by their physician within 120 days of demise; deaths of persons occurring in an emergency department; stillbirths or deaths of newborn infants in which there has been maternal use of or exposure to unprescribed controlled substances including street drugs or in which there is history or evidence of maternal trauma; solid organ donors; deaths of nonregistered hospice patients or patients in nonlicensed hospice programs; and deaths attributable to acts of terrorism. Minn. Stat. Ann. § 390.11.

Mississippi
Where a person is presented to a hospital emergency room unconscious and/or unresponsive, with cardiopulmonary resuscitative measures being performed, and dies within twenty-four (24) hours of admission without regaining consciousness or responsiveness, unless a physician was in attendance within thirty-six (36) hours preceding presentation to the hospital, or in cases in which the decedent had a prediagnosed terminal or bedfast condition, unless a physician was in attendance within thirty (30) days preceding presentation to the hospital. When a stillborn fetus is delivered and the cause of the demise is medically believed to be from the use by the mother of any controlled substance as defined in Section 41-29-105. Miss. Code. Ann. § 41-61-59.

Missouri
Death outside a licensed health care facility. Mo. Ann. Stat. § 58.451.

Montana
A medically suspicious death, unusual death, or death of unknown circumstances, including any fetal death; whenever death occurs in a manner that was unattended or unwitnessed and the deceased was not attended by a physician at any time in the 30-day period prior to death. Mont. Code Ann. § 46-4-122.

New Hampshire
Deaths associated with . . . mortal weapons; the death of any child from any cause when such death occurs at a day care facility . . . or when the child is in the custody of or being investigated by the department of health and human services; fetal deaths that result from intrauterine trauma when the fetus has attained 20 weeks gestation or 350 grams weight. N.H. Rev. Stat. Ann. § 611-B:11.

New Jersey
Deaths not caused by readily recognizable disease, disability or infirmity. N.J. Stat. Ann. § 52:17B-86.

New Mexico
Any deaths in nursing homes or other private institutions without recent medical attendance; any death due to neglect; deaths which are possibly directly or indirectly attributable to environmental exposure not otherwise specified; any death suspected to be due to infectious or contagious disease wherein the diagnosis and extent of disease at the time are undetermined. N.M. Code R. § 7.3.2.

New York
A death caused by criminal neglect. N.Y. County Law § 673 (McKinney).

North Dakota
An individual [who] died suddenly when in apparent good health in a suspicious or unusual manner . . . the death of any minor who has received or is eligible to receive a birth record, when the minor died suddenly when in apparent good health . . . severe, unexplained injury; an injury to a minor; starvation; suffocation, smothering, or strangulation; prior child abuse or neglect assessment concerns; open child protection service case on the victim. N.D. Cent. Code Ann. § 11-19.1-07; N.D. Cent. Code Ann. § 11-19.1-01.

Ohio
when any mentally retarded person or developmentally disabled person dies regardless of the circumstances. Ohio Rev. Code Ann. § 313.12.

Oklahoma
Deaths unattended by a licensed medical or osteopathic physician for a fatal or potentially-fatal illness; deaths of persons after unexplained coma. Okla. Stat. Ann. tit. 63, § 938.

Pennsylvania
Cave-ins and subsidences; any death in which trauma, chemical injury, drug overdose or reaction to drugs or medication or medical treatment was a primary or secondary, direct or indirect, contributory, aggravating or precipitating cause of death. The coroner shall regard any death as sudden if it occurs without prior medical attendance by a person who may lawfully execute a certificate of death in this Commonwealth, or if, within twenty-four hours of death, the decedent was discharged from such medical attendance or a change of such medical attendance had occurred, or if any such medical attendance began within twenty-four hours of death and the medical attendant refuses or is unable to certify the cause of death. Medical attendance includes hospitalization. 16 Pa. Stat. Ann. § 1237; 16 Pa. Stat. Ann. § 1239.

South Carolina
In a health care facility . . . within 24 hours after having undergone an invasive surgical procedure at the health care facility. S.C. Code Ann. § 17-5-530.

Tennessee
Deaths where neglect or abuse of extended care residents are suspected or confirmed. Tenn. Code Ann. § 38-7-108.

Washington
All deceased persons who come to their death suddenly when in apparent good health without medical attendance within the thirty-six hours preceding death; where a coroner's autopsy or post-mortem or coroner's inquest is to be held; hanging, electrocution, stabs or cuts, lightning, starvation, exposure, tetanus, strangulations, suffocation or smothering; or where death is due to premature birth; death results from alleged rape, carnal knowledge or sodomy, where death occurs in a jail or prison. Wash. Rev. Code Ann. § 68.50.010.

West Virginia
A person dies due to or in association with, violence, suspected violence, or by any external cause, regardless of the interval between injury and death. W. Va. Code R. § 64-84-6.

Wisconsin
When, after reasonable effort, a physician cannot be obtained to sign the medical certification as required  . . . within 6 days after the pronouncement of death or sooner under circumstances which the coroner or medical examiner determines to be an emergency. Wis. Stat. Ann. § 979.01.

1. One year of age or younger. D.C. Code § 5-1405.
2. In any suspicious or unusual manner, with particular attention to those persons sixteen years of age and under. Ga. Code Ann. § 45-16-24.
3. Death is suspected of having been caused by any type of physical injury, including poisoning, regardless of whether the suspected manner of death is homicide, suicide or accident. This circumstance must be reported irrespective of whether the deceased had been attended by a physician, was a patient in a hospital, survived for a considerable time following the physical injury or died from terminal natural causes consequent to and following the physical injury.  Me. Rev. Stat. tit. 22, § 3025.
4. The individual dies without medical attendance by a physician, or the individual dies while under home hospice care without medical attendance by a physician or a registered nurse, during the 48 hours immediately preceding the time of death, unless the attending physician, if any, is able to determine accurately the cause of death. Mich. Comp. Laws Ann. § 52.202.
5. Deaths occurring within twenty-four hours of arrival at a health care facility if death is unexpected. Minn. Stat. Ann. § 390.11.
6. A medically suspicious death, unusual death, or death of unknown circumstances, including any fetal death. Mont. Code Ann. § 46-4-122.
7. Death of a person confined in a public institution other than a hospital, infirmary or nursing home. N.Y. County Law § 673 (McKinney).
8. When any person, including a child under two years of age, dies suddenly when in apparent good health. Ohio Rev. Code Ann. § 313.12.
9. At the discretion of the coroner, all deaths of children under two years of age resulting from an unknown cause or if the circumstances surrounding the death indicate that sudden infant death syndrome may be the cause of death. S.D. Codified Laws § 23-14-18.
10. [A]nd death is reported under Chapter 264, Family Code. Tex. Crim. Proc. Code Ann. art. 49.04.

Arkansas
The examiner may conduct an autopsy on any firefighter, police officer, or eligible person who dies in the line of duty as a result of injuries sustained in the line of duty or within twenty-four (24) hours after participating in an emergency situation. Ark. Code Ann. § 12-12-326.

Colorado

Required: When the death is apparently nonnatural and occurs in a facility or during services regulated by the department of human services, and when the death is the result of an automobile accident and a hospital physician has not documented the extent of the injuries. Colo. Rev. Stat. Ann. § 30-10-606.5.

Florida
The circumstances of death are unusual or suspicious by reason of the body being unidentified after investigation, charred, or completely or partially skeletonized. Fla. Admin. Code Ann. r. 11G-2.003.

Iowa

Required: All cases in which the manner of death is undetermined; all deaths of commercial vehicle drivers that occur during the performance of their job duties; deaths of airplane pilots who die as a result of an airplane crash; deaths due to a natural disaster, including tornadoes and floods. Iowa Admin. Code r. 641-127.3.

Recommended: All cases which involve a motor vehicle crash, unless it is a single motor vehicle accident with no potential for litigation and there is an obvious cause of death or the injuries have been clearly documented by hospitalization; all pedestrian, bicycle, motorcycle, snowmobile, boating, watercraft, three- or four-wheeler or all-terrain vehicle fatalities; deaths due to failure of a consumer product; deaths due to alcohol; electrical- and lightning-related deaths; all deaths related to exposure, such as hypothermia and hyperthermia; all sport-related deaths, including but not limited to deaths from auto racing and deaths resulting from injuries sustained in football, basketball, baseball, softball, soccer, or other games or sports. Id.

Maryland
A medical examiner shall perform an autopsy of any fire fighter and any sworn personnel of the State Fire Marshal’s Office who dies in the line of duty or as a result of injuries sustained in the line of duty. Md. Code Ann., Health-Gen. § 5-310.

Minnesota
The coroner or medical examiner shall conduct an autopsy or require that one be performed in the case of a death reported to the coroner or medical examiner by the state fire marshal or a chief officer under section 299F.04, subdivision 5, and apparently caused by fire, and in which the decedent is pronounced dead outside of a hospital or in which identification of the decedent has not been confirmed. If the decedent has died in a hospital and identification is not in question, an autopsy may be performed or ordered by the coroner or medical examiner. Minn. Stat. Ann. § 390.11.

New Jersey
In all cases otherwise under the Medical Examiner’s jurisdiction where the decedent has been identified as a potential donor pursuant to P.L. 1969, c.161 (N.J.S.A. 26:6-57 et seq.), the medical examiner shall perform any necessary examination, autopsy or analysis of any organ or tissue in a manner and within a time period compatible with preservation of the organ or tissue for the purpose of transplantation.  

Discretionary: Autopsies may be performed when it appears in the discretion of the county medical examiner to be in the public interest to do so in all cases of human deaths occurring in the following circumstances: . . . all deaths caused by disease, disability or infirmity which are not readily recognizable; all deaths of inmates as defined in N.J.S.A. 52:17B-86(f) occurring in institutions maintained in whole or in part at the expense of the State or county when the inmate was not hospitalized therein for organic disease; all deaths from motor vehicle collisions to include drivers, occupants, and pedestrians. N.J. Admin. Code 13:49-1.1 & 13:49-1.2.

South Carolina

B) The coroner or medical examiner immediately shall request an autopsy if a child’s death occurs as defined in Section 17-5-540 [when a child dies in the county he serves:

(1) as a result of violence, when unattended by a physician, and in any suspicious or unusual manner; or
(2) when the death is unexpected and unexplained including, but not limited to, possible sudden infant death syndrome.

For the purposes of this section, a child is not considered to be “unattended by a physician” when a physician has, before death, provided diagnosis and treatment following a fatal injury.] S.C. Code Ann. §§ 17-5-520, 17-5-540.

Tennessee

Discretionary: Executed prisoners. Tenn. Code Ann. § 38-7-106.

Wisconsin

Required: If an individual dies while he or she is in the legal custody of the department and confined to a correctional facility in another state under a contract under s. 301.07, 301.21, or 302.25, the department shall have an autopsy performed by an appropriate authority in the other state or by the coroner or medical examiner of the county in which the circuit court is located that sentenced the individual to the custody of the department.

Discretionary: Homicide by negligent handling of dangerous weapon, homicide by negligent operation of vehicle, homicide resulting from negligent control of a vicious animal or homicide by intoxicated user of a vehicle or firearm.  Wis. Stat. Ann. §§ 979.025, 979.02 & 979.04.

Wyoming

Discretionary: When an inquisition is being held, if the coroner or the jury shall deem it requisite, he may summon one (1) or more physicians or surgeons, to make an autopsy or postmortem examination. Wyo. Stat. Ann. § 7-4-209.

1. (b) A reasonable suspicion exists that the death is by accident, suicide or poison, unless:
   1. The death is by poison and the deceased has survived in a hospital for a time sufficient to metabolize the poison, or
   2. The death is by accident or suicide and the cause of death can be determined from a review of the circumstances, history, and available medical records . . . Fla. Admin. Code Ann. r. 11G-2.003
2. [Unless inquiry into child’s death] shows that such death was expected or explainable with a reasonable degree of medical certainty. Ga. Code Ann. § 45-16-27.1.
3. If necessary in the opinion of coroner, autopsy is discretionary; if necessary in opinion of medical examiner, autopsy is required. Mo. Ann. Stat. §§ 58.451, 58.725
4. The county coroner or coroner’s physician shall perform, at county expense, an autopsy on any person less than nineteen years of age who dies a sudden death, except that no autopsy needs to be performed if (a) the death was caused by a readily recognizable disease or the death occurred due to trauma resulting from an accident and (b) the death did not occur under suspicious circumstances. Neb. Rev. Stat. § 23-1824.
5. Upon the death of a minor whose cause of death is suspected by the minor’s parent or guardian or the coroner or the coroner’s medical deputy to have been the sudden infant death syndrome, the coroner or the coroner’s medical deputy, after consultation with the parent or guardian, shall take custody of the body and shall arrange for the performance of the autopsy by the state forensic examiner or a pathologist designated by the state forensic examiner, unless the county coroner, sheriff, state’s attorney, and the parent or guardian all agree that an autopsy is unnecessary. N.D. Cent. Code Ann. § 11-19.1-11.
6. [If] an autopsy is contrary to the deceased person’s religious beliefs, [it can still be performed if] the coroner concludes the autopsy is a compelling public necessity . . . An autopsy is a compelling public necessity if it is necessary to the conduct of an investigation by law enforcement officials of a homicide or suspected homicide, or any other criminal investigation, or is necessary to establish the cause of the deceased person’s death for the purpose of protecting against an immediate and substantial threat to the public health. Ohio Rev. Code Ann. § 313.131.
7. (1) The medical examiner shall perform an autopsy to (a) aid in the discovery and prosecution of a crime; (b) protect an innocent person accused of a crime. Utah Code Ann. § 26-4-13.
8. If it is necessary to obtain or preserve evidence of the cause of death, the district attorney may order that a qualified physician perform an autopsy or postmortem examination of the body of any person who appears to have died by unlawful means, by violence, or when the cause of death is unknown. Wyo. Stat. Ann. § 7-4-209.