Some people object to listing toxicology results in the autopsy report, which is public record in many states. Most are embarrassed on behalf of a loved one. Some have another reason.
The couple I’ll call Jack and Jeri were living the Florida retirement dream: a big house, a swimming pool, boating, beaches and golf.
Jack said they’d typically have a little wine with dinner, watch TV until bedtime and share a nightcap. Jack would go to bed; Jeri would swim laps to help her sleep.
One morning, Jeri’s side of the bed was undisturbed. Jack ran downstairs and found her body floating in the pool.
Jeri’s autopsy findings were consistent with drowning. But people typically drink more than they or their families admit, so I waited for toxicology results before making a final determination.
Jeri’s blood alcohol was .27 percent – over three times the legal limit for driving and far more than could be explained by a nightcap and a couple of glasses of wine with dinner.
I certified Jeri’s cause of death as “drowning” and the manner as “accident.” In the description of how death occurred, I wrote “drowned in home pool while intoxicated.” My autopsy report included her blood alcohol level.
After reading my report, Jack came to my office to complain. Saying she drowned while intoxicated made his wife seem like a lush, he said. He didn’t want the children to remember their mother as a drunk.
Couldn’t I remove the phrase “while intoxicated”? Did the autopsy report have to include toxicology results?
I said my report had to be honest and complete.
Jack was persistent. The kids don’t have to know, do they? You don’t have to give them the report or the death certificate, do you?
I said autopsy reports were public record in Florida. It would be unlawful to refuse a request.
Well, Jack said, why don’t I give them one before they ask? I’ll white out the part about drinking, and they’ll never know.
Stifling my amusement, I warned again that anyone requesting a report from my office would get one. If the reports were ever compared, he’d have some explaining to do.
A few weeks later, an insurance representative called. “The insured had a very high blood alcohol. Do you feel intoxication was contributory to her death?” the representative asked.
“Of course,” I said. The last page says “drowned in home pool while intoxicated.”
“My copy doesn’t say that,” the insurance rep said.
Jeri’s policy wouldn’t pay if drugs or alcohol caused or contributed to death. So Jack whited out “while intoxicated” on the death certificate and autopsy report. I don’t know if he didn’t see the decimal point or didn’t understand the decimal system. He whited out the “7” in the alcohol test result, leaving the report to read “.2 percent.” I guess he thought “2” looked better than “27.”
I thought Jack’s machinations were funny. The insurance company didn’t. Jack was charged with insurance fraud. Since he’d sent altered documents through the mail, he was also charged with mail fraud.
When I spoke with Jack many years ago, I never guessed his real motive was to defraud an insurance company. I’ve become less trusting.
So many people lie. The experience of being repeatedly deceived teaches medical examiners to doubt much of what families say:
“My daughter would never kill herself.”
“My husband doesn’t use drugs.”
“My baby fell off the sofa.”
In my profession, near-universal skepticism is sadly necessary.
Dr. Carol J. Huser, a forensic pathologist, served as La Plata County coroner from 2003-12. She now lives in Florida and Maryland. Email her at firstname.lastname@example.org.