2000 Annual Review
Office of the Chief Medical Examiner
Introduction
The Office of the Chief Medical Examiner of the province of Alberta is responsible for the investigation and certification of all deaths by violence, as well as unexpected, unexplained and some unattended deaths, in accordance with the Fatality Inquiries Act and the Vital Statistics Act. Certain hospital deaths, notably maternal deaths, deaths that may be a direct or indirect result of anaesthesia, and deaths of patients certified under the Mental Health Act are included. Any death of a person in police custody or in jail, or of a child in the custody or guardianship of the government under the Child Welfare Act is also investigated. The area of jurisdiction is the province of Alberta, with a population of approximately 2.9 million.
The medical examiner system, under the direction of the Chief Medical Examiner, is managed from two regional offices - one located in Calgary and the other in Edmonton. The Chief Medical Examiner is based in Edmonton, while the Calgary office is under the direction of a Deputy Chief Medical Examiner. The Edmonton office administers the northern part of the province, and the Calgary office administers the geographical area south of a horizontal line between Jasper and Provost, through Hobbema. A histology laboratory is located in the Calgary office and a toxicology laboratory is located in Edmonton. Two Ph.D. chemists direct the toxicology laboratory. Office staff consists of medical investigators, forensic autopsy technicians, medico-legal record technicians, histology and toxicology technologists, administrators, photographers (including one photographer/radiology technologist), research officers, and secretaries. A medical investigator and medical examiner are available at all times for investigations and consultations in the Calgary and Edmonton regional offices. Autopsies and examinations are performed in these offices on weekdays.
Approximately 50 per cent of all medical examiner cases are investigated and certified by the four full-time medical examiner/forensic pathologists in Calgary and Edmonton. One hundred eighty part-time fee-for-service medical examiners, located throughout the province, investigate the remaining cases with the assistance of the RCMP, municipal police forces, and hospital-based pathologists. Their continuing support and willingness to perform this valuable service has made it possible to maintain a high quality province-wide system. Reports developed by the medical examiner in each case contain information on the cause, manner, and circumstances surrounding the death.
The Fatality Review Board subsequently looks at a proportion of the cases investigated by the Medical Examiner's Office (primarily accidental deaths). The board consists of a physician, a lawyer, a member of the public, and the Chief Medical Examiner (a non-voting member). The board's role is to recommend to the Minister of Justice and Attorney General which cases should go to a public fatality inquiry. All deaths of certified patients under the Mental Health Act, children in the custody or guardianship of the government under the Child Welfare Act, and individuals in custody or jail automatically go to public fatality inquiry unless the death was due entirely to natural causes, was not preventable, and the Fatality Review Board feels that the public interest would not be served by an inquiry. A public fatality inquiry is held before a Provincial Court judge and is primarily intended to make the circumstances surrounding a death public. The judge cannot make any legal findings of blame or responsibility for the death, but may make recommendations for the prevention of similar deaths in the future.
The Office of the Chief Medical Examiner in Alberta started the medical investigator program in Canada, and was the first system anywhere to recruit persons with exclusively medical training (largely nurses) to fill the role of investigator. The idea has received support in the United States. The Office of the Chief Medical Examiner in Alberta is the only death investigation agency in Canada to be accredited by the National Association of Medical Examiners, an American-based organization whose standards for medical examiner/coroner systems and facilities are high and unique.
The office is associated with the universities of Calgary and Alberta and provides training to students and professionals in various health and law related disciplines.
In 2000, a total of 5,291 deaths were reported to a medical examiner. This represents approximately one third of all deaths in Alberta during that year. Investigations were conducted into 2,903 deaths.