45 percent increase in Allegheny County overdose deaths strains medical examiner

The Allegheny County Medical Examiner’s office is receiving so many overdose cases that pathologists no longer complete full autopsies on every suspected overdose, Medical Examiner Karl Williams said Friday.

If a person dies under circumstances that point to an “obvious overdose,” the medical examiner’s office may simply do an external examination, screen the body’s urine for drugs and then draw blood to be sent for testing, Dr. Williams said.

“The gold standard, in a way, is to say you should do a complete autopsy even on obvious overdoses,” he said. “We have to stretch that a little bit.”

The pathologists consider whether the deceased had a history of drug abuse, whether investigators found stamp bags or needles at the scene, and whether the urine screen comes back positive for drugs as they decide whether a full autopsy is necessary, Dr. Williams said.

If it’s not, they’ll sign off on the death as an overdose but will still

draw blood to be sent for toxicology. That testing process typically takes a couple of weeks but can prove whether a person actually did die from an overdose.

“We’re almost never wrong,” Dr. Williams said. “But very rarely, with a 38year-old guy with the drug history and syringes at the scene, we could find something else. And then you’re stuck with not being able to know why [the person died]. So you’re sort of playing the odds game.”

It’s not unusual for the medical examiner’s office to conduct seven to 10 autopsies each day, Dr. Williams said. The office performed about 1,400 autopsies in 2016, up from 1,100 in 2014, he said.

Much of that increase is driven by overdose deaths in Allegheny County. The number of overdose deaths jumped by 45 percent in 2016 compared with 2015, according to data released by the medical examiner on Thursday.

In 2016, 613 people died from overdoses in the county compared with 424 in 2015, according to the medical examiner’s office.

During the last year, prosecutors and police have begun to treat each overdose case as a potential homicide until “otherwise indicated,” said Mike Manko, spokesman for the Allegheny County District Attorney’s office.

“This has also involved training municipal police officers in how to document a fatal overdose scene and how to preserve potential evidence,” he wrote in an email. “We are very comfortable with whatever policies and procedures Dr. Williams and his staff have in place to deal with the increase in fatal overdoses, and by using the protocols we have developed, we hope to be able to target more drug dealers and suppliers, and in turn reduce the alarming number of fatal overdoses.”