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Session Laws

1992

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CHAPTER 368 AN ACT RELATIVE TO THE DELIVERY OF MEDICOLEGAL SERVICES IN THE COMMONWEALTH.

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:

SECTION 1. Chapter 6 of the General Laws is hereby amended by striking out section 184, as appearing in the 1990 Official Edition, and inserting in place thereof the following section:-

Section 184. There shall be in the executive office of public safety a commission on medicolegal investigation, hereinafter called the commission, to consist of the attorney general, the secretary of public safety, the commissioner of public health or their designees, and thirteen persons to be appointed by the governor, one of whom shall be the dean of a medical school in Massachusetts, one of whom shall be a representative of the Massachusetts Medico-Legal Society, two of whom shall be forensic pathologists certified in said field of specialization by the American Board of Pathology and who are members of the Massachusetts Society of Pathologists and who reside in the commonwealth, one of whom shall be a physician licensed to practice medicine in the commonwealth and who is a member of the Massachusetts Medical Society, one of whom shall be an attorney licensed to practice law in the commonwealth who is experienced in criminal defense, one of whom shall be a professor of law licensed to practice law in the commonwealth, one of whom shall be a funeral director licensed in the commonwealth, two of whom shall be district attorneys in the commonwealth, one of whom shall be a chief of police of a city or town in the commonwealth, and two representatives of the general public who reside in the commonwealth. Each appointed member of the commission shall serve for a term of three years, or until his successor is appointed and qualified, whichever is longer; provided, however, that no appointee shall serve more than two consecutive terms. The members shall serve without compensation, but shall be reimbursed for travel and other expenses actually and necessarily incurred in the discharge of their duties. The commission shall meet at least three times each year. The governor shall appoint a chairman, who shall serve in that capacity at the governor's pleasure. The commission shall elect a vice chairman annually. The chief medical examiner, appointed pursuant to section two of chapter thirty-eight, shall be secretary to the commission. Meetings may be called by the chairman, vice chairman, secretary, or any four members. A quorum for the transaction of business shall be nine members.

The commission shall adopt such rules and regulations as are necessary to effectively carry out the program of medicolegal investigation in the commonwealth under the provisions of chapter thirty-eight; establish qualifications for appointment of medical examiners, forensic pathologists, and all other professional and technical personnel necessary to perform the work of the office of the chief medical examiner; advise the chief medical examiner in the development of the annual budget of said office; and review and approve the comprehensive system for the delivery of medicolegal services in the commonwealth, and any modifications thereto, developed by the chief medical examiner.

SECTION 2. The General Laws are hereby further amended by striking out chapter 38 and inserting in place thereof the following chapter:-

`tuc CHAPTER 38. MEDICAL EXAMINERS AND INQUESTS.

Section 1. As used in this chapter, the following words shall, unless the context requires otherwise, have the following the following meanings:-

"Commission", to the commission on medicolegal investigation, established by section one hundred and eighty-four of chapter six.

"Office", the office of the chief medical examiner.

Section 2. There shall be an office of chief medical examiner under the supervision and control of the chief medical examiner, which shall be within the executive office of public safety. Costs and expenses of the office shall be paid by the commonwealth.

The chief medical examiner shall be a physician who is a diplomate of the American Board of Pathology in Forensic Pathology, a graduate of an approved fellowship program in forensic medicine, a diplomate of the American Board of Anatomic and Forensic Pathology and licensed to practice medicine in the commonwealth and must reside within the commonwealth within six months after his appointment. The chief medical examiner shall be appointed by the governor for a term of five years from among a list of not less than three nominees recommended by the commission on medicolegal investigation. The governor may request additional nominees from the commission before making the appointment. The chief medical examiner's salary and the salary of the deputy chief medical examiner shall be set by the governor and shall be commensurate with those of similar positions in comparable jurisdictions.

In the case of the death, removal, resignation or permanent incapacity of the chief medical examiner, the governor shall appoint a new chief medical examiner within six months.

The chief medical examiner, with the approval of the commission, shall establish a comprehensive system to deliver medicolegal investigative services in the commonwealth. The chief medical examiner shall appoint a deputy chief medical examiner who shall perform all of the duties of the chief medical examiner in case of incapacity or absence. The chief medical examiner may appoint such associate chief medical examiners as necessary.

The chief medical examiner may, subject to the approval of the secretary of public safety, apply for and accept on behalf of the commonwealth any funds, including grants, bequests, gifts or contributions, from any person for the improvement of the system of medicolegal investigative services in the commonwealth. Such funds shall be deposited in a separate account with the state treasurer and received by him on behalf of the commonwealth. All such funds may be expended by the chief medical examiner, in accordance with law.

District medical examiners shall be appointed by the chief medical examiner to conduct appropriate medicolegal investigations within the commonwealth. Such medical examiners shall serve in areas or districts as determined by the chief medical examiner and for terms of office at his discretion. Such medical examiners shall be responsible, under the direction of the chief medical examiner or the deputy medical examiner or an associate chief medical examiner, for the investigation and certification as to the cause of deaths under their jurisdiction. District medical examiners shall be licensed to practice medicine within the commonwealth and shall reside therein. In areas where such individuals are not available, the chief medical examiner or his representative may appoint other appropriately qualified individuals to conduct medicolegal investigations. Those medical examiners and associate medical examiners who are functioning under prior gubernatorial appointments will continue to do so for the remainder of their term in their present districts.

The office of the chief medical examiner shall have custody of all files, reports, photographs and other articles generated by all employees or vendors of the office.

The chief medical examiner, with the approval of the commission, shall promulgate rules providing for the disclosure of autopsy reports, which shall not be deemed to be public records, to those who are legally entitled to receive them. Said rules may also establish fees to be paid to the office for photocopies of records.

Section 3. It shall be the duty of any person having knowledge of a death which occurs under the circumstances enumerated in this paragraph immediately to notify the office of the chief medical examiner, or the medical examiner designated to the location where the death has occurred, of the known facts concerning the time, place, manner, circumstances and cause of such death:

(1) death where criminal violence appears to have taken place, regardless of the time interval between the incident and death, and regardless of whether such violence appears to have been the immediate cause of death, or a contributory factor thereto;

(2) death by accident or unintentional injury, regardless of time interval between the incident and death, and regardless of whether such injury appears to have been the immediate cause of death, or a contributory factor thereto;

(3) suicide, regardless of the time interval between the incident and death;

(4) death under suspicious or unusual circumstances;

(5) death following an unlawful abortion;

(6) death related to occupational illness or injury;

(7) death in custody, in any jail or correctional facility, or in any mental health or mental retardation institution;

(8) death where suspicion of abuse of a child, family or household member, elder person or disabled person exists;

(9) death due to poison or acute or chronic use of drugs or alcohol;

(10) skeletal remains;

(11) death associated with diagnostic or therapeutic procedures;

(12) sudden death when the decedent was in apparent good health;

(13) death within twenty-four hours of admission to a hospital or nursing home;

(14) death in any public or private conveyance;

(15) fetal death, as defined by section two hundred and two of chapter one hundred and eleven, where the period of gestation has been twenty weeks or more, or where fetal weight is three hundred and fifty grams or more;

(16) death of children under the age of two years from any cause;

(17) any person found dead;

(18) death in any emergency treatment facility, medical walk-in center, day care center, or under foster care; or

(19) deaths occurring under such other circumstances as the chief medical examiner shall prescribe in regulations promulgated pursuant to the provisions of chapter thirty A.

A physician, police officer, hospital administrator, licensed nurse, or licensed funeral director, within the commonwealth, who, having knowledge of such an unreported death, fails to notify the office of the chief medical examiner of such death shall be punished by a fine of not more than five hundred dollars. Such failure shall also be reported to the appropriate board of registration, where applicable.

Section 4. Upon notification of a death in the circumstances enumerated in section three, the chief medical examiner or his designee shall carefully inquire into the cause and circumstances of the death. If, as a result of such inquiry, the chief medical examiner or such designee is of the opinion that the death was due to violence or other unnatural means or to natural causes that require further investigation, he shall take jurisdiction. The body of the deceased shall not be moved, and the scene where the body is located shall not be disturbed, until either the medical examiner or the district attorney or his representative either arrives at the scene or gives directions as to what shall be done at the scene. In such cases of unnatural or suspicious death where the district attorney's office is to be notified, the medical examiner shall not disturb the body or the scene without permission from the district attorney or his representative.

The medical examiner shall be responsible for making arrangements for transport of the body. The district attorney or his law enforcement representative shall direct and control the investigation of the death and shall coordinate the investigation with the office of the chief medical examiner and the police department within whose jurisdiction the death occurred. Either the medical examiner or the district attorney in the jurisdiction where death occurred may order an autopsy. Cases requiring autopsy shall be subject to the jurisdiction of the office for such purpose. As part of his investigation, the chief medical examiner or his designee may, in his discretion, notwithstanding any other provision of law, cause the body to be tested by the department of public health for the presence of any virus, disease, infection, or syndrome which might pose a public health risk.

If the medical examiner is unable to respond and take charge of the body of the deceased in an expeditious manner, the chief of police of the city or town wherein the body lies, or his representative, may, after conferring with the appropriate district attorney, move the body to another location until a medical examiner is able to respond. Before moving the body the police shall document all facts relevant to the appearance, condition and position of the body and every fact and circumstance tending to show the cause and circumstances of death.

In carrying out the duties prescribed by this section, the chief medical examiner or his designee shall be entitled to review and receive copies of medical records, hospital records, or information which he deems relevant to establishing the cause and manner of death. No person or hospital shall be subject to liability of any nature for providing such records or information in good faith at the request of the office.

Section 5. All law enforcement officers, district medical examiners, hospitals and other medical facilities, and other state, county and local officials shall cooperate with the office of chief medical examiner in the investigation of medicolegal cases. The office of the chief medical examiner may use the services of the department of public safety laboratory for the performance of tests, documentation of evidence, investigating procedures and consultation on special problems. The chief medical examiner, subject to appropriation, may establish and operate a pathology laboratory within the office of chief medical examiner to meet the needs of that office. If other services required by the office of chief medical examiner are not available in the department of public safety laboratory, the chief medical examiner may employ the services of other appropriate laboratories.

Section 6. If skeletal remains are deemed likely to be Native American, the state archaeologist shall be informed and in turn shall notify the commission on Indian affairs, which shall cause a site evaluation to be made to determine if the place where said remains were found is a Native American burial site.

Section 7. If, during the course of investigation, the medical examiner is of the opinion that the death may have been caused by the act or negligence of another, he shall at once notify the district attorney within whose district the deceased was found or, if such act or negligence has occurred in a different district, the district attorney for such other district. He shall also make available to the district attorney any and all records pertaining to such investigation. He shall in all cases forthwith certify to the city or town clerk or registrar in the place where the deceased died, the name and address, if known, or otherwise a description as full as may be of the deceased, and the cause and manner of death. Notwithstanding any other provision of law, such certification may indicate that the death was caused by auto-immune deficiency syndrome, so-called.

In cases of homicide, after indictment and arraignment, and while the defendant is in custody or subject to the jurisdiction of the court, upon his request, a copy of the official autopsy report and a copy of the inquest report, if any, shall be made available to him by the district attorney in accordance with the provisions of the Massachusetts Rules of Criminal Procedure.

Section 8. The chief medical examiner or his designee may request the attorney general or the district attorney to direct that an inquest be held. The attorney general or district attorney may, regardless of whether or not action has been taken by the office of the chief medical examiner, require an inquest to be held in case of any death. The district court which has jurisdiction over the matter shall thereupon hold an inquest.

The court shall give seasonable notice of the time and place of the inquest to the department of public utilities, in any case of death by accident upon a public conveyance regulated by said department, and to the registry of motor vehicles in any case of death in which any motor vehicle is involved. Such notice shall also be given to any parent, spouse, or other member of the deceased's immediate family or to the deceased's legal representative or legal guardian.

Any person who has been identified by the attorney general or the district attorney, as the case may be, as the target of an investigation in connection with the death of the deceased may be present during the holding of such inquest and be represented by counsel, and may request leave of the court to present or examine witnesses, and shall at the completion of the court's report of said inquest have the right to examine said report; provided, however, that no indictment shall be dismissed nor shall any evidence be suppressed for violation of the provisions of this paragraph. All other persons not required by law to attend may be excluded from the inquest; provided, however, that the parents, guardian or next of kin of the person whose death is the subject of the inquest shall be deemed to be interested persons who may be present during the holding of such inquest. The court may order, as it deems appropriate, that witnesses to be examined during the inquest be sequestered.

Section 9. If the court determines that the inquest relates to an accidental death upon a conveyance regulated by the department of public utilities, the court shall cause a transcript of the inquest proceedings, after review and written approval by the court, and the bill for such transcript, to be forwarded to said department within thirty days after the closing of the inquest proceedings, and, when made, a copy of the court's report on the inquest.

Section 10. The court shall report in writing when, where, and by what means the person met his death, the person's name, if known, and all material circumstances attending the death, and the name, if known, of any person whose unlawful act or negligence appears to have contributed thereto. The court shall file its report and a transcript of the inquest proceedings in the superior court for the county in which the inquest is held. Said transcript shall be impounded until the district attorney files a certificate with the superior court indicating that he will not present the case to a grand jury, or files notice with the superior court that the grand jury has returned a true bill or a no bill after presentment by the district attorney.

Section 11. If a person charged by an inquest report with the commission of a crime is at large, the district court, upon the request of the district attorney, shall forthwith issue process for such person's arrest, returnable before any court or magistrate having jurisdiction.

Section 12. No embalming fluid, or any substitute therefor, shall be injected into the body of any person whose death is being investigated by the office until authorization from a representative of the office has first been obtained.

Section 13. After investigation or examination by the office, the body shall be released to the person with the proper legal authority to receive it, including the surviving spouse, the next of kin, or any friend of the deceased, who shall have priority in the order named. If the body is unidentified or unclaimed after the investigation is completed, the medical examiner shall release it to the department of public welfare, which shall bury it in accordance with section eighteen of chapter one hundred and seventeen. Prior to the release of such unidentified or unclaimed body to the department of public welfare, the chief medical examiner or his designee shall certify to the city or town clerk in the municipality where the death occurred the facts of the death as required by section nine of chapter forty-six. If further identifying information is developed, the chief medical examiner or his designee shall furnish a completed certificate of death, as required by said section nine, to the city or town clerk.

In cases where jurisdiction is declined by the office, medical examiners shall have no responsibility for the pronouncement or certification of death. Immediately after pronouncement of death, a physician licensed in the commonwealth who attended the decedent during the decedent's last illness, or his covering physician, or the licensed physician who has declared such person dead, or, if the death occurred in a hospital, a hospital medical officer duly authorized by the administrator, shall, in the order named, furnish for registration a standard certificate of death as required by said section nine. The chief medical examiner or his designee may allow any body to be moved without pronouncement if excessive hardship to the family of the decedent would otherwise result. The office may promulgate regulations further defining the circumstances in which a body may be moved without pronouncement of death. Any physician described herein who refuses to pronounce and certify death in accordance with said section nine of chapter forty-six when jurisdiction has been declined by the office shall be subject to a fine of not more than five hundred dollars. Such refusal shall also be reported to the board of registration in medicine. The chief medical examiner or his designee may waive the requirements of this paragraph and assume jurisdiction for the purpose of certifying the facts of the death as required by said section nine in cases where excessive hardship would otherwise result due to travel or in other emergency situations as may be defined by regulations promulgated by the office.

Section 14. A medical examiner shall, on payment of a fee of fifty dollars, view the body and make personal inquiry concerning the cause and manner of death of any person whose body is intended for cremation or burial at sea and shall authorize such cremation or burial at sea only when no further examination or judicial inquiry concerning such death is necessary. Said fee shall be paid by the person to whom such authorization for cremation or burial at sea is given.

Section 15. A medical examiner responding to the scene of a death shall take charge of any money or other personal property of the deceased found on or near the body, or may request the police department to do so. The medical examiner or police department shall, unless such money or property is required as evidence, deliver it to the person entitled to its custody or possession, or, if not claimed within sixty days, to a public administrator. A medical examiner or police officer who fraudulently refuses to deliver such property within ten days after demand or who converts such property to his own use shall be punished by a fine of not more than one thousand dollars or by imprisonment for not more than two years.

Approved January 12, 1993.