Valerie Rao was shocked when she became the medical examiner for Boone and Callaway Counties. The medical examiner’s office wasn’t conducting autopsies after every death that was not of natural causes.
“I came here and my eyeballs nearly came out of my head,” Rao said. “They’re medical examiner’s cases. That’s my understanding of the law.”
Rao considers it standard medical practice to perform a postmortem examination to determine the cause of death on every body delivered to her office. As a result, since she became medical examiner on March 1, the number of autopsies conducted by her department has risen significantly.
The medical examiner’s office has already exceeded the amount allotted for it in the county’s 2004 budget, which anticipated about 70 autopsies costing about $300 each.. Rao attributes that to professional standards she has adhered to in a career that has spanned from Madras, India, to Miami.
“It’s not about big city or little city,” Rao said. “If I’m prepared to do the hard work, then that’s the work that needs to be done.”
The increase in the number of autopsies had prompted Fountain Enterprises, whose building at 5609 St. Charles Road has been used as the medical examiner’s office since 1997, to charge the county an additional fee. Early last month, the Boone County Commission authorized a change in the contract with Fountain Enterprises to allow MU to assume responsibility for facilities.
Boone County Auditor June Pitchford said the new contract with MU, which became effective Aug. 1, pays a flat fee for autopsy services.
“The approach that (Fountain Enterprises) used factored in overhead, property taxes and utilities, among other things,” Pitchford said.
The county will begin discussing its 2005 budget next week. Boone County Northern District Commissioner Skip Elkin said commissioners won’t be inclined to withhold the funds Rao needs for autopsies.
“We don’t dictate how the medical examiner performs his or her functions,” Elkin said.
Ed Adelstein, the deputy medical examiner, said Rao’s standards reflect how the profession of medical examiner has changed in recent years.
“Under the current litigious environment, we’re raising the number of autopsies,” Adelstein said. “(Rao) comes from an environment where there are extremely clever defense lawyers.”
Rao said the autopsies should be conducted on every person who does not die of natural causes. She gave the example of a presumed suicide of a pregnant woman in Texas who was found hanged in her apartment. Without conducting an autopsy, officials labeled her death a suicide. Later, her boyfriend confessed to murdering her.
“Think of that woman’s family,” Rao said. “Without the autopsy, her family thought she killed herself.”