Frequently Asked Questions of the

HAMILTON COUNTY Medical Examiner Office

(Page created in MS Word 6-24-2003, and updated as readers write in)

 

Back to Medical Examiner main page

 

 

This page has been set up for general public consumption and is suitable for all readers.  Its purpose is to address some of the questions about death and the process of what happens to the body after death.  Every effort has been made to reflect the current laws of Tennessee regarding handling of the dead and related post-mortem affairs, however, if you find any errors or any omitted items, or you would just like to add your own question to our list, please email the Medical Examiner's office.

 

It is not the place of a government entity to recommend or deny the services offered by private businesses, such as funeral homes, but it is within a government entity’s obligation to impartially make sure that citizens are aware of laws surrounding private business activity.  This FAQ page only addresses the handling of bodies in Tennessee, specifically Hamilton County, not our neighboring states of Georgia or Alabama (click on each for their contact information).

 

There are many references in this section to Tennessee state law, called Tennessee Code Annotated, or TCA.  References are provided in each section, but the reader is encouraged to visit LexisNexis to directly view the state laws (choose the “Tennessee” jurisdiction under the “Legal Resources” pull-down menu).  These references and LexisNexis® are not intended to replace appropriate professional legal advice; consult a lawyer knowledgeable in these issues  for accurate and up-to-date TCA information.  It is up to each and every Tennessean to be familiar with our state’s laws.

 

Click on any of the hyperlinks below to jump to that answer, or just simply browse the document.

 

1:  Why does the Medical Examiner Office have to become involved in a death?

2:  What if a death occurring in a licensed health care facility is suspicious, unusual or unexpected?

3:  Can we move the body?

4:  Is the Medical Examiner Office associated with law enforcement and do they have law enforcement powers?

5:  What do I do if a family member dies at home?

6:  Does a doctor have to “pronounce” someone dead?

7:  Am I required by Tennessee law to use a funeral home?

8:  Can I bury my family member on my private property?

9:  Are cemeteries on private property exempt from property taxes?

10:  Can I remove a cemetery from my private property?

11:  Can we move a body within our family cemetery or to a new location?  Do I need a disinterment/ reinterment permit?

12:  What is a transit permit?

13:  If I bury my loved one on my private property, am I required to have a vault and coffin?

14:  Is embalming required by Tennessee law?

15:  Should I have my loved one embalmed?

16:  Is cremation required in Tennessee?

17:  I was told that even though I chose cremation for my loved one that I would still have to purchase a casket.  Is this true?

18:  If we choose to bury our family member on our own private property, do we need to go to a funeral home to purchase a casket?

19:  Does a funeral home have to notify anyone that they are going to perform a cremation (or send the body to a licensed crematory)?

20:  What about a Tennessee death certificate?

21:  Does Tennessee have Coroners or Medical Examiners?

22:  Can I donate my loved one to science and how much does it cost?

23:  Are reports or photographs produced by the Medical Examiner Office available to the public and/or families, and how much do the reports cost?

24:  Why does it take so long to get an autopsy report/death certificate completed?

25:  Does your office have a training program or can I watch an autopsy?

26:  Do I need a burial permit if I want to bury my loved one on my private property?

27:  How much does an autopsy cost?

28:  Can my loved be an organ donor even if the body was taken to the Medical Examiner Office?

29:  Can the Medical Examiner Office subpoena medical records from hospitals and private physicians?  Do the new HIPPA laws apply to the Medical Examiner Office?

30:  Regarding funeral homes, what is a “General Price List" and how can I obtain a copy?

31:  What is a “direct cremation?”

32:  What is the Tennessee “Abuse of Corpse” law?

33. Does the Federal Trade Commission provide consumer information about funerals?

 

 

 

 

 

 

Q:  Why does the Medical Examiner Office have to become involved in a death?

 

A:  Tennessee law, or the Tennessee Code Annotated (TCA) 38-7-108(a)(1), “Death under suspicious, unusual or unnatural circumstances,” states,

 

“Any physician, undertaker, law enforcement officer, or other person having knowledge of the death of any person from sudden violence or by casualty or by suicide, or suddenly when in apparent health, or when found dead, or in prison, or in any suspicious, unusual, or unnatural manner, or where the body is to be cremated shall immediately notify the county medical examiner or the district attorney general, the local police, or the county sheriff, who in turn shall notify the county medical examiner.”  Deaths in licensed health care facilities (e.g., hospitals or nursing homes) need not be reported unless there are suspicious, unusual or unexpected circumstances.

 

Return to Top

 

Q:  What if a death occurring in a licensed health care facility is suspicious, unusual or unexpected?

 

A:  TCA 38-7-108(a)(2) states,

 

“In the event such death occurs in a suspicious, unusual, or unexpected manner in a hospital, outpatient facility, nursing home, treatment resource, clinic, or other health care facility, the facility shall immediately notify the county medical examiner of the occurrence of such death. In addition to any other penalties provided elsewhere for violation of the provisions of this part, failure of the health care facility to make the report required by the provisions of the preceding sentence shall be deemed to constitute a violation of the licensure provisions of title 68, chapter 11, part 2, and shall subject the institution to the penalties provided for in § 68-11-207.” 

 

NOTE:  Part (a)(2) above states that the “facility” is required to report the suspicious death, however, if the “family” feels that the death warrants investigation, then they should contact the District Attorney’s Office or law enforcement for investigative action. 

 

Return to Top 

 

Q:  Can we move the body?

 

A:  As a general rule no, but there are extenuating circumstances.  TCA 38-7-108(b) states,

 

“Whenever a death occurs under the circumstances as set forth in this chapter, the body shall not be removed from its position or location without authorization by the county medical examiner, except to preserve the body from loss or destruction or to maintain the flow of traffic on a highway, railroad, or airport. No body subject to post-mortem examination as provided by this chapter shall be embalmed without authorization by the county medical examiner.” 

 

      If you discover an unresponsive individual, it is understandable and natural human reaction to roll them over or reposition them to determine if they are alive or dead.  As long as you confine your movement of the body to these minor adjustments, you will not be held responsible for tampering with scene evidence. 

 

Return to Top 

 

Q:  Is the Medical Examiner Office associated with law enforcement and do they have law enforcement powers?

 

A:  No.  In Tennessee, the Medical Examiner System is organized under the Commission of Public Health.  The reason the Medical Examiner Office is organized under Public Health is because suspicious, unusual, or unnatural deaths may be the first sign or symptom of a public health threat that could affect us all.  A second reason that the Medical Examiner System is separate from law enforcement is to insure an independent medical investigation. The majority of cases investigated by the Medical Examiner Office are deaths occurring from natural disease processes, the most common being heart disease.  Accidents, suicides, and homicides collectively make up only about 5-10% of the cases investigated.  The Hamilton County Medical Examiner Office is not funded sufficiently to have an independent death scene investigation team.  We respond to scenes to assist law enforcement only at their request. 

 

Return to Top 

 

Q:  What do I do if a family member dies at home?

 

A:  If a death occurs at home, despite it seeming natural to die at home, the County Medical Examiner office and local law enforcement must be notified to investigate the circumstances of the death (unless the death occurs under Hospice care at home).  Law enforcement must go to the home to insure that no foul play or trauma is involved, and that a physician or County Medical Examiner will be available to complete a Tennessee death certificate.  If you call a funeral home directly, they will (or should by law) insure that the County Medical Examiner and local law enforcement have been notified before they remove the body.  This protocol must be followed even if the death is an apparently natural death at home. 

 

Return to Top 

 

Q:  Does a doctor have to “pronounce” someone dead?

 

A:  No.  There is no law in Tennessee stating that a doctor must “pronounce,” or attend the death of someone.  Tennessee allows this pronouncement to be made by anyone recognizing that a death has occurred.  In other words, the body of the deceased does not have to go to an emergency room to be pronounced dead.  Following this pronouncement you are required by law to report the death in accordance with the information in Question #1 above.

 

Return to Top 

 

Q:  Am I required by Tennessee law to use a funeral home?

 

A:  No.  There is no law in the State of Tennessee saying that a funeral home must be involved in handling the body of a deceased family member.  Any family has the right to pick up a body at a hospital or a medical examiner office, transport the body in their own private vehicle, and bury the body on their own private property. 

 

Tennessee law, or the Tennessee Code Annotated (T.C.A.) 62-5-102 states,

 

“Nothing herein shall be constituted to prevent or interfere with the ceremonies, customs, religious rites, or religion of any people, denomination, or sect, or to prevent or interfere with any religious denomination, sect, any body composed of persons of a denomination, or to prevent or interfere with any church or synagogue from having its committee or committees prepare human bodies for burial or to the families, friends or neighbors of deceased persons who prepare and bury their dead without charge. 

 

Tennessee state law has never taken away a family’s right to bury their own, but modern science and a better understanding of biohazard issues has made it clear that these are not the same times our ancestors lived in 150 years ago.  Whether the services of a funeral home are used or other alternative arrangements are made is purely a personal decision by the family.  You have the right to handle the body and burial affairs of your loved ones, however, serious consideration should be given to this decision because you may not be able to get help in the middle of the process if you become overwhelmed.  See Question #32 for Tennessee’s “Abuse of corpse” law.

 

If you do decide to handle all the post-mortem affairs of your loved one, and then you fail to do so in an appropriate and timely manner within the law, you may be charged with a felony as prescribed by TCA 39-17-312, “Abuse of corpse,” (see Question #32)

 

Return to Top 

 

Q:  Can I bury my family member on my private property? 

 

A:  Yes.  Tennessee has no law preventing anyone from burying their family member on their own private property.  The Zoning Office in the city or county in which the family plans to bury the body should be consulted to find out if any restrictions exist in the proposed burial location.  If no prohibitive zoning ordinances exist, then private property can be used to bury the body.  Hamilton County residents should contact the Hamilton County Building and Zoning Office, 1020 Development Resource Center, 1250 Market Street, Chattanooga, TN, 37402, telephone (423) 209-7860, to see if any restrictions may apply in the area the family proposes to start a family cemetery. 

 

      Please see Question #26 for information regarding burial permits.

 

Return to Top 

 

Q:  Are cemeteries on private property exempt from property taxes?

 

A:  They can be.  In choosing to bury on your private property, you essentially are creating (or adding to) a family cemetery.  If a family creates a family cemetery on their property, they must then have their property deed and plat map legally changed to truthfully and explicitly show the existence and location of the cemetery.  This will require the services of a registered land surveyor.  The measured amount of land used for cemetery purposes on private property is exempt from the computation of property taxes.  An application for the cemetery land exemption can be picked up at the Hamilton County Assessor of Property Office, 6135 Heritage Park Drive, Chattanooga, TN, 37416, telephone (423) 209-7300.  The application will have to be approved by the State of Tennessee.  Cemetery land must be visually inspected and measured by the County Tax Assessors Office to become eligible for property tax exemption, following approval by the State.  The knowledge and location of the cemetery must be made known to any future property owners.  Any future property owners must allow a public access easement across their property to the cemetery- in perpetuity.

 

Return to Top 

 

Q:  Can I remove a cemetery from my private property?

 

A:  Yes.  Property owners in Tennessee have the right to petition the court to have any cemetery removed and relocated, however, all costs for removal, transportation of coffins and human remains, and any monuments, the re-erection of such monuments, and reburial of the remains at a different location must be borne by the petitioning property owner.  The consanguineous (blood) relatives of those buried in the cemetery have the right to oppose the relocation in court (see the next question below).  Before relocating an entire cemetery from your private property, and before the disinterment permit can be obtained, you must petition the Chancery County of that county to have the land terminated as a cemetery.  This will be granted if the next-of-kin does not object in court, and if the criteria in TCA 46-4-101 are met.  Once the judge approves the termination order, you may then apply for the disinterment permit in accordance with the above. 

 

A County Vital Records Office can issue only one disinterment/reinterment permit for a single grave that is located within that County.  The disinterment/reinterment permit for more than one burial, part of a cemetery, or a whole cemetery must be issued by the State Registrar’s Office in Nashville, TN (615-741-1763).  See Question #11 for permits required and advice on who should move a cemetery.

 

If you have a cemetery on your property, you have legal obligations to protect that cemetery, whether it is your family’s cemetery or not.  You must also allow anyone to cross your property to access that cemetery.  TCA 46-8-103, “Duty to protect graves or crypt - Disturbances prohibited - Transfer of remains,” reads,

  

 (a)  A deed for real property which indicates the presence of a gravesite or crypt containing human remains on the property conveyed obligates the immediate and future buyer or buyers of the property to protect such gravesite or crypt from disturbance. The owner of real property has the responsibility for taking appropriate action, prior to conveying such property, to ensure that the deed reflects the presence of the gravesite or crypt on such property. 

 

 (b)  Real property which has a deed that reflects the presence of human remains on the property is protected from disturbance or development as follows: 

 

 (1) A gravesite may not be disturbed in the area of ten feet (10') surrounding the perimeter of the gravesite; and 

 

 (2) A crypt may not be disturbed in the area of five feet (5') surrounding the perimeter of the crypt. 

 

 (c)  The owner of real property which has a deed that reflects the presence of human remains on the property has the option of transferring the remains, at the owner's expense, pursuant to the procedure for termination of use as a cemetery in chapter 4 of this title. Upon complete transfer of all human remains from such property which are properly described on the deed, the buyer has the right to the use of the area previously containing the remains as is consistent for the remainder of the property. 

 

Return to Top 

 

Q:  Can we move a body within our family cemetery or to a new location?  Do I need a disinterment/ reinterment permit?

 

A:  Yes and yes.  If at any time the family wishes to relocate the body within the family cemetery or move the body to another cemetery, Tennessee law requires that a disinterment/reinterment permit must be obtained from the County Health Department or the State Registrar’s Office in Nashville. 

 

TCA 68-3-508 authorizes disinterment/reinterment to move cemeteries, parts of cemeteries, or to re-unite families.  No court order is needed, unless (per the Hamilton County Vital Records Office) the disinterred body is to be relocated out-of-state to a cemetery in which no pre-existing family member is buried.

 

TCA 38-1-104 and 38-7-107 authorize disinterment to be ordered by the court/district attorney in certain cases where criminal circumstances surrounding a death are suspected.  Court order is needed.

 

TCA 68-4-110 empowers the department of health to prepare suitable regulations governing the disinterment of dead bodies for the protection of public health. 

 

A family (or real property owner) has several choices for disinterring the body once the proper permits are obtained: 

 

A) they can do it themselves, since they interred their loved one in the first place;

 

B) if the coffin is still intact and the burial is a recent one, a funeral home can be contracted to assist in the removal and reburial by providing heavy equipment for the digging and transportation to the new cemetery; 

 

C) if the burial is old or historic and the coffin is most likely degraded and collapsed, the family might want to seek the services of a qualified archaeologist.  The “ole pine boxes” last only a few decades in the acidic East Tennessee soil, leaving behind any handles, nails, and placards.  These items can be used to date when a body was originally interred. The archaeologist should carefully excavate the remains and produce a written report of their findings.  Most archaeologists allow and even encourage family members to participate in the excavation, which gives the family a sense of connection to their historical past.  The written report is usually of great genealogical importance to the family.  Excavating old or historic burials with heavy equipment can result in the loss, destruction, or incomplete recovery of the body and any sentimental grave goods originally buried with the individual.  You may contact Tom Bodkin at the Hamilton County Medical Examiner Office (423-493-5175) or the Division of Archaeology in Nashville (615-741-1588, leave a message) to be given a list of contract archaeologists operating in Tennessee.

 

Return to Top 

 

Q:  What is a transit permit?

 

A:  If the body is to be transported across state lines, whether by a funeral home or privately by a family, a transit permit may be required by the receiving state.  Transit permits are not necessary if moving a body within in the State.  Some embalming restrictions may apply to inter-state transportation.  Consult the County Health Department’s Vital Records Division for these restrictions and other information about transit permits.  See also Question #26 about burial permits.

 

Return to Top 

 

Q:  If I bury my loved one on my private property, am I required to have a vault and coffin?

 

A:  No.  You may bury the body directly into the ground without vault or casket.  You also have the right to erect an above-ground chamber, room, or platform.  In choosing to bury your loved one on your private property, you should consider several things-  the body should be buried deep enough to prevent erosion of soil and exposure of the body, and to prevent scavenging animals from unearthing the grave.  Above-ground burials are also easily accessed by scavenging animals and birds.  For-profit cemeteries, on the other hand, have the right to require that a vault and casket be used on their grounds. 

 

 There is a special law regarding the burial of children under 12 years of age.  TCA 68-4-112, “Rigid containers not mandatory for remains of certain children,” states,

 

“A rigid receptacle or rigid container shall not be a mandatory requirement for the burial, entombment, or other final disposition of the remains of a person who was not more than twelve (12) years of age at the time of death.”

 

      Consult the cemetery or a lawyer to see if this “under-12” law applies to for-profit cemeteries.

 

Return to Top 

 

Q:  Is embalming required by Tennessee law?

 

A:  No.  This is a service provided by funeral homes.  Embalmers, whether they work privately or are employees of funeral homes are required by the State to have a license to perform this service.  You may ask a funeral home or private embalmer to produce their license upon request.

 

Return to Top 

 

Q:  Should I have my loved one embalmed?

 

A: Embalming on a large scale in the U.S. started by request of President Abraham Lincoln during the Civil War.  Not only was the War unpopular in the North, but many families were further outraged that the bodies of their fallen loved ones were badly decomposed, if not unrecognizable, by the time they reached their hometowns.  It took several weeks for bodies to be sorted and collected from battlefields in the South, and transported by trains to the North in hot boxcars.  Battlefield deaths soon were being embalmed almost on the spot in field hospitals.  The practice of preserving the body until family could gather, or for transporting the body long distances, has stuck with us ever since. 

 

      Although embalming is not required by law, a funeral home- as a private business entity- has the prerogative to require embalming if there is a delay in either making arrangements or if the family must wait any significant amount of time for other family members to arrive in town.  A “significant amount of time” takes into consideration the post-mortem changes that all bodies undergo (like the Civil War casualties in the pre-refrigeration days), and the fact that not all funeral homes in the Hamilton County/Chattanooga area offer cold storage.

 

Embalming can also be a way of reducing any potentially communicable biohazards or diseases.  Furthermore, although a family is not required to use a funeral home, they may seek the services of a licensed embalmer so that visitation can be held at the family’s home over a period of several days.  This would eliminate undesirable post-mortem changes of the body and reduce the potential of any communicable diseases. 

 

Embalming may be required for inter-state transportation of bodies.  Tennessee law does not require embalming if the body is being transported within Tennessee.

 

The Hamilton County Medical Examiner Office does not offer any embalming services. 

 

TECHNICAL NOTE:  Bodies are embalmed with formaldehyde, a chemical that has been classified by the American Conference of Governmental Industrial Hygienists (ACGIH) as a “Suspected Human Carcinogen” (http://www.meridianeng.com/formalde.html, accessed 6-23-2003).  Formaldehyde is an organo-hydrocarbon molecule (CH2O).  If you are concerned about burying an embalmed body you should know that this organic molecule is water soluble and is combustible. A complete cremation theoretically should combust all of the available formaldehyde and therefore should not pose an environmental threat.  It does not persist in the atmosphere for very long, or very far from the source (e.g., a crematory stack), because it is quickly oxidized (degraded) by sunlight. 

 

Return to Top 

 

Q:  Is cremation required in Tennessee?

 

A:  No.  As with embalming, cremation is only an option.  However, TCA 62-5-107 does require that,

 

(a)  A funeral director shall utilize the services only of licensed crematory facilities. 

 

(b)  If a funeral director utilizes the services of a crematory outside of Tennessee, the crematory must be a licensed facility of the state in which such crematory is located.

 

      We know of no successful attempts to extract DNA from cremated remains (cremains) due to the extreme heat (approximately 1400 degrees Fahrenheit).  If you would like to keep the DNA of a loved one, have a blood sample drawn and refrigerated, or pluck a few head hairs (you need the cells of the follicle attached to the hair shaft) and freeze them.

 

Return to Top 

 

Q:  I was told that even though I chose cremation for my loved one that I would still have to purchase a casket.  Is this true?

 

A:  No.  TCA 62-5-512 “Cremation without a casket” states,  

 

“No operator of a crematory facility shall require a person to be cremated in a casket; provided, that in the discretion of the operator of a crematory facility, a container composed of readily combustible materials that is suitable for cremation, other than a casket, may be required.”

 

Crematories usually require that the body be placed into a combustible container.  The construction of this container may vary, but is usually a particle board/cardboard box that allows the body to more easily slide into the retort.   The retort is the cremation chamber.  Metal caskets are not combustible and cannot be loaded into a retort.

 

For-profit cemeteries can and usually do require an “urn vault” for cremation urns.  The Chattanooga National Cemetery does not require such a vault for cremation urns.

 

Return to Top 

 

Q:  If we choose to bury our family member on our own private property, do we need to go to a funeral home to purchase a casket?

 

A:  No.  As a reminder, there is no law even requiring that a casket or vault be used.  However, if you so choose, Tennessee has recently passed legislation stating that businesses other than funeral homes can sell caskets to the general public.  

 

Return to Top 

 

Q:  Does a funeral home have to notify anyone that they are going to perform a cremation (or send the body to a licensed crematory)?

 

A:  Yes.  Prior to cremation, the County Medical Examiner of the county in which the death occurred by law must be notified of any and all cremations.  Also, TCA 62-5-513 “Delay of cremation,” states,

 

“If a person who signs the death certificate, a district attorney general or any law enforcement officer, or an emergency medical or rescue worker, emergency medical technician or paramedic who attended the person immediately prior to or after such person's death, signs a written statement requesting the delay of a cremation based upon a reasonable belief that the cause of death may have been due to other than accidental or natural causes, then the cremation of a dead human body shall be delayed based upon such request.”

 

      Tennessee law does not require a body to be embalmed prior to cremation. 

 

Return to Top 

 

Q:  What about a Tennessee death certificate?

 

A:  Whether your family handles all the arrangements and the burial or they elect a funeral home to do so, a Tennessee death certificate must still be filed with the Vital Records Division of the Health Department.  This is the only place you can get a certified copy- not from the Medical Examiner or from the decedent’s physician.  A death certificate is only official if it has been signed by a physician licensed to practice medicine in Tennessee (either an M.D. or a D.O.), and certified by the Health Department.  A signed and certified death certificate is usually required to close out the legal affairs of the deceased individual.  For Hamilton County residents, Vital Records can be reached at Chattanooga-Hamilton County Health Department, 921 East Third Street, Room 107, Chattanooga, TN, 37403, telephone (423) 209-8025.  Currently, certified copies of a death certificate are $7 each.

 

      Contact information and other archiving details for all Tennessee County Vital Records Offices may be viewed at http://www.vitalrec.com/tn.html.

 

Return to Top 

 

Q:  Does Tennessee have Coroners or Medical Examiners?

 

A:  Medical Examiners.  Each County Commission in Tennessee appoints a County Medical Examiner, unlike Coroners in other states who are elected for a term.  Georgia, for example, uses a mixed system in that individual counties have coroners who carryout initial investigations, but must send the body to a pathologist for an autopsy (e.g., to Atlanta).  County Medical Examiners in Tennessee must be a licensed Medical Doctor (M.D.) or Doctor of Osteopathy (D.O.).  A Coroner can be of any background or training, for example, the county sheriff, a funeral home director, or almost any other person can be the County Coroner.  Although Tennessee requires the County Medical Examiner to be a physician, they do not have to be a Forensic Pathologist.  The larger, more populated counties in Tennessee have their own Forensic Pathologists, and Hamilton County has two.  The County Medical Examiners in Tennessee’s smaller, less populated counties send the body to Forensic Pathologists in the larger cities for autopsy. 

 

      The Hamilton County Commission eliminated the Office of Coroner in 1978.  The County Medical Examiner does not have special authority to arrest the sheriff.

 

Return to Top 

 

Q:  Can I donate my loved one to science and how much does it cost?

 

A:  Yes and it is free.  Many families inquire about scientific donation as an alternative to traditional burials, usually due to financial reasons.  Tennessee law 68-4 allows institutions to receive donations for scientific study.  The Hamilton County Medical Examiner Office accepts donations of any age, sex, or race.  Currently, the Hamilton County Medical Examiner Office has about 60 skeletons that are used for research, teaching, and comparative purposes.  Skeletal donation usually gives families a peace of mind that their loved one will contribute to society long after their passing.

 

      People think that once the organs are harvested for transplantation, the remainder of the body can no longer be used.  This is not true.  But whether organs are harvested or not, the skeleton of the individual is a very valuable resource for forensic study.  Any family wishing to donate to the Hamilton County Medical Examiner Office needs only to fill out a single form and have it notarized (call us at 423-493-5175).  This can be done after Tennessee Donor Services has finished collection.  The skeleton will then be curated in perpetuity in Hamilton County in a secure, climate controlled building.  The University of Tennessee at Knoxville, Department of Anthropology also accepts skeletal donations, as does the Smithsonian Institution Anthropology Department in Washington, D.C.

 

Return to Top 

 

Q:  Are reports or photographs produced by the Medical Examiner Office available to the public and/or families, and how much do the reports cost?

 

A:  Yes and no.  In Tennessee, Medical Examiner Offices produce 3 public reports that anyone can get provided they pay the state mandated fees.  TCA 38-7-110 governs what documents are public and the cost of each document.  The 3 public documents are given free of charge to families of the decedent, law enforcement, public defender, criminal defense attorneys, district attorneys, and physicians and medical facilities (this list may vary by county in Tennessee).  The 3 documents are:

 

      1)  Report of Investigation by County Medical Examiner – this document is a one page, double-sided form that has basic information about the decedent and states his or her Cause of Death and Manner of Death.  Many families ask that the report be withheld from the public, but unfortunately we are not authorized to withhold this document from anyone or the media.  A recent Tennessee ruling allows law enforcement agencies to seal a medical examiner’s file only if they can demonstrate to the court that the information therein will jeopardize their investigation (refer to TCA 38-7-110(d).  Cost:  $5.

 

      2)  Toxicology Report – this is a report about the toxins, drugs, and/or alcohol in a person’s system at the time of death.  The sample (e.g., blood) is collected during the post-mortem examination.  Depending on the case, such as an apparent natural death, a toxicology analysis (and report) may not be performed due to budget constraints (a single case can cost the Hamilton County tax-payers $800!).  Many insurance companies will not pay out claims unless this report is submitted.  Insurance companies must also pay for any public documents.  Cost:  $5. 

 

      3)  Autopsy Report – this is a multi-page document describing the anatomical findings resulting from an autopsy.  Not every “body” that comes under the medical examiner’s jurisdiction warrants an autopsy, so depending on the case, this document may or may not be produced.  Cost:  $15.  Cost of all 3 reports:  $25.

 

      Photographs, x-rays, and histology sections/microscopic slides are necessary parts to any medicolegal investigation but are not public documents.  There are many special circumstances about the availability of this type of evidence; inquire within about your particular case. 

 

Return to Top 

 

Q:  Why does it take so long to get an autopsy report/death certificate completed?

 

A:  Many families are surprised (and angered) to find out that an autopsy report will not be ready for anywhere between 3 and 14 months.  The actual autopsy may only take a few hours, but the report is comprised of information that may take months to get back.  One example is the toxicology report.  There are no forensically accredited toxicology laboratories in the Hamilton County-Chattanooga area, and therefore all samples must be sent out.  The Tennessee Bureau of Investigation (TBI) Crime Lab in Nashville is frequently utilized in criminal cases and typically has the longest turn-around time, but at no direct cost to Hamilton County taxpayers.  To speed things up in the interest of families, we try to send some cases to private labs, which decreases the turn-around time but can cost Hamilton County taxpayers up to $800/case.  Other tests that must be sent out and contribute to the delay are genetic tests on infant deaths, histology (tissue sections taken at autopsy that must be made into microscope slides), and other samples sent to various experts around the country.

 

      Despite the delay we try to produce the highest quality information possible by utilizing some of the best labs in the country, and this simply cannot be rushed.

 

      Even though the autopsy report may be months in the making, we try to make the Report of Investigation by County Medical Examiner document (see previous question) available within a day or two of the death, however, it too is sometimes delayed pending laboratory tests.

 

      Death certificates are usually filed within a week of the death so that families can use this document to close out the legal affairs of the decedent.  However, in some complicated cases where lab reports are pending, the Cause of Death box on the death certificate may read “Cause of Death Pending Investigation.”  We will file a Delayed Report of Diagnosis – Death form with Vital Records when all the results are in and the medical examiner has made a final ruling on the Cause and Manner of Death.  In closing out the legal affairs of the decedent, some institutions may only need proof of the death, whereas others, such as insurance companies, require the final ruling on Cause and Manner of Death. 

 

Return to Top 

 

Q:  Does your office have a training program or can I watch an autopsy?

 

A:  No and no.  We are a small office with a case load that keeps us busy enough.  A 3 hour autopsy can turn into a 5 hour autopsy if we have to stop and explain everything and answer questions, and families and funeral homes are anxious to get the body.  We are not affiliated with any college or university and cannot offer any credit, nor do we offer any internships, fellowships, or continuing education programs.  This is not a training facility, but rather a work facility. 

 

Most importantly, autopsies are a private procedure that is between us and the family, and many families would agree that they do not want outsiders watching the procedure being performed to their loved one.  This is similar to asking a doctor if you could sit in the exam room and be privy to the private and personal information being discussed between doctor and patient.  Would you want a stranger watching your exam?  The autopsy area also produces biohazard contaminants for which we cannot be responsible if a non-employee is exposed.

 

Please see the Forensic Science Career Information link on our website for more information on how to become a forensic scientist, but like the rest of us, you will have to move out of Chattanooga to pursue your training.

 

Return to Top 

 

Q:  Do I need a burial permit if I want to bury my loved one on my private property?

 

A:  No, unless the body is to be transported out of state (and only if the burial state requires such a permit).  You will also need the transit permit for out-of-state burials.  Contact the Vital Records office in Hamilton County for more information at (423) 209-8025.  A Tennessee Death Certificate must be filed whether your family handles the burial at home or a funeral handles the arrangements.  The decedent’s private physician will have to complete this document, or the County Medical Examiner if the case fell under his/her jurisdiction.

 

Return to Top 

 

Q:  How much does an autopsy cost?

 

A:  The Hamilton County Medical Examiner Office is tax-supported.  When an autopsy is ordered it is part of the medical examiner office expense and performed at no cost to the family.  A private autopsy can be requested by a family for medical examiner cases in which an autopsy was not originally ordered, or on cases that did not fall under medical examiner jurisdiction.   The cost of a private autopsy varies from a baseline of $1500 to $3000 with additional expenses depending on the case needs.  Most hospitals offer autopsy services for patients who expire in the hospital if requested by the family.  The fee of the hospital autopsy is set by the hospital.

 

Return to Top 

 

Q:  Can my loved one be an organ donor even if the body was taken to the Medical Examiner Office?

 

A:  Yes.  Our office tries our best to accommodate family’s wishes by letting Tennessee Donor Services have the body before we even begin our exam.  In turn, Tennessee Donor Services has been very sensitive to our needs by preserving evidence and not operating in an area of the body that will be crucial to our examination/autopsy.  TCA 38-7-108(c)(1) states,

 

“If a body is subject to post-mortem examination under this chapter, the provisions of this chapter shall be suspended to the extent necessary for the preservation of any body or part thereof, as defined in § 68-30-102, where an anatomical gift of such body or such part has been made in accordance with the "Uniform Anatomical Gift Act," compiled in title 68, chapter 30, part 1.”

 

      Following organ harvesting by Tennessee Donor Services, the remainder of the body can still be donated for valuable forensic science research at no cost to the family or executor.  See also Question #22.

 

Return to Top 

 

Q:  Can the Medical Examiner Office obtain medical records from hospitals and private physicians?  Do the new HIPAA laws apply to the Medical Examiner Office?

 

A:  Yes.  The Health Insurance Portability and Accountability Act (HIPAA) of 1996 is designed to protect the privacy of a patient’s health and medical records.   HIPAA explicitly states that neither authorization by next of kin, nor a court order, is required to release private health information (PHI) to the County Medical Examiner in line of his or her duties [see 45 C.F.R. § 164.512(g)]. 

 

Researching a decedent’s past medical history is the first step in conducting a post-mortem investigation.  Not only deaths from apparent natural causes, but also homicide, suicide, and accident investigations as well.  It is vital that any medical examiner office obtain the most accurate medical history possible.  Once the decedent’s PHI is in the medical examiner’s case file, it too becomes protected by HIPAA laws, and is used only for the purposes of the investigation. 

 

Created even before the HIPAA laws, TCA 38-7-117 allows the medical examiner office to subpoena records through the appropriate district attorney.

 

Return to Top 

 

Q:  Regarding funeral homes, what is a “General Price List” and how can I obtain a copy?

 

A:  Funeral homes are required by U.S. Code of Federal Regulations 16 C.F.R. 453.2 to give a copy of their “General Price List” to anyone inquiring about funeral arrangements.  The consumer must be able to take the GPL with them when they leave the funeral home.  Funeral homes are required to “unbundle” their services for individual purchase at the consumer’s discretion and desires, however, for every good or service purchased the funeral home can charge for basic services and overhead.  There are 16 items (and their current price) a funeral home must disclose to a consumer upon beginning negotiations about funeral services.  Visit the CFR link above for the actual text of the law, but the following is an easy-to-read summary of the 16 items that must be disclosed to you (see also the Federal Trade Commission’s summary of these laws, accessed 6-24-2003):

 

1.  Forwarding of remains to another funeral home;

2.  Receiving remains from another funeral home;

3.  Direct cremation;

4.  Immediate burial;

5.  Basic services of funeral director, and staff, and overhead;

6.  Transfer of remains to funeral home;

7.  Embalming;

8.  Other preparation of the body;

9.  Use of facilities and staff for viewing;

10.  Use of facilities and staff for funeral ceremony;

11.  Use of facilities and staff for memorial service;

12.  Use of equipment and staff for graveside service;

13.  Hearse;

14.  Limousine;

15.  Either individual casket prices or the range of casket prices that appear on the Casket Price List;

16.  Either individual outer burial container prices or the range of outer burial container prices that appear on the Outer

Burial Container Price List.

 

Return to Top 

 

Q:  What is a “direct cremation?”

 

A:  A direct cremation is when you opt not to use the facilities of a funeral home, but do contract them to handle the cremation of a loved one.  The funeral home will transport to the crematory, return with the cremains (cremated remains), and return them to you in an urn.  You may purchase an urn from the funeral home, or you may ask the funeral home to place the cremains in some other sentimental container.  Many families choose direct cremation because it tends to be cheaper than a traditional funeral service, where you utilize the funeral home’s facilities and trained staff.  You may still ask the funeral home to let you view the body, and/or they may require someone in the family familiar with the decedent’s appearance to verify that the correct person is about to be cremated.  Even if the body is released from the medical examiner office, you may ask the funeral home to let you view the body before the cremation.

 

Return to Top 

 

Q:  What is the Tennessee “Abuse of Corpse” law?

 

A:  TCA 39-17-312, “Abuse of corpse” law states the following:

 

 (a)  A person commits an offense who, without legal privilege, knowingly: 

 

            (1) Physically mistreats a corpse in a manner offensive to the sensibilities of an ordinary person; 

 

(2) Disinters a corpse that has been buried or otherwise interred; or 

 

(3) Disposes of a corpse in a manner known to be in violation of law. 

 

(b)  A violation of this section is a Class E felony.

 

      You may charged with a felony for the mistreatment of a dead body or fetus if you choose to handle your loved one’s post-mortem affairs and do not do so in accordance with state laws.

 

 

Q:  Does the Federal Trade Commission provide consumer information about funerals?

A:  Yes.  The Federal Trade Commission’s (FTC) Bureau of Consumer Protection is mandated to “…protect consumers against unfair, deceptive, or  
      fraudulent practices.”  The FTC’s website contains a consumer’s guide to funerals at FTC's "Funerals:  A Consumer's Guide."  There is a lot of detailed
      information on their site, as well as many contact names and phone numbers.

 

 

Return to Top 

 

Back to Medical Examiner main page