Death investigation process

Overview

An OCME death investigation determines the:

• identity of the deceased
• date and place of death
• cause of death (why it occurred)
• manner of death

Manner of death

The OCME classifies a deceased's manner of death as one of the following:

Natural

A death that's caused by a medical illness. Many of the deaths the OCME investigates are due to natural causes.

Accidental

A death that's caused by an injury and there's no obvious intent to cause death.

Suicide

When someone dies and the evidence indicates that the person intended to cause their own death.

Homicide

Death that's caused directly or indirectly by the actions of another person. There's often, but not always, some indication of intent to cause the person's injury and / or death. Homicide is a neutral term that doesn't imply fault or guilt.

Unclassified

A death that's the result of the medical assistance in dying process (MAID).

Undetermined

When a complete death investigation doesn't give enough evidence to determine the manner of death.

How a death is investigated

Our investigation process is normally made up of 5 steps. Paper-based file reviews don’t follow these steps.

Step 1. Scene of death review

At the scene of death, an OCME medical investigator:

• interviews witnesses and next of kin who are already at the scene
• records the deceased's demographic information
• records the deceased's medical history
• takes photographs of the deceased and the scene
• gathers circumstantial information about how the death occurred
• collects any items that may be relevant to determining the cause of death

If an OCME medical investigator isn't at the scene of death, on-scene police will investigate on behalf of the OCME.

If someone dies in a hospital, the OCME may review the place that they were initially found.

Personal property

The OCME may seize some of the deceased’s personal property during the course of an investigation. This is logged and stored in a secure office.

After finishing the investigation:

• the OCME will return the property to the funeral home chosen by the next of kin when the body is released
• you may collect the property at the OCME office
• the OCME may keep the property for a longer period of time, depending on the investigation

If you have questions about personal property that’s been seized by the OCME, contact the medical investigator assigned to your case.

If the death is a homicide or suspicious in nature, the personal property may be held by the investigating municipal / federal police force until they’ve finished their criminal investigation.

Step 2. Body transportation

If a medical investigator has reviewed the scene of death and spoken to witnesses and family members, they may decide that the deceased should be transported to an OCME office for physical examination. When this occurs, body transportation firms are used to safely and compassionately move the deceased.

Step 3. Body identification

OCME medical examiners are available 24/7/365 and will make every effort to positively identify bodies as fast as is reasonably possible. Body identification may occur at the scene of death.

A body can be brought to the OCME if the identity is unknown.

To identify a body, a death investigator asks the person making the identification questions about themselves and how they know the deceased. Then the investigator may ask them to:

• view the deceased’s body at the scene of death if they’re present at the time
• attend an OCME office to view a CCTV image of the deceased
• view a photograph of the deceased

To help identify a body, the OCME may also:

• use the deceased’s scars and tattoos
• use circumstantial evidence
• take the deceased’s fingerprints
• do laboratory tests
• take x-rays for other tests, such as comparing an old bone injury, surgical hardware, dental records

Step 4. Examination

An OCME medical examiner may decide to do an external exam or an autopsy on the deceased’s body based on:

• their medical history
• the circumstances of their death
• an initial review of their body

If you, as a family member, object to a full autopsy being done on the deceased, let the medical investigator assigned to your case know as soon as possible. Your wishes will be taken into consideration and weighed against the OCME’s goal of maintaining the examination’s integrity.

Organ and tissue donation

If a family wants to donate the deceased’s organs and tissue, their request should be made to the medical investigator assigned to the case as soon as possible.

This request will be assessed by the medical examiner and weighed against the OCME’s goal of maintaining the examination’s integrity

Examination processes

A physical review of the deceased’s body, known as a post-mortem examination, will be done by an OCME medical examiner. The exam consists of one of these processes:

1. External examination:
   • this is a systematic review of the body, where:
     • the body is assessed for signs of natural disease and evidence of injury
     • x-rays, toxicology sampling and a partial internal cavity review may be done
2. Autopsy examination:
   • this is an external examination of the body, followed by a detailed dissection, where:
     • the body is inspected for signs of disease and trauma
     • small pieces of tissue of major organs and bodily fluids may be sampled for microscope examination or chemical / biological tests
     • a whole organ like a heart or brain may be retained for further tests

The autopsy examination process can take several hours to complete. Post-mortem examinations are only conducted on weekdays.

Step 5. Post-examination

The OCME releases the body to the funeral home chosen by the next of kin – once we can confirm the body’s identity.

A death investigator contacts the next of kin to discuss the findings of the investigation so far. If the case is suspicious in nature, the amount of information discussed may be limited due to the need to maintain the integrity of an ongoing criminal investigation.

The medical examiner then completes documents related to the investigation. This process can take some time because we’ll need to complete either:

• additional laboratory investigations
• further paper-based review of medical records and other reports

Once the investigation is complete, the medical examiner has the authority to issue proof of death documents and other death-related documents.

Step 6. Death documents

Depending on the type of post-mortem examination or paper-based file review that the OCME medical examiner does, the OCME may issue a number of different documents:

• Certificate of Medical Examiner
• External Examination Report
• Summary Autopsy Report
• Detailed Scientific Autopsy Report
• Toxicology Report

These documents can be ordered by next of kin or an authorized third party.

Due to the volume of cases that OCME medical examiners work on, the current completion time for death investigations is typically between 6 and 12 months.