Friday, 6 April 2007

Shortchanged Autopsies

April 5, 2007


Shortchanged Autopsies

One Pathologist'

His Illness Casts Doubt on His Work and Sheds Light on
Industry Problems


On television, medical examiners work with cutting-edge technology and
limitless budgets. They are surrounded by walls full of diplomas and
colleagues full of helpful insight.

In reality, the physicians tasked with investigating how and why people died
are often underqualified and underpaid. They regularly work alone, with
outdated technology, limited oversight and paltry budgets.

Dr. Johnny Glenn's small office in Tuscaloosa, Ala., located across the
street from a sewage-treatment plant, was a far cry from the plush forensic
labs seen on "CSI." From 1999 to 2004, Glenn examined hundreds of bodies.
His testimony at murder trials helped put suspects in jail and on death row.
For a time, he was the only state physician examining dead bodies in the
western third of Alabama.

But for at least a part of that time, he suffered from dementia and
depression. Now defense attorneys in the area, and at least one doctor who
took over for him, contend that Glenn was incompetent, his autopsies were
inadequate, his notes insufficient and his testimony inaccurate.

The discovery that Glenn may have been incompetent casts doubt on the trials
in which he participated, but experts said it also sheds light on the
problem of limited funding and poor oversight facing forensic laboratories
all over the country.

"The facility in Tuscaloosa is less than optimal," said Michael Sparks,
director of the Alabama Department of Forensic Science. "The increase in
funding we received in 2007 is the first substantial increase in 10 years.
If you're underfunded for 10 years in a row, you're basically in trouble."

Sparks only recently took over the department and was not in charge when
Glenn had what he described as a "catastrophic event that led him to need
immediate care at that time." The director maintained that until his
breakdown, Glenn was a competent though overworked physician.

Sparks said much of the attention surrounding Glenn, including a recent
story by The Associated Press, can be attributed to a former department
employee hired after Glenn's unexpected retirement. That employee, Sparks
said, noted that Glenn's reports were incomplete and his cases unfinished.

But according to the director, those sorts of complaints are typical when
one medical examiner reviews another's work, and they do not indicate the
quality of Glenn's autopsies.

Sparks also accused that other doctor of parlaying his time at the
department to become a paid expert witness for clients who are appealing
their convictions based on Glenn's testimony.

The problem in Tuscaloosa, Sparks said, wasn't that Glenn became ill. The
real problem was that there wasn't enough money to afford a second scientist
who could review his work or relieve him.

"He left work undone because there is so much work. . It's all about
funding. If my checkbook was unlimited it would be a nonissue," Sparks said.

Sparks plans to consolidate medical examiners in a new facility to ensure
they work in "teams of three or four" and will soon require examiners to be
board certified forensic pathologists.

Glenn was a trained family physician but never received certification by the
American Board of Pathology.

Nevertheless, lawyers said the state's decision to use Glenn's notes in
recent and upcoming trials, read by newly hired physicians in court, is
unfair. They recognize that funds are limited but want a review of all the
cases in which Glenn was involved.

"Alabama has always underfunded the Department of Forensic Sciences," said
Bobby Wooldridge, the Tuscaloosa public defender. "There's been a great deal
of difficulty keeping a medical examiner at all, and it has been difficult
for a number of years just maintaining doctors who will provide those

"The appropriate people failed to supervise and note Dr. Glenn's problem" --
and that, Wooldridge said, is a reflection of the "lack of commitment for
resources to the criminal justice system in general."

Since his retirement, lawyers whose clients were found guilty are hoping to
appeal those convictions, basing their appeals on Glenn's alleged

Bryan Stevenson, director of the Equal Justice Initiative of Alabama, said
his organization defended a client who was sentenced to death, his sentence
based in part on evidence presented in court by a medical examiner who
merely read Glenn's report.

Devon Moore was accused of shooting three police officers in Fayette, Ala.,
in 2005. Stevenson said Moore's appeal would rest in part on that medical
examiner's testimony.

"The state should have gotten a competent pathologist to re-examine [the
case]. Instead of getting a new pathologist to re-examine the evidence, they
just got another one to present incompetent testimony," he said.

A lack of adequate funding and the increase in associated problems with
evidence collection, handling and examination is "a serious problem because
[the state] frequently asks juries to convict based on scientific proof,"
Stevenson said. "If the forensic work that has been done is unreliable,that
undermines the state's assertion."

There is no federal agency that oversees states' forensics programs.
Comparing funding is difficult, because each state structures its labs and
budgeting differently.

Even the definition of what makes a medical examiner varies from state to
state, and sometimes within states, said Dr. Joseph Prahlow, president of
the National Association of Medical Examiners.

In some places, medical examiners must be board certified forensic
pathologists. In other places, they must be pathologists. In other places,
they just need to be doctors. And in others, he said, they do not even need
to be doctors.

Coroners are typically politically elected officials who assign doctors to
perform autopsies, whereas medical examiners are themselves physicians.

Requests for funds often go ignored, he said, until something goes wrong.

"Time and time again, examples of problems caused by underfunding appear,"
Prahlow said. "In any halfway decent size city, if there's a meltdown,
politicians have egg on their face and it's a big public relations
nightmare. Then money finally comes forward."

Part of the problem in retaining quality doctors is that state and local
governments are unwilling to pay for the best people.

"Forensic pathology is one of the few specialties where your salary is
significantly reduced after you receive more training," he said.

Forensic pathologists must first be trained pathologists, and then
additionally train to receive certification. Prahlow estimated that a
recently trained forensic pathologist earns on average $100,000 to $140,000.
Colleagues with less training who work as pathologists at a hospital earn on
average $220,000.

As of Dec. 31, 2006, there are just 1,245 board certified forensic
pathologists working in the United States, according to the American Board
of Pathology.

"The funding issue is critical, and having independent oversight methods is
critically important," said Eric Ferrero, a spokesman for the Innocence
Project, a defendant's rights organization.

In 2004, Congress passed and President Bush signed the Justice for All Act.
Within the law was a provision called the Paul Coverdell Forensic Science
Improvement Grant.

"The law says that in order to get federal money for crime labs, states have
to have in place an independent mechanism for receiving allegations of
negligence, misconduct and fraud," Ferrero said. "That affects tens of
millions of dollars in money that goes to state labs and could be a
breakthrough in the standards and oversights for state crime labs."


Source : abc News

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