Steve's Soapbox

Thursday, October 13, 2005

Brownwood Autopsies ?

Glaring, public errors in autopsies finally get county's attention
Medical examiner's office must cut workload
EDITORIAL BOARD - Austin American Statesman
Tuesday, October 11, 2005
Whatever problems another audit finds in the operation of the Travis County medical examiner's office, the county commissioners have to accept some of the responsibility.
Commissioners have known for years that the medical examiner's operation is not up to national standards and have, in fact, opposed efforts to bring it up to those standards. Travis was one of the counties that just last year protested attempts by the Texas Department of Public Safety to require that medical examiner's offices across the state be accredited.
Commissioners also know that the medical examiner's office, run by Dr. Roberto Bayardo, takes in autopsy work from other counties for a fee as a way to meet expenses. That is one of the reasons the county opposed seeking accreditation in the past — it would have forced the office to perform fewer autopsies each year.
Standards established by the National Association of Medical Examiners call for pathologists to perform no more than 350 autopsies annually, and in some instances, far fewer than that. Travis County's pathologists can average more than 500 a year.
About a third of the roughly 1,400 autopsies done in Bayardo's office are from outside Travis County. The outside work subsidizes the county's office and pays the pathologist performing the autopsy a $300 fee.
Burnet County commissioners, unhappy with the results of an autopsy in a criminal case last year, asked that its $1,800 fee be returned.
The review approved by the Travis County commissioners last week will analyze the actual forensic medical work done by the county's three pathologists. That charge comes after several high-profile mistakes, including the misidentified body from Burnet County and incorrect results from the autopsy of Austin police shooting victim Daniel Rocha.
An audit of Bayardo's office last summer reported that the pathologists perform too many autopsies, which can lead to mistakes.
County Judge Sam Biscoe said last month that he would like to aggressively pursue accreditation for the office, which would mean more pathologists or less outside work. Other commissioners have said that performing autopsies for other jurisdictions is not a proper way to pay for the medical examiner's office.
At least one audit and several highly publicized mistakes make it clear that something needs to change within Bayardo's operation. Everyone will be surprised if the just-approved medical review doesn't reach a similar conclusion.
The commissioners took an important step toward improving the medical examiner's office by adding money to this fiscal year's budget. They voted to add $331,000 for more personnel. Commissioners also approved hiring an office manager to improve efficiency, something recommended in the last audit. Alicia Perez, named as interim office manager, will determine who should conduct the medical review.
Commissioners now say their goal is to seek national accreditation, which will give them a blueprint for a competent, efficient medical examiner's office. If they had not opposed that in the past, they might have avoided some of their current headaches.
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