Question about coroner procedure

mreilly19 · Aug 11, 2012

Hi all, I am writing a story set in L.A. in 1992. One of my characters has discovered her great-aunt dead in an apartment. Since this takes place during the L.A. riots, she's unable to get any medical assistance (calls are being responded to for life-threatening emergencies only) when calling 911.

My characters then embark on another mission to help some friends. Post-mission they tell the cops "We need some assistance with a dead woman in an apartment. Please get an ambulance there."

My question is, would the coroner get called out? I'm envisioning this would be the case, along with an ambulance and a cop to check for foul play. In the case of the dead woman, she has passed away from a stroke - and it's very visible based on the paralysis of half her face. I guess the cop would also tape off the apartment as a crime scene and dust for prints, etc. but am not sure how to proceed here if the coroner/paramedia announces "Yep, it was a stroke all right."

Thanks for any advice!!

cornflake · Aug 11, 2012

mreilly19 said:
Hi all, I am writing a story set in L.A. in 1992. One of my characters has discovered her great-aunt dead in an apartment. Since this takes place during the L.A. riots, she's unable to get any medical assistance (calls are being responded to for life-threatening emergencies only) when calling 911.

My characters then embark on another mission to help some friends. Post-mission they tell the cops "We need some assistance with a dead woman in an apartment. Please get an ambulance there."

My question is, would the coroner get called out? I'm envisioning this would be the case, along with an ambulance and a cop to check for foul play. In the case of the dead woman, she has passed away from a stroke - and it's very visible based on the paralysis of half her face. I guess the cop would also tape off the apartment as a crime scene and dust for prints, etc. but am not sure how to proceed here if the coroner/paramedia announces "Yep, it was a stroke all right."

Thanks for any advice!!

Yes, they'd call the coroner for an obviously dead body in most cities including LA.

However, I have to ask how in the heck you think it'd be obvious she died from a stroke from the appearance of the body? That's not really possible.

I don't know how you'd tell paralyzed from not paralyzed facial musculature on a corpse. Nevermind that even if you could if you discovered her like a couple minutes after she died (which I still think is very unikely but for instance) in the timeframe it seems like you're talking about, you're probably either into or past rigor mortis so it'd be moot.

So if someone says 'we found a dead person in an apartment' that's going to trigger an investigation, yeah, unless there's a specific, known thing that they were under a dr.s' care for and even then it'll be looked at - could be accident, homicide, suicide, etc.

mreilly19 · Aug 12, 2012

Well, I have my characters find her dead with one side of her face drooping, and thus presumed she died from a stroke, but from what you're saying rigor mortis would render that observation impossible. That's a good catch.

The reason why I inject the "she died of a stroke" element at the time of finding the body is so that it can be established right away that no foul play was involved. However, I can do that through other means (nothing valuable missing, no sign of forced entry, nothing broken or otherwise indicating a fight took place, etc.)

It's more important for me to get the process right as far as who would show up; ambulance, coroner, cops, etc. I'm envisioning all 3 arriving, plus some questioning and statements, etc. followed by removal of the body, investigation of the scene and subsequent autopsy to discover cause of death.

cornflake said:
Yes, they'd call the coroner for an obviously dead body in most cities including LA.

However, I have to ask how in the heck you think it'd be obvious she died from a stroke from the appearance of the body? That's not really possible.

I don't know how you'd tell paralyzed from not paralyzed facial musculature on a corpse. Nevermind that even if you could if you discovered her like a couple minutes after she died (which I still think is very unikely but for instance) in the timeframe it seems like you're talking about, you're probably either into or past rigor mortis so it'd be moot.

So if someone says 'we found a dead person in an apartment' that's going to trigger an investigation, yeah, unless there's a specific, known thing that they were under a dr.s' care for and even then it'll be looked at - could be accident, homicide, suicide, etc.

jclarkdawe · Aug 12, 2012

Way too many variables to answer your question.

How old is the victim? What's her overall health like? What's her blood pressure, as that's one of the indicators of stroke risk? Young person in good health dying is markedly different then old person in poor health.

Next question is what is the temperature of the air. The hotter the air temperature, the faster decomposition begins. Decomposition begins within minutes of death, although not especially noticeable to the average person.

Now let's look at where the body was found. Is it in bed, a chair, against a wall, or sprawled on the floor. Where are her hands located? Is she cradling her head (frequently a massive stroke first indicates as a massive headache). Is her body in a relaxed position or does it indicate anxiety at the time of death?

Moving on to how long has it been after her death. Hours matter here. Twelve, twenty-four, or thirty-six hours produce markedly different results. Post-mortem lividity starts shortly after death and steadily progresses through the first twenty-four hours. Rigor mortis begins shortly after death with smaller facial muscles, progressing steadily until it starts leaving the body. Air temperature makes a lot of differences here. And last, but not least, is the rigor and lividity consistent with the body's position.

And all of this determines the initial on-scene determination and that determines who does what.

Best of luck,

Jim Clark-Dawe

Al Stevens · Aug 12, 2012

mreilly19 said:
The reason why I inject the "she died of a stroke" element at the time of finding the body is so that it can be established right away that no foul play was involved. However, I can do that through other means (nothing valuable missing, no sign of forced entry, nothing broken or otherwise indicating a fight took place, etc.)

I found the 72-year-old neighbor of a friend dead on the floor in her bedroom. She hadn't answered her door or phone in three days, so I picked the lock to her front door, went in, and found her. We called 911. They sent a uniformed policeman. He said he had to decide whether to call in the detectives. (Relatively small town.) He went through her things and found her doctor's phone number. He called the doctor, and the doctor said the woman had a serious heart condition, and such a death was not unexpected. The cop (or his superiors) decided not to turn it into a crime scene based only on that. He called for a county hearse, and they took the woman away. After that, I don't know what they did if anything to establish cause of death.

mreilly19 · Aug 12, 2012

She's about 66, in overall OK health, but I put in some clues as to her upcoming stroke - migraines for instance. Blood pressure higher than normal. Since the story takes place in L.A. in April, the air temperature is in the 70s. She's found toppled over on the couch, about 24 hours after death.

jclarkdawe said:
Way too many variables to answer your question.

How old is the victim? What's her overall health like? What's her blood pressure, as that's one of the indicators of stroke risk? Young person in good health dying is markedly different then old person in poor health.

Next question is what is the temperature of the air. The hotter the air temperature, the faster decomposition begins. Decomposition begins within minutes of death, although not especially noticeable to the average person.

Now let's look at where the body was found. Is it in bed, a chair, against a wall, or sprawled on the floor. Where are her hands located? Is she cradling her head (frequently a massive stroke first indicates as a massive headache). Is her body in a relaxed position or does it indicate anxiety at the time of death?

Moving on to how long has it been after her death. Hours matter here. Twelve, twenty-four, or thirty-six hours produce markedly different results. Post-mortem lividity starts shortly after death and steadily progresses through the first twenty-four hours. Rigor mortis begins shortly after death with smaller facial muscles, progressing steadily until it starts leaving the body. Air temperature makes a lot of differences here. And last, but not least, is the rigor and lividity consistent with the body's position.

And all of this determines the initial on-scene determination and that determines who does what.

Best of luck,

Jim Clark-Dawe

ironmikezero · Aug 12, 2012

Cops don't pronounce people dead - competent medical authorities do (coroner, medical examiner, ER physicians, etc.). There may be some exceptions based on jurisdiction (like EMTs/paramedics). In L.A. in the early '90s, it'd most likely be the ME.

The initial call (radio) would be in regard to an "unconscious person", and a patrol unit would be sent to meet the ambulance at the scene. Calls on fire/police channels are usually monitored (unless the frequency is encrypted) by lots of people (the media, newspaper reporters, etc.); so, any transmitted info is kept to a minimum. Some agencies make heavy use of the traditional "10-codes", but those are easily decrypted via the internet.

The patrol unit will determine, based on what they can see, whether or not it is a crime scene and so advise the dispatcher. Detectives and a rep from the ME's office may respond; if so, the patrol unit secures the scene and awaits their arrival.

If the victim has not yet succumbed, he/she is transported to a hospital. An officer typically accompanies and stays with the victim. The scene is always secured.

Al Stevens · Aug 12, 2012

ironmikezero said:
Cops don't pronounce people dead - competent medical authorities do (coroner, medical examiner, ER physicians, etc.). There may be some exceptions based on jurisdiction (like EMTs/paramedics). In L.A. in the early '90s, it'd most likely be the ME.

The initial call (radio) would be in regard to an "unconscious person", and a patrol unit would be sent to meet the ambulance at the scene. Calls on fire/police channels are usually monitored (unless the frequency is encrypted) by lots of people (the media, newspaper reporters, etc.); so, any transmitted info is kept to a minimum. Some agencies make heavy use of the traditional "10-codes", but those are easily decrypted via the internet.

The patrol unit will determine, based on what they can see, whether or not it is a crime scene and so advise the dispatcher. Detectives and a rep from the ME's office may respond; if so, the patrol unit secures the scene and awaits their arrival.

If the victim has not yet succumbed, he/she is transported to a hospital. An officer typically accompanies and stays with the victim. The scene is always secured.

That's quite unlike the experience I described. The cop came out first, alone, and without an ambulance. He didn't officially declare the lady dead as far as I know. That might have been done by whomever came in the coroner's wagon later. But there was no doubt about her condition. No pulse, no breathing, body cold, and significant lividity. He took his time looking things over. The scene was not secured.

Perhaps procedures are less stringent in smaller communities (pop. 44,000) where resources are limited and there is a large number of elderly people.

jclarkdawe · Aug 12, 2012

mreilly19 said:
She's about 66, in overall OK health, Twenty years ago, this would make her about 76 now. Sort of. But more 20 years ago, I would classify 66 at old enough to know that death is a significant possibility at any point in life. This would reduce the probability of death by some trauma.

but I put in some clues as to her upcoming stroke - migraines for instance. Here I have to warn you I'm not terribly sure of this, but I believe migraines are a condition in and off themselves. They may cause transient ischemic attacks (TIAs), which may also be caused by strokes. Strokes are caused by one of two conditions: either a blood clot blocking the flow of blood, or a rupture of one or more blood vessels in the brain.

Strokes caused by blood clots can be proceeded by smaller clots blocking smaller blood vessels. These clots cause a loss in function in the area of the brain that is being blocked from blood flow. If the clot is small enough, the clot on its own can break up, allowing blood to reflow into the area that the clot had been blocking.

These clots will cause, if they break up, a temporary loss of function, causing things such slurring of speech, loss of strength in one side of the body, and facial droop. My understanding (and not much of one) is that migraines can cause similar symptoms such as these, and all are labeled TIAs, although from different causes.

I believe that headaches with strokes are caused by broken blood vessels, which cause an increase in intercranial pressure.

Most noticeable signs of mini-strokes (TIAs) are things like slurred speech, sudden lazy eye, facial droop, loss of strength in one side, and coordination problems.

Blood pressure higher than normal. Okay.

Since the story takes place in L.A. in April, the air temperature is in the 70s. That's what I was thinking. Remember that when we're talking air temperature, we're talking the air temperature of the room in which she is found. Decomposition would be progressing at a reasonable right. Odor might be present, although probably mild, and the face would have begun to lose form to the point where ID is going to begin to become difficult. It's not going to be terribly obvious to people who haven't seen dead bodies before, but it will be noticeable to someone looking closely.

She's found toppled over on the couch, Toppled over the couch has many interpretations. She could have fallen forward from sudden onset and ended up there by dumb luck, she could have been trying to get to the sofa as she felt the stroke coming on, she could have been sitting and gotten to her feet as she felt the stroke coming on, her body might have spasmed in the death process, or it might be how her body ended up as her body relaxed in death. In other words, body position is important and is going to be one of the most important initial clues in determining whether this death is suspicious or natural. Starting point will be whether she is face up or face down.

about 24 hours after death. Rigor will have set in and most likely be complete, with maybe some release to smaller facial muscles like the eye lids. Lividity would be pronounced with significant discoloring of the lower points of the body. The balance of the body would be very pale compared to life. This paleness is significantly influenced by the person's natural coloring, but is easily identified with a minimum of experience.

Initial response depends upon whether the operator on the phone classifies this as a death or an unconscious person. If unconscious person, in LA, you'd get a rescue squad and engine company from the fire department, and police presence. Immediately upon arrival, the rescue squad (EMTs) would call medical control, describe the situation and the death would be called. Then police would take over with an investigation.

If the call is for a dead body, heavier police presence and only the rescue squad. No lights and sirens. The rescue squad would call medical control and confirm death by obvious signs. Then the police would take over with an investigation. LA had some very experienced rescue squads in this time period. It was one of the first areas to go with EMTs and paramedics.

Depending upon the body's position would be the biggest determination initially whether this is a natural death. As a former EMT, I could call it either way depending upon the body's position. If I'm suspicious, I convey my suspicions to the police and ME. If I'm not, and the death looks natural, I'll say that.

ME may or may not come out, depending upon everything looks. Natural death, older person, probably not. Suspicious definitely.

Best of luck,

Jim Clark-Dawe

cornflake · Aug 12, 2012

You can't see a face drooping like you're thinking in death even if we weren't talking about rigor mortis or past - the reason you can see it on a live person is because it's in contrast to the controlled musculature. If all the muscles are flacid, or rigid, it's not visible.

If they tell the cops there's a dead body they found, in a big city, you'll get cops and then a coroner's van most likely. The ambulance/fire rescue is more for more indeterminate things than someone very obviously dead.

No, cops can't make a death declaration but they do call out for an obvious body here. They'll call they found a floater in the river, etc. Yeah, the media shows up - that's what the media does.

Al - Yeah, smaller depts are different but not completely different. That's why I put in my original post about someone under a dr's care - if there's a known thing or something looks very obvious, it's generally treated as obvious, but people will still check, because you never know. Could still be anything.

ironmikezero · Aug 12, 2012

Al Stevens said:
Perhaps procedures are less stringent in smaller communities (pop. 44,000) where resources are limited and there is a large number of elderly people.

You're right, Al... The size/population of the location and available resources will always impact the response. I was thinking of Los Angeles in the '90s per the OP's setting.

mreilly19 · Aug 12, 2012

Thanks, all - once again my story thanks you too. Already the acknowledgments section of my book contains a huge note of thanks to the good people of Absolutewrite.com and their invaluable expertise.

Question about coroner procedure

mreilly19

cornflake

practical experience, FTW

mreilly19

jclarkdawe

Feeling lucky, Query?

Al Stevens

mreilly19

ironmikezero

practical experience, FTW

Al Stevens

jclarkdawe

Feeling lucky, Query?

cornflake

practical experience, FTW

ironmikezero

practical experience, FTW

mreilly19