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THE CORONER’S OFFICE Time to Build for the Future BY CHRISTINA VANDEPOL, M.D.
A
healthy young woman becomes ill while working from home in 2020 and dies within hours of being brought to the Emergency Room. She does not have COVID. A husband and father in his early fifties is found dead at home at the end of a trail of blood. A high school athlete collapses during a workout and cannot be resuscitated. A pregnant woman goes into labor and dies in the ambulance en route to the hospital. A frail elderly woman dies within days after a fall at a nursing home. Each case is referred to the Chester County Coroner’s Office (CCCO), which is tasked with determining the cause of death, how it happened, and whether or not there was criminal intent or neglect in these and thousands of other deaths every year. Headed by an elected official, the Coroner’s Office is an independent county government agency, but its budget and resources are determined by the County Commissioners. As Coroner, I found the resources available to the CCCO, especially the infrastructure, grossly inadequate and outdated for the needs of a county of over 525,000 people. Despite years of lobbying, little changed during my four years in office. In a previous article in this magazine (VandePol, 2019) which reviewed the 334 years’ history of the CCCO, I decried the fact that the office had “failed an accreditation audit in June 2019 because of the dismal state of its morgue and autopsy space.” In response, Dr. Donald Harrop, Chester County Coroner from 1966 to 1990, wrote a Letter to the Editor of this magazine in Fall 2019, urging that “we need to provide active physician leadership on...establishing a proper facility to continue to professionalize the Coroner’s Office.” He recounted how, decades ago, Chester County physicians advocated for a county health department in the face of vehement opposition from the County Commissioners and some other elected officials. The physicians, including Drs. Bob Poole,
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Bill Limberger, and of course Dr. Harrop himself, succeeded in getting the decision on a county-wide ballot, which voters then approved. The Chester County Health Department was formed, and County Commissioners now tout its accomplishments and benefits to the community. Perhaps history will repeat itself if Chester County finally constructs the infrastructure necessary to bring our Coroner’s Office into the 21st century. Has the COVID-19 pandemic, which has taken over 1,000 lives in Chester County, brought any changes to the Coroner’s Office since the June 2019 audit? Let’s go back (reluctantly) to March of 2020, when the first COVID-19 death was reported to the CCCO. In April 2020, as the death count climbed at an alarming rate, hospitals, nursing homes, funeral homes, and the Coroner’s Office scrambled for morgue space. Chester County had no county morgue so the CCCO had been dependent on limited donated morgue space in our hospitals. Hospital deaths took priority over Coroner cases for morgue storage though, and cross-contamination between hospital staff/patients and CCCO staff/decedents was a constant worry. The lesson learned was that hospitals are not a good location for coroner operations. Recent hospital closures further highlight the risk of depending on forprofit facilities to provide infrastructure for public services. With little to no access to hospital morgues during COVID-19, the CCCO had to arrange for body storage at private funeral homes. To address this emergency need, in May 2020 the county used funding from the Coronavirus Aid, Relief, Economic Security (CARES) Act to quickly construct refrigerated storage space in an existing county maintenance structure. This temporary fix, which consists of 12 refrigerator and 3 freezer spaces, remains in use at this time, but it is not a long-term solution because it lacks privacy, adequate security, or space for projected increases in
