The answer may surprise you. In the United States, there are two systems in place for handling these investigations: coroner and medical examiner. Coroners and MEs generally handle deaths occurring under specific circumstances, such as violent or suspicious deaths, accidents, sudden infant death but not death by natural causes. Deaths that warrant an investigation are generally outlined in the states’s statutes and legal code.

Some states have switched entirely to the ME system, while other states let local jurisdictions decide whether to use one—or both.

Virginia switched to a “statewide medical examiner system” in the 1940s.

West Virginia currently uses both systems.

Remember the hit ’70s-’80s TV medical-drama Quincy, M.E. where Jack Klugman plays an LA-based medical examiner who helps solve crimes? Today, California still uses both coroners and medical examiners, but some areas have moved to the ME model. In 2023, the Department of Medical Examiner in the County of Los Angeles (they also investigate deaths for the City of LA), dropped ‘Coroner’ from its name.

So what’s the difference between the two roles?
While there may be some overlap of duties, a striking difference, according to the National Association of Medical Examiners, is coroners may (or may not) have medical training, For example, in San Bernardino County (Calif.), the county’s coroner has degrees in criminal justice and communications plus extensive law enforcement experience, but autopsies are conducted by forensic pathologists (medical doctors trained in forensic pathology). One Pennsylvania county coroner is a registered nurse with training in forensic pathology. In West Virginia, local medical examiners working under the direction of the chief ME may be a physician, registered nurse, paramedic, physician’s assistant, or even an EMT.

To explore this topic further, the U.S. Centers for Disease Control and Prevention has published a list of coroner and medical examiner laws by state. ■