After two-year-old Renee Goode died while attending a slumber party at her father's Brazoria County home in January 1994, investigators were at a loss for answers. The toddler hadn't been ill prior to her death, so state law required that an autopsy be conducted to determine how she had died.
Since Brazoria, like the overwhelming majority of counties in Texas, does not have its own medical examiner's office, a justice of the peace there arranged to have the child's body transported to the Joseph A. Jachimczyk Forensic Center in Houston so that an autopsy could be conducted by one of the six pathologists who work for the Harris County Medical Examiner's office.
That autopsy was one of the 863 that Harris County pathologists performed in 1994 on bodies brought in from 14 nearby counties. Such outside or "private" autopsies accounted for 30 percent of the 2,851 autopsies conducted at the morgue that year. According to a recently completed report for Commissioners Court by Harris County Auditor Tommy Tompkins' office, those post-mortems came at an extra cost to Harris County taxpayers, while providing the M.E.'s pathologists with a tidy supplement to their already substantial incomes.
Counties outside of Harris are charged $900 for autopsies performed by Harris County pathologists. Of that, $500 goes to Harris County, while the remaining $400 is pocketed by the pathologist. However, the cost of using the county's facilities and equipment comes to $547 per autopsy -- meaning each private autopsy actually costs Harris County $47, or about $40,000 a year altogether. The auditor's report indicates that pathologists are giving priority to private autopsies over those for Harris County. Perhaps that shouldn't be surprising: outside work adds up to an average of $57,533 in additional income for each pathologist, on top of an annual salary of at least $121,500.
The pathologists are supposed to deduct from their time sheets the hours they devote to autopsies for other counties. That usually amounts to about an hour for each autopsy. Tompkins' study found that while that time is apparently subtracted from time sheets, there is no accounting for the possibility of autopsies' taking longer than an hour or for the periods the pathologists take off to testify in criminal cases growing out of autopsies they perform for other counties.
The report points out that pathologists in Dallas and Bexar counties do not receive extra compensation for private autopsies, which are considered part of their routine assignments. But the chief investigator for the local medical examiner doubts that arrangement would go over well with Harris County pathologists.
"If they take that money away from them, I'd be a little angry myself," says Pat Banks, who acknowledges the decision whether to continue splitting the private autopsy fee will be up to Commissioners Court. Banks also takes issue with the auditor's contention that outside autopsies are given priority by her office, saying that pathologists usually try to testify in out-of-county court cases on their days off.
In addition to the double dipping, the auditor determined that the M.E.'s office is severely understaffed. During the 1994 budget year, the county's pathologists performed an average of 475 autopsies each -- 175 more than the number recommended by the National Association of Medical Examiners. By comparison, the nine pathologists in Dallas County averaged 330 autopsies each in 1994; pathologists in Bexar County conducted an average of 300, the NAME-approved limit.
The heavy caseload is worth noting in light of several questionable rulings by the M.E.'s office in recent years, including its listing of the cause of Renee Goode's death as "undetermined."
Without a definitive ruling by the Medical Examiner's office, it is difficult for prosecutors to pursue murder charges against a suspect. But in the case of Renee Goode, whose body bore no outward signs of trauma, investigators from the Alvin Police Department and the Brazoria County District Attorney's Office joined the little girl's family in refusing to accept the M.E.'s ambiguous conclusion. They hired a private expert in pediatric forensic pathology and had the child's body exhumed for a second, more exhaustive examination, which determined that Renee had suffered "sustained blunt force" to her abdomen -- meaning she literally had been squeezed to death.
Although the M.E.'s office refused to change its ruling, Brazoria County authorities decided to proceed. Armed with the findings of the second autopsy -- and the fact that, shortly before her death, Michael Goode had taken out a $50,000 life insurance policy on the daughter he rarely saw -- prosecutors were able to convict the father of capital murder.
Dr. Linda Norton, a private pathologist from Dallas who testified for the prosecution, says Harris County pathologists were unable to determine how Renee Goode died because they didn't take the time to take a close look -- most likely because they didn't have the time. When the workload for pathologists exceeds 350 autopsies a year, Norton says, a medical examiner's office becomes little more than "a body mill."
"You can do a good workup on about 350 cases a year," says Norton, who participated in the exhumation of Lee Harvey Oswald's body. "But you start to push it beyond that and you then have to start cutting corners. And you just hope and pray that the corners you cut are not going to come back and bite you later."
(Chief investigator Banks concedes that the Medical Examiner's office is understaffed but emphatically denies there is any corner-cutting at the morgue.)
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Another problem cited by the auditor is the inadequacy of the computer technology used by the M.E.'s office. In fact, the office still uses typewriters to record death investigations. The report suggests a more extensive use of computers to "track the progress of a case from beginning to end" and "provide the basis for establishing performance standards." The computer shortage also makes it difficult to track the billing and payments for private autopsies and other services such as toxicology reports. The county is owed about $60,000 in delinquent bills for work done for other counties, according to the report.
One possible reason for the problems plaguing the M.E.'s office is suggested in the report's comparison of funding with the office's counterpart in Dallas County. Although Dallas County has roughly a million fewer people than Harris County, the Dallas County M.E.'s office has an annual budget of $5.6 million -- approximately $1 million more than the M.E.'s office here. Put another way, Dallas County devotes $3.03 per capita to its medical examiner, while Harris County spends $1.63.
One way or the other, change is coming to the M.E.'s office in 1996. An outside audit of the office is under way, and a search committee appointed by Commissioners Court is still scouring the nation to find a replacement for Dr. Joseph Jachimczyk, who retired last summer after 35 years as the county's chief medical examiner. Meanwhile, County Judge Robert Eckels strongly hints that one of those changes will be the discontinuance of splitting the fees for private autopsies with the pathologists.
"I'd like to see [the private autopsies] be just another part of the pathologists' job," said Eckels.