by Leah Willingham, Associated Press

An Associated Press (AP) analysis has found that Mississippi has long operated in violation of national standards for death investigations, accruing a severe backlog of autopsies and reports. Autopsies that should take days take weeks and the reports that should take months take a year or longer.

Too few pathologists are doing too many autopsies. Some cases are transferred hundreds of miles to neighboring states for reports without their family’s knowledge. Records sent to AP in April show the office was waiting for about 1,300 reports from as far back as 2011.

That leaves criminal cases incomplete.

The National Association of Medical Examiners, the office that accredits U.S. death investigations offices, dictates that 90% of autopsy reports should be returned within 60 to 90 days.

Mississippi’s office has never been accredited. The majority of U.S. medical examiner agencies, which are chronically underfunded and face a shortage of forensic pathologists, are unaccredited. States such as Georgia have raised the alarm about autopsy report delays of up to six months. But nowhere is the issue more severe than in Mississippi.

Mississippi’s delays are an “emergency-level” concern, said Dr. James Gill, the association’s 2021 president and a leader in the College of American Pathologists. “That’s a disaster situation where you need to do something drastic.”

Public Safety Commissioner Sean Tindell from Gulfport is a former Mississippi Court of Appeals judge who stepped into his role — overseeing the state medical examiner’s office, the highway patrol and other agencies — in May 2020. He called the backlog “unacceptable” and said he’s made eliminating it the top priority of his administration. He said working as a judge, he saw how trials were delayed while prosecutors awaited reports.

“I knew it was bad,” he told the AP. “I didn’t know it was this bad.  Families deserve better. I’m sorry that they’ve had to experience delays in laying to rest loved ones, to getting closure in these cases, but we’re going to fix the problem.”

Tindell said he’s instituted a policy that all reports must be back within 90 days. Using contractor pathologists in other states, the office began working to whittle down the backlog. Tindell said around 500 cases have been completed since summer.

But Tindell — who has hired two new pathologists, started university recruiting efforts and streamlined staff duties — said it’s been a challenge trying to fix old problems while facing new ones: the pandemic and an unprecedented increase in violent crime.

Mississippi saw 597 homicides in 2021 and 578 in 2020 — record numbers for the state of 3 million. That’s compared with 434 in 2019 and 382 in 2018.

Tindell said both the forensics laboratory and medical examiner’s office haven’t been a state priority for funding or staffing in over a decade. The forensic laboratory’s budget has essentially remained unchanged since 2008.

But during Mississippi’s 2022 legislative session, lawmakers approved $4 million that must be used to address backlogged cases.

Like most states, Mississippi does not perform an autopsy — a post-mortem surgical procedure by a forensic pathologist to determine cause of death — for all people. Autopsies are reserved for homicides, suicides, deaths of children and those in correctional facilities, and other unexpected cases. Forensic pathologists are responsible for performing autopsies at Mississippi’s two medical examiner offices — one in the Jackson metro area, one on the coast.

After the autopsy, pathologists complete a report explaining their findings and results, including an official cause of death. Reports can help determine whether a death was an accident, a suicide or a homicide. They shed light on child deaths, or show whether a person accused of murder acted in self-defense.

Beyond effects on criminal cases, the lack of an autopsy report and official death certificate can prevent families from collecting benefits.

Mississippi Lt. Gov. Delbert Hosemann said he’s been contacted by families who can’t get insurance payouts without a certificate.

“One that contacted us was a mom and two children whose husband died unexpectedly,” he said during a fall budget hearing. “They couldn’t get their life insurance benefits, and that’s the only money they had.”

Tindell said the problems won’t be fixed until the state is able to hire more pathologists. The National Medical Examiners Association standards recommend that pathologists perform no more than 250 autopsies a year. If pathologists perform more than 325 a year, the office risks losing accreditation.

In 2021, two Mississippi pathologists performed 461 and 421 autopsies. Arkansas’s six pathologists completed an average of approximately 282 each.

During most of the 1990s and 2000s, Mississippi had no state medical examiner, instead contracting with a private physician, Dr. Steven Hayne, who performed 80% of autopsies in the state. He completed as many as 1,700 autopsies a year.

Hayne’s work was repeatedly attacked in court as sloppy and scientifically unsound. Verdicts in multiple murder cases in which Hayne testified were overturned by the Mississippi Supreme Court.

In 2011, the state hired Pathologist Dr. Mark LeVaughn as its first chief medical examiner since 1995. During his tenure, LeVaughn spoke publicly repeatedly about a lack of resources, calling his office a critically understaffed public health risk.

Tindell said a substantial number of autopsy reports that are pending are LeVaughn’s. Because of the department’s staff turnover rate, LeVaughn was the only forensic pathologist handling all the autopsies in the state at times and fell behind on paperwork.

“He was put in the impossible situation of trying to do all the autopsies for the entire state, and just unfortunately, he was not able to get it all done,” Tindell said.

LeVaughn resigned as chief medical examiner in January 2021. He has since been rehired as a pathologist finishing outstanding reports and testifying on them in trials.

Tindell said the office expects an additional pathologist to start late next month, and that he’s recruiting to hire another as soon as possible.

In the meantime, to meet demand, the Mississippi Medical Examiner’s Office has been forced to send bodies to neighboring states such as Arkansas. In 2021, 284 autopsies were completed by contractor pathologists.

The National Medical Examiner’s Association recommends autopsies be completed within 72 hours. The turnaround time in Mississippi has exceeded three weeks in some cases.

Each of Mississippi’s 82 counties has an elected coroner who’s responsible for collecting and transporting bodies to the medical examiner’s office. They end up acting as liaisons with families and answering desperate calls month after month.

The Mississippi Crime Laboratory and office of the State Medical Examiner are located in Pearl, Miss., as seen in this Aug. 26, 2021 photograph. (AP Photo/Rogelio V. Solis)