by Rosemary Edmiston
Recently appointed Humboldt County Coroner Frank Jager, left, receives tips from former coroner Glenn Sipma.
With the retirement of Humboldt County's longtime coroner, the resignation of his replacement and recent appointment of a Eureka city councilman to the post, the Coroner's Office has undergone more than its share of changes.
But some members of the medical community say a lot more needs to be done. They are continuing to organize in an effort to convince county leaders that the job of coroner should be turned over to a forensic pathologist.
"There's a segment of our community, medical and non-medical, who continue to be concerned with the Coroner's Office because non-physicians are making medical decisions," said Dr. Tate Minckler, a retired Eureka physician.
As a result, there was disagreement as to whether an autopsy should have been performed in at least one case that Minckler knows of. His colleagues, he said, have told him of similar situations in the past couple years.
Humboldt County currently calls on a semiretired doctor from Hayfork to perform autopsies when the coroner deems it necessary. While the physician is not a certified forensic pathologist, he has performed thousands of autopsies. The issue, however, is quick access.
Public Health Officer Dr. Ann Lindsay believes having a doctor in the position of coroner, or improving the county's access to a qualified pathologist, might help lower Humboldt's disturbing number of Sudden Infant Death Syndrome cases, which is still twice the state's average, according to the latest county Health Department statistics.
"I think that if we were to investigate SIDS cases more thoroughly, perhaps we would find that some of them are not SIDS," she said.
In fact, the apparent failure to perform what some say may have been a necessary autopsy in a recent death case was one reason former Coroner Brad Smith resigned late last year, according to several knowledgeable sources. Smith could not be reached for comment.
Former councilman and law enforcement officer Frank Jager, who started work as coroner Feb. 23, said Smith may have tried to make too many changes in the department he oversaw for less than one year.
"I think Brad is a very knowledgeable person. I just think maybe he tried to do too much too soon up there and as a result maybe alienated some people he needed support from," Jager said.
In an article in the February edition of the Humboldt-Del Norte Medical Society Bulletin, Minckler wrote that Smith resigned "amid rumors of deep-seated problems, not all apparently of his making."
The problem with an elected coroner position, Minckler wrote, is that anyone can run for the job, and even when a competent person is elected "in well over half of the 'reviewed deaths,' the cause of death is determined by a non-physician with limited medical and/or forensic training.
"This is a circumstance in which someone could, quite literally, 'get away with murder,' " stated the article, titled "The Coroner Conundrum and the County Society: An Unfinished Complexity."
In regard to the county's infant mortality rate, Lindsay said it's the responsibility of a number of departments to make sure the system is properly examining individual cases.
"I think it's a mutual problem. I'm not trying to point blame," she said.
The county is in the process of developing a protocol in investigating Sudden Infant Death Syndrome cases, part of which includes having access to a qualified pathologist, Lindsay said.
The debate over Humboldt County's coroner system -- which is not uncommon among smaller or midsize counties -- began with the retirement last year of Glenn Sipma. With change imminent, it was a good time to consider appointing a medical examiner rather than a lay person to the position, Minckler said. But the Humboldt County Board of Supervisors disagreed, and retained the elected status of coroner.
Jager was appointed to fill the position for the remainder of Sipma's term and must run for election in the June primary. The only other announced candidate, Deputy Coroner Charles Van Buskirk, has pulled out of the race. Van Buskirk said he decided not to run because he felt the supervisors made a good choice in Jager.
Sipma, who returned as interim coroner when Smith resigned in October, says the county simply cannot afford to hire a full-time medical examiner. In California, he said, only four counties have medical examiners on staff -- Marin, San Francisco, Los Angeles and San Diego.
Sipma, who served as coroner for 17 years, earned $50,000 annually. A forensic pathologist would command a $140,000 salary, he said, and in a county Humboldt's size would only have to perform about 100 autopsies a year. That's a waste of money considering pathologists in larger counties may perform up to 700 autopsies annually for about the same amount of money, Sipma said.
Currently the county pays $60,000 yearly for the services of an on-call pathologist. Combine that with the coroner's salary and the county not only gets autopsies, but also has someone performing administrative and investigative work for a total of $110,000.
And, as Sipma sees it, performing an autopsy without a thorough preliminary investigation is close to worthless.
"Everybody's been watching 'Quincy' too much and they think the coroner has to be a doctor," he said.
"This county, I don't think, is ever going to be in the position to afford a medical examiner," said incoming coroner Jager, who believes a lay person with the right training is capable of deciding when an autopsy might be needed. Jager added that he intends to seek the advice of medical experts if any question exists as the need for a post-mortem exam.
Minckler -- who says the county "was lucky to have someone like Glenn (Sipma)" for so long -- does not think statistics should stop the pursuit of a medical examiner system.
"Just because it's done, doesn't make it right," he said, noting that one candidate in the pool Jager was chosen from was a jeweler.
"That's exactly the kind of thing that scares the public about an elected coroner," the doctor said.
According to Public Health Officer Lindsay, the coroner must also be someone whose qualities include compassion, a trait for which Sipma has received praise.
"It takes a real finesse. It's a very sensitive situation. It would be nice if someone had a background in the psychological aspects of grieving," Lindsay said.
Sipma has been working on a plan -- endorsed by a number of leaders in Humboldt's medical community -- to retain the services of a group of forensic pathologists out of Fairfield.
In late February, the interim coroner said he was still working out the details, but that he was optimistic an agreement would be reached with the Forensic Medical Group Inc. And even better news, he said, was that the group was considering moving one of its doctors to Humboldt. That person, said Sipma, might be able to perform autopsies in Humboldt, Del Norte and Mendocino counties.
In office just one week, Jager has immediate pressing problems that have little to do with personnel decisions. The autopsy room at the Coroner's Office doesn't have proper ventilation, the cold storage area needs to be upgraded and three deputy coroners are "crammed" into one small space.
Meanwhile, Jager said he was gearing up to take over a job that was "more daunting" than he thought it would be.
"It's going to be a tough pair of shoes for me to fill," he said.