N.C. OCME Frequently Asked Questions

We understand how hard it is to wait for answers. The time needed for an examination can vary based on the details of the case, how many cases we are handling, and the space available. We also work closely with law enforcement, medical specialists, and other agencies, which can add time. Please know that we are doing everything we can to complete a careful, thorough examination and return your loved one to you as soon as possible.

Not every situation requires a full autopsy. State laws guide when certain types of examinations must be done, and our medical examiners choose the method that will best determine the cause and manner of death. Many cases can be answered with an external exam, medical history, and testing such as toxicology or X-rays. If the pathologist feels that an external exam is not enough, they will move forward with a full autopsy. Families may also choose to arrange a private autopsy on their own if they wish.

We know how important it can be to see your loved one. Because our facility is a medical and forensic environment, we cannot safely allow viewings here. Your funeral home or cremation provider can help you arrange a viewing in a private, appropriate setting.

Every case is considered individually and reviewed by the OCME’s forensic pathologists before a decision is made on whether to accept it under medical examiner jurisdiction. While legislative guidelines require medical examiner involvement in some specific situations, no guideline can account for every possible scenario, and so the medical judgment of OCME pathologists forms the basis for these decisions.

Toxicology testing looks for substances that are most likely to be relevant to the case. It isn’t possible to test for every substance that exists, but we can add additional tests when forensically appropriate. As a result, we generally take a stepwise approach of testing for those substances most likely to be toxic contributors to death for a given case and possibly adding on more testing if it is medically indicated, in consultation with our toxicologists. If you have a reasonable suspicion that a particular substance may have contributed to your loved one’s death, notifying us of it will be tremendously helpful. If you are requesting a test that cannot be performed at our lab, someone with our office can walk you through other options, such as having samples released to a private lab for testing. Nearly all OCME cases have samples collected for toxicology, but in a small minority of cases, appropriate samples for testing are not obtainable, and so no testing is performed.

If the cause of death is clear at the time of autopsy or external examination, then the death certificate may be filled out with the cause and manner of death right away. If additional testing or information gathering is needed to rule out other contributors, then the cause and manner are generally left as pending until investigation has concluded (usually at the time of report completion, which may be delayed for reasons mentioned below). A pending death certificate may be used to provide legal proof of passing for closing utility accounts or other actions that may not need the final cause and manner of death to be listed.

Completion of final reports can be a long process, depending on many factors. Each case is unique and may be delayed by: specialist consultations on particularly difficult cases, tracking down needed investigative information (medical records, law enforcement reports, scene photos, EMS or other agency records, video footage, etc.), reviewing said records (sometimes 1000’s of pages’ worth for a single case), additional rounds of toxicology or histology (microscopic) testing, other specialized ancillary studies, delays from required courtroom testimony and/or meetings with attorneys, and answering inquiries from the public. We suggest reaching out to our office periodically to inquire if any updates or preliminary findings are available for discussion along the way.

We understand that dealing with insurance companies can be stressful. If the insurance company is willing to accept an updated death certificate. You can feel free to call our office and ask for an expedited amendment to the death certificate. We may not always be able to accommodate this request (it depends on the details of the case and stage of the investigation), but we are happy to help where we can.

While we understand the difficulty of waiting for answers and encourage families to call if they have new information, needs, or requests, calling repeatedly for updates generally slows down the process.

The first thing to do is notify law enforcement; they may have an urgent need for that information. Typically, law enforcement will then pass that information along to us at OCME, but you are welcome to share it with us directly as well. In most cases, we will need law enforcement confirmation of any new information before considering altering our determinations about a case.

In many cases, pathologists answer questions from family indirectly by providing information through the OCME’s Decedent Affairs staff. This is to allow the pathologist to focus on their examination and case report workload. If a pathologist determines it is necessary, based on questions you provide to decedent affairs, then the pathologist will reach out to you directly to discuss your loved one’s case.

Cause and manner of death determinations are expert opinions by highly trained forensic pathologists and/or local medical examiners, and informed by a thorough investigation and examination, but they are still opinions. If you would like to contest the cause and manner listed on a death certificate or information in any of our other reports, please outline your concerns and questions in an email and send it to ocme.decedentaffairs@dhhs.nc.gov. You may include any supporting documentation, photos, etc. that you feel are pertinent. Someone with our Decedent Affairs team will typically reach out to you within 24 hours of receipt.

We are obligated to release all those in our care to the funeral home or transport service that arrives at our facility with the appropriate documents. We are not authorized to inquire about who made funeral arrangements or attempt to verify legal rights and responsibilities. Establishing legal next of kin or a legal representative is a process that takes place within the court system and with the funeral home.

Due to limited capacity, the majority of those in our care will first go to one of our county facilities and return there after the physical examination is completed. This helps move along the process of reuniting you with your loved one a bit faster.

Per North Carolina law, we cannot deny anyone copies of case documentation. Please refer to State Statute G.S. 130A-389.1. However, due to a new Senate Bill, S429, if a district attorney or law enforcement agency places a case under criminal investigation, the OCME can only release the reports to a limited list of individuals, and all pediatric cases have a limited list of individuals who can receive reports. Details are provided on our document request portal."