Medicolegal Death Investigators – The Career You Didn’t Know Existed
By Lynn McCain | January 27
At the University of Michigan, we constantly uncover new career options that many of us never realized existed. One of these is our Medicolegal Death Investigators. The Department of Pathology is home to eight Medical Examiner Investigators (MEIs), six of which are Diplomates of the American Board of Medicolegal Death Investigators (D-ABMDI): Chelsea Cammarata, Lindsay Crater D-ABMDI, Edward Farrugia D-ABMDI, Jessica Hagan D-ABMDI, Eric LaPres D-ABMDI, Monique Micallef D-ABMDI, Troy Murrish D-ABMDI, and William Piper RN, MSN.
Whenever someone passes away outside of a medical facility, hospice or under a set of specific criteria with legal implications, our MEI staff are called. They investigate the details of what happened, when, where, and how. They talk with family and friends, the police investigating the scene, and review medical records.
“We are the eyes and ears for the forensic pathologists,” explained MEI Monique Micallef, D-ABMDI. “Once someone is pronounced dead, the Medical Examiner’s Office is notified and the MEI’s determine if a scene investigation is warranted. If so, we respond to the scene, typically within the hour. We are documenting the surroundings and the body via written notes and photography. We find out their medical history, current prescription and inventory the medications at the scene. The body is also thoroughly assessed for signs of natural disease, trauma and identifying features. We get the story from the police and witnesses about what happened leading up to their death.” They look for signs of foul play, drug use, possible suicide, traumatic injury, or other elements that may have contributed to death.
Our MEIs can be found at scenes of traffic accidents, deep in the woods with deer hunters, at the waterfront, in basements, on roofs, and anywhere else the deceased may be discovered. “We respond to all kinds of deaths,” states Ed Farrugia. “Sometimes, it is an elderly person with a lot of health problems. Other times, we are going to homicides, suicides, or accidents.”
“But that is not all,” Micallef chimed in. “Even if somebody makes it to the hospital after a car accident, it still falls under the medical examiner's jurisdiction and is reported to us. We then need to investigate that accidental death.”
Every detail is recorded, and the best next step is decided. Sometimes, the decision is death by natural causes, and the individual can be released to the funeral home. Other times, further investigation is required, and the individual is transported to the Medical Examiner’s Office based at Michigan Medicine. When these individuals arrive at the Michigan Medicine morgue, our MEIs are also assist the Forensic Pathologists with the autopsy. They lend insight into the environment and circumstances surrounding the death, enabling correlation of the death scene findings with the autopsy findings. This correlation can be critical to Forensic Pathologists in determining an accurate cause of death.
MEI’s follow multiple paths to this career. Many, like Farrugia, are retired police detectives. They have built their investigative skills over decades and bring this knowledge to the ME office. They already deeply understand scene investigation and how to work with people in traumatic environments. In some jurisdictions, all MEIs are members of the police department. Others, like Micallef, obtained a bachelor’s degree in criminal justice and a post-bachelor’s certificate in forensic investigation, obtaining a D-ABMDI credential. She completed an internship at the Wayne County Medical Examiner’s office, where she learned about this career path. Piper obtained a Master’s in Nursing with a focus on forensic nursing, and following eight years of emergency and critical care nursing experience in West Virginia, made the move to death investigations and recently joined U-M Pathology. Others come to the field from EMS or other backgrounds.
“Coming from nursing, my job was doing all that I could do to keep the patient alive. Now, my patient has already passed, and I am doing all that I can to find out why” reflected Piper.
Sometimes, MEIs are also called upon as expert witnesses in legal cases. When they gain the experience and expertise required to meet the criteria as expert witnesses, they may be asked to testify in homicide and other cases. “There are criteria that need to be taken for the prosecutor’s office qualifying you to become an expert witness on certain crime scenes” explained Farrugia. “Eric, another MEI in the department, was previously a fireman. As a death investigator and fireman, he may be called upon as an expert witness for people who died in a fire,” said Farrugia.
The job of an MEI is much more strenuous than it initially sounds. Beyond writing notes and taking photos, MEIs must be able to lift and move adult human bodies, which can be a couple hundred pounds. “It is a very physically taxing job. Sometimes you are moving patient bodies from the hospital bed to a gurney; other times you are moving them out of small, crowded rooms in a home,” explained Piper. “At accident scenes, you wield heavy equipment to get people out of vehicles. Sometimes, they are in a ditch in the woods. Not too long ago, I had to carry someone a quarter of a mile to get them to the van,” added Farrugia.
In addition, this career can be emotionally trying. “You are dealing with family and friends of the deceased on the worst day of their lives, and you have to ask them difficult questions surrounding drug use, suicide, mental illness…hard questions,” explained Micallef. Hagan adds “Growing up, I had two career paths in mind, the medical field or crime scene investigation. Finding my current position as an MEI is the best of both worlds. While working as an MEI can have its stressful moments, I find the job highly rewarding in that I am able to help families on their worst day. One of my favorite parts of the job is talking to families and hearing their sigh of relief when they learn valuable information on what comes next.”
Our MEIs are amazing, strong, resilient people who face others’ worst days, day in and day out. They ensure no stone is left unturned for families needing closure and justice. These dedicated professionals are deserving of our gratitude. I encourage you to take a moment and extend your appreciation for the services they provide.
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