 Welcome to Sheboygan County Government, working for you. My name is Adam Payne, County Administrator and co-host of this program with Chairman Tom Wagner and every month we strive to bring a different program or department so you can hear more about the good work of your county government. And this month, we're very pleased that our former coroner and currently medical examiner, David Lafines, with us. Welcome, Dave. Thank you, Adam. It's good to see you. It's very interesting to talk with and listen to as you're about to find because obviously he works in a very important area that many of us don't or certainly don't have a good feel for. So, Dave, it's good to have you here and please begin by just sharing a little bit about yourself. Well, I'm a local fellow, born and raised here in Sheboygan, married, actually be 44 years, it's coming October 6th, my wife Bonnie and I have two children, they're both married and each of them have two children themselves. By profession, I'm a registered nurse, retired from nursing after, gosh, I think it's 45 years. As you said, I was the coroner for 28 and currently I have two years in as a medical examiner, so I love Sheboygan, I have no plans on leaving after retirement and not sure when retirement is going to be. Well, we're in no hurry to see you go, as you know, and as you said, we were the elected coroner for 28 years and now you're the medical examiner and some folks might be wondering, well, what's the difference? Well, the difference, the coroner by state statutes is an elected position and a medical examiner is an appointed position. A medical examiner by state statutes applies to any county over 500,000 or any county who chooses to go that route and appoint the medical examiner. By appointing the medical examiner, as you know, you become a player of the county where you have the same rates as any other employee, but the county also has the right to maintain your employment as long as you do your job and you don't do your job. You can be terminated whereas an elected official, you have to have some pretty severe malfeasance before they can get rid of you. You know, you really prompt a question that we've had internally for some time because in county government there are 19 departments that we work with and we have six elected department heads and of course the coroner was one of them, the county clerk, the treasurer, the crook of courts, the sheriff, the register of deeds. And for years we've had the discussion of the very point you just mentioned, accountability. As you said as an elected coroner you could be elected and not necessarily be a registered nurse, not have the background and qualifications that fortunately you bring to this position. As an appointed medical examiner we can be sure that you have the background and experience in order before we hire you as a medical examiner and as an appointed medical examiner if you're not doing the job, if you're not serving the public well, the county board, the county administrator, we're going to make a change whereas if you continue to be elected, weren't doing a good job, weren't serving the public well, it could be four years before a change is made. So we've had discussions internally about our county clerk, our register of deeds, our treasurer, you know fortunately we have a number of very good elected officials but sometimes I think the public has this impression that well if you're elected you're more accountable to the public yet strictly speaking how many people really know how well their elected department heads are doing and whether or not they're meeting expectations and providing excellent service and if they're not they've got to wait four years or a number of years perhaps before they can make a change. So I'm just so pleased that you made the very successful smooth transition from coroner to medical examiner and of course we are so appreciative of your experience and credentials. And I know Dave you championed this change by the county board because you recognized when you retired you wanted to make sure that we could get a good person with the qualifications to fill this important role rather than possibly someone being elected that's popular but not a registered nurse or has your background. Touch on that just a little bit how do you think the transition's gone and why do you think this has been important? The transition went smooth. As you know I had when I proposed this I had not intended to and had no what I want to say is when I proposed this I did not propose it to say this is what you should do and oh I want to be your guy. I had no intention right I was going to continue on working as a registered nurse into a retirement but I wanted to make sure that another 28 years didn't go by and somebody was in there that wasn't doing a good job because unfortunately in these type of jobs people don't realize and they just oh yeah let's put that guy because his name was on the ballot and just sometimes it just the way it goes. Fortunately I believe I did a good job for 28 years and I would have continued on in the elected position had it happened the age I was but I wanted to make sure one of my goals was to change it over as so many counties are now doing out of the 72 counties we now have 38 counties that have transitioned from the corner system let me correct that Milwaukee and Dean have to have so 30 out of the 72 36 switched over to the corner system right from the corner to the medical exam because by statute it gave the county board that option right whereas for register of deeds county clerk for example treasurer for example clerk of courts for example these are administrative positions but the state law does not give the county board the option of either having elected or appointed they have to be elected and again overall throughout the history of Boyden County we've had some good elected officials. Julie Glancy is one that comes to mind who is our county clerk for over 30 years she was rock solid but uh it is an interesting discussion and I think the medical examiner approach has proven to be a good one and let's get back on point with qualifications so to be a medical examiner what kind of qualifications should one have state statutes doesn't dictate again for the corner nor do they do it for the medical examiner but personally you have to have some type of medical background be it a registered nurse be a licensed practical uh even going backwards but a good solid background in some form of medical knowledge you're looking at patient charts you're talking to doctors you're looking at prescriptions you have to have an understanding you have to be able to know the medical terms you have to understand the the diagnoses that we're talking about so to go in there with no knowledge it's not going to work I mean death is a part of life and if someone was coming to my home to or my grandparents home or something like that to investigate a death I certainly would want someone walking in the door that has those qualifications in background. Final question before I turn it over to to chairman Wagner so primary responsibilities give an overview or what are the primary responsibilities of being a medical examiner well primary responsibilities obviously you're you're there to pronounce death um the person's dead or they wouldn't have called me but they're not dead by law or on paperwork until I or one of my staff get there and that's the time that we use for pronouncement that's one of the the course of the government um or a position as pronounced so we pronounced death we um sign the death certificate we look into the cause and manner of death you do an investigation into it you speak with the physician you speak with the family members so there's all all different facets of of of how you do the investigation you know and you're there to comfort the family to a degree to go through the process of when was the person last seen you know what was going on in the last days of their lives if that's applicable so it's a communication and giving some as you said some guidance and comfort at a very difficult time right thank you welcome Dave thank I'm just glad to have you here um as you as you know um no one would probably like to have the medical examiner come to their home because there's obviously a death in that instance but it's a necessary part of life right and and you need to go through that so I want to get a little specific um as I understand that there are five different uh manners of death you want to talk about that please well you have the natural where someone dies from natural causes heart attack um congestive heart failure chronic obstructive some natural disease process then you have accidental where some incident or accident occurred that caused the death they fell fractured their hip they became debilitated uh developed pneumonia but the fall in the fracture caused was the the point so that becomes an accidental death you have suicide where the individual by some form took their own life and there's many many different ways that they do that then you have homicide where someone intentionally took someone else's life in some manner uh and your other last one is undetermined where after uh investigation autopsy whatever there is you cannot determine if it was a natural or an accidental uh you you've done your your homework so to speak you've done your testing you can't you can't decide you can't figure it out so you leave that open and you leave it as undetermined because sometimes down the road there's things that come to light and that always leaves it open in the eyes of the court that you can make that change rather than making a wrong determination you want to leave it open to the right determination it sounds like you can change them up to a year without a court order and after that you have to go through a court process to change change a cause for a matter a matter of death so how common is that where it's undetermined uh how common is that oh we maybe have one two a year sometimes you just uh you can't you just can't pin it down sure how many do you investigate a year how many deaths well we get lots of calls but we don't handle we don't take all the calls if they don't if they don't fall into the state statutes yeah we don't take them and there's state statutes are specific on on what we we take um there's the uh all obviously what we were just talking about all accidental deaths we we investigate all homicides we investigate uh deaths where they're unattended all of a sudden somebody uh is found at home yes that's probably the most common that happened to my uncle he happened to be in Fonlach County and he was living alone and passed on and you know they had the coroner there in Fonlach County at that point but now with the hospice a lot of people have hospice come in that's changed things a number of years yeah probably four years ago already we used to go to all hospice deaths because the hospice was something new right and we tested the waters uh talking with the district attorney and the chief of police they felt comfortable more comfortable let me say that we go to all those deaths but after a while it became um probably a mute point that we went it was just duplicating and everybody felt more at ease with hospice and accepting of hospice so we stopped going to those so our caseload dropped from let's say 580 down to about 250 okay so that was uh a big change absolutely if i don't you don't want to Mr. Chairman no would you would that be the case also if you pass away if you're in a nursing home or if you're in a hospital correct yes right yeah those would be situations you wouldn't investigate no not anymore yeah but you used to we used to yeah my experience with hospice those are so very very good now in handling things um when you do an autopsy what is the purpose of doing an autopsy and when are they generally done purpose of doing an autopsy is to find out the cause and manner cause of death to determine a manner of death sometimes an autopsy is required by law any any individual that dies in the custody of a law enforcement okay that's required state state statutes say that um when you have a let's say a car accident and you have probable litigation going on and you want to determine who died first uh or if there is anything there you may want to do an autopsy there uh probably our most frequent autopsy nowadays is any drug related deaths uh particularly if there's potential for um civil litigation where the district attorney is going to go after the supplier of the of the drugs okay you need that autopsy to say yes it was the drugs that caused the death not some medical condition so makes sense i would think sometimes there could be some family members who would prefer not to have an autopsy absolutely and you know especially in that difficult time so imagine that creates a little bit of right tension sometimes but you you just have to talk with the family you have to explain to them that we understand and the law takes precedence there are religious customs that supersede and we do honor them um so there are times when we want that autopsy and we have to back down because of religious customs just as always with anything the more you delve into something it just strikes me as there's much more complexities than uh on the surface that people might think it's certainly even myself relative to the issue not uncommon i know we have a connie morgue uh could you talk about that a little bit where it's located etc connie morgue is located in the basement of the court house uh so it's been around since what is it 1936 at the court houses bill they believe uh so it's a unique place a lot of people you just most people don't know it's there it's kind of a to get into it uh it's kind of a just oblivious door off the off the alleyway there but down in the basement there's a door mark before that says medical examiner's office um appointments my call for appointment i believe it says or something to that effect but we're we're there um and i know you did some renovations we did renovation you want to talk about that probably i guess it's probably five six years ago now right you want to talk about that a little bit sure that was uh it like i said it used to be a unique unique uh place it still is a unique place but we went from a uh a two uh compartment refrigeration unit which was a real uh challenge uh so to speak to put the bodies in there to a nice uh walk-in cooler system that accommodates uh three carts uh state-of-the-art facility where the once that we bring the body into the morgue we place it on the cart and that's where it stays the cart locks into a um system and everything's all stainless steel we do the autopsy right on that particular cart and when we're done goes right back into the morgue until the funeral home comes to take the deceased into their their custody and just a very nice facility plenty of cabinets you do anything uh other than autopsies in the morgue yes we do uh we also do uh tissue recovery and tissue recovery is if uh if you look at the back of your driver's license there's a place for marked uh to be a tissue donor uh and that tissue donor has two different functions it's organ donor organ donor is when you're uh if you happen to be in a accident uh where there are um injuries that are life threatening and your chances aren't going to live and they are keeping you alive by mechanical means and you're a candidate for organ donations so you will do that at the hospital but should you have died you're still um a candidate for tissue donation and tissue donation is where they can use body parts skin bone uh for people that have cancer uh severe burns and that's what we do when we uh do tissue recovery uh organization that we're affiliated with is rcs they come right to the the morgue everything is done under sterile conditions uh they come in to recover the tissue um and the body goes back to the goes to the funeral home after they're done the body is completely uh viewable for a traditional funeral um and up to 78 people can benefit from one tissue donation that's a lot that's that's amazing well thank you Dave Adam yeah I trust you're finding this interesting it's not a topic we we talk about every day and and day we certainly appreciate your service and the important work that you do so after you've determined the manner of death obviously the body needs to be cared for what generally are the next steps after that decision's been rendered by you or one of your deputies after um we're done at the house we're seen uh funeral home if the family has a funeral home uh funeral home is contacted uh funeral home will come to the the scene or the house and and make the removal of that body if the family does not have a a funeral home or they just can't make a decision at the present time that they need to talk to other family members um then we will have that the the body removed to the county morgue and we will hold the body there until uh the family can make a decision on a funeral home and i understand there's four final forms of disposition correct please touch on um you have burial the other one cremation uh entombment and the last one would be donation or scientific donation where the body would go to a medical college uh in which both my parents have actually excellent signed up for as u w madison grads and that's that's where your your medical students get their their training yeah interesting so four final forms of disposition as you said um one of the more i think growing in popularity forms is is cremation correct and the corner or medical examiner needs to sign off on that uh why do you think you're seeing a trend of more cremation and why is it that the medical examiner needs to sign off on that uh we need to sign off on it because uh with cremation once the body is cremated there is no nobody there's ashes uh the body is down to the size of a shoebox is where the ashes fit into uh and should there ever be any question of well i don't believe grandpa died from this i remember seeing this happen or that happen or i think that you know grandma put a hatchet in grandpa's head point being you can't go back and take a look at that body again you can't exhume them and take a look or take them out of the um where they're entombed so you have to view the body we have to take a look at that body we take a picture of that deceased to say yes that is so and so so in our our records we have a picture identified as so and so so no one can come back and say i don't think that is whom they say it is we can go back and say here's the picture who is this oh that's so and so that is who is cremated it's just a form that we can say yes body cremated is so and so do you get involved if there's an exhumation of a body then yes in order for a body to be exhumed from a local cemetery yes and no that's a that's a double question okay anybody exhumed from a local cemetery and moved to another cemetery or cremated they need a disinterprement permit needs to be from you pass me i have to sign off on that but if the body is being exhumed from this plot in cemetery x and moved over to this plot in cemetery x i don't need to be involved okay and that does happen obviously yes marriages marriages that thing only have a couple of minutes remaining and you know every time we go through the budget process we generally spend some time talking about the important work that you do and i always find it fascinating and and it's just an area that most of us don't think a lot about or don't want to think a lot about and after 30 plus years of service to this community i mean i can't imagine there is there isn't much you haven't seen as part of the budget discussion this year you were looking for additional resources for autopsies because of a unfortunately a growing trend could you talk a little bit about what are some of the growing trends you're seeing in death just to cut to the chase what i'm talking about is is drugs drugs yeah yeah we're seeing more and more drugs drug deaths um it seems like youth young adults um are turning to drugs and i'm not sure for what reason if there is a reason and there's that's not even a lot of the traditional drugs they're they're doing with some of the high end drugs the designer drugs are going on the internet and getting stuff and they're they're coming up with some spaced out stuff their labs can't even test for any yet and that stuff will you know it'll put down elephants and that's the stuff that they're they're taking into their system they have no no idea what it's going to do and yet they're willing to shoot it up sniff it up whatever method is acceptable for that type of stuff and as our viewers certainly can appreciate i think most of us have um been to a funeral and and dealt with those emotions and that loss and it's one thing when you you lose a parent or a grandparent who's lived a long life it's another one you lose a young person and and dav i just can't imagine what it's like to walk in on scenes and see a teenager was taking their life because of a drug overdose what have you so i just want to say thank you for your tremendous service to this community thank you for the care and guidance you give families throughout this community and thank you for your ongoing leadership it's it's important work and we appreciate it thank you sir thank you and absolutely i hope you learned a little bit more about our medical examiner's office and the very important work that dav and his staff do if you want to ask more questions or learn more please don't hesitate to contact david lafine dav thanks again for joining us next month our finance director wendy sharnan will be here to talk about the very important budget development process that's in place so until then thank you for joining us be well and we'll see you next month