HJNO Sep/Oct 2021

CORONERS’ ROUNDTABLE 22 SEP / OCT 2021 I  HEALTHCARE JOURNAL OF NEW ORLEANS   You wear a lot of hats as coroner of your parish. How would you describe the different aspects of your position? Charles “Chuck” Preston, MD This is a great question, because most folks don’t realize the scope of the duties of the coroner. Most folks think of us as just death investigation. At the St. Tammany Parish Coroner’s Office (STPCO), we are far more than death inves- tigation alone. We have a very large mental health responsibility as it relates to involun- tary orders for protection and commitments for people suffering mental health crises. Additionally, we have one person dedicated to mental health outreach who has been working closely with me, and on my behalf, to support the Safe Haven project, which will represent a single point of entry into the continuum of mental health services. It will include a crisis receiving center, dis- charge follow up and wraparound services for those who suffer from chronic mental illness or an acute mental health crisis. In addition to that, our office provides sexual assault nurse examiners (SANE) for the Florida parishes. These highly trained, specialized nurses respond to the hospital where a survivor of sexual assault is located and conduct a very thorough forensic examination as well as providing support to survivors of sexual assault. Also unique to the St. Tammany Parish Corner’s Office, we have an in-house DNA lab. Ninety-six percent of the work done by our in-house DNA lab is done for the benefit of law-enforcement and is a critical pillar in the justice system by both convicting the guilty and exonerating the innocent. We are involved in life safety initiatives, including the Cribs for Kids program, which supplies a safe sleep environment to help prevent infant deaths from co-sleeping and other unsafe sleep environments. We have programs to address gun safety in the house, pool safety and injury prevention from shaking babies. We also enjoy close alliances with the Louisiana Organ Procure- ment Association, LOPA, to facilitate the gift of life out of tragic, unexpected death. In addition to our outreach programs, we also sponsor a summer internship for college students interested in forensics or medicine so that they can have hands-on experience in the field of forensics. And, I would be completely remiss if I didn’t mention the St. Tammany Parish Cor- ner’s Office Chaplain Corps. We have over 40 volunteer chaplains who respond to the scenes of sudden death and provide spiri- tual support to the families who have been devastated by a sudden loss. These chap- lains are selfless, empathetic, and experts at listening and consoling grieving family members. Chaplains go through an exten- sive onboard training and then have con- tinuing education throughout the year. These chaplains are literally a godsend. Gerald “Gerry” Cvitanovich, MD Most people know that the coroner handles death inves- tigation, but they don’t know that the office also handles involuntary mental health commitments and rape exams. The three departments are all very different but are all important. Dwight McKenna, MD What many people may not know is that the coroner is responsible for a large portion of mental health patients, in term of orders of protective custody. We have to have them evaluated to see what kind of care they need. Also, we are respon- sible for all deaths in the city, to include homicide, suicide and others. The coroner has a vast range of responsibilities in this metropolitan area. What drew you to the office of coroner? Preston I was drawn to the office of coroner when I ran in a special election in 2014. The office was emerging from a bit of turmoil, but I recognized the critical infrastructure that had been established by the previous coroner and saw an opportunity to continue my life of service, now as an elected public servant. Cvitanovich I spent years as an ER doctor at East Jefferson. While there, I had a lot of contact with the coroner’s office, and I found it very interesting and challenging. McKenna My responsibility to community — to make sure deaths were properly recorded and human remains were protected and dis- posed of with dignity. When does your office get involved in a death? Preston The St. Tammany Parish Coroner’s Office investigates every death that occurs inside of St. Tammany Parish. Addition- ally, the office conducts a more thorough investigation of any death that is suspected to be non-natural, that is a death because of a homicide, a suicide or accident includ- ing overdoses. Some cases that are felt to be expected natural deaths are investigated with a simple phone call. When deaths are not natural and occur outside of a hospi- tal, the investigators respond to the scene and work together with law enforcement to gather information that will allow the foren- sic pathologist to comfortably and appro- priately classify the cause and the manner of death. It is important to note that while our investigations occur in parallel with law enforcement authorities, our goal is to establish the cause and the manner of death. Law enforcement is more focused on identi- fying whether a crime has been committed and determining who committed the crime. Of course, forensics obtained at autopsy are often critical in the successful prosecution of criminal suspects. Cvitanovich All deaths are not coroner’s cases. The cases we get involved in include homicides, suicides, accidents, overdoses, deaths in public, infant deaths, deaths within 24 hours of admission to the hos- pital, deaths from communicable diseases like AIDS/hepatitis/TB/COVID, in-custody deaths, and any other death deemed suspi- cious in the public interest.