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Medical Examiner and Coroner Outsourcing Study – A Qualitative Study and Cost-Benefit Analysis

NCJ Number
Date Published
January 2022
41 pages

In this project, the National Institute of Justice’s Forensic Technology Center of Excellence partnered with West Virginia University’s Project FORESIGHT to examine the outsourcing practices of Medical Examiner and Coroner (MEC) agencies that are implemented to mitigate the increased caseloads caused by the opioid epidemic, other drugs of interest, and the COVID-19 pandemic.


The project team interviewed MECs from across the United States to learn more about the contexts, policies and procedures, and costs and benefits of outsourcing various MEC agency tasks. The project found that the main reason agencies outsourced toxicology testing was because they did not have the capacity to complete certain tests in-house because of lack of instrumentation and staffing. Most MECs also reported they were limited by the number of appropriate private forensic laboratories or consultants, because the testing they need is specialized and there are few entities or individuals with the required capabilities. Many MECs and private laboratories have increased the comprehensiveness of the drugs and substances they test for and are now routinely testing for an expanded drug panel. Several participants reported increases in the use and presence of certain illicit substances, such as methamphetamine and cocaine, indicating that poly-drug use is now the norm. The challenging issues reported are the complexity of the required toxicological analyses, rising inflation-adjusted costs, and the higher laboratory productivity required. The main impacts of COVID-19 on MRCs were related to the decreased capacity of private laboratories to test samples in a timely manner because of the influx of potential COVID-19 samples that have needed analysis and supply chain shortage of consumables and other necessary instrumentation and resources. Regarding the cost-benefit of outsourcing, this report concludes it is a lower cost alternative for many MEC agencies, depending on the annual caseload for a jurisdiction. 1 table, 8 figures, and lists of references and a literature review