St. Germain

The office of the county medical examiner can be anywhere from a hospital waiting room to the side of a road.

Although outgoing Deschutes County Medical Examiner Deanna St. Germain has a county-provided office, only a lone file cabinet could call it home, St. Germain said.

Instead, St. Germain conducts most of her investigative work in the many places that deaths occur in Deschutes County. Either she or one of her three deputies is called to the scene when a death is reported to 911.

“Any death that is a homicide, suicide, accident or undetermined death is an ME case,” St. Germain said. “We actually go out during the investigation.”

St. Germain is leaving her post as county medical examiner after four years, during which she hired several deputy medical examiners and helped the county conduct an audit of the examiner’s annual expenses.

While Deschutes County Chief Deputy District Attorney Mary Anderson would not identify the candidate the county has selected to succeed St. Germain, she expects the new examiner will take office around the end of the month.

St. Germain expects a smooth transition. “I have the utmost confidence in her,” said St. Germain of the new pick. “It’s always nice to feel like you’re leaving everything in good hands.”

The county medical examiner’s role is to work locally to investigate the circumstances of death and to write a report for the state medical examiner’s office in Clackamas, according to State Medical Examiner Dr. Karen Gunson.

The report functions as a case history for forensic pathologists in Clackamas, who conduct autopsies for the entire state. Those pathologists in turn are on hand to testify in circuit court once their autopsies are complete, Gunson said.

St. Germain also works full time as the medical director of KIDS Center, a Bend nonprofit that provides an array of services to suspected victims of child abuse. While she said it is difficult to quantify the amount of work she does in her examiner capacity, in the past year the rising rate of suicide in the county has kept her occupied. Funding for medical investigation and operation is provided by the district attorney’s office.

St. Germain has spent the past four years expanding the capacity of the medical examiner’s office, according to St. Germain and Anderson.

“She put a lot of her own time and effort into (her work),” said Anderson. “It wasn’t just a cursory review.”

The audit showed that the costs for transporting bodies to Clackamas or Portland for autopsies varied depending on the funeral home.

Under state law, when a death requires investigation the medical examiner must designate a funeral establishment if it isn’t designated by family or friends of the deceased. The county arranges for a few different funeral homes in the area to house and transport the remains to Clackamas or Portland for an autopsy on a rotating schedule.

“Everything, from the costs (the funeral homes) were charging us to the rotation schedule” was inconsistent, said Anderson.

As a result of the audit, the medical examiner now routinely reviews the funeral home rotation schedule and invoices before payment. The district attorney’s office will also conduct an annual review of the medical examiner and its expenses every June.

The greatest variable expense of the medical examiner’s office is the cost to transport human remains to Clackamas or Portland for autopsies, according to the April audit.

The cost of transportation can run from $520 to $540 per body, depending on the funeral home. This does not include the costs for labor or for body bags, which also vary, according to the audit.

“It’s mainly a reimbursement,” said Kevin Korn, funeral director at Niswonger-Reynolds Funeral Home in Bend, which contracts with the county to house and transport bodies for autopsy. The transportation cost includes automotive upkeep and fuel and ensures that Niswonger-Reynolds has sufficient staff at any given time, Korn said.

As a result of the cost discrepancies between funeral homes for transportation and labor, overall expenses for the medical examiner can vary greatly from year to year.

They also depend on the number of deaths requiring autopsies. In 2011, autopsies cost the county $26,848, while in 2013, they cost $15,840, according to County Auditor David Givans, who cited totals from the actual budget for those fiscal years.

Both Anderson and St. Germain sought the audit to ensure that the costs and actions of the examiner were more predictable in the future, Anderson said.

“We’re trying to sort out these issues and reach some consistency,” Anderson said.

After four years on the job, St. Germain believes that the medical examiner in Deschutes County needs more support.

“The county’s support for the medical examiner position, it appears to me, is based on what the county looked like many years ago,” St. Germain said. “This position hasn’t really kept up” with a growing population and corresponding demand for services, she said.

The medical examiner is not an employee of Deschutes County, but is compensated based on a county contract. The county has allotted $35,000 for medical investigation to the district attorney’s office for the fiscal year 2014, according to the county’s line-item budget. Most, but not all, of that amount will go to the contract paid to the medical examiner, according to Givans.

“I think there needs to be more invested in this position,” said St. Germain. “It’s almost like a service to the county. It’s not reimbursed at a rate that you would expect for a doctor’s time.”

St. Germain said she uses part of her county compensation to pay the three deputy medical examiners — nurses whom she selected to help with the duties of medical examiner and who were trained in death investigation in Clackamas.

However, St. Germain said she greatly enjoyed her tenure as medical examiner.

“It’s just time for me to take a little bit of time and take care of myself,” said St. Germain.

One of the most rewarding parts of her job was collaborating with police, she said. “I enjoy working with law enforcement,” she said. “I do that in my everyday job as well, but it’s hard to let that part go.”

Dr. Karen Gunson, the state medical examiner, said St. Germain devoted more time to the position than previous Deschutes County medical examiners — most county medical examiners stick around for about two years, she said.

“She brought a lot of energy to the position that wasn’t there before,” Gunson said. “She was very industrious in getting good-quality deputy medical examiners and death investigators.”

— Reporter: 541-383-0376, cwithycombe@bendbulletin.com