- Associated Press - Sunday, October 11, 2015

MISSOULA, Mont. (AP) - Dr. Jaime Oeberst is determined to carry out Attorney General Tim Fox’s vision of a reformed and restructured state medical examiner’s office after years of backlogs and ethical controversies.

“She’s managed a medical examiner’s office that, frankly, is larger than anything we have in Montana,” Fox said of Oeberst, who led death investigations at Kansas’ largest county forensics lab and also served as district coroner. “We needed to have someone that promotes accountability and meets the expectations of our customers, the coroners and sheriffs. We’ll be working toward that goal and looking forward.”

Oeberst took over Montana’s top forensic pathology job about a month ago. In addition to rebuilding an expanded state medical examiner’s office along an outline created by Fox and funded by the Legislature, she arrived with her own goals: to standardize investigations by coroners statewide, to write operating procedures and quality control protocols for autopsies, and to earn national accreditation.

“I plan on starting from scratch,” she said. “But first, it’s important to get familiar with the system and the people I’m working with.”

County coroners, elected officials who usually have limited medical training, conduct death investigations and decide which cases to forward to the crime lab in Missoula for further study, usually those involving people who died violent or unexplained deaths.

Dr. Gary Dale, who led the medical examiner’s office for more than 20 years, resigned in April. His longtime deputy, Dr. Walter Kemp, took over until he also resigned in June, forcing the state’s coroners to temporarily send bodies to Washington or South Dakota for autopsies.

Both Dale and Kemp cited ethical concerns as their reason for leaving and did so at the peak of an internal debate with former attorney general, Gov. Steve Bullock, and current Attorney General Tim Fox over autopsies performed by Dr. Thomas Bennett, a state-appointed associate medical examiner with a history of problematic child death cases in Iowa.

Eastern Montana coroners, often frustrated with long transport times to Missoula, turned to Bennett’s private practice in Billings, where he performed autopsies for a fee and often provided results faster than the clogged state crime lab.

Under the new system championed by Fox, medical examiners will be state employees who report directly to Oeberst, blocking contractors like Bennett from doing official autopsies for coroners.

Oeberst, who is board-certified, will oversee the work of two deputy medical examiners - one at the state crime lab in Missoula who must still be hired, and one at a new satellite office in Billings who will start Dec. 1 - as well as two assistants.

The structure is similar to Oeberst’s three-pathologist team at the Sedgwick County Regional Forensic Science Center in Wichita, Kansas, where they performed about 900 autopsies a year for the state’s largest city and many surrounding rural counties. Montana coroners request about 500 autopsies a year.

Oeberst admits forensic pathology wasn’t her first career choice. After graduating from the University of California-Berkeley in her home state, she aspired to become a surgeon, notoriously one of the most difficult medical specialties to master.

“After my first year of clinical, I realized that what I really found rewarding about medicine was interacting with other professionals as opposed to patient contact,” she told the Missoulian (https://bit.ly/1P8LVve).

While still studying at Wake Forest School of Medicine, Oeberst worked cases for a small North Carolina coroner’s office where she did it all: processed crime scenes, examined bodies and testified in court. After a one-year fellowship in Dallas, she became a Sedgwick County deputy medical examiner in 2000, and later led death investigations at the center.

Dr. Timothy Rohrig expects Oeberst to pursue improvements to Montana’s system with tact and skill.

“She did it here,” Rohrig said, noting he became director of the Wichita-based lab around the same time as Chief Medical Examiner Dr. Mary Dudley and her new deputy, Oeberst, arrived. “There’s been a lot of changes in forensic sciences since the late ‘90s. She came here right when things were starting to move fast and she helped us move forward.”

Forensic sciences evolved rapidly as more governments shifted lab work into professional, scientific settings and out of police departments, where questions had been raised about the quality and independence of results.

Later, like many labs nationwide, decreased funding, increased caseloads and turnover led to backlogs, which local officials said Oeberst managed with thoughtful prioritization until new staff could be hired.

As deputy and chief medical examiner, Rohrig said Oeberst also strengthened frayed relationships with funeral homes, coroners and law enforcement officials from dozens of counties who sometimes had strong personalities.

“There was a little bit of coaching. Maybe every now and then, a shove,” he said. “She collaborated with them and got them to buy in on why we needed to make changes rather than do things the way they’d been doing them for 20 years.”

Oeberst said her priorities center on working with coroners to develop guidelines and standard forms for death investigations.

“You can’t do autopsies in a vacuum,” she said. “There are a lot of places that have been very good at sending typed materials with pictures and all that kind of stuff, but then others I don’t get anything. What I would like is if you looked at the paperwork from any given case you can’t tell where it came from other than by the coroner’s name signed at the bottom.”

Greg Kirkwood, president of the Montana Coroners Association, said he is eager to work with Oeberst and expects his colleagues to carefully consider how to implement her suggestions while maintaining their independence.

Although encouraged by the opening of a satellite office in Billings, he worries whether having pathologists work as government employees will limit their hours and if state leaders will commit the funding needed to keep the expanded office running smoothly.

Nola Foulston, who served as Sedgwick County district attorney for 24 years, said she enjoyed working with Oeberst, in part because of her commitment to “a 24/7 job.” It was common, she said, to reach a crime scene at 3 a.m. to find Oeberst already there.

“She had a very keen sense of what her responsibilities were,” Foulston said. “Jaime is not going to cut corners and she isn’t going to tell you what you want to hear. She’s going to tell you what you need to know.”

Although murders and other violent crimes are the most high-profile component of a medical examiner’s job, Oeberst said autopsies also are critical to identifying outbreaks of infectious diseases, such as the flu, and identifying hereditary conditions that might help a relative receive appropriate treatments sooner.

“That’s probably, for me, one of the more rewarding aspects,” she said. “To be able to cross that bridge and help the living as well as taking care of the deceased people.”


Information from: Missoulian, https://www.missoulian.com

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