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Cowlitz County coroner proposes in-house Randox testing to cut autopsy and toxicology costs
Summary
Coroner’s staff reported 2024 autopsy and reimbursement data, proposed purchasing a Randox analytical instrument that staff say would speed toxicology screening, and outlined potential savings versus private lab costs. The proposal would not eliminate full autopsies and requires training and ongoing test costs.
The coroner’s office presented its proposed 2026–27 budget and a plan to use a Randox in‑office analytical instrument to reduce autopsy and toxicology expenses.
Office staff said the county conducted 79 full autopsies in 2024 — 6 infants and 73 adults — and reported total autopsy charges for the year and associated reimbursements. The coroner’s presentation said autopsy reimbursements are handled through the state process and noted the reimbursement rate for children under age 3 is 100%; adult autopsy reimbursements were described as 40% of charges. The office reported total autopsy costs (including full externals and consults) and a 2024 reimbursement total of about $84,050.17; staff said reimbursements can take several months.
The coroner recommended adopting a Randox quantitative toxicology platform for on-site screening. Staff described the Randox as an analytical clinical-chemistry instrument with an annual maintenance cost the office estimated at $8,000 and a per-test consumable cost of about $50. By contrast, staff said sending specimens to certain private toxicology providers (NMS Labs) costs roughly $158 for a standard panel and about $243 for expanded panels. Using figures presented by the office, staff estimated that for a sample year with 35 drug-related cases that previously required autopsy and toxicology, the Randox option (annual fee plus $50 per test) would have cost about $10,000, compared with more than $73,000 for the same workload using outside lab services and full autopsies.
The coroner emphasized the Randox would not replace board‑certified laboratory testing where required. Staff said samples would still be sent to the Washington State Patrol (WSP) toxicology laboratory for confirmatory testing when that is necessary; the Randox would be used as an early screening tool to speed determinations on whether a full autopsy is required and to shorten the time families wait for a death certificate.
On indigent burials, the coroner said the budgeted indigent-burial line was reduced from about $5,600 to $700 after negotiating lower rates with local funeral providers and because actual expense last year was closer to $700. The office said most indigent dispositions are cremations and that some decedents are listed as “abandoned by family,” which increases county responsibility in the absence of family action.
Why it matters: autopsies and toxicology are among the coroner’s largest operating costs. Faster in‑office screening could reduce outside lab bills and the number of full autopsies performed when clinical history and screening results make them unnecessary, but the county will still incur contract pathologist costs for required autopsies.
Ending: The coroner’s office asked the board to consider the Randox approach as a cost‑saving and case‑management tool; commissioners asked clarifying questions about reimbursements and indigent burials.
