Washoe County Medical Examiner reports higher caseloads, steady organ-donation work and plans for accreditation

Washoe County Chief Medical Examiner Laura Knight told commissioners on May 27 that the county’s Regional Medical Examiner’s Office has seen caseloads rise since its 2017 facility opening, continues to provide services for neighboring rural counties, and is pursuing national accreditation.

Knight said the office serves Washoe County by statute and also provides death-investigation services to 18 additional counties in northern Nevada and adjacent parts of California. She said the regional work brings in about $1,600,000 in annual revenue and that the office completed between 1,150 and 1,400 body examinations annually in recent years. The office employs 39 full-time staff, 18 full-time medical-legal death investigators/autopsy technicians, 10 intermittent investigators, five medical examiners and a small administrative team.

Knight highlighted innovations and partnerships intended to improve efficiency and prevention efforts: a Lodox full-body x-ray scanner that speeds case processing; federal grants supporting a data specialist and a planned forensic epidemiologist; and collaboration with the Nevada Donor Network for tissue procurement. "We are meeting industry benchmarks, which means that more than 90% of our autopsy reports are completed and finalized within 60 days or less," Knight said.

On manner and cause trends, Knight pointed to a COVID-era peak in 2021 and steady increases in accidental deaths tied to the drug epidemic through 2023. She reported a decline in drug-related deaths from 360 in 2023 to 283 in 2024 but said 283 remains a significant number. Methamphetamine was the single most common drug identified, with fentanyl often present as well. Knight also noted 47 homicides in 2024 and a high number of suicides concentrated among men and seniors, with firearms the most common method.

Knight described the office's broader responsibilities: 24/7 scene responses, next-of-kin notification, identification services, authorizing organ and tissue donation, expert courtroom testimony and mass-fatality planning and exercises. She said the office facilitated 42 organ donation cases last year.

Funding has grown to match the office's regional role; Knight said a large opioid-response grant increased fiscal 2025 revenue projections and will support the forensic epidemiologist position. She said the office has applied to the National Association of Medical Examiners for accreditation and is awaiting an on-site inspection.

Commissioners asked about staff wellness. Knight said the office maintains a robust wellness program, including a counselor on contract for critical-incident debriefings, training on burnout and vicarious trauma and modest morale-boosting events funded from restricted death-certificate fees. "We really need that extra support to have the counselor come in," she said, describing the emotional demands of investigators who regularly respond to suicides and child deaths.

Commissioners applauded the office’s work and reaffirmed support for continuing organ-donation messaging and other collaborative prevention efforts.