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Medical examiner budget: investigators cite steady autopsy demand and body-bag costs
Summary
Jail administrator and medical investigator Mark Gargano told the board the county's medical examiner budget is driven by unpredictable autopsy demand, about 20% of cases sent for autopsy (often to the University of Iowa), and recurring supply costs such as body bags; he noted 124 cases last year and 10 already this year.
Mark Gargano, the jail administrator who also serves as a county medical investigator, briefed supervisors on the medical examiner budget and caseload. He said the county cannot predict autopsy demand, reported roughly 124 ME cases last year and said the county was already handling 10 cases in the first three weeks of the year. "We clearly have no way to indicate how many autopsies are going to be needed throughout the course of the year," Gargano said.
Gargano described the ME budget's main cost drivers: supply items (notably single-use body bags), autopsy fees and any specialized testing sent to outside labs. He said the average autopsy cost is about $2,000 and that approximately 20% of cases historically are sent for autopsy or additional testing at the University of Iowa or other labs. "Our main expense is body bags," Gargano said, noting they are single-use for safety and that attempts to reuse such items would not be safe or practical.
He outlined statutory criteria that commonly trigger autopsies: multi-person automobile crashes, deaths of young children, work-related incidents, suspected homicides, and many suicides, where the state recommends autopsy to determine cause and manner of death. Gargano said the county now relies on a mix of investigators and that some specialized training and travel previously required (e.g., to St. Louis University) has been reduced by state-run training options in Ankeny and the Iowa Association of County Medical Examiners conference.
Gargano asked supervisors to recognize the inherent variability in ME expenses when evaluating the budget and to maintain modest flexibility for supplies and autopsy-related costs rather than cutting those lines because of unpredictability in caseload and testing needs.
