Amend’s Decisions Could Skew Stats Officials Worry Questionable Causes Of Death Can Lead To Inaccurate Reports Of Health Trends

Unless a family member dies, most people pay no attention to the county coroner.

After all, isn’t the coroner a behind-the-scenes kind of guy who quietly conducts business in a cluttered office on Broadway?

Not this year.

Since taking office in January, Dr. Dexter Amend has paraded the Spokane County coroner’s office into the footlights of the public stage.

His job - helping discover what kills people in Spokane County - is critical to community health.

Unexpected deaths are his domain. He can ease the pain of grieving families by figuring out how a loved one died. He can help solve mysterious murders and find out whether babies die from falls or abuse.

Researchers track health trends by studying the coroner’s death certificates.

But while Amend plays a star role in determining how people die, health officials worry the decisions he is now making will skew those important statistics.

“On occasion, we’ll question some diagnoses he’s put on death certificates,” says Dr. John Beare, health officer at the Spokane County Health District. “Some of them just don’t seem to fit.”

Without accurate death certificates, he says, “we get a skewed look at what causes death in the county.”

Sometimes, instead of helping rule out foul play in death investigations, police say Amend refuses autopsies they request.

“It’s almost common practice that no one calls the coroner until after we’re all done (investigating the scene),” says a law enforcement officer. “No one wants him out there.”

Families who have encountered Amend after a loved one died describe him as “callous” and “insensitive.”

Amend, a retired urologist, is also turning the heads of people who didn’t know his name a month ago, such as Chris Christenson, who is circulating petitions to recall him. Christenson, a retired schoolteacher, took notice after Amend publicly condemned homosexuality.

The same comments prompted doctors on the Spokane County Medical Society’s ethics committee to review the coroner’s conduct. That review has just begun.

Even a fellow politician often mired in controversy himself wants the coroner to lie low: “It’s detracting from this agency’s mission,” says County Commissioner Steve Hasson. “It’s hard to serve the public.”

Hasson says he knows Amend’s “sensitivity level is not good” and “his bedside manner is not the best,” but what irks the commissioner most is when the coroner preaches morals.

“We need to separate church and state,” Hasson says. “You just don’t bring church to work with you.”

Through his secretary, Amend refused to comment.

Dr. Donald Reay, King County’s chief medical examiner, isn’t surprised when he hears rumblings about the Spokane coroner.

The state has absolutely no guidelines for when coroners should perform autopsies. When coroners are elected every four years in Spokane County, Reay says, what can you expect but chaos?

“I don’t think you really have a systematic way of doing things,” Reay says. “I don’t think there’s any clear design or vision of what death investigation is about.”

Reay holds an appointed, rather than an elected, position and has developed his own guidelines for when to do autopsies.

He described Amend’s encounters with relatives of the deceased as “callous and judgmental.”

Numerous families told Spokesman-Review reporters Amend offended and angered them after their loved ones died.

One couple, for example, said he graphically explained how their toddler’s organs could be reused. A single woman said Amend told her to go to church and find a husband.

“It’s very unfortunate that these families dealing with a sudden death have to deal with this kind of government insensitivity,” says Reay.

“I can assure you if I did this kind of thing, I wouldn’t have a job.”

Doctors at the Spokane County Medical Society agree the controversy surrounding Amend is evidence the county needs a medical examiner system instead of a coroner system.

A medical examiner would be an appointed forensic pathologist who specializes in death investigation and autopsies.

The medical society has pushed for such a system for three decades, says president Dr. John Gollhoffer.

“A recall doesn’t really solve the problem,” says Gollhoffer, “because the coroner would be replaced by another non-qualified individual.”

Says internist Dr. Robert Wigert: “The basic feeling of our group is even though this guy is a physician, he does not understand clinical medicine. It doesn’t mean he’s doing a good job as coroner.”

State law is extremely vague about a coroner’s role, leaving lots of latitude for them to work as they please.

Chuck Armstrong, a north Spokane janitor, knows just how ambiguous the law is. He began studying it after becoming incensed when Amend didn’t autopsy his 50-year-old wife, Judy, who died suddenly in her bed last January.

“There’s just too many loopholes for them,” says Armstrong. “(Amend) can do just about anything he wants to do and there’s nothing we can do about it.”

Amend decided Judy Armstrong died from an overdose of an asthma inhalant, although her husband said she didn’t use it.

State guidelines for conducting autopsies, if not stricter laws, may be available in a couple of years.

The state Forensics Council, appointed by the governor, has just begun meeting to hash out such guidelines.

The suggestions wouldn’t be mandatory, says Judy Arnold, council member and Thurston County coroner.

“There’s no sense trying to invent the wheel all over again,” says Arnold. “It would give you a place to start - what you should do, what you shouldn’t do.”

, DataTimes