Coroner’S Days Winding Down Spokane County Will Switch To Medical Examiner System In January

Come Jan. 1, Spokane County taxpayers say goodbye to Coroner Dexter Amend.

Spokane joins three other Washington counties - King, Pierce and Snohomish - that employ full-time medical examiners.

The switch, overwhelmingly approved by voters two years ago, ends nearly a century of elected Spokane coroners, capped by public outrage over Amend’s disturbing death investigations.

Spokane’s first medical examiner, Dr. George Lindholm, pledges to be a different kind of county official.

With Amend firmly in mind, county commissioners agreed to pay a lot for Lindholm’s services: about $350,000 a year.

For the extra money, the county will get more autopsies performed each year and a better-managed office, according to Lindholm.

“This medical examiner system gives the county a sophistication level it hasn’t had before,” he said.

Lindholm is a forensic pathologist who has performed autopsies for the county for 13 years. “My goal is to run a well-run office so that people won’t even I know I exist.”

Because Lindholm is a contract worker, commissioners can fire him for any good reason. More importantly, the county can’t be sued due to his mistakes or misdeeds.

In the past four years, at least five lawsuits seeking a combined $4 million in damages have been filed against the county, accusing the coroner of misconduct or invasion of privacy.

One suit claims Amend asked the grieving mother of a 16-year-old Spokane murder victim if the girl had been sodomized by gang members.

Amend has denied asking the question, although other bereaved families have reported being stunned by the coroner’s homophobic inquiries.

The 77-year-old retired urologist declined to be interviewed for this article.

“His real problem,” said Spokane County Commissioner Phil Harris, “is that Dexter just talked too much.

“Dexter was a good doctor. But it took him a long time to realize he needed to keep his opinions to himself about homosexuality and other things.”

Coroners are elected officials who by law can determine whether a death occurred in circumstances requiring an autopsy. The coroner can decide the scope of the autopsy and who will perform it if he doesn’t have the skill.

Coroners must sign death certificates in cases with unnatural circumstances. In Washington, a coroner does not need to be a doctor.

Medical examiners must be trained physicians who can perform autopsies. Frequently, the examiner is also a pathologist - a certified specialist in diagnosis and analysis of bodily changes caused by disease or injury.

Backers of a medical examiner system say the coroner’s post is inadequate for a county as large as Spokane.

The most compelling reason for retaining a coroner: The elective office tends to be more independent than other county departments, and voters have the final say on how well the job is done.

“That’s the only argument I can come up with,” said Graham McConnell, the 83-year-old retired doctor who served as Spokane’s coroner from 1986 to 1994.

“But voters only get their say once every four years. That’s not often enough.”

The change to a medical examiner system, however, won’t be cheap.

Taxpayers will spend almost a million dollars in 1999 to set up the new office and pay for salaries and services. The local cost is estimated at $874,000, with the state picking up the balance.

That compares to the coroner’s current operating budget of about $600,000.

Of the $350,000 per year Lindholm will receive, he said his actual salary and benefits will be about $160,000 - almost three times what Amend earned. The rest will cover administrative costs and other expenses.

“It’s more expensive to set up a medical examiner system at first,” said Dr. Norman Thiersch, Snohomish County’s medical examiner. “But it’s cheaper in the long run when you consider alternatives.”

Thiersch said Lindholm will help as an expert witness in criminal trials, helping prosecutors tie evidence from a crime scene to the person on trial.

“The matter of how one maintains chain of evidence, of how carefully one follows accepted standards when doing death-scene investigations - all that extra care and professionalism will pay off when some of these criminal cases are taken to court,” said Thiersch.

While Lindholm will be a special contract worker, the budget for his office includes the salaries of six other full-time county employees.

Three will be medical examiners who have the job of visiting death scenes and determining the scope of the investigation. There will also be an office administrator and two clerical workers.

Adding to the costs are plans for a hundred or so more autopsies a year.

Amend authorized about 300 autopsies in 1997. Lindholm expects to perform between 380 and 440 a year, or in roughly 10 percent of deaths in the county.

Lindholm said he believes in making sure that every potential concern over a person’s death be investigated through an autopsy.

During the past four years, Lindholm and Amend have butted heads a number of times over whether an autopsy should be done. Those cases almost always involved apparent suicides, often with drugs present in the body.

Sometimes it came down to money. Each autopsy Amend asked Lindholm to perform cost the county an additional $1,000.

Lindholm said medical examiners tend to notice things other doctors might miss, aiding law enforcement.

In the infamous 1986 Seattle cyanide-Tylenol cases, an investigator assigned to the King County Medical Examiner’s Office was the first person to suspect murder.

“It came down to an investigator doing an autopsy who smelled cyanide,” Lindholm said.

Lindholm’s new contract with the county lets him continue performing autopsies for other counties in North Idaho and Eastern Washington. The arrangement benefits local taxpayers. Each autopsy will cost the rural counties $1,020, but Lindholm keeps only $270. The other $750 goes to Spokane County.

Voters won’t be losing anything by switching to a medical examiner, according to Public Defender Don Westerman.

“Dr. Lindholm is a very strong personality who is going to be politically independent, ” he said. “It’s going to be a significant gain for the county.”

Amend leaves legacy of controversy By Tom Sowa Staff writer Since being elected in 1994, Dexter Amend has cost Spokane County taxpayers more than $200,000 in legal fees. About $180,000 comes from the cost of defending against several lawsuits filed by people angered by Amend’s death investigations. The cases include a 1995 suit by Lori Beal, the mother of 9-year-old Rachel Carver, who was murdered by her uncle. After an autopsy, Amend astounded police and other officials by saying he determined the child had been sodomized “over and over, and sodomy is a homosexual act.” Amend also once held up the cremation and funeral of an AIDS victim by demanding an autopsy with extra attention on the man’s rectum. “Let’s just say that Dr. Amend helped prove just how antiquated the coroner’s job is,” said a county department head who didn’t want to be identified. Amend was the subject of a three-day hearing in 1996 by the Washington Medical Quality Assurance Commission, which reviewed four of his death investigations. The agency fined Amend $1,000 and ordered him to attend 20 hours of “sensitivity” training. Voters attempted to recall Amend in 1996, collecting 35,000 signatures. The state Supreme Court stopped that effort, ruling that the recall petition was invalid. In fall 1996, more than 80 percent of voters supported a measure to replace the coroner’s post with the medical examiner system.