Forensic Anthropology at the New York City Office of Chief Medical Examiner

Isotopic analyses of human remains augment the biological profile with geolocation and dietary information, furthering efforts to identify unknown individuals from a forensic context. Here we test the methodological resolution of geolocation (δ18O, 87Sr/86Sr) and dietary (δ13C, δ15N) isotopes of one identified individual who immigrated to New York City from St. Vincent and the Grenadines (SVG), Lesser Antilles. Isotope-based geolocation estimates did not identify the childhood residency on SVG, but did point to New York City as a possible residence during early adulthood. The individual’s C3-based diet did not significantly change from childhood to early adulthood, illustrating the maintenance of food traditions after the immigration event. This study illustrates that further development of tissue-specific isoscapes incorporating bioavailable foods, drinking water, and cultural traditions is warranted to refine methodological resolution of isotopic applications in forensic anthropology.

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Evaluation of 4-fluoroisobutyrylfentanyl in blood samples from 247 authentic cases submitted to the New York City Office of Chief Medical Examiner in 2017–2018

Forensic Toxicology ◽

10.1007/s11419-019-00518-6 ◽

2020 ◽

Vol 38 (2) ◽

pp. 340-351

Author(s):

Justine Pardi ◽

Allison Toriello ◽

Gail Cooper

Keyword(s):

New York ◽

New York City ◽

York City ◽

Medical Examiner ◽

Blood Samples

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Human Immunodeficiency Virus Infection Newly Diagnosed at Autopsy in New York City, 2008–2012

Open Forum Infectious Diseases ◽

10.1093/ofid/ofv146 ◽

2015 ◽

Vol 2 (4) ◽

Cited By ~ 3

Author(s):

Chitra Ramaswamy ◽

Tanya M. Ellman ◽

Julie Myers ◽

Ann Madsen ◽

Kent Sepkowitz ◽

...

Keyword(s):

New York ◽

Human Immunodeficiency Virus ◽

New York City ◽

Hiv Testing ◽

York City ◽

Population Based ◽

Medical Examiner ◽

Newly Diagnosed ◽

Hiv Diagnosis ◽

Immunodeficiency Virus

Abstract Background. Studying the most extreme example of late diagnosis, new HIV diagnoses after death, may be instructive to HIV testing efforts. Using the results of routine HIV testing of autopsies performed by the Office of Chief Medical Examiner (OCME), we identified new HIV diagnoses after death in New York City (NYC) from 2008 to 2012. Methods. Population-based registries for HIV and deaths were linked to identify decedents not known to be HIV-infected before death. Multivariable logistic regression models were constructed to determine correlates of a new HIV diagnosis after death among all persons newly diagnosed with HIV and among all HIV-infected decedents receiving an OCME autopsy. Results. Of 264 893 deaths, 24 426 (9.2%) were autopsied by the NYC OCME. Of these, 1623 (6.6%) were infected with HIV, including 142 (8.8%) with a new HIV diagnosis at autopsy. This represents 0.8% (142 of 18 542) of all new HIV diagnoses during the 5-year period. Decedents newly diagnosed with HIV at OCME autopsy were predominantly male (73.9%), aged 13–64 years (85.9%), non-white (85.2%), unmarried (81.7%), less than college educated (83.8%), and residents of an impoverished neighborhood (62.0%). Of all HIV-infected OCME decedents aged ≥65 years (n = 71), 22.0% were diagnosed at autopsy. The strongest independent correlate of new HIV diagnosis at autopsy in both multivariable models was age ≥65 years. Conclusions. Human immunodeficiency virus diagnoses first made after death are rare, but, when observed, these diagnoses are more commonly found among persons ≥65 years, suggesting that despite highly visible efforts to promote HIV testing community-wide, timely diagnosis among older adults living in impoverished, high-prevalence neighborhoods may require additional strategies.

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Injury Deaths Related to Hurricane Sandy, New York City, 2012

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2016.36 ◽

2016 ◽

Vol 10 (3) ◽

pp. 378-385 ◽

Cited By ~ 8

Author(s):

Kacie Seil ◽

Ariel Spira-Cohen ◽

Jennifer Marcum

Keyword(s):

New York ◽

New York City ◽

York City ◽

Vital Statistics ◽

Hurricane Sandy ◽

Red Cross ◽

Medical Examiner ◽

Mortality Data ◽

Multiple Sources ◽

Demographic Patterns

AbstractObjectiveThis project aimed to describe demographic patterns and circumstances surrounding injury deaths in New York City (NYC) related to Hurricane Sandy.MethodsInjury deaths related to Hurricane Sandy were classified by using data from multiple sources: NYC’s Office of Vital Statistics death records, Office of Chief Medical Examiner case investigation files, and American Red Cross disaster mortality data. Injury deaths were classified as being related to Hurricane Sandy if they were caused directly by the storm’s environmental forces or if they were indirectly caused by an interruption of services, displacement, or other lifestyle disruption.ResultsWe identified 52 injury deaths in NYC related to Hurricane Sandy. Most decedents were male (75%); nearly half were aged 65 years and older (48%). Most (77%) deaths were caused by injuries directly related to Hurricane Sandy. Ninety percent of direct deaths were caused by drowning; most (73%) occurred within 3 days of landfall. Half (50%) of the 12 indirect deaths that occurred up to 30 days after the storm were caused by a fall. Nearly two-thirds (63%) were injured at home. Three-quarters (75%) of fatal injuries occurred in evacuation Zone A.ConclusionsRisk communication should focus on older adults, males, and those living in evacuation zones; more evacuation assistance is necessary. NYC’s fatal injury profile can inform future coastal storm planning efforts. (Disaster Med Public Health Preparedness. 2016;10:378–385)

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Dementia in the Forensic Setting: Diagnoses Obtained Using a Condensed Protocol at the Office of Chief Medical Examiner, New York City

Journal of Neuropathology & Experimental Neurology ◽

10.1093/jnen/nlab059 ◽

2021 ◽

Author(s):

David S Priemer ◽

Rebecca D Folkerth

Keyword(s):

New York ◽

New York City ◽

Cerebrovascular Disease ◽

York City ◽

Hippocampal Sclerosis ◽

Lewy Body Disease ◽

High Rate ◽

Medical Examiner ◽

Age Related ◽

Jakob Disease

Abstract Individuals with dementia may come to forensic autopsy, partly because of non-natural deaths (e.g. fall-related), and/or concerns of abuse/neglect. At the New York City Office of Chief Medical Examiner (NYC OCME), brains from such cases are submitted for neurodegenerative disease (ND) work-up. Seventy-eight sequential cases were evaluated using a recently published condensed protocol for the NIA-AA guidelines for the neuropathologic assessment of Alzheimer disease (AD), a cost-cutting innovation in diagnostic neuropathology. ND was identified in 74 (94.9%) brains; the most common were AD (n = 41 [52.5%]), primary age-related tauopathy (n = 26 [33.3%]), and Lewy body disease ([LBD], n = 25 [32.1%]). Others included age-related tau astrogliopathy, hippocampal sclerosis of aging, progressive supranuclear palsy, multiple system atrophy, amyotrophic lateral sclerosis, argyrophilic grain disease, and Creutzfeldt-Jakob disease. 26.8% of AD cases involved a non-natural, dementia-related death, versus 40.0% for LBD. Finally, 70 (89.7%) cases had chronic cerebrovascular disease, 53 (67.9%) being moderate-to-severe. We present a diverse distribution of NDs notable for a high rate of diagnoses associated with falls (e.g. LBD), a potential difference from the hospital neuropathology experience. We also report a high burden of cerebrovascular disease in demented individuals seen at the NYC OCME. Finally, we demonstrate that the aforementioned condensed protocol is applicable for a variety of ND diagnoses.

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Sudden Unexpected Infant Death Certification in New York City: Intra-Agency Guideline Compliance and Variables that May Influence Death Certification

Academic Forensic Pathology ◽

10.23907/2017.046 ◽

2017 ◽

Vol 7 (4) ◽

pp. 536-550

Author(s):

Melissa A. Pasquale-Styles ◽

Margaret Regensburg ◽

Ruijun Bao

Keyword(s):

Risk Factors ◽

New York ◽

New York City ◽

Cause Of Death ◽

Infant Death ◽

York City ◽

Medical Examiner ◽

Sudden Infant ◽

Death Certification ◽

Infant Deaths

Introduction Differences in certification of similar sudden infant deaths exists among forensic pathologists. This study sought to measure adherence to intra-agency guidelines for infant death certification in one jurisdiction and describe variables that may be associated with the differentiation of sudden infant death syndrome (SIDS), asphyxia, and undetermined death certifications. Methods A retrospective study of deaths at the New York City Office of Chief Medical Examiner identified 427 sudden infant deaths with investigation and autopsy whose cause of death was ruled SIDS, asphyxia, or undetermined. Cases were reviewed for number and types of risk factors for asphyxia, demonstrable evidence of asphyxia, potential competing causes of death, and a doll reenactment. Descriptive and statistical analysis was performed. Results Of 427 deaths, the causes of 100 deaths (23.4%) were ruled asphyxia; 43 (10.0%) SIDS; and 284 (66.5%) undetermined. Forensic pathologists conformed to agency guidelines in 406 deaths (95.1%). Three or more risk factors for asphyxia were found in 328 deaths (76.8%). Demonstrable evidence of asphyxia (40.7%) was most associated with a certification of asphyxia. A potential competing cause of death (20%) was most associated with undetermined. A doll reenactment had little association with certification type. Discussion Guidelines in one agency were effective at limiting incorrect SIDS diagnoses. The interpretation of risk factors can be subjective. Diagnostic overlap occurred in deaths certified differently as SIDS, asphyxia, and undetermined, despite similar findings. Elimination of SIDS as a certification option and better guidelines that help differentiate asphyxia and undetermined deaths are recommended for improved infant death certification.

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