Grand Junction-based forensic pathologist Dr. Robert Kurtzman has accepted an out-of-state job working for a state medical examiner’s office, which has huge implications for the Colorado counties he serves.
Kurtzman, who will continue working in the state through the end of October, performs autopsies for 10 Colorado counties and the Southern Ute Indian Tribe. After the 2012 retirement of former La Plata County coroner Dr. Carol Huser, also a forensic pathologist, Kurtzman began traveling to Durango each week to perform autopsies.
His absence will mean time and money to transport bodies to cities that have a forensic pathologist.
The problem is rooted in the state’s coroner system.
Coroners are charged with determining the cause of death and deciding if an autopsy is necessary – decisions that are medical in nature. In about 10 states including Colorado, coroners are elected and not required to hold a medical degree. If the coroner does not hold that certification, someone who does must conduct postmortem examinations.
Conversely, seven states follow the medical examiner system, which means only a medical professional can make the call about cause of death. In 1992, Kurtzman moved from Michigan, which has such a system. The rest of the country follows a combined system.
Demand for forensic pathologists is high; according to a 2009 report released by the National Academy of Sciences, there are fewer than 500 full-time practitioners in the nation. This scarcity prompted the National Commission on Forensic Science to appeal to the U.S. Attorney General earlier this year to consider policy that would recruit and retain forensic pathologists.
The issue at stake is multi-faceted for the Four Corners, which does not necessarily see enough cases to warrant hiring a full-time practitioner. Kurtzman handled about 200 cases yearly for the tribe as well as Pitkin, Garfield, Eagle, Rio Blanco, Moffat, La Plata, Archuleta, Dolores, Montezuma and San Juan counties. About 100 of those cases were in Southwest Colorado.
Coroner Jann Smith said La Plata County alone transports an average of two to three bodies weekly for autopsies. Transports are typically urgent cases, such as homicides, that can’t wait for Kurtzman’s weekly visit.
“We’ve talked about possible solutions like finding a replacement for him,” Smith said. “We have a doctor that may be willing to come down. If that doesn’t happen, we’d have to travel several hours, likely to Colorado Springs.”
Smith did not disclose the name of the medical professional who may step in to take over Kurtzman’s work, but she said with his assistance, autopsies could be performed in Durango.
About five autopsies can be accomplished in a day if done locally, Smith estimated. It’s a different story if the body is transported. Factoring in travel time, the coroner and all parties involved can be tied up for 10 hours or more for each autopsy.
“If we have to go to Colorado Springs, and we have three bodies, that’s two vehicles, plus money and manpower,” Smith said. “Plus there’s the risk of an accident.”
Topography makes transportation a challenge, particularly in Southwest Colorado, and the associated delays are tough on families, Smith said.
These complications support some experts’ argument that the coroner system is outdated.
Amy Martin, a Denver-based medical examiner who now does part-time consulting, holds this opinion, and she says certifying death is a strictly medical practice.
“Ideally, we would have something like a regional medical-examiner system,” Martin said. “It might be easier for a regional system to reallocate resources. For instance, send bodies to a central location.”
Martin is not alone in her opinion that the coroner system has hung on so long because coroners, particularly in smaller counties, hold substantial political power. Some forensic pathologists are also against a system overhaul, because they stand to gain financially.
However, both Martin and Kurtzman believe Colorado has many competent coroners, and death investigators have a vital role in the process.
“Coroner and medical-examiner systems have one goal and that is to investigate sudden unexpected deaths and violent deaths,” Kurtzman told The Durango Herald. “The purpose of the investigations is to acquire knowledge from the deceased to improve the lives of the living and for medicolegal documentation. Coroner and medical-examiner systems can easily accomplish the same goal.”
Kurtzman will begin his new job in Montana before the year’s end. La Plata County, which funds the coroner’s office, will then have some decisions to make.
County Commissioner Julie Westendorff said the commission has not discussed the budget yet, and she cannot comment at this time. The board will meet with the coroner’s office Oct. 20 about next year’s budget.
jpace@durangoherald.com
