Secondary Data Analysis of the North Carolina Office of the Chief Medical Examiner's Suspected Poisoning Death Investigation Efforts

With a continued increase in North Carolina’s population, an increase in death is inevitable. As efforts to increase a community’s health through policies, partnerships, and education have grown, the need for robust, multidisciplinary and multicomponent data is required to support these interventions. Understanding the investigative processes of one of these possible data sources, the North Carolina Office of the Chief Medical Examiner, is essential. Determination of how suspected poisoning deaths are investigated in the state of North Carolina. A secondary analysis was conducted using data collected by the local medical examiners across the state of North Carolina and the North Carolina Office of the Chief Medical Examiner in cases where naloxone was identified in the decedent’s toxicology report from October 1, 2017 through May 31, 2018. Qualitative and quantitative data were abstracted and analyzed to evaluate the quality of the data collected by the statewide medical examiner system. The decedent’s history of receiving medication-assisted treatment was most frequently not specified on death investigation reports. Other variables that were not continuously specified on death investigation reports included history of diagnosed mental illness, suicide ideation and attempt, chronic pain, arrest and/or incarceration, and inpatient or outpatient treatment for substance use disorder or mental health treatment. The variables identified as important to public health efforts are not consistently reported by North Carolina local medical examiners on death investigation reports. It is thus highly recommended that the leadership of the North Carolina Office of the Chief Medical Examiner revise the current investigation report to encourage established variables to be reported during the death investigation process.Master of Public Healt