ChesterCountyMedicineSummer2019 - 23

for coroners in Pennsylvania don't include any medical training or
background, only a one-week Coroners' Education Course to be
taken before being sworn into office.

Murder has been a
constant but relatively
infrequent manner of
death in Chester County
What is a Coroner's Case?
throughout the centuries,
some variations in
We have spotty records of causes of death in the 1700s, with more
of death. In the
extensive records for the 1800s. Looking over those 2 centuries, I was
was usustruck by the high number of drownings, something we rarely see
now. The majority of these drownings were workplace accidents, with
a typical description being "fell into a mill race." Boating accidents
"hit in the head with a Chestnut [tree]
weren't unusual either. Transportation accidents typically involved
stabbing and gunshot wounds had
horses and wagons or carts, but in the late 1800s the first train deaths
wounds are the most common
were recorded. In fact, 10 fatal train accidents occurred in 1876 alone.
for example, 4/12 homicides
A single train accident due to "severe weather" resulted in 7 deaths
with 8/11 in 2018.
on October 5, 1877 and literally dozens of deaths were attributed
to "transport accident - train" in the last decade of the 19th century.

Changing Technology

Handwritten notes were the only records in the early years of
the office. We still take notes, but now everything is documented in
increasingly complex databases. Paralleling the experience of physicians,
we spend at least as much time on data entry and documentation as
we do going to a scene or speaking with families.
The internet is playing a big role these days. Text messages sometimes tell us more about time of death than rigor mortis, suicide
notes may be digital rather than handwritten, and online purchases
of abused substances are common.

The first fatal automobile accident in our County was recorded
in 1909 when a 5-year old was struck by a car. Automobile accidents
and cardiovascular disease gradually dominated the caseload in
the 20th century. Drunk driving and fatal motor vehicle accidents
(MVAs), especially in those under 21, were a major concern in the
60's and 70's. Legislative changes concerning the drinking age, DUI
definitions, and seat belts have resulted in a decline in MVAs since
then. Alcohol and other substances and lack of seat use are still
associated with fatal MVAs today, however.
Murders, suicides, and "substance" deaths have always been part
of the coroner's caseload, but the substance in the early centuries was
almost always alcohol. Other drugs became a concern in the late 1960's
and Coroner Harrop -with obvious prescience - began advocating for
a toxicology laboratory. Drug deaths, first called "adverse reactions
to drugs and poisons," were separately tracked beginning in 1976.
Today, of course, we are in the throes of an "opioid epidemic." In
2018, there was a total of 112 accidental drug overdose deaths in
Chester County, with opioids present in more than 70% of cases.
Falls are currently the second most common cause of accidental
death in Chester County (after drug overdoses). Coroner Rothenberger
first expressed concern about this when he observed an increase
in falls in those over age 65 in the late 1990's. Now we see falls
contributing to accidental death primarily in those over 75. Even if
it is an indirect cause of death, hospitals and hospices must notify
the Coroner if a fall initiated the terminal events.

Probably the biggest game-changer for death investigations in
the past 50 years, however, is DNA testing, a topic now so complex
it warrants its own future article. One example will suffice for now,
the case of a Vietnam era Marine, Cpl. Robert Daniel Corriveau.
Found murdered on the Pennsylvania Turnpike in 1968, his body
was not identified until 2012 after an exhumation to obtain DNA.

Final Thoughts
One thing that hasn't changed is that the Coroner's Office is
one of the most fascinating county government agencies not just
historically but every day. We have the privilege and responsibility
of seeing a side of Chester County that others rarely do, and the
opportunity to make a difference every day for people who have lost
a family member, friend, or colleague. I encourage Chester County
medical professionals to consider working or volunteering with us,
especially if you are looking for a completely different way to apply
your experience after retirement.
Thanks to Laurie Rofini and Clifford Parker of the Chester
County Archives, Dorothy I. Lansing, M.D., Historian and
Archivist, for her 1981 history, to Drs. Donald Harrop and
Norm Goodman for excellent conversations and information about their experiences as Coroner and Chief Deputy
Coroner, respectively, and to Dr. Rodger Rothenberger
for his 1999 paper on the History of the Chester County
Coroner's Office.

SUMMER 2019 | CHESTER COUNT Y Medicine 23


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