Death in custody

Death in custody is the most demanding investigation that a medical examiner or coroner can perform. The investigation requires attention to detail at the time of scene investigation and autopsy examination, as well as a careful assessment of the toxicologic results and circumstances of the death. Synthesis of the many facts that are developed during the investigation should allow the medical examiner or coroner to establish a reasonable cause of death. There can be legitimate points of disagreement of interpretation because the conclusions so frequently are predicated on physiologic processes and not on anatomic findings. It is incumbent on the medical examiner and coroner responsible for investigating deaths of these types to utilize all the information generated during the investigation and to identify an appropriate cause of death.