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Medicolegal Investigation for Cremation Clearance

How and Why?

Gill, James R. MD; Olko, Holly G. MS; DeJoseph, Maura E. DO

The American Journal of Forensic Medicine and Pathology: September 2019 - Volume 40 - Issue 3 - p 238–241
doi: 10.1097/PAF.0000000000000479
Original Articles

This study on cremation clearance examines whether physical inspections detect more unnatural unreported deaths than medicolegal investigations without inspections. We reviewed all deaths reported to the medical examiner for cremation clearance during 2 distinct years and compared subsequent amendments of death certificates after 2 different investigative methodologies (1 with and 1 without physical inspection). Of 10,367 deaths in 2012, there were 86 deaths (0.83%) in which the investigation with physical inspection resulted in amendments to the death certificate. Of 11,906 deaths in 2016 without physical inspection, there were 153 that resulted in amendments (1.3%) including 2 homicides. For the detection of accidents, there was no statistically significant difference (χ2 = 0.8119, P = 0.367552). For cremation investigations, the work effort and costs of performing physical inspections do not appear justified given the similar detection rates (approximately 1%) for unnatural deaths among the 2 groups. Both methods, however, do detect unreported unnatural deaths.

From the Connecticut Office of the Chief Medical Examiner, Farmington, CT.

Manuscript received November 26, 2018; accepted February 16, 2019.

This research has been accepted as a platform presentation at the American Academy of Forensic Science Meeting in Baltimore on February 21, 2019.

The authors report no conflict of interest.

Reprints: James R. Gill, MD, Office of the Chief Medical Examiner, 11 Shuttle Rd, Farmington, CT 06032. E-mail:

Online date: April 9, 2019

© 2019 by Lippincott Williams & Wilkins.