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Former chief medical examiner being phased out

Dr. Henry Nields had served as a part-time contractor for the state medical examiner’s office after retiring as chief examiner.
Dr. Henry Nields had served as a part-time contractor for the state medical examiner’s office after retiring as chief examiner. Globe File/Globe Staff

The state’s chief medical examiner is phasing out her predecessor, Dr. Henry Nields, from his role as a part-time contractor — a move that has surprised staff in an office that’s struggled to quickly complete death investigations.

Dr. Mindy J. Hull, who replaced Nields in October 2017, told him in an e-mail last week that “at this time . . . we do not anticipate needing your services” because the office has been able to hire several new full-time examiners. She said it allows her to staff each of the agency’s four offices in Boston, Holyoke, Worcester, and on Cape Cod without “extra” contracted workers.

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But Nields is the only one of four part-time, contracted medical examiners the agency uses who was removed from its June schedule, according to internal copies reviewed by the Globe. And the three others are each scheduled to work the same or a similar number of days as they have in May.

The decision appeared to catch Nields off guard. He had e-mailed Hull that morning about a potential plan to work in the Boston office on certain days, and after seeing her response, he reached out to staff members to say he was leaving the office.

Nields had been productive, too, completing nearly 150 cases during the final six months of 2018, more than half of which were autopsies, according to the office’s most recent annual report. No other contractor had done more autopsies in that time.

“I am told that my services are no longer needed here, so I am checking out of the OCME hotel,” Nields wrote in his e-mail to staff, using an acronym for the Office of the Chief Medical Examiner. “I know that the character of this office is, and will remain, strong because of you all.”

Efforts to reach Nields for further comment were not successful.

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Hull’s office has run the risk of losing its newly won accreditation, specifically because of its slipping performance in completing autopsies.

Felix Browne, a spokesman for the office, defended the decision, noting that Nields’ contract hasn’t technically been terminated, but due to new hires, the office expects “less of a need” for contracted workers.

Two part-time assistant medical examiners were promoted to full time in February and April, a new staff medical examiner started in May, and two fellows, whose work is currently supervised, will also become full time on July 1, he said.

Browne said Nields wanted to work in the Boston office, where it “didn’t need help.” Nields had been scheduled for five days in May, all in the Worcester or Holyoke offices.

“Dr. Hull is carrying out reforms intended to boost office productivity and reduce turnaround times so that grieving families can get the answers they need on a timely basis,” Browne said.

The National Association of Medical Examiners told Hull in January that her office will “most likely” lose its fully accredited status after it reported it was unable to complete 90 percent of its autopsy reports within 90 days — a key standard — during an annual review late last year.

At the time, association officials said they would delay a decision on the office’s status, including whether to downgrade it to a provisional accreditation, so Hull could submit more information.

As of Wednesday, the Massachusetts agency was still listed as fully accredited in the association’s online database.

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The office has faced an ever-rising tide of cases, driven in part by the state’s opioid epidemic. It reported handling 6,145 cases in fiscal 2018, a 4 percent jump from the previous year. To keep up, the office has routinely forgone autopsies in favor of less-rigorous testing in Hull’s tenure — including in cases of suspected fatal overdoses, which runs counter to best-practice standards.

The timing of Hull’s decision caught several in the office by surprise. The same day she
e-mailed Nields, a jury had returned a guilty verdict against Pallavi Macharla in a high-profile shaken baby death trial at which Nields had recently testified.

He took the stand about two weeks earlier, testifying that 6-month-old Ridhima Dhekane died of blunt force trauma to her head and being shaken, supporting the prosecutors’ case and directly contradicting the testimony of his former student, Dr. Anna McDonald.

Nields retired as chief medical examiner in 2017, roughly 10 years after he first took over the office in an acting capacity. He was credited with a number of improvements, including opening a new facility in Sandwich and planning for a new facility in Westfield, and the then-public safety secretary, Daniel Bennett, praised him as the “ultimate professional.”

But his tenure also included controversy. He faced perennial shortages in funding and staff, and came under criticism for the lengthy turnaround times for completing death investigations that have long dogged the agency. The lag in finishing reports was the primary obstacle to the office getting fully accredited while he was chief medical examiner.

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The office also faced scrutiny for its handling of suspicious infant deaths, especially after three assistant medical examiners retracted shaken-baby syndrome homicide rulings they had initially made and revised the manners of death to be undetermined.

Two such cases were dropped, though a third — the case against Macharla — forged on, ultimately leading to her conviction.

Nields testified two weeks ago that he had no doubt from overseeing the autopsy on the infant that Ridhima died of blunt force trauma to her head and being shaken. He said there were no signs of any disease or other significant findings that would explain the baby’s death. But he also acknowledged during the trial that he found no cuts or bruises on Ridhima’s head that would correspond with the massive bleeding discovered in her brain and behind her eyes.

McDonald, his former student, testified that Ridhima died from cardiac arrest. McDonald, who at the time was a doctor-in-training in the medical examiner’s office, originally ruled Ridhima died of blunt force trauma and shaking injuries. Nields supervised that autopsy.


Matt Stout can be reached at matt.stout@globe.com. Follow him on Twitter @mattpstout.