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After ‘temporary’ performance slip, medical examiner’s office to keep accreditation

The Massachusetts medical examiner’s office will keep its newly won accreditation despite struggling to quickly turn around autopsies, sparing the agency a potentially embarrassing demotion.

Describing the agency’s slipping performance as “temporary,” the National Association of Medical Examiners decided against stripping the Office of the Chief Medical Examiner of the full accreditation status it earned less than a year ago. Leaders at the association, known as NAME, disclosed the development last week in response to questions from the Globe.

Dr. Mindy HullExecutive Office of Public Safety.

The decision came after NAME officials had warned the state’s chief medical examiner, Dr. Mindy J. Hull, in January that her office would “most likely” be downgraded. The agency had reported that it was unable to complete 90 percent of its autopsy reports within 90 days — a key standard set by NAME — during an annual review late last year.

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Hull argued that the performance, which put the office’s turnaround time at 84 percent since it was last reviewed, was due to “unforeseen” personal issues involving two medical examiners and the performance of a part-time contractor.

Dr. Jonathan Arden, the organization’s president, said that inspectors felt the problems in the Massachusetts office were “relatively speaking, temporary” and that Hull was actively working to address them.

“That’s why they weren’t summarily demoted or had their accreditation removed,” he said of the Massachusetts office, noting that NAME inspectors are allowed discretion when weighing the office’s performance against the association’s standards.

“The accreditation process is meant to be rigorous,” Arden said, “but it’s not meant to be punitive.”

Dr. Barbara C. Wolf, who chairs the NAME committee tasked with reviewing accreditations, said in an e-mail last week that the panel decided the Massachusetts office “should maintain” its fully accredited status.

She did not say when the committee made its decision, nor did she respond to further questions. Arden said he was unsure of the timing of the decision.

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A spokesman for Hull’s office declined to comment.

Gaining the accreditation has been a long-time goal of the chief medical examiner’s office, which has long grappled with completing autopsy reports in a timely manner. For example, it completed them within the 90-day window just 58 percent of the time in the two years before Hull took over in October 2017.

Last August, however, it finally earned full accreditation. That review was based, in part, on data detailing the office’s turnaround time over a three-month period between the end of 2017 and the beginning of 2018.

The list the office submitted, which the Globe obtained through a public records request, included 787 cases, 94 percent of which the office reported completing within 90 days. But less than half of them were labeled as being an autopsy. Under Hull, the office has regularly forgone autopsies in favor of less-rigorous tests known as external examinations, which generally take one-third the time.

The Globe also requested the application — essentially a checklist of standards it must meet — that the medical examiner’s office submitted as part of its initial, successful review. But the agency said it couldn’t produce it. Officials said the application was submitted online, where it’s no longer available since it’s been overwritten in NAME’s database by a subsequent application for renewal in December.

“Therefore, due to the computerized NAME database and online submission process, the OCME is not in possession of the original application,” Eric B. Hogberg, the office’s general counsel, wrote in a letter to the Globe.

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The accreditation program is not a requirement for public medical examiner offices. Instead, it’s an endorsement that an office is meeting the “minimum standards for an adequate medicolegal system,” according to the association’s website.

The potential of losing it had rattled the office. Hull became so concerned about the threat to the office’s reputation earlier this year that she actively sought help from officials at NAME when she thought a local TV station would report on the developments, according to e-mails reviewed by the Globe.

At the time, Hull staunchly defended the office, saying it was “in good shape, and cleaning up many old messes.”

“This should be vetted by NAME not the media,” Hull wrote in one e-mail to Arden.

Hull has touted the office’s efforts to bring in more full-time staff to address its rising caseload — moves that she argued earlier last month were the basis for phasing out her predecessor from a part-time contractor’s position.

The agency had promoted two part-time assistant medical examiners to full-time status in February and April, and added a new staff medical examiner in May. Officials have said that two fellows, whose work is currently supervised, will also become full-time employees on July 1.

The office is slated to undergo another annual review from NAME this year.


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

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Twitter @mattpstout.