'Overdose After Overdose After Overdose:' Opioid Deaths Strain Palm Beach County Medical Examiner

Jul 18, 2017

Nowhere in South Florida has been hit harder by the opioid overdose epidemic than Palm Beach County.

The number of fatal opioid overdoses has gone up 230 percent in the past two years. More than 540 people died last year. All of those fatalities have to be autopsied by one of the county’s five pathologists.

WLRN’s Peter Haden spoke with Palm Beach County Medical Examiner Dr. Michael Bell about the effect the increase has had on his office.

BELL:  It's not like we're seeing more homicides or more traffic fatalities or more drownings. It's just opioid overdoses.

WLRN:  How long have you been a medical examiner?

Almost 28 years.

Is this the most heavy workload you've seen while you've been practicing?

It's up there. The other time was when I was in Broward back in the late 1980s, early 1990s, when we were bringing in all the people who died of AIDS and autopsying them. That was a similar case load. And you can see by the numbers, this opioid epidemic has killed the same number of people who were dying of AIDS — back in the AIDS epidemic.

Since there's more work, there's more cases. It leads to backlogs. There's a backlog in reports and finishing cases -- whether it's for families, law enforcement, attorneys, insurance companies etc. There's the increased chance of making mistakes. There's also a fatigue factor. There's no time to reflect upon the cases. There are really no breaks for the morgue staff.

The Palm Beach County Medical Examiner’s Office processed 762 fatal drug overdoses in 2016. “This opioid epidemic has killed the same number of people who were dying of AIDS — back in the AIDS epidemic,” said Dr. Bell.
Credit Peter Haden / WLRN

Obviously it increases the number of bodies we have in the building. And while we do have storage for all of them, again, the more cases you have coming and going, the more potential you have for making mistakes — such as releasing the wrong body to the wrong funeral home etc.

Since I became the chief, we have been accredited by the National Association of Medical Examiners. But in 2016, if we had been inspected that year we would have failed. Because by the end of the year, we did not have enough medical examiner staff to maintain the individual autopsy-per-doctor number at a sufficiently low level to continue accreditation. So if there were no increase in staff, we would lose our accreditation.

What consequences would that have?

Certainly when you lose accreditation, that can always be brought up in trial.

What's the average age of overdose victims that you see?

I would say...20s, 30s.

A man convulses in the street from a heroin overdose two blocks away from the Delray Beach Police Station. Nov. 18, 2016.
Credit Delray Beach Police Department

Has it had an impact on you personally — seeing this rise in young people?

Well, I think what you're asking is, has it affected me psychologically?

Yes.

No. Look, I'm a professional. There's something about my psyche that has allowed me to do this job for so many years. I mean, if you're going to get upset about seeing dead people, you're not going to do this job, right? So there's a selection process at the very beginning. But, it’s tiring. Coming in and seeing overdose after overdose after overdose. You know, after a day when I'm in the morgue, I am absolutely beat.

Was there a time when you knew that something had changed?

Yes. In 2015. Every morning we have what's called “morning report,” where we go over the cases that were done the previous day and the cases that came in overnight. It became quite apparent that our workload was substantially increasing and that was all due to drug overdoses. It was really that dramatic. I didn't have to do any counting.

What did you think? Did you take anything away from that?

Yes — I was hoping it would go away. But it didn’t. It just got worse. And that's why we're at this crisis point. I haven't seen a drop off yet. It hasn't decreased. And I don't know when it will.

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*Note: The Palm Beach County Medical Examiner’s Office recently hired two additional staff members. Dr. Bell says that will allow it to maintain accreditation.