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Sheriff Wanted Medical Examiner to Alter Reports

by Dale Chappell

A pair of San Joaquin County forensic pathologists recently quit, citing abusive treatment working under Sheriff Steve Moore. They say Moore tried to influence their decisions in cases, especially on deaths that occurred at the hands of law enforcement.

“I realized that I had to leave to seek employment in another county in California where the sheriff is not like Sheriff Steve Moore,” wrote Dr. Bennet Omalu in his resignation letter in December. A neuropathologist, Dr. Omalu rose to fame in 2015 when Will Smith portrayed him in the movie “Concussion,” based on the doctor’s research into CTE, the degenerative brain disease suffered by football players with traumatic brain injuries.

“The Sheriff was using his political office as the coroner to protect police officers whenever someone died while in custody or during arrest,” Dr. Omalu wrote to his supervisors about Moore’s interference, which he said had gotten worse the last two years. “The Sheriff does whatever he feels like doing as the coroner,” he claimed.

Just before Dr. Omalu quit, his partner, Dr. Susan Parson, one of only 1,000 board certified pathologists in the country, also quit because of Moore. “Sheriff Moore’s retaliatory behavior, arrogant expectations and of those under his employ, created an utterly untenable work environment,” she wrote in her resignation letter. Dr. Parson, who had been on the job less than a year, called Moore “unbearable.”

The two doctors say Moore told them to classify deaths caused by law enforcement “accidents,” rather than homicides, in order to protect the officers involved. The doctors say they felt “extremely intimidated, harassed, threatened and controlled,” by Moore to cover for the actions of the officers. “In his mind, he seems to believe that every officer-involved death should be ruled an accident because police did not mean to kill anyone,” Dr. Omalu asserted.

In 50 of California’s 58 counties, the elected sheriff is also the county coroner, overseeing the medical investigations of suspicious deaths and all deaths resulting from police custody. Under the system, a forensic pathologist, who is a medical doctor, works under the sheriff.

While the doctor determines the “cause” of death under the system, it is the sheriff—a non-medical professional—who decides and certifies the “manner” of death, i.e., whether it was an accident, homicide, etc. The sheriff decides how the death happened. “I think the downside basically is either a perceived or real conflict in the goals of the two entities,” Dr. Randy Hanzlick, a retired pathologist and professor at Emory University Medical School, said about the sheriff-coroner system. A 2011 study by the National Association of Medical Examiners found that 43 percent of those who worked in a sheriff-coroner system reported that the sheriff changed the cause of death on a death certificate in a way that had conflicted with the autopsy results.

California lawmakers proposed to change this aspect of the system last year, giving doctors the authority to determine both the cause and manner of death, but the bill failed. It was opposed by the California State Sheriffs’ Association, and part of the bill that would have killed the sheriff-coroner system was stricken. The bill that became law January 1, 2017 retained the sheriff as the final authority on classifying how a person died, even when a police officer-involved death.

In a particularly troubling 2008 case, Dr. Omalu performed an autopsy on David Humphreys, who died at the hands of police following a chase on a freeway. Police told Dr. Omalu they Tased Humphreys once or twice. When he asked for the Taser report on the number of shocks delivered, the police claimed the report did not exist. Later, he discovered the report did exist, and it revealed that police had Tased Humphreys 31 times. That previously concealed information prompted Dr. Omalu to change his conclusion from “accidental” to homicide. The family has filed a lawsuit.

Dr. Omalu cited other incidents, such as those in which the sheriff ordered hands cut from bodies for fingerprinting. Omalu refused, calling it “body mutilation,” and he complained to the county hospital’s medical director. Other forensic pathology experts contacted said cutting hands off for fingerprinting “fell outside the established practice of medicine.” Nevertheless, Dr. Omalu was reprimanded by the sheriff for refusing to follow orders.

Saying he would rather avoid losing his medical license for “aiding and abetting” the sheriff’s “unlicensed practice of medicine,” Dr. Omalu quit. The San Joaquin County district attorney said in a statement that it is “gathering information” on the issue, but made no comment on whether it plans to pursue charges. 


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