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R.I. medical officials seek input on performance

PROVIDENCE -- In the next several months, funeral home directors, state agencies, healthcare providers, and some families will receive a survey asking how well the Rhode Island medical examiner's office handled their cases.

It will be the first time the office has polled the people who rely on it for expert testimony, burial help, autopsy reports, and other matters. Health officials said they want to find out from the people who have used the office's services how it is doing.

''It's like a customer satisfaction survey, like if you go to a restaurant and say how did you find the food, how did you find the service?" explained Dr. Elizabeth Laposata, chief medical examiner.

The surveys are part of a gaggle of overhauls underway at the medical examiner's office, the subject of harsh criticism for certain aspects of its handling of the Station nightclub fire, organ donations, and how quickly it performs autopsies. By revamping its computer systems, working with organ banks, and communicating with lawmakers, the office hopes to improve a tarnished public image.

''Could we do better? Yes," said David Gifford, acting director of the Health Department. ''Is it that we're not doing a good job? No."

A report in July funded by the US Department of Homeland Security faulted Laposata for not reporting to the scene of the Station blaze and not alerting the Health Department director as soon as she heard of the fire. While the report also praised the department for its overall handling of the fire, it kicked off a barrage of criticism. Since then, the office has been cited by state inspectors for 10 poor workplace conditions, blamed for making it difficult for organ banks to harvest tissue, and criticized about autopsies taking longer than six months.

Laposata said the criticism is unfair. She said her office last year satisfied 364 autopsy requests and had only 19 that took more than six months. She said bodies are released to families usually within 72 hours.

A bill introduced by Senator Joseph Polisena would move the office under supervision of the State Police, which he said is a more fitting place. Both the Health Department and State Police are against the move, arguing that the medical examiner does more than crime scene work. Most of the nation's medical examiners are either independent or overseen by state health departments.

Another state lawmaker, Senator Leo Blais, plans to submit legislation that would break down some of the obstacles to donating organs and tissue.

According to the New England Organ Bank, dozens of potential donations were unable to be harvested because of systemic problems at the office. Sean Fitzpatrick, the organ bank's spokesman, said among the office's problems are the time it takes to complete autopsy reports and staffing levels after hours.

''We're not saying they are legally restricting more than they should," Fitzpatrick said. ''But compared to other medical examiner's offices, there are a number of hurdles that prevent donations."

Dr. Bob Marshall, a Health Department spokesman, acknowledged that certain rules and regulations may prevent some donations from going through, but ''we don't have a responsibility to harvest organs ourselves."

He said the office approved 74 donations of 80 requested by regional organ banks.

''We don't have a dedicated staff that is there to support organ donation and tissue transplantation," Marshall said. To preserve evidence, harvesting cannot take place at the office without a medical examiner on duty. That is tricky on nights and weekends when the office is not fully staffed, he said.

Gifford, the Health Department director, plans to streamline operations by revamping the office's information technology. An upgraded system is expected to free staffers from hours of pen-and-pad documentation and allow them to more quickly analyze data.

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