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Lubbock's medical examiner may lack required license

BY ELLIOTT BLACKBURN
AVALANCHE-JOURNAL

March 12, 2008

Lubbock’s medical examiner may lack the state-required license to perform autopsies for courts
in Texas, which could challenge two years of forensic work for 86 counties.

Thomas Beaver, the county’s chief medical examiner, never gained a full medical license to
practice medicine in Texas, according to records filed with the Texas Medical Board. The board
issued Beaver a temporary faculty license in 2006.

State licensing officials said the law was not clear on whether that meant Beaver could serve as
the county’s chief medical examiner. Statute governing the county-appointed post requires a
state medical license but does not describe what kind.

No allegations had been made Wednesday of any actual problems with Beaver’s service, and an
Austin man who intends to file a complaint with the state medical licensing board believes the
examiner to have all practical qualifications. The Lubbock County District Attorney’s Office
said it was comfortable with its arrangement with the Health Sciences Center.

But any uncertainty on the status of the medical examiner could confuse the status of forensic
work brought to trial in the hyper-technical world of Texas law, local attorney Rod Hobson Jr.
said.

“This is the very reason that we went to this system, so that we never had these problems again,”
Hobson said.

It’s not clear, medical board general counsel Robert Simpson said, how exclusive legislators
intended the office of medical examiner to be. Texas law requires that “no person shall be
appointed medical examiner unless he is a physician licensed by the State Board of Medical
Examiners.”

Beaver received and has maintained a temporary faculty permit when he arrived from Florida in
July 2006. He has had the annual license extended at least once, according to state medical board
rules and records, and he allowed his medical license from Florida to turn delinquent in January,
according to medical board records from that state.

The license limits Beaver to practicing medicine as a teacher and to seeing patients as a full
doctor under Texas Tech’s supervision, according to state medical rules. Beaver must renew the
temporary license with the board every year, but there is no limit to the number of times the
permit can be renewed and “two years is not at all unusual,” medical board spokeswoman Jill
Wiggins said.

The full Texas medical license follows different requirements and rules.

That’s a big difference, said David Fisher, an Austin resident who plans to file a complaint with
the state medical board challenging the Lubbock office later this week.

Fisher, who described himself as a document consultant, believes the license isn’t good enough
to serve as medical examiner. He had no doubt that Beaver and his assistant, Tom Parsons, had
all the professional qualifications for the job. But high-profile problems in the Texas legal
system with forensic work meant that everything must work aboveboard, he said.

The arrangement made Beaver responsible to Tech — a medical examiner should be


independent, Fisher said.

“I don’t know that there’s anything wrong there,” he said. “I just know that there’s the potential
for wrong there.”

Lubbock County’s district attorney’s office, which through the county contracts with the Health
Sciences Center for autopsy services, considers the license sufficient based on the information
available Wednesday, civil district attorney John Grace said.

When asked about the issue, Simpson, with the medical board, said someone outside of the
board would need to decide what the law meant by a licensed physician, he said.

“It would just have to be subject to a court interpretation,” Simpson said. “It would need
to come up in some sort of legal controversy that would be decided by court.”

More obvious problems dogged Lubbock’s medical examiner’s office for two decades.
Commissioners created the post in 1994, not long after a forensic pathologist pleaded guilty to
seven felony counts of falsifying autopsies for three area counties,

Attorneys scrutinized the office again a few years later, in 1997, when evidence emerged that a
Lubbock medical examiner investigator swayed a consultant’s cause of death ruling by
describing irrelevant accusations levied against a defendant.

County commissioners voted in 2000 to turn over autopsies to the Health Sciences Center after a
wave of complaints and resignations following the appointment of a non-licensed medical
examiner. Another examiner retired three years later after complaints that he had removed breast
implants during an autopsy and kept them.

The licensing question surprised Hobson, who participated in the effort to create the medical
examiner position more than 10 years ago. The Lubbock attorney has served as both a prosecutor
and a defense attorney.

He would not want to have the licensing question settled during any case he was trying — a case
that would obviously involve a death and serious questions of guilt or innocence, he said.

“We don’t want to get into that,” Hobson said of trial lawyers working on both sides of a case.
“We want someone who meets the statute.”

Beaver met the statute, as far as the county could tell, Grace said.

“Should a complaint actually be filed against the Lubbock County medical examiner concerning
his credentials, we will of course review the situation in light of the specifics of the complaint,”
Grace read from a statement. “Until such time as we receive and review such a complaint, any
further inquiry is academic.”

To comment on this story:

elliott.blackburn@lubbockonline.com uE074 766-8722

james.gallagher@lubbockonline.com uE074 766-8706

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Complaint filed against Lubbock medical examiner


By Elliott Blackburn | AVALANCHE-JOURNAL

Friday, March 28, 2008


Story last updated at 3/28/2008 - 1:38 am

Lubbock's medical examiner has fraudulently practiced medicine outside the scope of his license,
according to a man who said Thursday he filed a formal complaint with the state medical board.

David Fisher, an Austin document specialist, filed the complaint Thursday afternoon with the
Texas Medical Board. The complaint questions the entire structure of Lubbock's Medical
Examiner's Office, which serves 86 counties.

Chief Medical Examiner Thomas Beaver earns his salary from the Texas Tech Health Sciences
Center and is licensed to practice medicine under the center's authority as a professor.

That conflicts with the state's description of a medical examiner, Fisher said. State criminal code
requires the position to be appointed by and responsible to the county commissioner's court.

Lubbock doesn't have the worst problems ever seen in the state, but it's an issue that needs to be
resolved, Fisher said.

"It's about time for Texas, being the second largest state in the nation, to at least come up to the
beginning of the 21st century on these medico-legal autopsies since they are the foundation of
the Texas criminal justice system," Fisher said. "If you can tamper with a criminal autopsy, then
there's nothing to be said for the other forensic sciences."

The Lubbock County District Attorney's office and Health Science Center representatives said
they had not seen the complaint and would wait for more information.

County Judge Tom Head could not be reached for comment.

The arrangement has confused other medical examiners contacted by the Avalanche-Journal and
concerned some local attorneys who were not aware of the licensing questions.

The medical board may only comment on any disciplinary action taken and could not confirm
the existence of a complaint Thursday. Its general counsel said weeks ago when asked about the
accusations that the issue required an interpretation of the law and would take a court case or
attorney general's decision to resolve.

Lubbock Avalanche Journal


State may view complaint against Lubbock County medical
examiner
By Elliott Blackburn | Avalanche-Journal

Wednesday, August 06, 2008


Story last updated at 8/6/2008 - 2:15 am

The Texas Attorney General's Office may begin looking into the region's Lubbock-based
medical examiner's office.

The Texas Medical Board appears to have forwarded to the attorney general in late July a
complaint filed last spring against Chief Medical Examiner Thomas Beaver.

The medical board does not confirm or deny complaints and would not confirm Tuesday whether
it referred anything to the attorney general's office.

But in a late July letter to complainant David Fisher, a document consultant outside Austin, the
board said it had referred the matter to the state's chief legal enforcer.

"Review of your complaint indicates this matter is not within the jurisdiction of this agency and
will be referred to the Office of the Attorney General for review and possible action," the letter,
provided by Fisher, reads.

Fisher raised questions last spring over the county's arrangement with the Texas Tech Health
Sciences Center to manage the Lubbock County Medical Examiner's Office and whether Beaver
held the proper license to serve as its chief.

State law requires the medical examiner be appointed and paid by the county. County
commissioners named Beaver interim chief medical examiner in July 2006 but do not directly
pay him or for the office.

Instead, Lubbock and numerous other counties throughout the region contract with the Health
Sciences Center for forensic services on criminal and civil death investigations, an
arrangement not explicitly laid out in state law.

The attorney general's office could not confirm Tuesday whether it had received anything related
to the Beaver issue.

Medical school Dean Dr. Steven Berk again stressed the county's approval of the contract with
Tech years ago, and the unchallenged skills, if not licenses, of the forensic pathologists who
work at the office.

"I'm no legal expert, as far as that goes," Berk said. "But certainly, I think it's important to have
that clarified."

Lubbock County Assistant District Attorney John Grace echoed Berk's comment.

"We'll wait to see what the A.G. says and abide by their ruling and the medical board's," Grace
said.

To comment on this story:

elliott.blackburn@lubbockonline.com 766-8722

james.gallagher@lubbockonline.com 766-8706

Lubbock Avalanche Journal

Tech to end medical examiner role


By Elliott Blackburn | AVALANCHE-JOURNAL

Thursday, August 07, 2008


Story last updated at 8/7/2008 - 1:45 am

Lubbock and roughly 80 South Plains counties must find a new medical examiner by the end of
next year.

The Texas Tech Health Sciences Center will stop managing the county's medical examiner by
fall 2009 after deciding the forensic work poorly fit the medical school's overall mission.

County Judge Tom Head said HSC President John Baldwin informed him last week of the
center's intent to end its contract to operate the Lubbock County Medical Examiner's Office; a
certified letter explaining the decision was dated August 5.

There was no ill will between the county and the HSC, but the decision was a surprise, Head
said.

"It's just kind of in limbo right now," he said. "We can't do away with it; we need it, for our cases
and for the South Plains."

Lubbock County years ago contracted operation of the county medical examiner's office to the
HSC, following problems with autopsies performed by the county in the 1980s and with a
privately contracted firm in the late 1990s.

Four forensic pathologists - three working under medical teaching permits secured through Tech
and a fourth licensed to practice independently - perform civil and criminal death investigations
for counties across the region.

Amarillo, Plainview, Big Spring and Lubbock all contract for autopsies through the Lubbock
County Medical Examiner's Office.

Commissioners reasoned a medical school could better recruit and monitor the specialists
required to perform death investigations.

As recently as July, medical school officials said the office was an important service that brought
top talent in a rare field to Lubbock.

But with a large patient load, ambitious research program and other goals, the office no longer fit
well with HSC goals, said Dr. Steven Berk, dean of the medical school.

"As you know, this is a very specialized, very high-profile, very expensive program," Berk said.
"And it's really a program that we all agree has to go back to the county."

Berk said the decision had nothing to do with a complaint filed last spring by David Fisher,
a document consultant out of Elgin.

Fisher argued the organization of the office and the chief medical examiner's faculty license
violated state laws describing how such an office may be formed.

County attorneys have said the argument has no merit. Both the county and the HSC have noted
no filed complaint that takes issue with the quality of the pathologists' work.

The Texas Medical Board does not confirm the existence of complaints, but a letter provided
earlier this week by Fisher from the board said officials considered the matter out of their
jurisdiction and forwarded the accusations to the Texas Attorney General's Office.

Complaints on such a high-profile area of medicine were to be expected, with or without merit,
Berk said.

"If it's not one issue, it will be another," he said. "This is a very high-profile area of medicine,
and, you could say, probably an area that the county would be more suited to deal with in the
future."

Commissioners will decide how to handle the contract's end in October, after the budget season,
Head said - he was still in the process of informing the other elected officials. Berk offered to
assist the county in finding pathologists to staff the office.

"What we want to do is have a very good transition program, because it is very difficult to recruit
medical examiners and forensic pathologists," Berk said.

Fisher said he continues to pursue the complaint against the medical examiner's office in
Lubbock and in other cities because the justice system must be held to a high standard.

"You're talking about people's lives, both the victims and the defendants, and any time you can
do a shortcut around the law, the whole system falls apart," Fisher said.

The change will not be as simple as swapping letterhead and who issues the paychecks.

Tech owns the morgue and the current forensic building; the county would need to lease or
purchase it. Three of the forensic pathologists currently working in Lubbock would need to
secure a different medical license to allow them to work independent of the university.

The HSC also will need to make changes. Counties contract directly through the center for
forensic services, worth more than $1.6 million. The pathologists are associate professors paid
indirectly from autopsy income - Tech would have had to find new funding if it had chosen to
keep the program.

To comment on this story:

elliott.blackburn@lubbockonline.com 766-8722

james.gallagher@lubbockonline.com 766-8706

Lubbock Avalanche-Journal

Former Lubbock County medical examiner returning


Elliott Blackburn |
Wednesday, December 24, 2008

Lubbock County will bring back a former medical examiner as commissioners work to rebuild a
program abruptly slated for termination last August.

Commissioners will meet next week to name Sridhar Natarajan the county's chief medical
examiner, a job he quit nearly three years ago.

County authorities began working to take over forensic autopsy duties in August, when the
Texas Tech Health Sciences Center told officials Tech intended to stop providing the service by
September 2009.

Natarajan would be a county employee not affiliated with Tech, Commissioner Patti Jones said.

"We've still got details to work out, but this is the first step," Jones said. "We don't feel like we
could have found a better fit for this position."

Health Sciences Center representatives who could discuss the transition could not be reached for
comment Tuesday.

Control of morgue facilities, currently owned by Tech, and other details were still under
negotiation, Jones said. The more than 80 counties that use the university will have to contract
with the county or other providers as Tech has shifted out of the business.

The county had considered contracting out its forensic work but believed other medical examiner
offices around the state too busy to take on the cases, Jones said. There was also concern about
managing evidence if the county had to transport bodies long distances, she said.

Tech had given the county a year, but current interim chief medical examiner Thomas Beaver
and medical examiner Steven Cogswell will leave the office in February, she said.

"It's moving much faster than we would have ever cared to," Jones said.

Tech took over the medical examiner's office eight years ago. The center lent credibility and
expertise to a badly shaken county office, commissioners reasoned, after two serious autopsy
scandals in a decade.

A Central Texas document investigator challenged the legality of the office last spring. State law
describes medical examiners as licensed physicians employed by a county, but the office is not
included in the Lubbock County budget. All counties needing forensic services contracted with
Tech, rather than the county, and Beaver holds a temporary faculty license valid only as long as
he worked for the Health Sciences Center.

Tech and county attorneys said the arrangement followed state law. Health Sciences Center
officials described the program last summer as an important chance to recruit and train rare
specialists for high-quality work, but announced in early August that Tech would no longer
handle the program.

Natarajan became chief examiner between 2003 and 2006 after reporting to the Health Sciences
Center complaints about his predecessor, Jerry Spencer.

Spencer retired. Natarajan continued to work for Tech as chief medical examiner until he
resigned in March 2006. He took up a private practice in San Antonio but continued to testify in
Lubbock on autopsies he had performed.

Natarajan is a skilled and trustworthy examiner, Lubbock County Criminal District Attorney
Matt Powell said.

"He's nothing but professional and a guy that loves Lubbock," Powell said. "The thing about him
is even the defense lawyers like him because they know he's being honest."

To comment on this story:

elliott.blackburn@lubbockonline.com 766-8722

walt.nett@lubbockonline.com 766-8706

KCBD News Channel 11 Lubbock

Consider This… New Medical Examiner

12/30/08

I did a double take Monday night when I saw the story about Lubbock County Commissioners
hiring a new medical examiner - a decision they were forced to make after Texas Tech stopped
offering autopsy service.

What shocked me was the nearly $450,000 dollar salary. That's nearly a half a million dollars a
year for a medical examiner.

Consider this, the Lubbock County Sheriff makes $77,000, the Lubbock County District
Attorney makes $135,000, the Lubbock School Superintendent $210,000, the City Manager
$225,000 and the Chancellor of Texas Tech University makes $412,000.

After doing a little research, I learned that the medical examiner in Austin is paid $282,716.46,
and Lubbock County's medical examiner will be paid $450,000? Is this the most important job in
town? Are medical examiners in such high demand? Is this the best deal taxpayers could get? I'm
not sure, but it just looks out of whack to me and it appears to be a done deal.

Going forward, commissioners should find a way to offset this huge expense to benefit taxpayers
- contract with other counties to pay some of this salary or perhaps start another partnership with
Texas Tech.

I've said before that politicians are bad at managing money. I hope Lubbock County can prove
me wrong on this one.

We want to know what you think. Voice your opinion by e-mailing us at


considerthis@kcbd.com or write us at:

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County to ink pact with forensic group as 'back up' plan


Saturday, 11 July 2009

By THOMAS JENKINS
Big Springs Herald

Staff Writer
With Texas Tech's University Medical Center getting out of the autopsy business the end of July,
Howard County Commissioners will be considering a contract with South Plains Forensic
Pathology to help fill the void.

County Judge Mark Barr said UMC will stop providing autopsy services Aug. 1, ending a long-
running relationship between the school and Howard County.

“We've known about this for some time now, so we're just trying to make plans to fill the gaps in
the meantime,” said Barr. “There's a new lab opening up in Odessa, and that's the one we're
planning to use for the majority of our autopsies. However, they don't expect to be up and
running until sometime in September or October, so we're signing this contract with South Plains
Forensic Pathology to hold us over until then.”

Barr said the contract doesn't require the county to pay anything unless services are rendered.

“This contract doesn't require money up front, and the contract is non-exclusive, so we can use
whoever we want,” said Barr. “It just opens the door for us to use them if we get into a bind. It's
basically just a back-up plan.”

Texas Tech Health Sciences Center officials announced the school's intentions to end its
contract to manage the Lubbock County Medical Examiner's Office almost a year ago, following
a slew of complaints filed against the examiners office for allegedly performing illegal autopsies.

A complaint filed with the Texas Medical Board last year by Austin-based document researcher
David Fisher alleges the Lubbock County Medical Examiner's Office has committed fraud on an
epic scale over the past 15 years, along with allegations of conspiracy between Texas Tech
University and the Lubbock Hospital District.

Also during Monday morning's meeting, commissioners are expected to meet with officials from
the Lubbock-based Alternative Dispute Resolution Services to discuss an inter-local agreement
that could give local judges another tool in the fight against truancy.

“Lubbock has a grant to fund this mediation service for kids with truancy problems,” said Barr.
“So when the kids go in to see the justice of the peace or school officials, it allows them to order
the students and their families take part in this program, which is set up to counsel them and find
out why they are having truancy problems.

“There are a lot of different reasons a child might not want to go to school. They can be scared of
what's going on in the school, and sometimes it's problems at home. This gives the JPs the
chance to do something other than just fine the parents and require they get counseling.”

Monday's meeting is to get under way at 10 a.m. in the commissioners courtroom, located on the
second floor of the county courthouse.

Contact Staff Writer Thomas Jenkins at 263-7331 ext. 232

citydesk@bigspringherald.com

County secures autopsy services


Big Springs Herald

Tuesday, 14 July 2009


beginning of next month, Howard County commissioners approved a “back-up” plan Monday
morning that consists of a contract with another Lubbock forensic firm.
Commissioners gave the go ahead for a contract with Lubbock-based South Plains Forensic
Pathology, a contract that will give the court some breathing room until a more permanent
autopsy provider can be nailed down.
“We've always sent our autopsies to University Medical Center (in Lubbock),” said County Judge
Mark Barr. “However, (the medical examiners office at) UMC is closing down Aug. 1. We have
been approached by a company, Southeast Forensics, and they are going to be over here in
Odessa. They have a little better rate and we want to use them, however, they may not be open
until October.
“So we're going to have to have some kind of agreement in place with South Plains Forensic
Pathology. This is only an option to use their services. This contract doesn't mean we have to use
them, and we really need a back-up plan anyway.”
Barr said the contract doesn't require the county to pay any fees unless the government entity uses
their services.
Justice of the Peace Kathryn Wiseman said she's seen the rates charged by South Plains Forensic
Pathology, and they are similar to what the county was already paying UMC, which housed the
Lubbock Medical Examiners Office for quite some time.
“I thought their (South Plains Forensic Pathology) fee schedule was pretty stiff, but it is
comparable to what we were paying,” said Wiseman. “The basic autopsy is $2,000 and it goes up
from there. Infants are always $2,500, and when they have to come testify it's always higher.
“We don't have a fee schedule from Southwest Forensics yet. When their representative came and
talked to us, it was quite a bit less. Plus, their turn around — the rate they can get the autopsy
report to us — is a lot quicker. It's within three weeks, instead of two months, which is what it's
been with UMC. They are supposed to be open Sept. 1, and that's when our contract with Texas
Tech ends on Aug. 31.”
Wiseman also commented on the lack of timeliness from the UMC office in the past.
“They have been so slow. I never really could tell what the problem was,” said Wiseman. “I think
one of the problems is they kept having turnover in staff.”
Texas Tech Health Sciences Center officials announced the school's intentions to end its contract
to manage the Lubbock County Medical Examiner's Office almost a year ago, following a slew of
complaints filed against the examiners office for allegedly performing illegal autopsies.
A complaint filed with the Texas Medical Board last year by Austin-based document researcher
David Fisher alleges the Lubbock County Medical Examiner's Office committed fraud on an epic
scale over the past 15 years, along with allegations of conspiracy between Texas Tech University
and the Lubbock Hospital District.
“This guy in Austin, has he checked them (South Plains Forensic Pathology) out? Is he going to
let them operate?” asked Commissioner Jerry Kilgore with a grin.
“I really don't know,” said Wiseman. “He's still in contact with us.”
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