EL PASO COUNTY CORONER’S OFFICE

THE EL PASO COUNTY CORONER’S OFFICEEL PASO COUNTYCORONER’S OFFICE2020 ANNUAL REPORT

THE EL PASO COUNTY CORONER’S OFFICE01The Coroner’s Office (EPCCO) serves El Paso County byinvestigating all sudden, unexpected, and non-natural deaths.While many natural deaths can be certified by the decedent’sphysician, approximately one quarter of deaths require furtherinvestigation to determine cause and manner of death andensure public health and safety. In addition to performing 920autopsies on El Paso County Deaths, the office performed373 autopsies for a fee for 21 surrounding counties.TOTAL CASESINVESTIGATED6037TOTAL AUTOPSIESPERFORMED1293(9% Increase over 2019)In 2020, the Coroner’s Office staff consisted of five boardcertified forensic pathologists including elected Coroner LeonKelly, M.D., Deputy Chief Medical Examiner Emily Russell, M.D.,and Associate Coroners Dan Lingamfelter, D.O., TravisDanielsen, M.D., and Christopher Hauch, M.D., as well as twoadministrative staff, nine death investigators, fourtoxicologists, one histologist, and five morgue technicians.

THE EL PASO COUNTY CORONER’S OFFICE02Why Perform an Autopsy?Colorado Revised Statute (C.R.S.) 30.10.606 describes the roles andresponsibilities of the coroner in investigating deaths. A completeforensic investigation provides the cause and manner of how anindividual died. The investigation can assist in settling insurance andestate claims as well as the implementation of civil and criminalactions. Identifying cause and manner of death is a critical componentof ensuring public health and safety. The surviving family and generalpublic can have peace of mind that a thorough investigation wascompleted.It is the responsibility of the Coroner’s Office to identify the decedentand notify next-of-kin. In many cases, identification and next-of-kinnotification can be quickly achieved. However, in cases of burns,extensive injury, or decomposition this can prove more challenging.Our office ensures all leads have been exhausted in pursuit ofidentification and notification. At the time of this report, 5 cases datingback to 2012 are pending identification. In 2020, 67 unclaimed remainswere released to the Public Administrator.MEANS OF IDENTIFICATIONVisual or– 632CircumstancesOutside– 373CoronersFingerprints – 284Dental – 1DNA – 0Medical – 1

THE EL PASO COUNTY CORONER’S OFFICE03What is an Autopsy?An “autopsy” can encompass several levels of examination:23728237 cases in 2020 were“external only” examinations,in which the cause and mannerare well established by theexternal examination* and athorough medical history.28 of the 2020 examinationswere partial autopsies andtypically consisted of “headonly” examinations to ensurethat head trauma didn’t causeor contribute to death.93%77293% of cases had toxicologytesting performed. Samplesare nearly always collected,but testing may not beperformed at the discretion ofthe physician772 of 920 El Paso Countyautopsies required deathscene investigation El Paso County Coroner’sOffice does not performHospital Autopsies.10281028 Examinations includeda full internal exam in whicheach organ and body cavityis examined and isconsidered a completeautopsy.0The El Paso CountyCoroner’s Office did notperform anyexhumations in 2020*External Examination – Every autopsy includes a thorough examination of the outside of thedecedent’s body documenting changes of natural disease, identifying marks and scars, medicaltreatment, injuries, and an inventory of clothing and property.Average time to completionThe average number of days from autopsy to report completion during 2020 was 29days. 61 cases (4.7%) took greater than 60 days to complete due to theircomplexity or ongoing investigation. This meets the national standard of 10% ofcases completed beyond 60 days.

THE EL PASO COUNTY CORONER’S OFFICE04What Deaths are Investigated?Colorado Revised Statutes (C.R.S) 30-10-606 mandate that thefollowing deaths are reported to and investigated by the coroner:// Sudden, unexpected, or non-natural// No physician available to certify the death// Industrial accidents// Deaths in the custody of law enforcement or in the careof a public institution// Deaths due to contagious diseases// All unexplained deathsResponsibilities of the Coroner:// Pronounce death// Determine cause and manner of death// Identify human remains// Notify next-of-kin// Investigate death in conjunction with but independent oflaw enforcement agencies// Collect evidence on or in the body// Secure a decedent’s property for next-of-kin// Provide expert testimony// Grant tissue/organs for donation

THE EL PASO COUNTY CORONER’S OFFICE052020 Revenue for El Paso County Coroner’sOfficeGrant for Violent Death ReportingOut-of-County Autopsy FeesOut-of-County Toxicology FeesHistology FeesFacility FeesTotal Revenue for 2020 3,838 556,150 171,390 3,500 1,600 736,478 †El Paso County Citizen Cost Breakdown2019 Population*Total 2020 Budget720,403 2,980,002 2,980,002- 736,478(Budget) 2,243,524 720,403Overall Cost to Citizens 3.11(Revenue)(Population)Annual cost to each El PasoCounty Citizen)*US Census Bureau (2019†This represents a 6% increase in revenue over 2019

THE EL PASO COUNTY CORONER’S OFFICE06Overall Breakdown of Autopsies Performed bythe El Paso County Coroner’s 1KIOWALAS 23PARKCROWLEY910PROWERSCUSTER2618RIO GRANDEEL PASO92019SAGUACHE337TELLERBACAELBERT1,293 – TOTAL CASES

THE EL PASO COUNTY CORONER’S OFFICE07Manner of DeathThere are five manners of death that can be listed on a ColoradoDeath Certificate.Natural - Deaths due solely to disease or agingAccident - Deaths due to unintentional injurySuicide - Deaths due to an intentional self-inflicted injuryHomicide - Deaths due to the intentional injurious actionof another individualUndetermined - Deaths in this category may or may nothave a determined cause of death, or may have severaldifferent possible manners.Unclassified - Death of a fetus in utero (in the uterus)does not receive a manner determination19552020 El Paso County Breakdown309178Natural (309 - 33.6%)Unclassified (3 - 0.3%)Accident (356 - 38.7%)Suicide (178 - 19.3%)3356Homicide (55 - 6.1%)Undetermined (19 - 2.0%)

THE EL PASO COUNTY CORONER’S OFFICE08Deaths Due to Natural DiseasesCardiovascular309 Total50%15514%43Pulmonary Embolism6%17Non COVID-19 Infections5%15COVID-19*4%13Diabetes4%12Pulmonary Disease3%10Cancer/Neoplasm2%7Morbid Obesity2%7Geriatric lar2%6Epilepsy1%4Other1%4Liver Disease1%2Complications of Pregnancy/Birth1%1Chronic AlcoholSignificant Contributing Causes - The diseases that are most commonly listed as significantcontributing factors in death alongside those causes listed above include obesity, diabetes, pulmonarydisease, cardiovascular disease, smoking, and chronic alcoholism.*The majority of COVID-19 Deaths occur in the hospital or a care facility setting and are not investigatedby the coroner. These deaths represent those that died at home or prior to diagnosis.

THE EL PASO COUNTY CORONER’S OFFICE09Deaths Due to AccidentsWe saw an increase in accidents (332 in 2019) largely due to increases in drugrelated deaths (130 in 2019) and motor vehicle related deaths involvingpedestrians and motorcycles. These increases were partially off-set by adecrease in falls in the elderly that due to COVID-19 safety measures for longterm care were not brought to our office for examination.356 TotalDrugs52%186Motor Vehicle Accidents22%78Falls5%32Pedestrian Injury4%13Others2%8Unsafe Sleep - icycle Crashes1%4Carbon Monoxide 1%3Fires/Burns 1%3Choking 1%3Motor Vehicle vs. Bicycle 1%3Firearms 1%2Blunt Force Injury AccidentsMotorcycle29Falls in Adults Elderly23*Falls from height4Passenger vehicles49Falls down stairs5Pedestrian13Bicycle7*Reduced from 85 in 2019 due to release to treating physician for death certification

THE EL PASO COUNTY CORONER’S OFFICE10Motor Vehicle Crashes2Type of Vehicle Involved8SedanSUVMotorcycleTruck26 - 33%13 - 17%29 - 37%8 - 10%Other/Unknown2 - 3%26291313Type of Collision231FrontSideRearRollover2424 - 39%1 - 2%13 - 21%2Use of Restraint/seatbeltYesNoUnknown23 - 38%20 - 41%2027 - 55%2 - 4%27Suspected Primary Cause of CrashOperator Error67%Reckless Driving/Excessive Speed19%Road Condition6%Distracted Driver3%Mechanical Failure3%Impaired Driver1%Unknown1%Vehicle vs. PedestrianPedestrian at fault62%Of the 44 fatal accidents where the decedentwas the “at fault driver” and toxicology wasperformed 32 had drugs, alcohol, or THC intheir system at autopsyDrugs:7Alcohol: 6THC:5Drugs THC: 4Driver at fault38%Alcohol THC:4Drugs Alcohol: 2Drugs, Alcohol THC: 4

THE EL PASO COUNTY CORONER’S OFFICE11Drug Related Accidental DeathsThe total number of drug-related deaths increased significantly from 2019 (130) due toincreases in fentanyl deaths (21 in 2019 to 47 in 2020), methamphetamine (66 increasedto 91), cocaine (20 increased to 30), and heroin (35 increased to 43). Forty percent ofdeaths were due to a combination of substances.186 TotalMethamphetamine ( /- other meds)51Heroin ( /- other meds)14Heroin Methamphetamine23Prescription Opioids ( /- Ethanol or other meds)17Methamphetamine Prescription Opioids2Fentanyl Other Prescription Drugs5Cocaine12Non-Opioid Prescription Drugs4Fentanyl22Heroin, Cocain Methamphetamine1Methamphetamine Fentanyl ( /- other meds)5Cocaine Heroin ( /- other meds)1Heroin, Fentanyl Cocaine1Ethanol3Methamphetamine Prescription Opioids1Cocaine Methamphetamine2Mathamphetamine, Fentanyl, Heroin Cocaine1Mathamphetamine, Fentanyl Heroin2Cocaine Prescription Opioids1Ketamine ( /- other meds)1Fentanyl Cocaine9Mitragynine ( /- Ethanol or other meds)3Freon Gas Methamphetamine1Freon Gas2Fentanyl, Methamphetamine Cocaine2Opioids resulting in deathHeroinOxycodoneHydrocodoneFentanylFentanyl Heroin36101374108 TotalMethadoneFentanyl RX OpioidsMixed RX OpioidsHeroin RX OpioidsTramadol76232

THE EL PASO COUNTY CORONER’S OFFICE122020 Drug Related Death Facts8%67%Of medication used inthe overdose wasprescribed by thedecedent’s physician.Of accidental drugdeaths were male66%20%Have a priorvhistory ofsubstance abuseor addiction24%Deaths of all causesthat have marijuanametabolites presentat autopsyRepresents a 3% increasefrom 2019Have a knownhistory ofmental illness86%Percentage of theaccidental opioiddeaths that wereheroin or fentanylThe average ageat death (range of15 - 70 years) old)41 YEARS61%Death scenev investigationsrevealed drugs, drugparaphernalia ormedications of abuse118Total number ofopioid related deaths(including accidentand suicides)v82 in 2019

THE EL PASO COUNTY CORONER’S OFFICE13Deaths Due to Homicide2020 marked a sharp increase in homicides (35 in 2019) to numbersmore similar to prior years (56 in 2018).Firearms34Blunt Force/Altercation8Sharp Force Injuries4Strangulation6Blunt and Sharp Force1Other255 Total4%2%11%7%62%14%Apparent Circumstances of the HomicidesAltercation16Domestic/Family Violence19Officer Involved*5Reckless use of firearm3During the Commission of Another Crime12*All 5 officer-involved deaths resulted from a use of force (firearms, restraint, taser) thatresulted in the death of another. Therefore, the manner is ruled a homicide. However, thisdetermination is not an opinion on the legality of the force used as this judgement is withinthe purview of the District Attorney and the justice system.53% of decedents personally knew the suspect in their death.