Thu. Jan 9th, 2025

Dr. Marius C. Tarau started his job as Rhode Island’s chief medical examiner on Monday, Dec. 16, 2024. He is the first permanent chief for the office in over eight years. (Courtesy of Rhode Island Department of Health)

The hiring of two permanent assistant medical examiners is among the top priorities of Rhode Island’s new chief medical examiner, who has been on the job for three weeks.

Dr. Marius Tarau is the first permanent leader in over eight years for the Office of State Medical Examiners, which investigates deaths known or suspected to be the result of an accident, homicide or suicide, as well as unexplained or sudden deaths. Tarau’s first day on the job was Dec. 16. He takes over an office that in recent years has lagged in producing timely autopsy reports, resulting in the downgrading of its accreditation.

After eight years of searching, why can’t Rhode Island hire a permanent chief medical examiner?

“Dr. Tarau is still getting acclimated and is assessing the current operations of the office,” Rhode Island Department of Health spokesman Joseph Wendelken told Rhode Island Current in an email. “Until he has done that full assessment, he is a little reluctant to be doing interviews.” 

A native of Romania, Tarau most recently served as chief medical examiner for the Jackson County Medical Examiner Office in Kansas City, Missouri, and as a forensic pathology consultant, according to his resume. He is certified by the American Board of Pathology in Anatomic Pathology and Forensic Pathology. 

Tarau will earn an annual salary of $393,750, far higher than the salary of the department’s director, Dr. Jerome Larkin, who earns $250,000.

The state’s former head pathologist Christina Stanley resigned in August 2015 after being placed on administrative leave. Since then, the office had been staffed, in part, by an acting chief medical examiner and contractors. Stanley earned less than $240,000, but the chief medical examiner’s position received pay bumps over the years to make the state more competitive amid a national shortage of trained pathologists. The fiscal 2024 state budget increased the chief medical examiner’s salary fron about $280,000 to $375,000.

National standards set a benchmark for medical examiner offices to finalize autopsy reports for 90% of cases within 90 days, but staffing challenges led Rhode Island to fall short in recent years. State health department data show only 38% of cases in 2022 and 20% in 2023 were closed in 90 days.

Last year 2024, the office investigated a total of 1,439 deaths, of which 214 cases have been open for more than 90 days, Wendelken said.

Of the state’s nine medical examiners, seven are part-time contractors. The reliance on part-time, contract physicians has contributed to cases taking longer to close, Wendelken said.

“We often needed to exceed those 90 days over the past two years to ensure that we maintained our standards for quality and accuracy,” Wendelken said in an email. 

The failure to meet the 90 in 90 standard was cited by the professional accreditation team from the National Association of Medical Examiners, which downgraded Rhode Island’s office from fully accredited to provisional status. The association’s executive director, Denise McNally, said in an email that Rhode Island is “in progress” for its annual renewal.

“During the last accreditation cycle, the accreditation team acknowledged that the exceedance of the ‘90% in 90 days’ benchmark was the result of the national shortage of forensic pathologists, and they otherwise described the office as well-integrated and quality-driven.” Wendelken wrote.

Wendelken said the health department is also taking steps in the State Health Laboratories to decrease the turnaround time on toxicology testing. He could not provide any details on how long the tests are taking. 

“In some instances, the time needed for confirmatory results from toxicology testing contributes to the delay in closing out cases,” Wendelken wrote.

Rhode Island is not alone in its struggles to keep up with autopsy caseloads. A performance audit by the Massachusetts Office of Auditor General released in December found that the state’s Office of the Chief Medical Examiner met the 90 in 90 standard in 85% of cases sampled. 

“In many instances, getting information from an autopsy is an important part of the closure process for people who have lost a loved one,” Tarau said in a statement forwarded to Rhode Island Current. “We are looking at our structure and processes in the Office now to see what adjustments we can make to ensure that all cases are closed in a timely way. A search for additional full-time medical examiners is also a priority, and would significantly affect our case turnaround time.” 

Larkin, who was hired as the health department’s permanent director last year, praised Tarau’s experience and credentials.

“I look forward to supporting Dr. Tarau as he builds on the solid foundation we have in the State Medical Examiner’s Office and as he explores what improvements we can make in our work to support the death investigation process, provide critical information to law enforcement partners, screen deaths for public health significance, and support the families of the deceased,” Larkin said in a statement.

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