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Pima County Office Of The Medical Examiner – Annual Report 2015
2 Rev: 06/06/2016
TABLE OF CONTENTS
INTRODUCTION PAGE 4
OVERVIEW PAGES 4-6
ORGANIZATIONAL CHART PAGE 7
TOTAL CASES PAGE 8
MEDICAL EXAMINER (ME) CASES PAGE 8 ME CASES PAGE 9
ME CASES BY AGE PAGE 9
ME CASES BY MANNER PAGE 10
PIMA COUNTY ME CASES BY MANNER PAGE 10
HOMICIDE DEATHS PAGE 11 HOMICIDE 2009-2015 PAGE 11
HOMICIDE BY AGE PAGE 11
HOMICIDE BY SEX PAGE 12
HOMICIDE BY CAUSE PAGE 12
ACCIDENT DEATHS PAGE 13 ACCIDENT BY AGE PAGE 13
ACCIDENT BY SEX PAGE 13
ACCIDENT BY CAUSE PAGE 14
ACCIDENT BY CAUSE 2012-2015 PAGE 14
SUICIDE DEATHS PAGE 15 SUICIDE BY AGE PAGE 15
SUICIDE BY SEX PAGE 15
SUICIDE BY CAUSE PAGE 16
SUICIDE BY CAUSE 2012-2015 PAGE 16
NATURAL DEATHS PAGE 17 NATURAL BY AGE PAGE 17
NATURAL BY SEX PAGE 17
NATURAL BY CAUSE PAGE 18
NATURAL BY CAUSE 2013-2015 PAGE 18
UNDETERMINED MANNER OF DEATH PAGE 19 UNDETERMINED MANNER BY AGE PAGE 19
UNDETERMINED MANNER BY SEX PAGE 19
UNDETERMINED MANNER BY CAUSE PAGE 20
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OVERDOSE DEATHS PAGE 21 OVERDOSE DEATHS 2010-2015 PAGE 21
OVERDOSE DEATHS BY AGE PAGE 22
OVERDOSE DEATHS BY SEX PAGE 22
OVERDOSE DEATHS BY MANNER PAGE 23
SELECT DRUGS BY YEAR 2013-2015 PAGE 23
OVERDOSE DEATHS BY DRUG PAGE 24
MOTOR VEHICLE RELATED FATALITIES PAGE 25 MOTOR VEHICLE FATALITIES 2011-2015 PAGE 25
MOTOR VEHICLE FATALITIES BY AGE PAGE 25
MOTOR VEHICLE FATALITIES BY SEX PAGE 26
MOTOR VEHICLE FATALITIES BY TYPE PAGE 26
W.H. BIRKBY FORENSIC ANTHROPOLOGY LABORATORY PAGE 27 FA EXAMS BY NUMBER 2007-2015 PAGE 27
FA EXAMS BY CONDITION OF REMAINS PAGE 28
FA EXAMS BY TYPE PAGE 28
UNDOCUMENTED BORDER CROSSER (UBC) REMAINS PAGE 29
UBC RECOVERIES CY2001–2015 PAGE 30
UBC RECOVERIES FEDFY2002–2015 PAGE 30
UBC RECOVERIES BY MONTH PAGE 31
UBC RECOVERIES BY AGE PAGE 31
CONDITION OF RECOVERED REMAINS PAGE 32
UBC RECOVERIES BY SEX PAGE 32
UBC RECOVERIES BY CAUSE PAGE 33
UBC RECOVERIES BY NATIONALITY PAGE 33
UBC RECOVERIES BY NATIONALITY, 2001-2015 PAGE 34
IDENTIFIED V. UNIDENTIFIED UBC RECOVERIES PAGE 34
DNA IDENTIFICATIONS 2001-2015 PAGE 35
DEATHS BY COUNTY PAGE 36 APACHE COUNTY PAGE 36 - 39
COCHISE COUNTY PAGE 40 - 44
GILA COUNTY PAGE 45 - 49
GRAHAM COUNTY PAGE 50 - 53
GREENLEE COUNTY PAGE 54 - 57
LA PAZ COUNTY PAGE 58 - 62
NAVAJO COUNTY PAGE 63 - 67
PIMA COUNTY PAGE 68 - 87
PINAL COUNTY PAGE 88 - 92
SANTA CRUZ COUNTY PAGE 93 - 97
YUMA COUNTY PAGE 98 - 101
Pima County Office Of The Medical Examiner – Annual Report 2015
4 Rev: 06/06/2016
INTRODUCTION
The Pima County Office of the Medical Examiner (PCOME) investigates any death in
Pima County that is sudden, violent, unexpected, or in which the cause of death is
unknown. The PCOME also serves as the Medical Examiner (ME) for Cochise and
Santa Cruz Counties and performs examinations as needed for eight additional counties.
In 2015 there were 9,134 deaths in Pima County; of these 2,437 (27%) were reported to
the PCOME for investigation. This annual report consists of three main sections. The
first is an overview of the activities and notable events of the office over the course of the
report year. The second is a statistical review of the types of cases processed by the
office over the same time period. The third is a by-county breakdown of certain death
classifications.
OVERVIEW The PCOME was fully accredited by the National Association of Medical Examiners
(NAME) following a two day inspection in October 2011. This accreditation is effective
from October 24, 2011 through October 24, 2016 and requires annual accreditation
verification. NAME accredited offices represent the highest quality of death
investigation systems. There are 69 fully accredited Medical Examiner’s Offices across
the United States. The PCOME has the distinction of being the sole fully accredited
office in Arizona.
Reportable Deaths
Arizona Revised Statute §11-593 delineates ten circumstances in which a death is
reportable to the PCOME.
1. Death when not under the current care of a health care provider as defined
pursuant to section 36-301.
2. Death resulting from violence.
3. Death occurring suddenly when in apparent good health.
4. Death occurring in a prison.
5. Death of a prisoner.
6. Death occurring in a suspicious, unusual or unnatural manner.
7. Death from disease or accident believed to be related to the deceased's
occupation or employment.
8. Death believed to present a public health hazard.
9. Death occurring during, in association with or as a result of anesthetic or
surgical procedures.
10. Unidentifiable bodies.
Investigations
Our 11 medical investigators processed 2,437 reports of deaths from Pima County and
734 reports from 10 additional Arizona counties in 2015. Jurisdiction was declined in
874 of these cases. A total of 2,007 decedents were transported to the PCOME for
examination or storage in 2015.
Pima County Office Of The Medical Examiner – Annual Report 2015
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Examinations
Pima County forensic pathologists and anthropologists performed 1,456 autopsies, 348
external examinations, 290 death certifications, 145 anthropologic examinations, and
reviewed 6,323 death certificates for cremations in 2015.
Education, Training and Activities
1) Medicolegal Death Investigators
Calendar year 2012 saw a transition from the term Forensic Medical Investigator
(FMI) to Medicolegal Death Investigator (MDI) for our 11 MDIs in keeping with
national norms. Eight MDIs, our MDI Supervisor, and Morgue Supervisor are
certified by the American Board of Medicolegal Death Investigators to provide
competent medicolegal death investigations. PCOME Forensic Pathologists
lecture to the MDIs on varying topics monthly. In accordance with our MDI
quality assurance and performance improvement program, 10% of reports are
pathologist reviewed monthly and 10% of reports are peer reviewed quarterly.
2) Community education, presentations and media interviews
The PCOME receives numerous requests from various groups, organizations,
individuals and schools for presentations regarding a host of forensic issues
annually. Not all requests can be honored due to time and personnel constraints,
but examples of educational activities include but are not limited to: presentations
at local primary and secondary schools; lectures at various institutions and
departments at the University of Arizona; presentations and tours for
humanitarian organizations; and the teaching of a 3-credit-hour death
investigation class at Pima Community College. The Chief Medical Examiner
recorded 115 media interviews, emails and phone calls over the calendar year.
Pima County’s Forensic Anthropologist and Postdoctoral Fellow gave numerous
platform and poster presentations to various organizations and at national
anthropologic and forensic conferences.
3) University of Arizona College of Medicine, Department of Pathology and School
of Anthropology
PCOME Forensic Pathologists hold clinical appointments with the Department of
Pathology at the University of Arizona, College of Medicine, where they are
involved with pathology resident and medical student teaching. Two pathology
residents, seven medical students and two pathology post-sophomore fellows
rotated through the PCOME for month-long rotations in 2015. Our Forensic
Anthropologist also holds an academic appointment at the University of Arizona
and three anthropology interns trained at our facility in 2015.
Law Enforcement and Legal System
The availability of our pathologists to assist or advise law enforcement personnel in their
investigations and the legal system in its proceedings is an important function of the
PCOME. Involvement of the PCOME in the legal system generally consists of pretrial
interviews, depositions and courtroom testimony. In 2015, the office’s six forensic
pathologists and two anthropologists participated in a number of pretrial interviews,
depositions and jury trials both in Pima and out-of-county cases.
Pima County Office Of The Medical Examiner – Annual Report 2015
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Organ and Tissue Donation
Pursuant to A.R.S §36-861, the PCOME refers death notifications to, and partners with,
Donor Network of Arizona (DNA) and other associated tissue research agencies for the
coordination and procurement of anatomic gifts. The importance of supporting the
efforts of the organ and tissue transplant and research communities in Arizona cannot be
understated. Anatomic gifts can be life saving for organ and tissue recipients and these
donations are always in short supply.
Organ Donations with PCOME Involvement 2015
Heart Lungs Liver Kidneys Pancreas Sm. Intestine Total
10 7 21 49 3 0 90
The total lives saved through organ donation involving deaths investigated by the
PCOME in 2015 were 82 with 90 organs being transplanted. The authorization for the
procurement of organs was granted in 100% of cases.
Cornea Donations with PCOME Involvement 2015
Corneas Recovered Corneas Transplanted
200 155
There were 200 corneas recovered and 155 transplanted in 2015 with PCOME
involvement. The release of corneas was granted 97% of the time.
Tissue Donation with PCOME Involvement 2015
Bone Skin Vascular Heart Aortoiliac
106 74 34 40 14
The PCOME was involved in 20% of all DNA tissue recoveries in 2015. The average
release of tissue for procurement was granted 85% of the time across the state of Arizona
in 2014. The release of tissues was granted 95% of the time by the PCOME, significantly
above the state average.
Pima County Office Of The Medical Examiner – Annual Report 2015
7 Rev: 06/06/2016
OFFICE OF THE MEDICAL EXAMINER
ORGANIZATIONAL CHART AS OF DECEMBER 31, 2015
Chief Medical Examiner
Gregory Hess MD
Administrative Services Manager
Vacant
Administrative Specialist
Charlotte Rupel
Administrative
Michele Gough
Linda Hernandez
Amber Bates
Morgue Supervisor
Chris Smith D-ABMDI
Pathology Assistants
Gabriel Costell
Louie Goad
Ricky Rosales
Lindsay Hershberger
Jessie Carlson
Kristine Clor
Medicolegal Death Investigator Supervisor
Gene Hernandez D-ABMDI
Medicolegal Death Investigators
Thomas Buck D-ABMDI
Eric Slocum D-ABMDI
Ron Foster D-ABMDI
Selina Herrera D-ABMDI
Jeff Huesgen D-ABMDI
Marcy Yates D-ABMDI
Trevis Hairston D-ABMDI
Christine Dougall D-ABMDI
Jorge Romero
Kelsey Scott
Raelene Ruiz
Deputy Chief Medical Examiner
Eric Peters MD
Forensic Pathologists
Cynthia Porterfield DO
David Winston MD, PhD
Jennifer Chen MD
Vacant
Forensic Anthropologists
Bruce Anderson PhD
Catherine Bird PhD
Pima County Office Of The Medical Examiner – Annual Report 2015
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TOTAL CASES
The total cases handled by the PCOME in a given year are the sum of the ME cases
(autopsies, external examinations, and death certificate cases), cases in which jurisdiction
was declined, and the number of cases stored at our facility during the calendar year
(storage cases). ‘All Counties’ includes cases examined at the PCOME from Apache,
Cochise, Gila, Graham, Greenlee, La Paz, Navajo, Pinal, Santa Cruz and Yuma counties
in addition to Pima County.
MEDICAL EXAMINER CASES
The PCOME considers all cases in which the cause and manner of death are determined
by this office as “medical examiner cases.” Those cases include autopsies, external
examinations and death certificate (DC) cases. Autopsies are examinations where a
decedent is examined both externally and internally for evidence of injury or natural
disease which may have caused or contributed to the individual’s death. External
examinations consist of an external examination of the body without the internal
examination. A DC case involves review of the medical records, law enforcement
reports and any other information that may be necessary to determine the cause and
manner of death without physical examination of the decedent. In 2015, for Pima and all
other counties listed above, 1456 autopsies, 348 external examinations and 290 DC cases
were performed at the PCOME. Pima County alone accounted for 922 autopsies, 294
external examinations and 273 DC cases.
1983 1864 19702139 2195 2133
25232611 2520
24372292 2337
2505 2577 2501 2602
32033350
3159 3171
0
500
1000
1500
2000
2500
3000
3500
4000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Total Cases 2006 - 2015
Pima County
All Counties
Pima County Office Of The Medical Examiner – Annual Report 2015
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922
294 273
534
5417
0
100
200
300
400
500
600
700
800
900
1000
Autopsy External DC
2015 Medical Examiner Cases
Pima County
Other Counties
27 19 7
43
222 222256
415
328
187 174
99 88
Medical Examiner Cases by Age - 2015
Pima County Office Of The Medical Examiner – Annual Report 2015
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627
904
280
18590
ME Cases (all counties) by Manner of Death - 2015
Natural - 30%
Accident - 43%
Suicide - 13%
Undetermined - 9%
Homicide - 4%
440
655
199
133 56
ME Cases (Pima only) by Manner of Death - 2015
Natural - 30%
Accident - 44%
Suicide - 13%
Undetermined - 9%
Homicide - 4%
Pima County Office Of The Medical Examiner – Annual Report 2015
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HOMICIDE DEATHS
The PCOME certified 90 deaths as homicide in 2015, 56 from Pima County and 34 from
other counties. Homicide totals from 2009 – 2015 are compared below. Homicide
victims were most frequently male (71%), between 20-29 years of age (29%) and died as
the result of firearms (68%).
121131 131
136
123
9990
72
93 9179
88
6256
4938 40
57
35 37 34
0
20
40
60
80
100
120
140
160
2009 2010 2011 2012 2013 2014 2015
Homicide 2009 - 2015
Total Homicide
Pima County
Out of County
04 1 2
26
19
16
12
3 4 20 1
0
5
10
15
20
25
30
Homicide by Age - 2015
Pima County Office Of The Medical Examiner – Annual Report 2015
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64
26
Homicide by Sex - 2015
Male - 71%
Female - 29%
61
10
8
8 3
Homicide by Cause - 2015
Firearms - 68%
Asphyxia - 11%
Sharp Force - 9%
Blunt Force - 9%
Other - 3%
Pima County Office Of The Medical Examiner – Annual Report 2015
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ACCIDENT DEATHS
Deaths due to accidents accounted for 43% of the ME deaths investigated by the PCOME
in 2015. Accident victims were most frequently males (63%), between 50-59 years of
age (18%) and died as the result of a drug or medication overdose (35%).
8 9 5
27
115 117 111
164
8571
111
78
4
0
20
40
60
80
100
120
140
160
180
Accident by Age - 2015
573
289
Accident by Sex - 2015
Male - 63%
Female - 37%
Pima County Office Of The Medical Examiner – Annual Report 2015
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312
270
207
4433 17 7 14
Accident by Cause - 2015
Overdose - 35%
Blunt Force Trauma - 30%
Motor Vehicle Accident - 23%
Exposure To Elements - 5%
Asphyxia - 4%
Drowning - 2%
Fire Deaths - 1%
Other - 2%
245
283268
312
201
231 223
270
221
197 190207
0
50
100
150
200
250
300
350
2012 2013 2014 2015
Accident by Cause (Top 3) 2012 - 2015
Overdose
Blunt Force Trauma
Motor Vehicle Accident
Pima County Office Of The Medical Examiner – Annual Report 2015
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SUICIDE DEATHS
Suicide deaths accounted for 13% of the ME deaths investigated by the PCOME in 2015.
Suicide victims were most frequently males (76%), between 50-59 years of age (21%)
and died as the result of firearms (54%).
0 0 013
43
32
41
58
48
2217
60
0
10
20
30
40
50
60
70
Suicide by Age - 2015
213
67
Suicide by Sex - 2015
Male - 76%
Female - 24%
Pima County Office Of The Medical Examiner – Annual Report 2015
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150
51
51
12 14
Suicide by Cause - 2015
Firearms - 54%
Hanging - 18%
Overdose - 18%
Asphyxia - 4%
Other - 5%
128
144139
150
59
7266
5147
33 37
51
0
20
40
60
80
100
120
140
160
2012 2013 2014 2015
Suicide by Cause (Top 3) 2012 - 2015
Firearms
Hanging
Overdose
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NATURAL DEATHS
Natural deaths accounted for 30% of the ME deaths investigated by the PCOME in 2015.
Individuals who died from natural causes were most frequently males (69%), between
60-69 years of age (29%) and died as the result of cardiovascular disease (62%).
4 4 1 1
2429
76
165
182
81
43
161
0
20
40
60
80
100
120
140
160
180
200
Natural Deaths by Age - 2015
430
197
Natural Deaths by Sex - 2015
Male - 69%
Female - 31%
Pima County Office Of The Medical Examiner – Annual Report 2015
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39140
32
51
1826
69
Natural Deaths by Cause - 2015
Cardiovascular Disease - 62%
Sequelae of Chronic AlcoholAbuse - 6%
Pulmonary Disease - 5%
Infectious Disease - 8%
Diabetes Mellitus - 3%
Malignacy - 4%
Other - 11%
579
409 391
7354 4052
26 3247 44 5139 35 18
40 26 26
0
100
200
300
400
500
600
700
2013 2014 2015
Natural Death by Cause 2013 - 2015
Cardiovascular
Chronic Alcohol
Pulmonary
Infectious
Diabetes
Malignancy
Pima County Office Of The Medical Examiner – Annual Report 2015
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UNDETERMINED MANNER OF DEATH
Deaths in which the manner of death was undetermined accounted for 9% of the ME
deaths investigated by the PCOME in 2015. Individuals who died with an undetermined
manner were most frequently males (75%), of unknown age (44%) and died from
undetermined causes (85%). Many of these deaths represent skeletal remains of
undocumented border crossers who died in the deserts of southern Arizona.
10 2 0 3 14
25
12
22
10 5 1 0
81
0
10
20
30
40
50
60
70
80
90
Undetermined Manner of Death by Age - 2015
139
37
9
Undetermined Manner of Death by Sex - 2015
Male - 75%
Female - 20%
Unknown - 5%
Pima County Office Of The Medical Examiner – Annual Report 2015
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157
166 6
Undetermined Manner of Death by Cause - 2015
Undetermined - 85%
Overdose - 9%
Blunt Force Injury - 3%
Other - 3%
Pima County Office Of The Medical Examiner – Annual Report 2015
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OVERDOSE DEATHS
There were 379 deaths attributed to an overdose of either a single drug (211 deaths, 56%)
or a combination of drugs (168 deaths, 44%) in 2015. Overdose deaths commonly
involved males (56%) between the ages of 50-59 (27%). The majority of these deaths
were classified as accidents (82%).
Opiate drugs (heroin, oxycodone, methadone, hydrocodone, morphine, oxymorphone,
hydromorphone, tramadol, opiate unspecified) and fentanyl (a synthetic opioid narcotic)
accounted for the majority of overdose deaths, either as a single drug or as a component
of a poly-drug overdose. Heroin was the most commonly abused illicit drug contributing
to death in 2015 followed by methamphetamine.
The number of heroin deaths is likely underreported as heroin is rapidly metabolized to
morphine by the body and if the parent compound indicative for heroin (6-
monoacetylmorphine) is not present on the toxicology report these deaths may be
classified as either morphine intoxication or opiate intoxication.
Acute alcohol intoxication alone, not as component of a poly-drug overdose, accounted
for 11 overdose (3%) deaths in 2015.
Fentanyl related deaths more than doubled from 7 deaths in 2014 to 17 deaths in 2015.
273 277
314327 324
379
0
50
100
150
200
250
300
350
400
2010 2011 2012 2013 2014 2015
Overdose Deaths 2010 - 2015
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0 0 1 9
52
81 83
102
37
9 2 00
20
40
60
80
100
120
<1 1-5 6-12 13-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89 >90
Overdose Deaths by Age - 2015
214
165
Overdose Deaths by Sex- 2015
Male - 56%
Female - 44%
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312
5116
Overdose Deaths by Manner - 2015
Accident - 82%
Suicide - 13%
Undetermined - 4%
55
64
57
64 62
49
5954
49
78
57
90
53
77
93
34
26
34
0
10
20
30
40
50
60
70
80
90
100
2013 2014 2015
Select Drugs by Year 2013 - 2015
Oxycodone
Morphine
Alcohol
Methamphetamine
Heroin
Cocaine
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34
90
93
57
15
8
1
25
49
2
7
3
17
47
4
49
6
25
13
18
10
3
3
2
1
5
4
3
2
2
2
5
0 10 20 30 40 50 60 70 80 90 100
Cocaine
Methamphetamine
Heroin
Oxycodone
Hydrocodone
Oxymorphone
Hydromorphone
Methadone
Morphine
Codeine
Tramadol
Opiate Unclassified
Fentanyl
Benzodiazepines
Barbiturates
Alcohol
Diphenhydramine
SSRI/SNRI
Tricyclics
Atypical Antipsychotics
Muscle Relaxants
Anti-seizure Agents
Sleep Aids
Promethazine
MDMA (ecstasy)
Acetaminophen
Amphetamine
Buproprion
Ethylene Glycol
Spice
Buprenorphine
Other
Overdose Deaths by Drug - 2015
Pima County Office Of The Medical Examiner – Annual Report 2015
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MOTOR VEHICLE RELATED FATALITIES
Motor vehicle related fatalities accounted for 209 total deaths in 2015. The majority, 138
deaths, were occupants of a motor vehicle involved in an accident (MVA). Of the
remaining, 22 were motorcycle accidents (MCA), 38 were pedestrians or bicyclists struck
by vehicles and 3 were operating an all-terrain vehicle (ATV). Individuals who died
from motor vehicle related fatalities were most frequently males (66%) and between 20-
29 years of age (23%).
209214
199 196
209
100
120
140
160
180
200
220
240
260
2011 2012 2013 2014 2015
Motor Vehicle Fatalities by Year 2011 - 2015
05 3
11
48
31
23
34
2117
14
2
0
10
20
30
40
50
60
<1 1-5 6-12 13-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89 >90
Motor Vehicle Fatalities by Age - 2015
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148
61
Motor Vehicle Fatalities by Sex - 2015
Male - 66%
Female - 34%
138
35
2211 3
Motor Vehicle Fatalities by Type - 2015
MVA - 66%
Pedestrian - 17%
MCA - 11%
Bicyclist - 5%
ATV - 1%
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W.H. BIRKBY FORENSIC ANTHROPOLOGY LABORATORY
Forensic Anthropologists at the W.H. Birkby Forensic Anthropology
Laboratory within the PCOME performed 145 examinations (biological
profiles, trauma evaluations, dental examinations and examinations for identification) in
2015 on human remains of forensic significance. An additional 29 examinations were
performed on remains ultimately deemed non-human, prehistoric or otherwise not
forensically significant and jurisdiction of the remains was declined (JD) in those cases.
The extent of postmortem decomposition of a particular set of remains is important when
performing a Forensic Anthropology (FA) examination. Remains examined by Forensic
Anthropologists were categorized as minimally decomposed, decomposing, mummified,
skeletal or burnt. In 2015, skeletal remains comprised 63% of FA examinations. Four
main types of exams are performed; biologic profiles, dental, trauma and identification
examinations.
Biological profiles refer to charting, measurements, descriptions, radiographs and
photographs taken to estimate sex, age, ancestry, stature and postmortem interval of a set
of remains. Dental and identification examinations entail charting, descriptions,
radiographs and photographs in an effort to identify an unknown individual or confirm a
suspected identity. Trauma examinations entail charting, measurements, descriptions,
radiographs and photographs to characterize the nature of an injury, implement used to
cause injury to the bone, age of injury, etc. It is common for a particular set of remains to
receive more than one type of examination. Most (92%) FA exams include a biological
profile with dental examination (88%) when applicable. Less common are examinations
for identification (12%) or trauma (14%) with or without biological profiles and dental
examinations.
97
113
148 149
171161 163
149 145
1222
14 18 14 1330 26 29
0
20
40
60
80
100
120
140
160
180
200
2007 2008 2009 2010 2011 2012 2013 2014 2015
Number of FA Exams 2007 - 2015
Exams
JD
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9220
10
20 3
FA Exam by Condition of Remains - 2015
Skeletal - 63%
Decomposing - 14%
Burnt - 7%
Mummified - 14%
Minimal Decomposition - 2%
133128
1720
0
20
40
60
80
100
120
140
Biologic Profile Dental Identification Trauma
FA Examination by Type - 2015
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UNDOCUMENTED BORDER CROSSER (UBC) REMAINS
The term ‘UBC’ refers to foreign nationals who die attempting to cross the southern
Arizona desert without permission from the United States government. Calendar year
(CY) 2010 saw the highest number of UBC recoveries (223) recorded at the PCOME as
compared to the annual average (171 recoveries per year on average from 2002 - 2015).
The PCOME has received 2,465 recovered remains of suspected UBCs since 2001. The
recoveries per year are adjusted annually to account for the association of remains found
months or years apart later discovered to be that of the same individual.
There were 138 UBC recoveries in calendar year 2015. As is the historic norm, UBC
recoveries peaked during the warmer months (June – Sep) with 80 recoveries (58% of
total for year) in 2015. Many remains are not identifiable due to postmortem changes and
efforts by UBCs to obscure their identities. Of the decedents who were identified, 39%
(22 decedents) were between 30-39 years of age. Additionally, 86% (119) of the
recovered remains, identified or unidentified, were males, 8% (11) were females and 6%
(8) were of unidentifiable sex.
Since the exact date and time of death of found remains are often unknown, PCOME staff
determine a ‘postmortem interval (PMI)’, which is an assessment of what period of time
elapsed from death to recovery of the remains. A 1-8 body condition scale was
developed in 2013 to provide a more objective measure of the PMI. The PMI is an
estimate and therefore subject to error. The PMIs for the body condition categories are
listed following the Condition of Recovered UBC Remains table on page 32 of this
report. In 2015, 19 remains (condition 1) were found within less than a day of death
(14%), 48 remains (conditions 2-4) were found with a few days up to a few weeks from
death (35%), and skeletal remains (body conditions 5-7) accounted for 70 (51%) of the
recovered remains.
The cause of death was undetermined in 72% (100) of cases, primarily due to limitations
of examination of decomposed and skeletal remains. Of the remainder, environmental
exposure to extremes in heat or cold combined with dehydration comprised 20% (28) of
deaths. Other, less frequent, causes of death included blunt force injuries from falls or
motor vehicle accidents (4), drowning (3), gunshot wound injuries (1 case), electrocution
(1), and envenomation (1).
In 2015, 49 (89%) of identified UBCs were of Mexican nationality, followed by
Guatemalans (2 or 4%), Hondurans (2 or 4%) and Salvadorans (2 or 4%). Since 2001,
identified UBCs of Mexican nationality have been the most numerous (1,338, 85%),
followed by Guatemalans (131, 8%) and Salvadorans (42, 3%). Of the 2,469 decedents
since 2001, 1,578 (64%) have been identified, 309 (20%) by DNA comparison to a
family or law enforcement reference sample. As of December 31, 2015, 887 decedents
remain unidentified.
Pima County Office Of The Medical Examiner – Annual Report 2015
30 Rev: 06/06/2016
77
148155
170
192
171
214
161
189
223
178
156168
129138
0
50
100
150
200
250
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
UBC Recoveries CY2001 - 2015
143 147
168
197
168
207
159
183
222
174168
178
120135
0
50
100
150
200
250
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
UBC Recoveries FedFY2002 - 2015
Pima County Office Of The Medical Examiner – Annual Report 2015
31 Rev: 06/06/2016
86 6
5 5
19
14
28
19
1011
7
0
5
10
15
20
25
30
UBC Recoveries by Month - CY2015
0 0 08
18 22
4 4 0 0 0 0
82
0
10
20
30
40
50
60
70
80
90
UBC Recoveries by Age - CY2015
Pima County Office Of The Medical Examiner – Annual Report 2015
32 Rev: 06/06/2016
1 - Fully fleshed (PMI < 1 day)
2 - Decomposed (PMI < week)
3 - Decomposition with focal skeletonization (PMI < 3 weeks)
4 - Mummification with skeletonization (PMI < 5 weeks)
5 - Skeletonization with articulation/ligamentous attachments (PMI < 3 months)
6 - Complete skeletonization with disarticulation (PMI < 6-8 months)
7 - Complete skeletonization with bone degradation (PMI > 6-8 months)
8 - Other
19
11
15
22
11
25
34
10
5
10
15
20
25
30
35
40
1 2 3 4 5 6 7 8
Condition of Recovered UBC Remains - CY2015
119
118
UBC Recoveries by Sex- CY2015
Male - 86%
Female - 8%
Unknown - 6%
Pima County Office Of The Medical Examiner – Annual Report 2015
33 Rev: 06/06/2016
100
28
4 3 1 1 1
UBC Recoveries by CYCause - 2015
Undetermined - 72%
Exposure To Elements - 20%
Blunt Force Trauma - 3%
Drowning - 2%
Firearms - <1%
Electrocution - <1%
Envenomation - <1%
49
2 2 2
Identified UBC Recoveries by CYNationality - 2015
Mexican - 89%
Guatemalan - 4%
Honduran - 4%
Salvadoran - 4%
Pima County Office Of The Medical Examiner – Annual Report 2015
34 Rev: 06/06/2016
1338
131
42
31
10
6
4
2
3
4
3
4
Mexican - 85%
Guatemalan - 8%
Salvadoran - 3%
Honduran - 2%
Ecuadorian - <1%
Peruvian - <1%
Brazilian - <1%
Dominican - <1%
Colombian - <1%
Uncertain - <1%
Costa Rican - <1%
Other - <1%
0 200 400 600 800 1000 1200 1400 1600
Identified UBC Recoveries by Nationality 2001 - 2015
1578
55
887
83
0
200
400
600
800
1000
1200
1400
1600
1800
2001 - 2015 2015
Identified vs Unidentified UBC Recoveries
Identified
Unidentified
Pima County Office Of The Medical Examiner – Annual Report 2015
35 Rev: 06/06/2016
13
16 16 16 16
19 1822
48
31
26
37
2218
0
10
20
30
40
50
60
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
DNA Identifications by Year 2001 - 2015
Pima County Office Of The Medical Examiner – Annual Report 2015
36 Rev: 06/06/2016
Apache County
Apache County contracts with an appointed non-Forensic Pathologist physician(s),
termed an Alternate Medical Examiner(s) (AME) (A.R.S. §11-591); who triages,
investigates and certifies deaths that fall under the jurisdiction of the medical examiner in
Apache County. The Apache County AME does not perform autopsy examinations and
if the AME deems an autopsy is necessary to certify the cause and manner of death, the
decedent may be referred to the PCOME for an examination and death certification. The
PCOME is not aware of how many deaths occurring in Apache County are reported to
the Apache County AME, nor the total number or types of deaths certified by the AME.
The PCOME only has a record of deaths reported to, or referred for examination to Pima
County. Deaths on Native American tribal lands do not have to be reported through the
respective death investigation system of that County and may be reported directly to the
PCOME as necessary for the needs of the appropriate agency investigating that death
(Bureau of Indian Affairs (BIA), FBI or local tribal police departments).
Seventeen deaths from Apache County were reported to the PCOME in 2015, sixteen of
which required autopsy examinations. Some pertinent statistics regarding these deaths
are detailed in the tables and graphs below.
*Arizona Department of Vital Statistics as of 06/02/16
454
522 510530 544
584
471
607 601
554
0
100
200
300
400
500
600
700
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Apache County Mortality by Year 2006 - 2015*
Pima County Office Of The Medical Examiner – Annual Report 2015
37 Rev: 06/06/2016
8
5
17
14
12
17
0
2
4
6
8
10
12
14
16
18
2010 2011 2012 2013 2014 2015
Apache County Deaths Reported to the PCOME 2010 - 2015
16
1
Apache County Deaths by Type of Exam 2015
Autopsy
Jurisdiction Declined
Pima County Office Of The Medical Examiner – Annual Report 2015
38 Rev: 06/06/2016
7
5
2
2
Apache County Deaths by Manner of Death 2015
Accident
Natural
Undetermined
Homicide
4
4
2
2
1
4
Apache County Deaths by Type of Death 2015
Overdose
Cardiovascular
Motor vehice accident
Firearms
Asphyxia
Other
Pima County Office Of The Medical Examiner – Annual Report 2015
39 Rev: 06/06/2016
9
3
3
1
1
0 1 2 3 4 5 6 7 8 9 10
Apache County Deaths by Law Enforcement Agency 2015
Pima County Office Of The Medical Examiner – Annual Report 2015
40 Rev: 06/06/2016
Cochise County
Cochise County contracts with the PCOME to certify deaths that fall under the
jurisdiction of the medical examiner in Cochise County. Cochise County does not
maintain an in-county Medical Examiner’s office to conduct death scene investigations,
transport remains, or triage deaths reportable to the medical examiner. Cochise County
does provide third party transportation services, local law enforcement death scene
investigation and archival support for examinations that occurred prior to July 1, 2012.
The PCOME works closely with Cochise County law enforcement agencies, the public
fiduciary office and funeral homes to facilitate investigations, disposition of remains and
transportation respectively. The PCOME is also involved as needed with mass fatality
planning, child fatality review, or other medical examiner related issues in Cochise
County.
In calendar year 2015 there were 1289 deaths in Cochise County; of these 270 (21%)
were reported to the PCOME for investigation and/or examination. Some pertinent
statistics regarding these deaths are detailed in the tables and graphs below.
*Arizona Department of Vital Statistics as of 06/02/2016
1140
1093
1185
1122
12181183
1204
1266
1201
1289
950
1000
1050
1100
1150
1200
1250
1300
1350
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Cochise County Mortality by Year 2006 - 2015*
Pima County Office Of The Medical Examiner – Annual Report 2015
41 Rev: 06/06/2016
151
268
246
270
0
50
100
150
200
250
300
2012 (partial year) 2013 2014 2015
Cochise County Deaths Reported to the PCOME 2012 - 2015
123
2416
107
Cochise County Deaths by Type of Exam 2015
Autopsy
External
Death Certification
Jurisdiction Declined
Pima County Office Of The Medical Examiner – Annual Report 2015
42 Rev: 06/06/2016
64
51
30
612
Cochise County Deaths by Manner of Death 2015
Accident
Natural
Suicide
Homicide
Undetermined
24
13
17
23
3 2
Cochise County Accidents by Type 2015
Overdose
Blunt Force Injuries
Motor Vehicle
Asphyxia
Exposure
Drowning
Other
Pima County Office Of The Medical Examiner – Annual Report 2015
43 Rev: 06/06/2016
4
2
Cochise County Homicides by Type 2015
Firearms
Asphyxia
322
3
5
34 2
Cochise County Naturals by Type 2015
Cardiovascular
Diabetes
Infectious
Pulmonary
Pulmonary Embolus
Chronic Alcohol Abuse
Other
Pima County Office Of The Medical Examiner – Annual Report 2015
44 Rev: 06/06/2016
16
4
4
42
Cochise County Suicides by Type 2015
Firearms
Hanging
Overdose
Asphyxia
Sharp Force Injury
84
65
10
15
13
25
8
6
4
3
36
0 10 20 30 40 50 60 70 80 90
Cochise County Deaths by Law Enforcement Agency 2015
Pima County Office Of The Medical Examiner – Annual Report 2015
45 Rev: 06/06/2016
Gila County
Gila County contracts with an appointed Forensic Pathologist Medical Examiner, who
triages, investigates and certifies deaths that fall under the jurisdiction of the medical
examiner (ME) in Gila County. The Gila County ME performs some autopsy
examinations in Payson if the ME deems an autopsy is necessary to certify the cause and
manner of death. Additionally, the ME may refer some decedents from southern Gila
County to the PCOME for an examination and death certification as necessary. The
PCOME is not aware of how many deaths occurring in Gila County are reported to the
ME, nor the total number or types of deaths certified by the ME. The PCOME only has a
record of deaths reported to, or referred for examination to Pima County. Deaths on
Native American tribal lands do not have to be reported through the respective death
investigation system of that County and may be reported directly to the PCOME as
necessary for the needs of the appropriate agency investigating that death (BIA, FBI or
local tribal police departments).
Thirty two deaths from Gila County were reported to the PCOME in 2015, 31 of which
required autopsy examinations. Some pertinent statistics regarding these deaths are
detailed in the tables and graphs below.
*Arizona Department of Vital Statistics as of 06/02/2016
627
666718
646661 682 655
696747
797
0
100
200
300
400
500
600
700
800
900
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Gila County Mortality by Year 2006 - 2015*
Pima County Office Of The Medical Examiner – Annual Report 2015
46 Rev: 06/06/2016
48 48
57
81
42
32
0
10
20
30
40
50
60
70
80
90
2010 2011 2012 2013 2014 2015
Gila County Deaths Reported to the PCOME 2010 - 2015
31
1
Gila County Deaths by Type of Exam 2015
Autopsy
External
Pima County Office Of The Medical Examiner – Annual Report 2015
47 Rev: 06/06/2016
17
6
7
2
Gila County Deaths by Manner of Death 2015
Accident
Natural
Suicide
Undetermined
96
2
Gila County Accidents by Type 2015
Motor Vehicle
Overdose
Drowning
Pima County Office Of The Medical Examiner – Annual Report 2015
48 Rev: 06/06/2016
4
1
1
Gila County Naturals by Type 2015
Cardiovascular
Chronic Alcohol Abuse
Infectious
1
2
1
1
1
1
Gila County Suicides by Type 2015
Hanging
Firearms
Blunt Force Injury
Overdose
Sharp Force Injury
Motor Vehicle
Pima County Office Of The Medical Examiner – Annual Report 2015
49 Rev: 06/06/2016
12
1
10
5
1
2
1
0 2 4 6 8 10 12 14
Gila County Deaths by Law Enforcement Agency 2015
Pima County Office Of The Medical Examiner – Annual Report 2015
50 Rev: 06/06/2016
Graham County
Graham County contracts with an appointed non-Forensic Pathologist physician(s),
termed an Alternate Medical Examiner(s) (AME) (A.R.S. §11-591), who triages,
investigates and certifies deaths that fall under the jurisdiction of the medical examiner in
Graham County. The Graham County AME does not perform autopsy examinations and
if the AME deems an autopsy is necessary to certify the cause and manner of death, the
decedent may be referred to the PCOME for an examination and death certification. The
PCOME is not aware of how many deaths occurring in Graham County are reported to
the Graham County AME, nor the total number or types of deaths certified by the AME.
The PCOME only has a record of deaths reported to, or referred for examination to Pima
County. Deaths on Native American tribal lands do not have to be reported through the
respective death investigation system of that County and may be reported directly to the
PCOME as necessary for the needs of the appropriate agency investigating that death
(BIA, FBI or local tribal police departments).
Five deaths from Graham County were reported to the PCOME in 2015, all of which
required autopsy examinations. Some pertinent statistics regarding these deaths are
detailed in the tables and graphs below.
*Arizona Department of Vital Statistics as of 06/02/2016
295 282 294271
302
245
300
275283
247
0
50
100
150
200
250
300
350
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Graham County Mortality by Year 2006 - 2015*
Pima County Office Of The Medical Examiner – Annual Report 2015
51 Rev: 06/06/2016
1413
15
17
13
5
0
2
4
6
8
10
12
14
16
18
2010 2011 2012 2013 2014 2015
Graham County Deaths Reported to the PCOME 2010 - 2015
5
Graham County Deaths by Type of Exam 2015
Autopsy
Pima County Office Of The Medical Examiner – Annual Report 2015
52 Rev: 06/06/2016
31
1
Graham County Deaths by Manner of Death 2015
Accident
Natural
Homicide
31
1
Graham County Deaths by Type of Death 2015
Overdose
Firearms
Cardiovascular
Pima County Office Of The Medical Examiner – Annual Report 2015
53 Rev: 06/06/2016
1
1
2
1
0 0.5 1 1.5 2 2.5
Graham County Deaths by Law Enforcement Agency 2015
Pima County Office Of The Medical Examiner – Annual Report 2015
54 Rev: 06/06/2016
Greenlee County
Greenlee County contracts with an appointed non-Forensic Pathologist physician(s),
termed an Alternate Medical Examiner(s) (AME) (A.R.S. §11-591), who triages,
investigates and certifies deaths that fall under the jurisdiction of the medical examiner in
Greenlee County. The Greenlee County AME does not perform autopsy examinations
and if the AME deems an autopsy is necessary to certify the cause and manner of death,
the decedent may be referred to the PCOME for an examination and death certification.
The PCOME is not aware of how many deaths occurring in Greenlee County are reported
to the Greenlee County AME, nor the total number or types of deaths certified by the
AME. The PCOME only has a record of deaths reported to, or referred for examination
to Pima County. Deaths on Native American tribal lands do not have to be reported
through the respective death investigation system of that County and may be reported
directly to the PCOME as necessary for the needs of the appropriate agency investigating
that death (BIA, FBI or local tribal police departments).
Thirteen deaths from Greenlee County were reported to the PCOME in 2015, all of which
required autopsy examinations. Some pertinent statistics regarding these deaths are
detailed in the tables and graphs below.
*Arizona Department of Vital Statistics as of 06/02/2016
65 63
52 5055
71
64
43
52
70
0
10
20
30
40
50
60
70
80
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Greenlee County Mortality by Year 2006 - 2015*
Pima County Office Of The Medical Examiner – Annual Report 2015
55 Rev: 06/06/2016
10
4
6
12
9
13
0
2
4
6
8
10
12
14
2010 2011 2012 2013 2014 2015
Greenlee County Deaths Reported to the PCOME 2010 - 2015
13
Greenlee County Deaths by Type of Exam 2015
Autopsy
Pima County Office Of The Medical Examiner – Annual Report 2015
56 Rev: 06/06/2016
6
6
1
Greenlee County Deaths by Manner of Death 2015
Accident
Natural
Homicide
6
3
2
11
Greenlee County Deaths by Type of Death 2015
Overdose
Cardiovascular
Pulmonary
Firearms
Chronic Alcohol Abuse
Pima County Office Of The Medical Examiner – Annual Report 2015
57 Rev: 06/06/2016
10
2
1
0 2 4 6 8 10 12
Greenlee County Deaths by Law Enforcement Agency 2015
Pima County Office Of The Medical Examiner – Annual Report 2015
58 Rev: 06/06/2016
La Paz County
La Paz County contracts with an appointed non-Forensic Pathologist physician(s), termed
an Alternate Medical Examiner(s) (AME) (A.R.S. §11-591), who triages, investigates
and certifies deaths that fall under the jurisdiction of the medical examiner in La Paz
County. The La Paz County AME does not perform autopsy examinations and if the
AME deems an autopsy is necessary to certify the cause and manner of death, the
decedent may be referred to the PCOME for an examination and death certification. The
PCOME is not aware of how many deaths occurring in La Paz County are reported to the
La Paz County AME, nor the total number or types of deaths certified by the AME. The
PCOME only has a record of deaths reported to, or referred for examination to Pima
County. Deaths on Native American tribal lands do not have to be reported through the
respective death investigation system of that County and may be reported directly to the
PCOME as necessary for the needs of the appropriate agency investigating that death
(BIA, FBI or local tribal police departments).
Forty deaths from La Paz County were reported to the PCOME in 2015, 37 of which
required autopsy examinations. Some pertinent statistics regarding these deaths are
detailed in the tables and graphs below.
*Arizona Department of Vital Statistics as of 06/02/2016
200 204 200
227
200186
225
247 253244
0
50
100
150
200
250
300
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
La Paz County Mortality by Year 2006 - 2015*
Pima County Office Of The Medical Examiner – Annual Report 2015
59 Rev: 06/06/2016
29
21
13
2422
40
0
5
10
15
20
25
30
35
40
45
2010 2011 2012 2013 2014 2015
La Paz County Deaths Reported to the PCOME 2010 - 2015
37
1 2
La Paz County Deaths by Type of Exam 2015
Autopsy
Jurisdiction Declined
External
Pima County Office Of The Medical Examiner – Annual Report 2015
60 Rev: 06/06/2016
17
11
6
32
La Paz County Deaths by Manner of Death 2015
Accident
Natural
Undetermined
Suicide
Homicide
8
6
11
1
La Paz County Accidents by Type 2015
Motor Vehicle
Overdose
Exposure
Asphyxia
Blunt Force Injury
Pima County Office Of The Medical Examiner – Annual Report 2015
61 Rev: 06/06/2016
2
La Paz County Homicides by Type 2015
Firearms
7
2
1
1
La Paz County Naturals by Type 2015
Cardiovascular
Malignancy
Infectious
Unknown
Pima County Office Of The Medical Examiner – Annual Report 2015
62 Rev: 06/06/2016
3
La Paz County Suicides by Type 2015
Firearms
3
14
12
8
3
0 2 4 6 8 10 12 14 16
La Paz County Deaths by Law Enforcement Agency 2015
Pima County Office Of The Medical Examiner – Annual Report 2015
63 Rev: 06/06/2016
Navajo County
Navajo County contracts with an appointed non-Forensic Pathologist physician(s),
termed an Alternate Medical Examiner(s) (AME) (A.R.S. §11-591), who triages,
investigates and certifies deaths that fall under the jurisdiction of the medical examiner in
Navajo County. The Navajo County AME does not perform autopsy examinations and if
the AME deems an autopsy is necessary to certify the cause and manner of death, the
decedent may be referred to the PCOME for an examination and death certification. The
PCOME is not aware of how many deaths occurring in Navajo County are reported to the
Navajo County AME, nor the total number or types of deaths certified by the AME. The
PCOME only has a record of deaths reported to, or referred for examination to Pima
County. Deaths on Native American tribal lands do not have to be reported through the
respective death investigation system of that County and may be reported directly to the
PCOME as necessary for the needs of the appropriate agency investigating that death
(BIA, FBI or local tribal police departments).
Thirty deaths from Navajo County were reported to the PCOME in 2015, 28 of which
required autopsy examinations. Some pertinent statistics regarding these deaths are
detailed in the tables and graphs below.
*Arizona Department of Vital Statistics as of 06/02/2016
860 888793
825 819899 897
976 937
882
0
200
400
600
800
1000
1200
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Navajo County Mortality by Year 2006 - 2015*
Pima County Office Of The Medical Examiner – Annual Report 2015
64 Rev: 06/06/2016
35
29
36
33 33
30
0
5
10
15
20
25
30
35
40
2010 2011 2012 2013 2014 2015
Navajo County Deaths Reported to the PCOME 2010 - 2015
28
1 1
Navajo County Deaths by Type of Exam 2015
Autopsy
Jurisdiction Declined
External
Pima County Office Of The Medical Examiner – Annual Report 2015
65 Rev: 06/06/2016
11
8
4
4
2
Navajo County Deaths by Manner of Death 2015
Natural
Accident
Suicide
Homicide
Undetermined
2
22
1
1
Navajo County Accidents by Type 2015
Motor Vehicle
Exposure
Fire
Overdose
Blunt Force Injury
Pima County Office Of The Medical Examiner – Annual Report 2015
66 Rev: 06/06/2016
3
1
Navajo County Homicides by Type 2015
Sharp Force Injury
Asphyxia
3
4
2
1
1
Navajo County Naturals by Type 2015
Infectious
Other
Cardiovascular
Chronic Alcohol Abuse
Pulmonary Embolus
Pima County Office Of The Medical Examiner – Annual Report 2015
67 Rev: 06/06/2016
3
1
Navajo County Suicides by Type 2015
Hanging
Asphyxia
16
2
9
1
1
1
0 2 4 6 8 10 12 14 16 18
Navajo County Deaths by Law Enforcement Agency 2015
Pima County Office Of The Medical Examiner – Annual Report 2015
68 Rev: 06/06/2016
Pima County TOTAL MORTALITY
The number of deaths reported to the medical examiner’s office in a given time frame is a
reflection of the total population that the office serves. In 2015 there were 9,134 deaths
in Pima County; of these 2,437 (27%) were reported to the PCOME for investigation.
*Arizona Department of Vital Statistics as of 06/06/16
TOTAL CASES
The total cases handled by the PCOME from Pima County in a given year are the sum of
the ME cases (autopsies, external examinations, and death certificate cases), cases in
which jurisdiction was declined, and the number of cases stored at our facility during the
calendar year (storage cases).
7885 7899 8075 8065 8163 83928713 8592 8725 9134
0
2000
4000
6000
8000
10000
12000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Pima County Mortality by Year 2006 - 2015*
Pima County Office Of The Medical Examiner – Annual Report 2015
69 Rev: 06/06/2016
MEDICAL EXAMINER CASES
The PCOME considers all cases in which the cause and manner of death are determined
by this office as “medical examiner cases.” Those cases include autopsies, external
examinations and death certificate (DC) cases. Autopsies are examinations where a
decedent is examined both externally and internally for evidence of injury or natural
disease which may have caused or contributed to the individual’s death. External
examinations consist of an external examination of the body without the internal
examination. A DC case involves review of the medical records, law enforcement
reports and any other information that may be necessary to determine the cause and
manner of death without physical examination of the decedent. In 2015, 922 autopsies,
294 external examinations and 273 DC cases were performed on deaths from Pima
County.
1983 1864 19702139 2195 2133
25232611
25202437
0
500
1000
1500
2000
2500
3000
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Total Cases from Pima County 2006 - 2015
Pima County Office Of The Medical Examiner – Annual Report 2015
70 Rev: 06/06/2016
922
294 273
0
100
200
300
400
500
600
700
800
900
1000
Autopsy External DC
2015 Pima County Medical Examiner Cases
15 144
31
146 148166
283
234
137 143
9175
Pima County Medical Examiner Cases by Age - 2015
Pima County Office Of The Medical Examiner – Annual Report 2015
71 Rev: 06/06/2016
440
655
199
133 56
Pima County ME Cases by Manner of Death - 2015
Natural - 30%
Accident - 44%
Suicide - 13%
Undetermined - 9%
Homicide - 4%
1171
640
72
44
41
16
15
31
0 200 400 600 800 1000 1200 1400
Pima County Deaths by Law Enforcement Agency 2015
Pima County Office Of The Medical Examiner – Annual Report 2015
72 Rev: 06/06/2016
HOMICIDE DEATHS
The PCOME examined 56 homicides from Pima County in 2015; 4% of total Pima
County deaths certified. Homicide totals from 2009 – 2015 are compared below.
Homicide victims were most frequently male (73%), between 20-29 years of age (27%)
and died as the result of firearms (70%).
72
93 91
79
88
6256
0
10
20
30
40
50
60
70
80
90
100
2009 2010 2011 2012 2013 2014 2015
Pima County Homicide 2009 - 2015
0 2 1 2
15
12
10
7
23 2 0 0
0
2
4
6
8
10
12
14
16
Pima County Homicide by Age - 2015
Pima County Office Of The Medical Examiner – Annual Report 2015
73 Rev: 06/06/2016
41
15
Pima County Homicide by Sex - 2015
Male - 73%
Female - 27%
39
5
5
4 3
Pima County Homicide by Cause - 2015
Firearms - 70%
Sharp Force - 9%
Blunt Force - 9%
Asphyxia - 7%
Other - 5%
Pima County Office Of The Medical Examiner – Annual Report 2015
74 Rev: 06/06/2016
ACCIDENT DEATHS
Deaths due to accidents accounted for 44% of the deaths investigated by the PCOME in
2015. Accident victims were most frequently males (62%), between 50-59 years of age
(16%) and died as the result of blunt force injuries (38%) often as the result of such
conditions as complications of a hip fracture or intracranial hemorrhage from a fall.
48
3
17
74 76 72
107
62 60
94
74
4
0
20
40
60
80
100
120
Pima County Accident by Age - 2015
409
246
Pima County Accident by Sex- 2015
Male - 62%
Female - 38%
Pima County Office Of The Medical Examiner – Annual Report 2015
75 Rev: 06/06/2016
215
246
121
31 6 22 14
Pima County Accident by Cause - 2015
Overdose - 33%
Blunt Force Trauma - 38%
Motor Vehicle Accident - 18%
Exposure To Elements - 5%
Drowning - <1%
Asphyxia - 3%
Other - 2%
181
212199
215
190208 204
246
128 123114 121
0
50
100
150
200
250
300
2012 2013 2014 2015
Pima County Accident by Cause (Top 3) 2012 - 2015
Overdose
Blunt Force Injury
Motor Vehicle
Pima County Office Of The Medical Examiner – Annual Report 2015
76 Rev: 06/06/2016
SUICIDE DEATHS
Deaths due to suicide accounted for 13% of the deaths investigated by the PCOME in
2015. Suicide victims were most frequently males (76%), between 50-59 years of age
(28%) and died as the result of firearms (56%).
0 0 09
29
2427
44
34
15 14
30
0
5
10
15
20
25
30
35
40
45
50
Pima County Suicide by Age - 2015
151
48
Pima County Suicide by Sex - 2015
Male - 76%
Female - 24%
Pima County Office Of The Medical Examiner – Annual Report 2015
77 Rev: 06/06/2016
112
36
38
6 7
Pima County Suicide by Cause - 2015
Firearms - 56%
Hanging - 18%
Overdose - 19%
Asphyxia - 3%
Other - 4%
100106
101
112
4046 43
3633
22 25
38
0
20
40
60
80
100
120
2012 2013 2014 2015
Pima County Suicide by Cause (Top 3) 2012 - 2015
Firearms
Hanging
Overdose
Pima County Office Of The Medical Examiner – Annual Report 2015
78 Rev: 06/06/2016
NATURAL DEATHS
Deaths due to natural causes accounted for 30% of the deaths investigated by the
PCOME in 2015. Individuals who died from natural causes were most frequently males
(67%), between 60-69 years of age (30%) and died as the result of cardiovascular disease
(60%).
2 2 0 1
17 20
49
111
132
58
33
14
10
20
40
60
80
100
120
140
Pima County Natural Deaths by Age - 2015
295
145
Pima County Natural Deaths by Sex - 2015
Male - 67%
Female - 33%
Pima County Office Of The Medical Examiner – Annual Report 2015
79 Rev: 06/06/2016
265
30
20
38
1621
50
Pima County Natural Deaths by Cause - 2015
Cardiovascular Disease - 60%
Sequelae of Chronic AlcoholAbuse - 7%
Pulmonary Disease - 5%
Infectious Disease - 9%
Diabetes Mellitus - 4%
Malignacy - 5%
Other - 11%
Pima County Office Of The Medical Examiner – Annual Report 2015
80 Rev: 06/06/2016
UNDETERMINED MANNER OF DEATH
Deaths of undetermined manner accounted for 9% of the deaths investigated by the
PCOME in 2015. Individuals who died with an undetermined manner were most
frequently males (77%), of unknown age (53%) and died from undetermined causes
(88%). Many of these deaths represent skeletal remains of UBCs who died in the deserts
of southern Arizona.
5 2 0 2
1116
814
4 1 0 0
70
0
10
20
30
40
50
60
70
80
Pima County Undetermined Manner of Death by Age - 2015
103
23
7
Pima County Undetermined Manner of Death by Sex - 2015
Male - 77%
Female - 17%
Unknown - 5%
Pima County Office Of The Medical Examiner – Annual Report 2015
81 Rev: 06/06/2016
117
9 3 4
Pima County Undetermined Manner of Death by Cause - 2015
Undetermined - 88%
Overdose - 7%
Blunt Force Injury - 2%
Other - 3%
Pima County Office Of The Medical Examiner – Annual Report 2015
82 Rev: 06/06/2016
OVERDOSE DEATHS
There were 262 deaths attributed to an overdose of either a single drug (138 deaths, 53%)
or a combination of drugs (124 deaths, 47%) in 2015. Overdose deaths commonly
involved males (56%) between the ages of 50-59 (28%). The majority of these deaths
were classified as accidents (82%).
Opiate drugs (heroin, oxycodone, methadone, hydrocodone, morphine, oxymorphone,
hydromorphone, tramadol, opiate unspecified) and fentanyl (a synthetic opioid narcotic)
accounted for the majority of overdose deaths, either as a single drug or a component of a
poly-drug overdose. Heroin was the most commonly abused illicit drug contributing to
death in 2015 followed by methamphetamine.
The number of heroin deaths is likely underreported as heroin is rapidly metabolized to
morphine by the body and if the parent compound indicative for heroin (6-
monoacetylmorphine) is not present on the toxicology report these deaths may be
classified as either morphine intoxication or opiate intoxication.
Acute alcohol intoxication alone, not as component of a poly-drug overdose, accounted
for 6 overdose (2%) deaths in 2015.
222210
228240 241
262
0
50
100
150
200
250
300
2010 2011 2012 2013 2014 2015
Pima County Overdose Deaths 2010 - 2015
Pima County Office Of The Medical Examiner – Annual Report 2015
83 Rev: 06/06/2016
0 0 16
36
53 55
74
27
64
00
10
20
30
40
50
60
70
80
<1 1-5 6-12 13-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89 >90
Pima County Overdose Deaths by Age - 2015
148
114
Pima County Overdose Deaths by Sex- 2015
Male - 56%
Female - 44%
Pima County Office Of The Medical Examiner – Annual Report 2015
84 Rev: 06/06/2016
215
389
Pima County Overdose Deaths by Manner - 2015
Accident - 82%
Suicide - 15%
Undetermined - 3%
3935
47
35354038
55
71 73
25
33
0
10
20
30
40
50
60
70
80
2014 2015
Select Pima County Drugs by Year 2014 - 2015
Oxycodone
Morphine
Alcohol
Methamphetamine
Heroin
Cocaine
Pima County Office Of The Medical Examiner – Annual Report 2015
85 Rev: 06/06/2016
33
55
73
35
9
5
1
19
35
1
3
4
14
34
4
40
3
15
12
12
6
0
2
0
1
4
2
4
0 10 20 30 40 50 60 70 80
Cocaine
Methamphetamine
Heroin
Oxycodone
Hydrocodone
Oxymorphone
Hydromorphone
Methadone
Morphine
Codeine
Tramadol
Opiate Unclassified
Fentanyl
Benzodiazepines
Barbiturates
Alcohol
Diphenhydramine
SSRI/SNRI
Tricyclics
Atypical Antipsychotics
Muscle Relaxants
Anti-seizure Agents
Sleep Aids
Promethazine
MDMA
Acetaminophen
Ethylene Glycol
Other
Pima County Overdose Deaths by Drug - 2015
Pima County Office Of The Medical Examiner – Annual Report 2015
86 Rev: 06/06/2016
MOTOR VEHICLE RELATED FATALITIES
Motor vehicle related fatalities accounted for 121 total deaths in in Pima County in 2015.
The majority, 70 deaths, were occupants of a motor vehicle involved in an accident
(MVA). Of the remaining, 16 were motorcycle accidents (MCA), 33 were pedestrians or
bicyclists struck by vehicles, and 2 were all-terrain vehicle (ATV) accidents. Individuals
who died from motor vehicle related fatalities were most frequently males (70%) and
between 20-29 years of age (22%).
117
130125
118 121
0
20
40
60
80
100
120
140
160
2011 2012 2013 2014 2015
Pima County Motor Vehicle Fatalities by Year 2011 - 2015
0
5
1
6
27
21
9
18
13
11
8
20
5
10
15
20
25
30
<1 1-5 6-12 13-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89 >90
Pima County Motor Vehicle Fatalities by Age - 2015
Pima County Office Of The Medical Examiner – Annual Report 2015
87 Rev: 06/06/2016
85
36
Pima County Motor Vehicle Fatalities by Sex - 2015
Male - 70%
Female - 30%
7025
16
8 2
Pima County Motor Vehicle Fatalities by Type - 2015
MVA - 58%
Pedestrian - 21%
MCA - 13%
Bicyclist - 7%
ATV - 2%
Pima County Office Of The Medical Examiner – Annual Report 2015
88 Rev: 06/06/2016
Pinal County
Pinal County contracts with the PCOME to provide examination or other support services
beyond what Pinal County provides internally. Pinal County maintains its own Medical
Examiner’s office staffed to conduct death scene investigations, transport remains, assist
with the performance of some external examinations at the OME facility in Pinal County,
and triage deaths reportable to the ME as stated in A.R.S §11-593 above. Not all deaths
in Pinal County are reported to the PCOME through the Pinal County Medical
Examiner’s Office. Deaths on Native American tribal lands do not have to be reported
through the respective death investigation system of that County and may be reported
directly to the PCOME as necessary for the needs of the appropriate agency investigating
that death (BIA, FBI or local tribal police departments). The Pinal County Medical
Examiner’s Office issues its own annual report. Please reference that report for details
concerning deaths occurring in Pinal County that are not referred to the PCOME.
In calendar year 2015 there were 2911 deaths in Pinal County; of these 264 (9%) were
reported to the PCOME for examination. Some pertinent statistics regarding these deaths
are detailed in the tables and graphs below.
*Arizona Department of Vital Statistics as of 06/02/2016
1948 2033 2023 19942258
23802440 2457
2629
2911
0
500
1000
1500
2000
2500
3000
3500
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Pinal County Mortality by Year 2006 - 2015*
Pima County Office Of The Medical Examiner – Annual Report 2015
89 Rev: 06/06/2016
140
304 308
223
200
264
0
50
100
150
200
250
300
350
2010 2011 2012 2013 2014 2015
Pinal County Deaths Reported to the PCOME 2010 - 2015
236
17 10
1
Pinal County Deaths by Type of Exam 2015
Autopsy
External
Jurisdiction Declined
DC Case
Pima County Office Of The Medical Examiner – Annual Report 2015
90 Rev: 06/06/2016
76
110
32
1421
Pinal County Deaths by Manner of Death 2015
Natural
Accident
Suicide
Homicide
Undetermined
42
44
8
74
2 2 1
Pinal County Accidents by Type 2015
Overdose
Motor Vehicle
Blunt Force Injury
Asphyxia
Exposure
Aircraft
Drowning
Other
Pima County Office Of The Medical Examiner – Annual Report 2015
91 Rev: 06/06/2016
10
3
1
Pinal County Homicides by Type 2015
Firearms
Asphyxia
Blunt Force Injuries
55
5
4
2 22
6
Pinal County Naturals by Type 2015
Cardiovascular
Infectious
Pulmonary
Pulmonary Embolus
Chronic Alcohol
Malignancy
Other
Pima County Office Of The Medical Examiner – Annual Report 2015
92 Rev: 06/06/2016
13
6
8
23
Pinal County Suicides by Type 2015
Firearms
Hanging
Overdose
Blunt Force Injury
Other
91
26
30
31
15
12
11
13
10
9
0 10 20 30 40 50 60 70 80 90 100
Pinal County Deaths by Law Enforcement Agency 2015
Pima County Office Of The Medical Examiner – Annual Report 2015
93 Rev: 06/06/2016
Santa Cruz County
Santa Cruz County does not maintain an in-county Medical Examiner’s office to conduct
death scene investigations, transport or examine remains, or certify deaths reportable to
the medical examiner. Nor does Santa Cruz County appoint or contract with an Alternate
Medical Examiner. The PCOME acts as the de-facto appointed ME for Santa Cruz
County. When deaths occur in Santa Cruz County pursuant to A.R.S. §11-593, Santa
Cruz County law enforcement agencies investigate the circumstances of the death and
notify the PCOME as necessary.
In calendar year 2015 there were 291 deaths in Santa Cruz County; of these 55 (19%)
were reported to the PCOME for investigation and/or examination. Some pertinent
statistics regarding these deaths are detailed in the tables below.
*Arizona Department of Vital Statistics as of 06/02/2016
238
263252
284
262247
303286
275291
0
50
100
150
200
250
300
350
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Santa Cruz County Mortality by Year 2006 - 2015*
Pima County Office Of The Medical Examiner – Annual Report 2015
94 Rev: 06/06/2016
5854
59
51
46
55
0
10
20
30
40
50
60
70
2010 2011 2012 2013 2014 2015
Santa Cruz County Deaths Reported to the PCOME 2012 - 2015
37
9
8
Santa Cruz County Deaths by Type of Exam 2015
Autopsy
External
Jurisdiction Declined
Pima County Office Of The Medical Examiner – Annual Report 2015
95 Rev: 06/06/2016
19
16
4
7
Santa Cruz County Deaths by Manner of Death 2015
Natural
Accident
Suicide
Undetermined
4
44
3
1
Santa Cruz County Accidents by Type 2015
Overdose
Motor Vehicle
Drowning
Exposure
Blunt Force Injury
Pima County Office Of The Medical Examiner – Annual Report 2015
96 Rev: 06/06/2016
17
1 1
Santa Cruz County Naturals by Type 2015
Cardiovascular
Pulmonary
Chronic Alcohol
3
1
Santa Cruz County Suicides by Type 2015
Firearms
Hanging
Pima County Office Of The Medical Examiner – Annual Report 2015
97 Rev: 06/06/2016
27
22
2
4
0 5 10 15 20 25 30
Santa Cruz County Deaths by Law Enforcement Agency 2015
Pima County Office Of The Medical Examiner – Annual Report 2015
98 Rev: 06/06/2016
Yuma County
Yuma County contracts with the pathology group at Yuma Regional Medical Center to
perform examinations and certify deaths that fall under the jurisdiction of the medical
examiner in Yuma County. Some decedents (typically suspected homicides) are referred
to the PCOME for an examination and death certification at the discretion of the Yuma
County Medical Examiner’s Office. The Yuma County Medical Examiner’s Office
issues its own Annual Report. Please reference that report for details concerning deaths
occurring in Yuma County that are not referred to the PCOME.
Five deaths from Yuma County were reported to the PCOME in 2015, all five of which
required autopsy examinations. Some pertinent statistics regarding these deaths are
detailed in the tables below.
*Arizona Department of Vital Statistics as of 06/02/2016
1164 1180 1105
1306 12791350 1386 1320
1425 1413
0
200
400
600
800
1000
1200
1400
1600
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
Yuma County Mortality by Year 2006 - 2015*
Pima County Office Of The Medical Examiner – Annual Report 2015
99 Rev: 06/06/2016
20
18 18
1516
5
0
5
10
15
20
25
2010 2011 2012 2013 2014 2015
Yuma County Deaths Reported to the PCOME 2010 - 2015
5
Yuma County Deaths by Type of Exam 2015
Autopsy
Pima County Office Of The Medical Examiner – Annual Report 2015
100 Rev: 06/06/2016
4
1
Yuma County Deaths by Manner of Death 2015
Homicide
Natural
2
2
1
Yuma County Deaths by Type of Death 2015
Firearms
Blunt Force Injury
Cardiovascular
Pima County Office Of The Medical Examiner – Annual Report 2015
101 Rev: 06/06/2016
1
2
1
1
0 0.5 1 1.5 2 2.5
Yuma County Deaths by Law Enforcement Agency 2015