Coroners in Northern California are farming out thousands of cases each year to a private firm whose doctors have dissected the wrong body and have given inaccurate testimony that helped send an innocent person to jail.
Doctors with Forensic Medical Group Inc. routinely handle caseloads that leaders in the field of forensic pathology call risky, conducting as many as three autopsies in an hour or nine autopsies in a single shift, an investigation by Frontline, NPR, ProPublica, the Investigative Reporting Program at UC Berkeley, and California Watch has found.
Although some of the firm's doctors have been praised for their skills and professionalism, the Forensic Medical Group also has employed physicians who were fired by public agencies for substandard work. The firm twice hired a doctor with a record of poor performance, who five years after botching a case in Sonoma County and after being found incompetent by the California State Bar, was hired a second time.
The region's justice system has come to rely on the Fairfield-based doctors' group, with more than a dozen counties contracting with the firm to do some or all of their death investigations.
Yet the agencies that hire the company often do not check who is performing the work until problems arise, said Chris Andrian, a Sonoma County defense attorney who twice won the release of clients due to the firm's mistakes. In some cases, errors by Forensic Medical Group made it impossible to hold anyone accountable for suspicious deaths.
"They are not being vetted in terms of their backgrounds, their skills, their ability," Andrian said of the private doctors. "You hire a company, and you take the company as a whole. And you never know what you're getting."
The group's doctors acknowledge they have made mistakes, but say that, overall, they have improved death investigation in the region, sometimes under difficult conditions. They often conduct examinations in facilities that are a far cry from state-of-the-art labs seen on TV and drive 100 miles or more between cases on a single day.
The firm has tripled its client list over the past 15 years, propelled by a need for its services, said Dr. Kelly Arthur-Kenny, one of the practice's owners and a primary provider of autopsies in Sonoma County.
"A lot of cases are getting done," she said. "And people don't have a problem with that."
Officials for the Sonoma County Sheriff's Office, which oversees the morgue's operation, said they are satisfied with the professionalism and experience of the group's doctors and are reviewing renewal of the contract this summer.
But Forensic Medical Group's emergence as the dominant provider of autopsy work in Northern California has drawn attention as emblematic of larger flaws in the U.S. death investigation system.
In California and across the nation, a shortage of forensic pathologists has left coroners and medical examiners overburdened. A 2009 study by the National Academy of Sciences concluded that the country has fewer than half the pecialists it needs to competently investigate suspicious deaths.
Many localities rely on uncertified or minimally trained practitioners and look into only a small fraction of all fatalities. Indeed, without Forensic Medical Group, certain types of deaths would go entirely without scrutiny in some of California's most rural areas.
While most autopsy work in Southern California is done by forensic pathologists on the public payroll, the farther north you travel, the more likely that autopsies are being performed by private doctors who are paid based on the volume of work they handle.