Read the 2020 Pima County Office of the Medical Examiner’s Annual report. Read the introduction that starts on page 5 of the actual report (Not the memorandum).
https://webcms.pima.gov/government/medical_examiner/
In a minimum 2 page report in APA format,
· Write an introduction to your report and include a definition of a Medical Examiner’s Case. As part of your introduction include: Who are medical examiners? When did they come into existence? What are they responsible for doing? Who is the Chief Medical Examiner in Pima county? What is M.E.’s role in the investigation and prosecution of murder cases?
Legal Aspects and Workload
· Identify the Arizona State Statute that covers the reporting of death
· list the 9 instances where a death is required to be reported to the PCOME.
· List the 5 manners of death
Data and Analysis
· How many decedents were processed by PCOME in 2020 and how many were examined by PCOME?
· Read pages 9-11 in the report and summarize what you read. What is your reaction?
· Read pages 12 – 13 and summarize what you have read
· Read pages 44-46 and summarize what you have read
· Identify one trend associated with those statistics.
· Then select any other category in the report that interests you and write a question you have about that category and write a brief answer/explanation to your question.
Reflection and What You Learned
· Reflect on what you have read in the PCOME report discuss what you learned?
References:
· Document any references to include the PCOME report and any other research you did in this section. This must be in APA format.
· Hanging Indents
· Alphabetical Order
· Double-spaced
After submitting this on D2L go to your WKL chart in your notebook and update your What I Learned Column.
Check List for a complete Report:
1. Read the 2020 Pima County Medical Examiner’s Report ◻︎
2. Write your report in APA format ◻︎
3. Write an Introduction and include a definition for a Medical Examiner’s Case ◻︎
4. Write out the Arizona State Statute that covers the reporting of death in Arizona ◻︎
5. List the 9 instances where a death is required to be reported to the Medical Examiner’s Office ◻︎
6. State how many decedents were processed and how many were examined in 2020 ◻︎
7. Read pages 9-11 then 12-13 and 44-46 and summarize what you read in each section ◻︎
8. Identify one trend associated with a statistic or statistics from those pages and your reaction ◻︎
9. Select any other death related category in the report that interests you, ask a question about that category, then summarize the information and your reaction ◻︎
10. Complete your report by writing about what you learned from this report. What resonated with you? ◻︎
11. Create a reference entry in APA format to complete your report.
12. Submit your report on D2L
13. Upload any interesting fact you learned on your KWL chart in your notebook.
APA Format Reminders:
1. Cover page and page numbers upper right corner
2. Topic Headings
3. Introduction
4. Legal Aspects and Workload
5. Data and Trends
6. Reflection and What You Learned
7. Reference List
1
Report Template
2
Report Template
Your Name
PA347
Pima County Office of the Medical Examiner
2020 Report Analysis
Date
INTRODUCTION
Write an introduction to your report and include a definition of a Medical Examiner’s Case. As part of your introduction include: Who are medical examiners? When did they come into existence? What are they responsible for doing? Who is the Chief Medical Examiner in Pima county? What is M.E.’s role in the investigation and prosecution of murder cases?
LEGAL ASPECTS AND WORKLOAD
Identify the Arizona State Statute that covers the reporting of death
list the 9 instances where a death is required to be reported to the PCOME.
List the 5 manners of death
DATA AND ANALYSIS
How many decedents were processed by PCOME in 2020 and how many were examined by PCOME?
Read pages 9-11 in the report and summarize what you read. What is your reaction?
Read pages 12 – 13 and summarize what you have read
Read pages 44-46 and summarize what you have read
Identify one trend associated with those statistics.
Then select any other category in the report that interests you and write a question you have about that category and write a brief answer/explanation to your question.
REFLECTION (WHAT I LEARNED)
Reflect on what you have read in the PCOME report discuss what you learned?
What resonated with you?
What will you remember from completing this report
One interesting fact from the PCOME Report and one interesting fact from Gene Hernandez’s talk.
REFERENCES
Document any references to include the PCOME report and any other research you did in this section. This must be in APA format.
Hanging Indents
Alphabetical Order
Double-spaced
Pima County Office Of The Medical Examiner – Annual Report 2020
2
Rev: 04/30/2021
TABLE OF CONTENTS
INTRODUCTION PAGE 5
OVERVIEW PAGES 5-7
ORGANIZATIONAL CHART PAGE 8
TOTAL REPORTED DEATHS & CASES PAGE 9
MEDICAL EXAMINER (ME) CASES PAGE 9
ME CASES (ALL COUNTIES) PAGE 10
ME CASES BY AGE (ALL COUNTIES) PAGE 10
ME CASES BY MANNER (ALL COUNTIES) PAGE 11
ME CASES BY MANNER (PIMA COUNTY) PAGE 11
HOMICIDE DEATHS (ALL COUNTIES) PAGE 12
HOMICIDE DEATHS 2010-2019 PAGE 12
HOMICIDE DEATHS BY AGE PAGE 12
HOMICIDE DEATHS BY SEX PAGE 13
HOMICIDE DEATHS BY CAUSE PAGE 13
ACCIDENT DEATHS (ALL COUNTIES) PAGE 14
ACCIDENT DEATHS BY AGE PAGE 14
ACCIDENT DEATHS BY SEX PAGE 14
ACCIDENT DEATHS BY CAUSE PAGE 15
ACCIDENT DEATHS BY CAUSE 2016-2020 PAGE 15
SUICIDE DEATHS (ALL COUNTIES) PAGE 16
SUICIDE DEATHS BY AGE PAGE 16
SUICIDE DEATHS BY SEX PAGE 16
SUICIDE DEATHS BY CAUSE PAGE 17
SUICIDE DEATHS BY CAUSE 2016-2020 PAGE 17
NATURAL DEATHS (ALL COUNTIES) PAGE 18
NATURAL DEATHS BY AGE PAGE 18
NATURAL DEATHS BY SEX PAGE 18
NATURAL DEATHS BY CAUSE PAGE 19
UNDETERMINED MANNER OF DEATH (ALL COUNTIES) PAGE 20
UNDETERMINED MANNER BY AGE PAGE 20
UNDETERMINED MANNER BY SEX PAGE 20
UNDETERMINED MANNER BY CAUSE PAGE 21
Pima County Office Of The Medical Examiner – Annual Report 2020
3
Rev: 04/30/2021
OVERDOSE DEATHS (ALL COUNTIES*) PAGE 22
*IF YOU WANT PIMA COUNTY ONLY, GO TO PAGE 57
OVERDOSE DEATHS 2011-2020 PAGE 22
OVERDOSE DEATHS BY AGE PAGE 23
OVERDOSE DEATHS BY SEX PAGE 23
OVERDOSE DEATHS BY MANNER PAGE 24
SELECT DRUGS BY YEAR 2013-2020 PAGE 24
OVERDOSE DEATHS BY DRUG PAGE 25
MOTOR VEHICLE RELATED FATALITIES (ALL COUNTIES) PAGE 26
MOTOR VEHICLE FATALITIES 2011-2020 PAGE 26
MOTOR VEHICLE FATALITIES BY AGE PAGE 26
MOTOR VEHICLE FATALITIES BY SEX PAGE 27
MOTOR VEHICLE FATALITIES BY TYPE PAGE 27
W.H. BIRKBY FORENSIC ANTHROPOLOGY LABORATORY PAGE 28
FA EXAMS BY NUMBER 2011-2020 PAGE 28
FA EXAMS BY CONDITION OF REMAINS PAGE 29
FA EXAMS BY TYPE PAGE 29
UNDOCUMENTED BORDER CROSSER (UBC) REMAINS PAGE 30
RECOVERIES BY CY2000–2020 PAGE 31
RECOVERIES BY FEDFY2000–2020 PAGE 31
RECOVERIES BY MONTH 2020 PAGE 32
RECOVERIES BY MONTH 2000-2020 PAGE 32
RECOVERIES BY AGE 2020 PAGE 33
RECOVERIES BY AGE 2000-2020 PAGE 33
CONDITION OF REMAINS 2020 PAGE 34
CONDITION OF REMAINS 2000-2020 PAGE 34
POOLED CONDITION OF REMAINS 2000-2020 PAGE 35
RECOVERIES BY SEX 2020 PAGE 35
RECOVERIES BY SEX 2000-2020 PAGE 36
RECOVERIES BY CAUSE 2020 PAGE 36
RECOVERIES BY CAUSE 2000-2020 PAGE 37
RECOVERIES BY NATIONALITY 2020 PAGE 37
RECOVERIES BY NATIONALITY 2000-2020 PAGE 38
IDENTIFIED V UNIDENTIFIED UBC RECOVERIES PAGE 38
METHODS OF IDENTIFICATION 2000-2020 PAGE 39
Pima County Office Of The Medical Examiner – Annual Report 2020
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Rev: 04/30/2021
DEATHS BY COUNTY – MEDICAL EXAMINER* PAGE 40
PIMA COUNTY PAGES 40 – 68
HOMICIDE DEATHS PAGE 44
ACCIDENT DEATHS PAGE 47
SUICIDE DEATHS PAGE 50
NATURAL DEATHS PAGE 53
UNDETERMINED DEATHS PAGE 55
OVERDOSE DEATHS PAGE 57
MOTOR VEHICLE DEATHS PAGE 62
HEAT RELATED DEATHS PAGE 64
INDIGENT INTERMENT PAGE 66
HOMELESS DECEDENTS PAGE 69
COCHISE COUNTY PAGES 71 – 91
GRAHAM COUNTY PAGES 92 – 96
LA PAZ COUNTY PAGES 97 – 101
SANTA CRUZ COUNTY PAGES 102 – 106
*MEDICAL EXAMINER COUNTIES – PIMA COUNTY SERVES AS APPOINTED MEDICAL EXAMINER
DEATHS BY COUNTY – NON-MEDICAL EXAMINER* PAGE 107
APACHE COUNTY PAGES 107 – 109
GILA COUNTY PAGES 110 – 112
GREENLEE COUNTY PAGES 113 – 115
NAVAJO COUNTY PAGES 116 – 118
PINAL COUNTY PAGES 119 – 121
YUMA COUNTY PAGES 122 – 124
*NON-MEDICAL EXAMINER COUNTIES – PIMA COUNTY PERFORMS EXAMINATIONS ON FEE-FOR-
SERVICE BASIS BUT DOES NOT SERVE AS APPOINTED MEDICAL EXAMINER FOR THESE COUNTIES
Pima County Office Of The Medical Examiner – Annual Report 2020
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Rev: 04/30/2021
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, Graham,
La Paz and Santa Cruz Counties and performs examinations as needed for five additional
counties. In 2020 there were 13,461* deaths in Pima County; of these 3,920 (29%) were
reported to the PCOME for investigation. This annual report consists of four 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 all cases
processed by the office regardless of the county of death. The third is a breakdown of
certain death classifications for the five counties for which the PCOME is the appointed
medical examiner. The fourth is a breakdown of certain death classifications for deaths
reported to the PCOME from counties in which the PCOME is not the appointed medical
examiner.
OVERVIEW
The PCOME was fully accredited by the National Association of Medical Examiners
(NAME) following a two-day inspection in October 2011. This accreditation was
effective from October 24, 2011 through October 24, 2016 and required annual
accreditation verifications. The office was re-inspected in January 2017 and received
continued full accreditation valid through October 25, 2021. NAME accredited offices
represent the highest quality of death investigation systems. There are 95 fully and
provisionally accredited Medical Examiner’s Offices across the United States. The
PCOME has the distinction of being one of two fully accredited offices 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. Unexpected or unexplained death.
4. Death of a person in a custodial agency as defined in section 13-4401.
5. Unexpected or unexplained death of an infant or child.
6. Death occurring in a suspicious, unusual or non-natural manner, including
death from an accident believed to be related to the deceased’s occupation or
employment.
7. Death occurring as a result of anesthetic or surgical procedures.
8. Death suspected to be caused by a previously unreported or undiagnosed
disease that constitutes a threat to public safety.
9. Death involving unidentifiable bodies.
*Total registered deaths in Pima County – residents and non-residents
Pima County Office Of The Medical Examiner – Annual Report 2020
6
Rev: 04/30/2021
Investigations
Our 11 medical investigators processed 3,920 reports of deaths from Pima County and
725 reports from 11 additional Arizona counties in 2020. Jurisdiction was declined in
2,095 of these cases. A total of 2,295 decedents were transported to the PCOME for
examination or storage in 2020.
Examinations
Pima County forensic pathologists and anthropologists performed 1,524 autopsies, 588
external examinations, 430 death certifications, 242 anthropologic examinations, and
reviewed 8,803 death certificates for cremation authorization in 2020.
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. Seven MDIs, our MDI Supervisor, and Administrative
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 (barring
COVID restrictions). In accordance with our MDI quality assurance and
performance improvement program, 10% of reports are reviewed by a pathologist
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 165 media interviews, emails and phone calls over the calendar year.
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. Four pathology
residents and three medical students rotated through the PCOME for month-long
rotations in 2020. Funded by the Department of Pathology, the PCOME began a
Forensic Pathology training program in 2016; the only such training program
offered in Arizona. Our Forensic Anthropologists hold academic appointments at
the University of Arizona did not accept interns in 2020 secondary to COVID.
Pima County Office Of The Medical Examiner – Annual Report 2020
7
Rev: 04/30/2021
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 2020, the office’s seven forensic
pathologists and three anthropologists participated in a number of virtual interviews,
depositions and one jury trial. Throughput of cases through the legal system was
severely curtailed in 2020 secondary to the pandemic.
Organ and Tissue Donation
Pursuant to A.R.S §36-861, the PCOME refers death notifications to, and partners with,
Donor Network of Arizona (DNAZ) 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. The authorization for the procurement of organs
was granted in 100% of cases. The PCOME has long been the state leader in percentage
of release on tissue and ocular cases and 2020 was no different. The release of tissues
and corneas was granted over 95% of the time.
Organ Donations with PCOME Involvement 2020
Heart Lungs Liver Kidneys Pancreas Sm. Intestine Total
13 24 29 69 7 1 143
Tissue Donation with PCOME Involvement 2020
Tissue Heart Ocular
127 58 49
Pima County Office Of The Medical Examiner – Annual Report 2020
8
Rev: 04/30/2021
OFFICE OF THE MEDICAL EXAMINER
ORGANIZATIONAL CHART AS OF DECEMBER 31, 2020
Chief Medical
Examiner
Gregory Hess MD
Administrative Services
Manager
Christopher Smith D-ABMDI
Administrative
Specialist
Charlotte Rupel
Administrative
Ysela Chavez
Linda Hernandez
Amber Bates
Morgue Supervisor
Lindsay Hairston
Pathology Assistants
Gabriel Costell
Louie Goad
Jeremy Cox
Kayla Hare
Brittney Klein
Kristine Clor
Indigent Interment
Lorenia Ton
Medicolegal Death
Investigator Supervisor
Gene Hernandez D-ABMDI
Medicolegal Death
Investigators
Meghan Matuszczak
Eric Slocum D-ABMDI
Raelene Ruiz D-ABMDI
Selina Herrera D-ABMDI
Chuck Harding
Trevis Hairston D-ABMDI
MaryAlice Pratt D-ABMDI
Kelsey Scott D-ABMDI
Timothy Jessup D-ABMDI
Jamie Gilligan
Nyssa Walker
Deputy Chief Medical
Examiner
Eric Peters MD
Forensic Pathologists
Krista Timm MD
David Winston MD PhD
Jennifer Chen MD
Kevin Lougee DO
Bruce Parks MD
Forensic Anthropologists
Bruce Anderson PhD
Jennifer Vollner PhD
Caitlin Vogelsberg PhD
Pima County Office Of The Medical Examiner – Annual Report 2020
9
Rev: 04/30/2021
TOTAL REPORTED DEATHS & 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 reported to the PCOME from Apache
(35), Cochise (370), Gila (15), Graham (49), Greenlee (8), La Paz (85), Maricopa (3),
Navajo (44), Pinal (6), Santa Cruz (99) and Yuma (11) counties in addition to Pima
County (3,920).
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 2020, for Pima and all
other counties listed above, 1,524 autopsies (60% of total deaths certified (TDC)), 588
external examinations (23% TDC) and 430 DC cases (17% TDC) were performed or
certified at the PCOME. Pima County alone accounted for 1,146 autopsies, 510 external
examinations and 394 DC
cases.
49
5
680 739 639 734 7
25
475 506 4
85
725
21
3
3
2523 2611 2520 24
3
7
2657 2705
277
4
30
5
8
392
0
26
28
3
203
33
50
3159 3
17
1
338
2
3180 32
80
35
43
46
45
2011 2012 2013 2014 2015
2016 2017 2018 2019 20
20
Total Reported Deaths 2011 – 2020
Out-of-County Pima County Office Total
Pima County Office Of The Medical Examiner – Annual Report 2020
10
Rev: 04/30/2021
114
6
5
10
3943
78
78
36
Autopsy
External DC
2020 Medical Examiner Cases
Pima County
Other
Counties
17 8
9
72
291 2
98
2
61
377
4
31
2
82
225
1
13
1
66
Medical Examiner Cases by Age – 2020
Pima County Office Of The Medical Examiner – Annual Report 2020
11
Rev: 04/30/2021
1
1
69
7
33
2
83
2
32
120
ME Cases (all counties) by Manner of Death – 2020
Accident – 46%
Natural – 29%
Suicide – 11%
Undetermined – 9%
Homicide – 5%
9
92
5
44
225
200
86
ME Cases (Pima only) by Manner of Death – 2020
Accident – 48%
Natural – 27%
Suicide – 11%
Undetermined – 10%
Homicide – 4%
Pima County Office Of The Medical Examiner – Annual Report 2020
12
Rev: 04/30/2021
HOMICIDE DEATHS
The PCOME certified 120 deaths as homicide in 2020, 86 from Pima County and 34
from other counties. Homicide totals from 2011 – 2020 are compared below. Homicide
victims were most frequently male (81%), between 20-29 years of age (28%) and died as
the result of firearms (72%).
131
136
1
23
99
90
114 113 1
14
92
120
91
79
88
62
56
65
84 79
69
86
2011 2012
2013 2014 2015
2016 2017 2018 2019 2020
Homicide Deaths 2011 – 2020
All Counties Pima County
0 1
2
14
33
29
11
15
10
4
0 0 1
Homicide Deaths by Age 2020
Pima County Office Of The Medical Examiner – Annual Report 2020
13
Rev: 04/30/2021
97
23
Homicide Deaths by Sex 2020
Male – 81%
Female – 19%
86
14
12
3 5
Homicide Deaths by Cause 2020
Firearms
– 72%
Sharp Force
– 12%
Blunt Force
– 10%
Asphyxia – 2%
Other – 4%
Pima County Office Of The Medical Examiner – Annual Report 2020
14
Rev: 04/30/2021
ACCIDENT DEATHS
Deaths due to accidents accounted for 46% of the ME deaths investigated by the PCOME
in 2020. Accident victims were most frequently males (68%), between 20-29 years of
age (16%) and died as the result of an overdose (43%).
4 2 5
35
183
169
1
42
163
143
98
135
84
6
Accident Deaths by Age 2020
790
379
Accident Deaths by Sex 2020
Male – 68%
Female – 32%
Pima County Office Of The Medical Examiner – Annual Report 2020
15
Rev: 04/30/2021
499
3
21
2
19
76
16 15 12 11
Accident Deaths by Cause 2020
Overdose – 43%
Blunt Force – 27%
Motor Vehicle – 19%
Exposure – 7%
Fire Deaths – 1%
Asphyxia – 1%
Drowning
– 1%
Other – < 1%
3
18
290 2
89
3
51
499
305
300
2
64
243
321
2
34
180
194
220 219
2016 2017 2018 2019 2020
Accident Death by Cause (Top 3) 2016 – 2020
Overdose Blunt Force Motor Vehicle
Pima County Office Of The Medical Examiner – Annual Report 2020
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Rev: 04/30/2021
SUICIDE DEATHS
Suicide deaths accounted for 11% of the ME deaths investigated by the PCOME in 2020.
Suicide victims were most frequently males (78%), between 20-29 years of age (17%)
and died as the result of firearms (61%).
0
0
2
18
48
42
33
47
37
24 25
7
0
Suicide Deaths by Age 2020
221
62
Suicide Deaths by Sex 2020
Male – 78%
Female – 22%
Pima County Office Of The Medical Examiner – Annual Report 2020
17
Rev: 04/30/2021
172
58
24
12
17
Suicide Deaths by Cause 2020
Firearms – 61%
Hanging
– 20%
Overdose – 8%
Asphyxia – 4%
Other – 6%
143
161
1
54
180
172
46
57
60
75
58
27
27
36
31
24
2016 2017 2018 2019 2020
Suicide Deaths by Cause (Top 3) 2016 – 2020
Firearms Hanging Overdose
Pima County Office Of The Medical Examiner – Annual Report 2020
18
Rev: 04/30/2021
NATURAL DEATHS
Natural deaths accounted for 29% of the ME deaths investigated by the PCOME in 2020.
Individuals who died from natural causes were most frequently males (70%), between
60-69 years of age (31%) and died as the result of cardiovascular disease (52%).
1 2 0 4
15
46
63
1
39
229
1
49
64
21
0
Natural Deaths by Age 2020
510
223
Natural Deaths by Sex 2020
Male – 70%
Female – 30%
Pima County Office Of The Medical Examiner – Annual Report 2020
19
Rev: 04/30/2021
384
75
102
32
25
33
82
Natural Deaths by Cause 2020
Cardiovascular – 52%
Chronic Alcohol – 10%
Infectious Disease – 14%
Pulmonary Disease – 4%
Diabetes Mellitus – 3%
Malignacy – 4%
Other – 11%
Pima County Office Of The Medical Examiner – Annual Report 2020
20
Rev: 04/30/2021
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 2020. Individuals who died with an undetermined
manner were most frequently males (67%), of unknown age (64%) and died from
undetermined causes (89%). Many of these deaths represent skeletal remains of
undocumented border crossers who died in the deserts
of southern Arizona.
10
3 0 1
12 12 12 13 12
7
1 1
148
Undetermined Manner of Death by Age 2020
156
41
35
Undetermined Manner of Death by Sex 2020
Male – 67%
Female – 18%
Unsure – 15%
Pima County Office Of The Medical Examiner – Annual Report 2020
21
Rev: 04/30/2021
207
8 6 3 8
Undetermined Manner of Death by Cause 2020
Undetermined – 89%
Blunt Force – 3%
Overdose – 3%
Firearms – 1%
Other – 3%
Pima County Office Of The Medical Examiner – Annual Report 2020
22
Rev: 04/30/2021
OVERDOSE DEATHS
There were 529 deaths attributed to an overdose of either a single drug (273 deaths, 52%)
or a combination of drugs (256 deaths, 48%) in 2020. Overdose deaths commonly
involved males (71%) between the ages of 30-39 (23%). The majority of these deaths
were classified as accidents (94%). Over the last ten years, overdose deaths certified by
the PCOME increased 91% from 277 deaths in 2011 to 529 deaths in 2020.
Opiate drugs (heroin, oxycodone, methadone, hydrocodone, morphine, oxymorphone,
hydromorphone, tramadol, opiate unspecified) and fentanyl (a synthetic opioid narcotic)
contributed to the majority of overdose deaths (364 deaths, 69%), either as a single drug
or as a component of a poly-drug overdose. Fentanyl was the most commonly abused
illicit drug contributing to death in 2020 followed by methamphetamine.
The number of heroin deaths is likely underreported as heroin is rapidly metabolized to
morphine by the body and if the metabolite indicative for heroin (6-monoacetylmorphine)
is not present on the toxicology report these deaths may be classified as either morphine
intoxication or opiate intoxication.
Fentanyl related deaths continued to increase (3300% increase) from a low of 7 deaths in
2014 to 238 deaths in 2020. Fentanyl related deaths increased 133% in one year from
102 in 2019 to 238 related deaths in 2020.
277
314 327 324
379
356
328 333
387
529
2011 2012 2013
2014 2015 2016 2017 2018 2019 2020
Overdose Deaths 2011 – 2020
Pima County Office Of The Medical Examiner – Annual Report 2020
23
Rev: 04/30/2021
2 0 1
14
117 120
98
109
59
5 2 1 1
Overdose Deaths by Age 2020
373
156
Overdose Deaths by Sex 2020
Male – 71%
Female – 29%
Pima County Office Of The Medical Examiner – Annual Report 2020
24
Rev: 04/30/2021
Select Drugs by Year 2013 – 2020
499
24
6
Overdose Deaths by Manner 2020
Accident – 94%
Suicide – 5%
Undetermined – 1%
0
50
100
150
200
250
2013 2014 2015 2016 2017 2018 2019 2020
Heroin Fentanyl Oxycodone
Morphine
Meth Cocaine Benzo Alcohol
Pima County Office Of The Medical Examiner – Annual Report 2020
25
Rev: 04/30/2021
89
30
6
2
3
20
16
2
3
13
2
38
218
66
39
74
7
13
4
6
5
3
4
9
12
Heroin
Oxycodone
Hydrocodone
Oxymorphone
Hydromorphone
Methadone
Morphine
Codeine
Tramadol
Opiate Unspecified
Fentanyl
Methamphetamine
Cocaine
Benzodiazepines
Ethanol
Antihistamines
SSRI/SNRI
Methanol
Atypical Antipsychotics
Muscle Relaxants
Mitragynine
Acetaminophen
Amphetamine
Other
Overdose Deaths by Drug 2020
Opiate compounds are red
Pima County Office Of The Medical Examiner – Annual Report 2020
26
Rev: 04/30/2021
MOTOR VEHICLE RELATED FATALITIES
Motor vehicle related fatalities accounted for 227 total deaths in 2020. The majority, 113
deaths, were occupants of a motor vehicle involved in an accident (MVA). Of the
remaining, 34 were motorcycle accidents (MCA), 73 were pedestrians or bicyclists struck
by vehicles and 7 involved all-terrain vehicles (ATV). Individuals who died from motor
vehicle related fatalities were most frequently males (74%) and between 60-69 years of
age (19%).
209
214
199
1
96
209
239
184
196
223 227
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Motor Vehicle Fatalities by Year 2011 – 2020
2 2 3
17
42
36
26 27
43
19
10
0
<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 2020
Pima County Office Of The Medical Examiner – Annual Report 2020
27
Rev: 04/30/2021
1
67
60
Motor Vehicle Fatalities by Sex 2020
Male – 74%
Female – 26%
113
55
34
18
7
Motor Vehicle Fatalities by Type 2020
MVA – 50%
Pedestrian – 24%
MCA – 15%
Bicyclist – 8%
ATV – 3%
Pima County Office Of The Medical Examiner – Annual Report 2020
28
Rev: 04/30/2021
W.H. BIRKBY FORENSIC ANTHROPOLOGY LABORATORY
Forensic Anthropologists at the W.H. Birkby Forensic Anthropology
Laboratory within the PCOME performed 175 examinations (biological
profiles, trauma evaluations, dental examinations and examinations for identification) in
2020 on human remains of forensic significance. An additional 67 examinations were
performed on remains ultimately deemed non-human, prehistoric or otherwise not
forensically significant and these remains were classified as jurisdiction declined (JD)
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 2020, skeletal remains comprised 82% of FA examinations. Five
main types of exams are performed: biologic profiles, dental examinations, trauma
evaluations, comparisons to antemortem information and field activities.
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 examinations entail charting, descriptions, radiographs and
photographs in an effort to preserve dental information. 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.
Comparisons are evaluation of postmortem distinctive skeletal characteristics or dental
information to antemortem information for purposes of identification. Field activities are
exhumations or other excursions from the office to assist local law enforcement with the
recovery of remains. It is common for a particular set of remains to receive more than
one type of examination.
1
71
161 163
149 145 143
139
118
145
175
14 13
30 26 29 27
35
43 46
67
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Number of FA Exams 2011 – 2020
Exams JD
Pima County Office Of The Medical Examiner – Annual Report 2020
29
Rev: 04/30/2021
144
1
3
8
2
8
FA Exam by Condition of Remains 2020
Skeletal – 82%
Mummified – 7%
Decomposing – 5%
Fully Fleshed – 1%
Burnt – 5%
161
130
10
4 0
Biologic Profiles Dental
Examinations
Comparisons Trauma Field Activities
FA Examination by Type 2020
Pima County Office Of The Medical Examiner – Annual Report 2020
30
Rev: 04/30/2021
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 (222) recorded at the PCOME as
compared to the annual average (164 recoveries per year on average from 2002 – 2020).
The PCOME has received 3,275 recovered remains of suspected UBCs since 2000. 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 220 UBC recoveries in calendar year 2020. Of the decedents who were
identified, 71% (51 decedents) were between 20-39 years of age. Additionally, 75%
(164) of the recovered remains, identified or unidentified, were males, 8% (18) were
females and in 17% (38) the sex was unable to be determined at the time of the writing of
this report.
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 34 of this
report. In 2020, 39 remains (condition 1) were found within less than a day of death
(18%), 47 remains (conditions 2-4) were found with a few days up to a few weeks from
death (21%), and skeletal remains (body conditions 5-7) accounted for 134 (61%) of the
recovered remains.
The cause of death was undetermined in 74% (162) 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 21% (46) of
deaths. Other, less frequent, causes of death included blunt force trauma (10 cases),
hanging (1 case), and gunshot wounds (1 case).
In 2020, 57 (76%) of identified UBCs were of Mexican nationality, followed by 11
Guatemalans (15%), 2 Hondurans (3%), and 2 Colombians (3%). Since 2000, identified
UBCs of Mexican nationality have been the most numerous (1,673, 80%), followed by
Guatemalans (246, 12%) and Salvadorans (59, 3%) and Hondurans tied (59, 3%). Of the
3,275 decedents recovered since 2000, 2,084 (64%) have been identified. As of
December 31, 2020, 1,190 decedents remain unidentified.
Pima County Office Of The Medical Examiner – Annual Report 2020
31
Rev: 04/30/2021
74 77
147
155
169
195
1
68
214
162
190
2
22
178
154
165
127
135
148
118 121
136
220
UBC Recoveries CY2000 – 2020
71 76
143 146
167
199
167
207
160
182
221
174 168
177
119
135 139 135
118 124
209
UBC Recoveries FedFY2000 – 2020
Pima County Office Of The Medical Examiner – Annual Report 2020
32
Rev: 04/30/2021
21 21
13 12 12 13
25 25
35
16
14 13
UBC Recoveries by Month 2020
173
192 179
208
300
482
560
358
286
188 177 172
UBC Recoveries by Month 2000 – 2020
Pima County Office Of The Medical Examiner – Annual Report 2020
33
Rev: 04/30/2021
0
0 0
5
30
21
15
0 1
0 0 0
148
UBC Recoveries by Age 2020
3 2 7
224
7
57
667
3
26
92
16 0 0 0
11
81
UBC Recoveries by Age 2000 – 2020
Pima County Office Of The Medical Examiner – Annual Report 2020
34
Rev: 04/30/2021
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
39
21
5
21 23
12
99
0
1 2 3 4 5 6 7 8
Condition of Recovered UBC Remains 2020
991
371
242
319
285
341
723
3
1 2 3 4 5 6 7 8
Condition of Recovered UBC Remains 2000 – 2020
Pima County Office Of The Medical Examiner – Annual Report 2020
35
Rev: 04/30/2021
Pooled Body Conditions of Recovered UBC Remains by Year 2000 – 2020
1 – 4 represents not fully skeletal remains with a likely PMI of ≤ 3 months
5 – 7 represents fully skeletal remains with a likely PMI of ≥ 3 months
0
20
40
60
80
100
120
140
160
180
1 – 4 5 – 7
164
18
38
UBC Recoveries by Sex 2020
Male – 75%
Female – 8%
Unsure – 17%
Pima County Office Of The Medical Examiner – Annual Report 2020
36
Rev: 04/30/2021
2737
483
55
UBC Recoveries by Sex 2000 – 2020
Male – 84%
Female – 15%
Unsure – 1%
162
46
10
1 1
UBC Recoveries by Cause 2020
Undetermined – 74%
Exposure – 21%
Blunt Force Trauma – 5%
Hanging – <1%
Gunshot Wound – <1%
Pima County Office Of The Medical Examiner – Annual Report 2020
37
Rev: 04/30/2021
1617
1239
220
84 46
38
16 13
UBC Recoveries by Cause 2000 – 2020
Undetermined – 49%
Exposure – 39%
Blunt Force – 7%
Firearms – 3%
Natural Causes – 1%
Drowning – 1%
Hanging – <1%
Other – <1%
57
11
2 2
Identified UBC Recoveries by Nationality 2020
Mexican – 76%
Guatemalan – 15%
Colombian – 3%
Honduran – 3%
Pima County Office Of The Medical Examiner – Annual Report 2020
38
Rev: 04/30/2021
1673
246
59
59
15
8
5
4
4
3
2
2
3
Mexican – 80%
Guatemalan – 12%
Salvadoran – 3%
Honduran – 3%
Ecuadorian – <1%
Peruvian – <1%
Colombian – <1%
Brazilian – <1%
Costa Rican – <1%
Indian – <1%
Nicaraguan – <1%
Dominican – <1%
Other – <1%
Identified UBC Recoveries by Nationality 2000 – 2020
3275
220
2083
72
1192
148
2000 – 2020 2020
Identified vs Unidentified UBC Recoveries
Total Recoveries Identified Unidentified
Pima County Office Of The Medical Examiner – Annual Report 2020
39
Rev: 04/30/2021
U
B
C
M
e
th
o
d
s
o
f
Id
e
n
ti
fi
ca
ti
o
n
2
0
0
0
–
2
0
2
0
Pima County Office Of The Medical Examiner – Annual Report 2020
40
Rev: 04/30/2021
PIMA COUNTY
TOTAL MORTALITY
The number of deaths reported to the medical
examiner’s office in a given period is a
reflection of the total population that the office
serves. In 2020 there were 13,461 deaths
registered in Pima County; of these 3,920 (29%)
were reported to the PCOME for
investigation.
*Deaths of Pima County residents
†Total registered deaths in Pima County – residents and non-residents
8392 8713 8592 8725
9241 9492
10555 10703 10880
13461
2011* 2012* 2013* 2014* 2015* 2016* 2017† 2018† 2019† 2020†
Pima County Total Mortality 2011 – 2020
Pima County Office Of The Medical Examiner – Annual Report 2020
41
Rev: 04/30/2021
TOTAL REPORTED DEATHS
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).
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 2020, 1146 autopsies
(56% of total deaths certified (TDC)), 510 (25% of TDC) external examinations and 394
(19% of TDC) DC cases were performed on deaths from Pima
County.
2133
2523 2611 2520 2437
2657 2705
2774
3058
3920
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Total Reported Deaths from Pima County 2011 – 2020
Pima County Office Of The Medical Examiner – Annual Report 2020
42
Rev: 04/30/2021
1146
510
394
Autopsy External DC
2020 Pima County Medical Examiner Cases
11 7 9
54
231
245
198
292
345
211
200
101
147
Pima County Medical Examiner Cases by Age 2020
Pima County Office Of The Medical Examiner – Annual Report 2020
43
Rev: 04/30/2021
992
544
225
200
86
Pima County ME Cases by Manner of Death 2020
Accident – 48%
Natural – 27%
Suicide – 11%
Undetermined – 11%
Homicide – 4%
Pima County Office Of The Medical Examiner – Annual Report 2020
44
Rev: 04/30/2021
HOMICIDE DEATHS
The PCOME examined 86 homicides from Pima County in 2020; 4% of total Pima
County deaths certified. Homicide totals from 2011 – 2020 are compared below.
Homicide victims were most frequently male (84%), between 20-29 years of age (27%)
and died as the result of firearms (76%).
91
79
88
62
56
65
84
79
69
86
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Pima County Homicide Deaths 2011 – 2020
0 0
2
11
23
20
11 11
6
2
0 0 0
Pima County Homicide Deaths by Age 2020
Pima County Office Of The Medical Examiner – Annual Report 2020
45
Rev: 04/30/2021
72
14
Pima County Homicide Deaths by Sex 2020
Male – 84%
Female – 16%
65
9
7
5
Pima County Homicide Deaths by Cause 2020
Firearms – 76%
Sharp Force – 10%
Blunt Force – 8%
Other – 6%
Pima County Office Of The Medical Examiner – Annual Report 2020
46
Rev: 04/30/2021
Pima County Homicide Deaths by Cause (Top 3) 2016 – 2020
41
56
54
48
65
8
12 12
6 9
13
8
10 10
7
2016 2017 2018 2019 2020
Firearms Sharp Force Blunt Force
Pima County Office Of The Medical Examiner – Annual Report 2020
47
Rev: 04/30/2021
ACCIDENT DEATHS
Deaths due to accidents accounted for 48% of the Pima County deaths certified by the
PCOME in 2020. Accident victims were most frequently males (67%), between the ages
of 20-29 (16%) and died as the result of an overdose (42%).
577
655
754 751
716
823
992
2014 2015 2016 2017 2018 2019 2020
Pima County Accident Deaths 2014 – 2020
3 2 5
26
154
143
111
127 125
83
128
80
5
Pima County Accident Deaths by Age 2020
Pima County Office Of The Medical Examiner – Annual Report 2020
48
Rev: 04/30/2021
669
323
Pima County Accident Deaths by Sex 2020
Male – 67%
Female – 33%
421
302
175
50
13 10 15
Pima County Accident Deaths by Cause 2020
Overdose – 42%
Blunt Force – 30%
Motor Vehicle – 18%
Exposure – 5%
Asphyxia – 1%
Drowning – 1%
Other – 2%
Pima County Office Of The Medical Examiner – Annual Report 2020
49
Rev: 04/30/2021
Pima County Accident Deaths by Cause (Top 3) 2016 – 2020
233
253 246
306
421
279 279
249 239
302
142 138 146
187
175
2016 2017 2018 2019 2020
Overdose Blunt Force
Motor Vehicle
Pima County Office Of The Medical Examiner – Annual Report 2020
50
Rev: 04/30/2021
SUICIDE DEATHS
Deaths due to suicide accounted for 11% of the Pima County deaths certified by the
PCOME in 2020. Suicide victims were most frequently males (77%), between 50-59
years of age (19%) and died as the result of firearms (64%).
188
199
177
223 221
253
225
2014 2015 2016 2017 2018 2019 2020
Pima County Suicide Deaths 2014 – 2020
0 0
2
13
32
37
23
42
31
17
23
5
0
Pima County Suicide Deaths by Age 2020
Pima County Office Of The Medical Examiner – Annual Report 2020
51
Rev: 04/30/2021
173
52
Pima County Suicide Deaths by Sex 2020
Male – 77%
Female – 23%
143
38
20
12
4
8
Pima County Suicide Deaths by Cause 2020
Firearms – 64%
Hanging – 17%
Overdose – 9%
Asphyxia – 5%
Sharp Force – 2%
Other – 4%
Pima County Office Of The Medical Examiner – Annual Report 2020
52
Rev: 04/30/2021
Pima County Suicide Deaths by Cause (Top 3) 2016 – 2020
104
123
127
148
143
34
47 47
60
38
21 24
33
26
20
2016 2017 2018 2019 2020
Firearms Hanging
Overdose
Pima County Office Of The Medical Examiner – Annual Report 2020
53
Rev: 04/30/2021
NATURAL DEATHS
Deaths due to natural causes accounted for 27% of the Pima County deaths certified by
the PCOME in 2020. Individuals who died from natural causes were most frequently
males (69%), between 60-69 years of age (31%) and died as the result of cardiovascular
disease (50%).
510
440
501
471
513
480
544
2014 2015 2016 2017 2018 2019 2020
Pima County Natural Deaths 2014 – 2020
1 2 0 3
12
35
44
108
171
105
48
15
0
Pima County Natural Deaths by Age 2020
Pima County Office Of The Medical Examiner – Annual Report 2020
54
Rev: 04/30/2021
373
171
Pima County Natural Deaths by Sex 2020
Male – 69%
Female – 31%
271
58
82
27
17
18
10 61
Pima County Natural Deaths by Cause 2020
Cardiovascular – 50%
Chronic Alcohol – 11%
Infectious Disease – 15%
Malignacy – 5%
Pulmonary Disease – 3%
Diabetes Mellitus – 3%
Thromboemboli – 2%
Other – 11%
Pima County Office Of The Medical Examiner – Annual Report 2020
55
Rev: 04/30/2021
UNDETERMINED MANNER OF DEATH
Deaths of undetermined manner accounted for 11% of the Pima County deaths certified
by the PCOME in 2020. Individuals who died with an undetermined manner were most
frequently males (68%), of unknown age (70%) and died from undetermined causes
(89%). Many of these deaths represent skeletal remains of UBCs who died in the deserts
of southern Arizona.
152
133
168
147
139
185
200
2014 2015 2016 2017 2018 2019 2020
Pima County Undetermined Manner 2014 – 2020
6 3 0 1
10 10 9
4
12 4 1 1
139
Pima County Undetermined Manner of Death by Age 2020
Pima County Office Of The Medical Examiner – Annual Report 2020
56
Rev: 04/30/2021
136
31
33
Pima County Undetermined Manner of Death by Sex 2020
Male – 68%
Female – 16%
Unsure – 16%
178
8
3
5 6
Pima County Undetermined Manner of Death by Cause 2020
Undetermined – 89%
Blunt Force – 4%
Firearms – 2%
Overdose – 3%
Other – 3%
Pima County Office Of The Medical Examiner – Annual Report 2020
57
Rev: 04/30/2021
PIMA COUNTY OVERDOSE DEATHS IN 2020
There were 446 deaths attributed to an overdose of either a single drug (230 deaths, 52%)
or a combination of drugs (216 deaths, 48%) in 2020. Overdose deaths commonly
involved males (71%) between the ages of 30-39 (24%). The majority of these deaths
were classified as accidents (94%).
Opiate compounds are typically heroin, oxycodone, methadone, hydrocodone, morphine,
oxymorphone, hydromorphone, tramadol, codeine, fentanyl (a synthetic opioid narcotic)
and clandestinely manufactured fentanyl analogs. In 2020 an opiate compound
contributed to 312 (70%) of the 446 total overdose deaths. Opiate compounds, which
contributed to an overdose death in 2020, are indicated in red in the Pima
County
Overdose Deaths by Drug 2020 figure.
The number of heroin deaths (78 deaths, 17%) is likely underreported as heroin is rapidly
metabolized to morphine by the body and if the metabolite indicative for heroin (6-
monoacetylmorphine) is not present on the toxicology report these deaths may be
classified as either morphine intoxication (morphine) or opiate intoxication (opiate
unspecified).
Fentanyl was the most commonly abused illicit drug in 2020, contributing to 46% of all
2020 overdoses, followed by methamphetamine (41%).
OVERDOSE TRENDS
Overdose deaths in Pima County increased 112% overall from 2011 (210) to 2020 (446),
punctuated by plateaus from 2013 (240) to 2014 (241), from 2015 (262) to 2016 (263)
and again from 2017 (286) to 2018 (286). Unfortunately, 2020 overdose deaths represent
a significant increase (32% one year increase) from 2019. The impact of opiate
compounds on overdose deaths is of significant interest. An opiate compound
contributed to 175 (67%) of the 263 total overdose deaths in 2016, 189 (66%) of the 286
total overdose deaths in 2017, 181 (63%) of the 286 overdose deaths in 2018, 208 (62%)
of the 337 overdose deaths in 2019 and 312 (70%) of the 446 overdose deaths in 2020 as
previously described.
Pima County is experiencing a rapid increase in the number of overdose deaths in which
fentanyl is found to be a contributing factor. Fentanyl contributed to 5 overdose deaths in
2014 in contrast to 207 deaths in 2020, a 4040% increase in the number of deaths
involving fentanyl from 2014.
Interestingly, methamphetamine related deaths have also increased in frequency from 38
deaths in 2014 to 182 deaths in 2020, a 379% increase. The significant decrease is seen
in oxycodone deaths, a 51% decrease from 2014 (39 deaths) to 2020 (19 deaths).
Pima County Office Of The Medical Examiner – Annual Report 2020
58
Rev: 04/30/2021
210
228
240 241
262 263
286 286
337
446
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Pima County Overdose Deaths 2011 – 2020
2 0 1
14
101
105
79
84
51
5 2 1 1
Pima County Overdose Deaths by Age 2020
Pima County Office Of The Medical Examiner – Annual Report 2020
59
Rev: 04/30/2021
316
130
Pima County Overdose Deaths by Sex 2020
Male – 71%
Female – 29%
421
20
5
Pima County Overdose Deaths by Manner 2020
Accident – 94%
Suicide – 5%
Undetermined – 1%
Pima County Office Of The Medical Examiner – Annual Report 2020
60
Rev: 04/30/2021
78
19
2
1
2
17
15
2
1
13
207
182
61
33
57
5
9
1
5
4
2
1
3
3
1
8
10
Heroin
Oxycodone
Hydrocodone
Oxymorphone
Hydromorphone
Methadone
Morphine
Codeine
Tramadol
Opiate Unspecified
Fentanyl
Methamphetamine
Cocaine
Benzodiazepines
Alcohol
Antihistamines
SSRI/SNRI
Tricyclics
Atypical Antipsychotics
Muscle Relaxants
Methanol
Sleep Aids
Acetaminophen
Mitragynine
Buproprion
Amphetamine
Other
Pima County Overdose Deaths by Drug 2020
Opiate compounds are red
Pima County Office Of The Medical Examiner – Annual Report 2020
61
Rev: 04/30/2021
Pima County Overdoses by drug by year 2014 – 2020
0
50
100
150
200
250
2014 2015 2016 2017 2018 2019 2020
Heroin Fentanyl Oxycodone Morphine
Methamphetamine Cocaine Benzodiazepines Alcohol
Pima County Office Of The Medical Examiner – Annual Report 2020
62
Rev: 04/30/2021
PIMA COUNTY MOTOR VEHICLE RELATED FATALITIES
Motor vehicle related fatalities accounted for 182 total deaths in Pima County in 2020.
The majority, 84 deaths, were occupants of a motor vehicle involved in an accident
(MVA). Of the remaining, 29 were motorcycle accidents (MCA), 64 were pedestrians or
bicyclists struck by vehicles, and 5 were all-terrain vehicle (ATV) accidents. Individuals
who died from motor vehicle related fatalities were most frequently males (75%) and
between 20-29 years of age (21%).
117
130
125
118 121
146
141
148
189
182
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Pima County Motor Vehicle Fatalities 2011 – 2020
2 2
3
11
36
28
21
23
35
14
7
0
<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 2020
Pima County Office Of The Medical Examiner – Annual Report 2020
63
Rev: 04/30/2021
137
45
Pima County Motor Vehicle Fatalities by Sex 2020
Male – 75%
Female – 25%
84
50
29
14 5
Pima County Motor Vehicle Fatalities by Type 2020
MVA – 46%
Pedestrian – 27%
MCA – 16%
Bicyclist – 8%
ATV – 3%
Pima County Office Of The Medical Examiner – Annual Report 2020
64
Rev: 04/30/2021
PIMA COUNTY HEAT RELATED FATALITIES
Heat (hyperthermia) related fatalities accounted for 19 total deaths in Pima County in
2020, excluding undocumented border crosser deaths. For environmental deaths
involving UBCs, please reference the UBC section on page 36 of this report.
6
5 5
3
7
10
11
7
10
19
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Pima County Heat Related Fatalities 2011 – 2020
0 0 0 0
1 1
3
5
2
4
2
1
<1 1-5 6-12 13-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89 >90
Pima County Heat Related Fatalities by Age 2020
Pima County Office Of The Medical Examiner – Annual Report 2020
65
Rev: 04/30/2021
10
9
Pima County Heat Related Fatalities by Sex 2020
Male – 53%
Female – 47%
Pima County Office Of The Medical Examiner – Annual Report 2020
66
Rev: 04/30/2021
Indigent Interment Program in Pima County
Legal responsibility for interment of a decedent rests with the next of kin (NOK) as
determined pursuant to A.R.S. §36-831. The County may provide interment services for
circumstances in which the NOK are found to be financially unable to pay for
arrangements or in which the decedent is unclaimed or abandoned. The PCOME was
appointed administrator of the County’s Indigent Interment Program (IIP) and Pima
County Cemetery (PCC) in September 2018, in-lieu of the County Public Fiduciary’s
Office, the previously appointed admistrator.
In 2020, 681 applications for IIP consideration, approximately 5% of the total deaths
(13,461) in the county, were processed by our IIP coordinator. In general, IIP
applications can be divided into those that are approved for County assistance and those
that are disapproved. Regardless of application outcome, special interest groups such as
veterens and the homeless are over represented in comparison to the general population
in IIP consideration. Some statistical information concerning application outcomes and
those interest groups will be provided in this report.
Definitions – Please consider these definitions when reviewing the charts on the
following pages
Approved – The interment of the decedent’s remains was funded by the County
Disapproved – The interment of the decedent’s remains was not funded by the
County
Met poverty standard – The decedent’s NOK are known, but meet current federal
poverty guidelines as promulgated by the U.S. Department of Health &
Human Services, and therefore qualify for government interment assistance
Abandonment – The decedent’s NOK are known but fail, or refuse to make
interment arrangements for the decedent
Unidentified – The indentity of the decedent is unknown and therefore NOK and
presence or abscense of financial hardship is unknown
No NOK – A search is conducted for family for a decedent in an effort to locate
any known NOK who might make interment arrangements but no NOK are
found
Burial – The decedent is interred either at the PCC or other cemetary as buried
remains, not cremated or otherwise altered remains
Cremation – The decedent is interred as cremains in a columbarium at the PCC,
columbarium at another cemetary, or released to NOK for their retention
At the end of 2020, 70 burial plots remain available in the PCC and 1,086 cremation urn
locations remain available in the PCC columbaria. The PCC end-of-year columbaria
inventory stood at 1,554 remains with a total capacity of 2,640 remains amongst the four
columbaria.
Pima County Office Of The Medical Examiner – Annual Report 2020
67
Rev: 04/30/2021
IIP Approvals vs Disapprovals
405 (60%) of the 681 IIP referrals were approved for County assistance in 2020. All 405
approvals resulted in cremation as the final disposition of the remains. 274 (40%) of the
referrals were disapproved and family, guardians or local assistance groups assumed
responsibility for the disposition of the remains.
203
108
93
Reason for IIP Approval 2020
No NOK – 50%
Met Poverty Standard – 27%
Abandonment – 23%
246
110
49
Disposition of IIP Cremation Approvals 2020
PCC – 61%
Claimed by NOK – 27%
Veterens Cemetery – 12%
Pima County Office Of The Medical Examiner – Annual Report 2020
68
Rev: 04/30/2021
IIP Special Interest Groups
Veterans
100 (15%) of the 681 IIP applications were veterans. 66 veterans were approved through
the IIP and 34 were disapproved. Veterans approved through the IIP programs are
interred at the Southern Arizona Veterans Memorial Cemetery in Marana unless
otherwise claimed by surviving family members.
Homeless
73 (11%) of the 681 IIP applications were decedents believed to be homeless. 50
homeless decedents were approved through the IIP and 23 were disapproved.
40
15
11
Reason for IIP Veteran Approval 2020
No NOK – 61%
Abandonment – 23%
Met Poverty Standard – 17%
34
9
7
Reason for IIP Homeless Approval 2020
No NOK – 68%
Met Poverty Standard – 18%
Abandonment – 9%
Pima County Office Of The Medical Examiner – Annual Report 2020
69
Rev: 04/30/2021
HOMELESS DECEDENTS
Caveats concerning the interpretation of homeless decedents in this section
– These figures are not inclusive for all homeless deaths in Pima County in 2020.
This only represents deaths reported to the PCOME and we have no knowledge of
homeless decedents who were not reported to the PCOME. Homelessness, in and
of itself, is not an OME reporting criteria (see page 5 for reporting criteria).
– Homeless in this data set is defined by a “yes” or “no” data field in an electronic
case management system and is populated by a death investigator during the
course of an initial death report to the PCOME. There will be instances in which
a decedent was classified as homeless initially but is later found not to be and
instances in which a decedent was not classified as homeless initially but is later
learned to be. In short, this data will contain errors.
– There are different forms of homelessness (chronic, episodic, transitional and
hidden) and this data does not have the granularity to differentiate between these
forms.
Decedents deemed to be homeless (156) accounted for 4% of the Pima County deaths
reported to the PCOME in 2020. Jurisdiction was accepted in 124 (79%) of those
reported and declined in 32 (21%) of reported deaths. Certified (accepted) homeless
decedents were frequently males (79%), between 50-59 years of age (23%) and died as
the result of overdoses (53%).
0 0 0
2
19
21
25
28
25
4
0 0 0
Pima County Homeless Deaths by Age 2020
Pima County Office Of The Medical Examiner – Annual Report 2020
70
Rev: 04/30/2021
98
26
Pima County Homeless Deaths by Sex 2020
Male – 79%
Female – 21%
66
12
11
7
4
4
3
17
Pima County Homeless Deaths by Cause 2020
Overdose – 53%
Firearms – 10%
Pedestrians – 9%
Cardiac Disease – 6%
Exposure – 3%
Chronic Alcohol – 3%
Sharp Force Injury – 2%
Other – 14%
Pima County Office Of The Medical Examiner – Annual Report 2020
71
Rev: 04/30/2021
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
available as needed with mass fatality planning,
fatality review panels, or other medical examiner related issues in Cochise County.
TOTAL MORTALITY
The number of deaths reported to the medical examiner’s office in a given period is a
reflection of the total population that the office serves. In 2020 there were 1,631 deaths
of Cochise County residents; of these 370 (23%) were reported to the PCOME for
investigation.
*Arizona Department of Vital Statistics as of 04/06/2021
1183 1204
1266
1201
1305 1342 1344
1360 1402
1631
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Cochise County Resident Mortality by Year 2011 – 2020*
Pima County Office Of The Medical Examiner – Annual Report 2020
72
Rev: 04/30/2021
TOTAL REPORTED DEATHS
The total cases investigated by the PCOME from Cochise County in a given year are the
sum of the ME cases (autopsies, external examinations, and death certificate cases) and
cases in which jurisdiction was declined.
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 2020, 144 autopsies,
50 external examinations and 11 DC cases were performed on deaths from Cochise
County.
151
268
246
270 276
253
280 284
370
2012 (half
year)
2013 2014 2015 2016 2017 2018 2019 2020
Cochise County Deaths Reported to the PCOME 2012 – 2020
Pima County Office Of The Medical Examiner – Annual Report 2020
73
Rev: 04/30/2021
144
50
11
Autopsy External DC
Cochise County Medical Examiner Cases 2020
3
1 0
7
16 16
22
42
40
31
14
6 7
Cochise County Medical Examiner Cases by Age 2020
Pima County Office Of The Medical Examiner – Annual Report 2020
74
Rev: 04/30/2021
74
85
30
12
3
Cochise County ME Cases by Manner of Death 2020
Natural – 39%
Accident – 41%
Suicide – 15%
Undetermined – 6%
Homicide – 1%
Pima County Office Of The Medical Examiner – Annual Report 2020
75
Rev: 04/30/2021
HOMICIDE DEATHS
The PCOME examined one firearms and two blunt force related homicide deaths from
Cochise County in 2020; 1% of total deaths certified. Homicide totals from 2013 – 2020
are compared below.
3
7
6 6
2
0 1
3
2013 2014 2015 2016 2017 2018 2019 2020
Cochise County Homicide Deaths 2013 – 2020
Pima County Office Of The Medical Examiner – Annual Report 2020
76
Rev: 04/30/2021
ACCIDENT DEATHS
The PCOME examined 85 accident deaths from Cochise County in 2020; 41% of total
Cochise County deaths certified. Accident victims were most frequently males (69%),
between 50-59 years of age (28%) and died as the result of an overdose (46%).
39
45
64 63
55
58
49
85
2013 2014 2015 2016 2017 2018 2019 2020
Cochise County Accident Deaths 2013 – 2020
1
0 0
4
10 10
11
24
13
6
3
2
1
Cochise County Accident Deaths by Age 2020
Pima County Office Of The Medical Examiner – Annual Report 2020
77
Rev: 04/30/2021
59
27
Cochise County Accident Deaths by Sex 2020
Male – 69%
Female – 31%
39
20
9
9
3 5
Cochise County Accident Deaths by Cause 2020
Overdose – 46%
Motor Vehicle – 24%
Blunt Force – 11%
Exposure – 11%
Asphyxia – 3%
Other – 5%
Pima County Office Of The Medical Examiner – Annual Report 2020
78
Rev: 04/30/2021
Cochise County Accident Deaths by Cause (Top 3) 2016 – 2020
*Blunt Force (9) is tied with Exposure (9) as an accidental cause of death in 2020
19 19
22 21
39
24
20
18
15
20
14
9 10
5
9
2016 2017 2018 2019 2020*
Overdose Motor Vehicle Blunt Force
Pima County Office Of The Medical Examiner – Annual Report 2020
79
Rev: 04/30/2021
SUICIDE DEATHS
The PCOME examined 30 suicide deaths from Cochise County in 2020; 15% of total
Cochise County deaths certified. Suicide victims were most frequently males (80%),
between 60-69 years of age (20%) and died as the result of firearms (63%).
29
36
30 29
31
18
37
30
2013 2014 2015 2016 2017 2018 2019 2020
Cochise County Suicide Deaths 2013 – 2020
0 0 0
3
5
2
4
3
6
4
2
1
0
Cochise County Suicide Deaths by Age 2020
Pima County Office Of The Medical Examiner – Annual Report 2020
80
Rev: 04/30/2021
24
6
Cochise County Suicide Deaths by Sex 2020
Male – 80%
Female – 20%
19
8
2 1
Cochise County Suicide Deaths by Cause 2020
Firearms – 63%
Hanging – 27%
Overdose – 7%
Suffocation – 3%
Pima County Office Of The Medical Examiner – Annual Report 2020
81
Rev: 04/30/2021
Cochise County Suicide Deaths by Cause (Top 3) 2016 – 2020
23
26
14
27
19
3
2
3
4
8
2
1 1
4
2
2016 2017 2018 2019 2020
Firearms Hanging Overdose
Pima County Office Of The Medical Examiner – Annual Report 2020
82
Rev: 04/30/2021
NATURAL DEATHS
The PCOME examined 74 natural deaths from Cochise County in 2020; 39% of total
Cochise County deaths certified. Individuals who died from natural causes were most
frequently males (70%), between 60-79 years of age (27%) and died as the result of
cardiovascular disease (69%).
96
58
51 53
68
84
73 74
2013 2014 2015 2016 2017 2018 2019 2020
Cochise County Natural Deaths 2013 – 2020
0 0 0 0 0
4
6
14
20
18
9
3
0
Cochise County Natural Deaths by Age 2020
Pima County Office Of The Medical Examiner – Annual Report 2020
83
Rev: 04/30/2021
52
22
Cochise County Natural Deaths by Sex 2020
Male – 70%
Female – 30%
51
7
5
3
8
Cochise County Natural Deaths by Cause 2020
Cardiovascular – 69%
Chronic Alcohol – 9%
Nonspecific Natural – 7%
Infection
– 4%
Other – 10%
Pima County Office Of The Medical Examiner – Annual Report 2020
84
Rev: 04/30/2021
UNDETERMINED MANNER OF DEATH
The PCOME examined 12 undetermined deaths from Cochise County in 2020; 6% of
total Cochise County deaths certified. Individuals who died with an undetermined
manner were most frequently males (67%), of unknown age (42%) and died from
undetermined causes (92%). The vast majority of these deaths represent decomposed
remains, which oftentimes precludes a definitive cause of death determination.
12
3
12
9
10
9
11
12
2013 2014 2015 2016 2017 2018 2019 2020
Cochise County Undetermined Manner 2013 – 2020
2
0 0 0
1
0
1 1
0
1
0 0
5
Cochise County Undetermined Manner of Death by Age 2020
Pima County Office Of The Medical Examiner – Annual Report 2020
85
Rev: 04/30/2021
8
3
1
Cochise County Undetermined Manner of Death by Sex 2020
Male – 67%
Female – 25%
Unsure – 8%
11
1
Cochise County Undetermined Manner of Death by Cause 2020
Undetermined – 92%
Overdose – 8%
Pima County Office Of The Medical Examiner – Annual Report 2020
86
Rev: 04/30/2021
OVERDOSE DEATHS
There were 42 deaths attributed to an overdose of either a single drug (18 deaths, 43%) or
a combination of drugs (24 deaths, 57%) in 2020. Overdose deaths commonly involved
males (55%) between the ages of 50-59 (43%). The majority of these deaths were
classified as accidents (93%).
18
30
22 21
24 25
42
2014 2015 2016 2017 2018 2019 2020
Cochise County Overdose Deaths 2014 – 2020
0 0 0 0
6 6
5
18
7
0 0 0
<1 1-5 6-12 13-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89 >90
Cochise County Overdose Deaths by Age 2020
Pima County Office Of The Medical Examiner – Annual Report 2020
87
Rev: 04/30/2021
23
19
Cochise County Overdose Deaths by Sex 2020
Male – 55%
Female – 45%
39
2 1
Cochise County Overdose Deaths by Manner 2020
Accident – 93%
Suicide – 5%
Undetermined – 4%
Pima County Office Of The Medical Examiner – Annual Report 2020
88
Rev: 04/30/2021
8
7
2
1
1
1
1
0
1
0
13
23
2
4
0
6
0
2
1
0
1
0
0
0
0
1
1
Heroin
Oxycodone
Hydrocodone
Oxymorphone
Hydromorphone
Methadone
Morphine
Codeine
Tramadol
Opiate Unspecified
Fentanyl
Methamphetamine
Cocaine
Benzodiazepines
Barbiturates
Alcohol
Antihistamines
SSRI/SNRI
Tricyclics
Atypical Antipsychotics
Muscle Relaxants
Anti-seizure Agents
Sleep Aids
Acetaminophen
Ethylene Glycol
Amphetamine
Other
Cochise County Overdose Deaths by Drug 2020
Opiate compounds are red
Pima County Office Of The Medical Examiner – Annual Report 2020
89
Rev: 04/30/2021
Cochise County Overdoses by drug by year 2014 – 2020
0
5
10
15
20
25
2014 2015 2016 2017 2018 2019 2020
Heroin Fentanyl Oxycodone Morphine
Meth Cocaine Benzo Alcohol
Pima County Office Of The Medical Examiner – Annual Report 2020
90
Rev: 04/30/2021
MOTOR VEHICLE RELATED FATALITIES
Motor vehicle related fatalities accounted for 20 total deaths in Cochise County in 2020.
The majority, 11 deaths, were occupants of a motor vehicle involved in an accident
(MVA). Of the remaining, three were motorcycle accidents (MCA), four were bicyclists
struck by a vehicle, and two were pedestrians struck by vehicles. Individuals who died
from motor vehicle related fatalities were most frequently males (80%) between the ages
of 60-69 years (25%).
10
17
24
21
18
15
20
2014 2015 2016 2017 2018 2019 2020
Cochise County Motor Vehicle Fatalities 2014 – 2020
0 0 0
2
1
3 3
2
5
2 2
0
<1 1-5 6-12 13-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89 >90
Cochise County Motor Vehicle Fatalities by Age 2020
Pima County Office Of The Medical Examiner – Annual Report 2020
91
Rev: 04/30/2021
16
4
Cochise County Motor Vehicle Fatalities by Sex 2020
Male – 80%
Female – 20%
11
3
4
2
Cochise County Motor Vehicle Fatalities by Type 2020
MVA – 80%
MCA – 15%
Bicyclist – 20%
Pedestrian – 10%
Pima County Office Of The Medical Examiner – Annual Report 2020
92
Rev: 04/30/2021
GRAHAM COUNTY
Graham County contracts (beginning July 1, 2020)
with the PCOME to certify deaths that fall under the
jurisdiction of the medical examiner in Graham
County. Graham 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. Graham
County does provide third party transportation
services, local law enforcement death scene
investigation and archival support for
investigations/certifications that occurred prior to
July 1, 2020. The PCOME works closely with
Graham County law enforcement agencies, the
public fiduciary office and funeral homes to
facilitate
investigations, disposition of remains and
transportation respectively. The PCOME is
available as needed with mass fatality planning,
fatality review panels, or other medical examiner related issues in Graham County.
TOTAL MORTALITY
The number of deaths reported to the medical examiner’s office in a given period is a
reflection of the total population that the office serves. In 2020 there were 383 deaths of
Graham County residents; of these 49 (13%) were reported to the PCOME for
investigation.
*Arizona Department of Vital Statistics as of 04/06/2021
245
300
275 283
251
278
305
336
286
383
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Graham County Resident Mortality by Year 2011 – 2020*
Pima County Office Of The Medical Examiner – Annual Report 2020
93
Rev: 04/30/2021
13
15
17
13
5
9
11
18
12
49
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Graham County Deaths Reported to the PCOME 2011 – 2020
315
6
7
Graham County Deaths by Type of Exam 2020
Autopsy
External
Jurisdiction Decline
Death Certification
Pima County Office Of The Medical Examiner – Annual Report 2020
94
Rev: 04/30/2021
22
15
3 2
Graham County Deaths by Manner of Death 2020
Accident
Natural
Homicide
Suicide
8
8
2
3
1
Graham County Accident Deaths by Type 2020
Overdose
Motor Vehicle
Exposure
Blunt Force
Carbon Monoxide
Pima County Office Of The Medical Examiner – Annual Report 2020
95
Rev: 04/30/2021
7
2
2
4
Graham County Natural Deaths by Type 2020
Cardiovascular
Infectious
Diabetes
Other
11
Graham County Suicide Deaths by Type 2020
Firearms
Hanging
Pima County Office Of The Medical Examiner – Annual Report 2020
96
Rev: 04/30/2021
2
1
Graham County Homicide Deaths by Type 2020
Firearms
Sharp Force
Pima County Office Of The Medical Examiner – Annual Report 2020
97
Rev: 04/30/2021
LA PAZ COUNTY
La Paz County contracts (beginning July 1, 2020)
with the PCOME to certify deaths that fall under
the jurisdiction of the medical examiner in La Paz
County. La Paz 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. La Paz
County does provide third party transportation
services, local law enforcement death scene
investigation and archival support for
investigations/certifications that occurred prior to
July 1, 2020. The PCOME works closely with La
Paz County law enforcement agencies, the public
fiduciary office and funeral homes to facilitate
investigations, disposition of remains and
transportation respectively. The PCOME is
available as needed with mass fatality planning,
fatality review panels, or other medical examiner related issues in La Paz County.
TOTAL MORTALITY
The number of deaths reported to the medical examiner’s office in a given period is a
reflection of the total population that the office serves. In 2020 there were 362 deaths of
La Paz County residents; of these 85 (23%) were reported to the PCOME for
investigation.
*Arizona Department of Vital Statistics as of 04/06/2021
186
225
247 253 254
270
320 317 308
362
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
La Paz County Resident Mortality by Year 2011 – 2020*
Pima County Office Of The Medical Examiner – Annual Report 2020
98
Rev: 04/30/2021
21
13
24
22
40
29 29 30
23
85
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
La Paz County Deaths Reported to the PCOME 2011 – 2020
36
8
26
15
La Paz County Deaths by Type of Exam 2020
Autopsy
External
Jurisdiction Declined
Death Certification
Pima County Office Of The Medical Examiner – Annual Report 2020
99
Rev: 04/30/2021
17
33
5
3 1
La Paz County Deaths by Manner of Death 2020
Accident
Natural
Undetermined
Suicide
Homicide
5
6
3
3
La Paz County Accident Deaths by Type 2020
Overdose
Motor Vehicle
Exposure
Blunt Force
Pima County Office Of The Medical Examiner – Annual Report 2020
100
Rev: 04/30/2021
22
4
2
2
2 1
La Paz County Natural Deaths by Type 2020
Cardiovascular
Infectious
Nonspecific
Chronic Alcohol
Neoplasm
Embolism
3
La Paz County Suicide Deaths by Type 2020
Firearms
Pima County Office Of The Medical Examiner – Annual Report 2020
101
Rev: 04/30/2021
1
La Paz County Homicide Deaths by Type 2020
Sharp Force
Pima County Office Of The Medical Examiner – Annual Report 2020
102
Rev: 04/30/2021
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 2020 there were 463 deaths of Santa Cruz County
residents; of these 99 (21%) 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 04/06/2021
247
303
286 275
294 301 297 278
335
463
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Santa Cruz County Resident Mortality by Year 2011 – 2020*
Pima County Office Of The Medical Examiner – Annual Report 2020
103
Rev: 04/30/2021
54
59
51
46
55
51 50 52 48
99
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Santa Cruz County Deaths Reported to the PCOME 2011 – 2020
56
12
28
3
Santa Cruz County Deaths by Type of Exam 2020
Autopsy
External
Jurisdiction Declined
Death Certification
Pima County Office Of The Medical Examiner – Annual Report 2020
104
Rev: 04/30/2021
29
25
4
9
4
Santa Cruz County Deaths by Manner of Death 2020
Accident
Natural
Suicide
Undetermined
Homicide
14
4
7
3 1
Santa Cruz County Accident Deaths by Type 2020
Overdose
Motor Vehicle
Exposure
Blunt Force
Drowning
Pima County Office Of The Medical Examiner – Annual Report 2020
105
Rev: 04/30/2021
13
5
3
4
Santa Cruz County Natural Deaths by Type 2020
Cardiovascular
Infectious
Nonspecific
Other
2
1
1
Santa Cruz County Suicide Deaths by Type 2020
Firearms
Overdose
Carbon Monoxide
Pima County Office Of The Medical Examiner – Annual Report 2020
106
Rev: 04/30/2021
3
1
Santa Cruz County Homicide Deaths by Type 2020
Firearms
Sharp Force
Pima County Office Of The Medical Examiner – Annual Report 2020
107
Rev: 04/30/2021
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
A
ME, 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).
Thirty-five deaths from Apache County were reported to the PCOME in 2020, 29 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 04/06/21
584
471
607 601
646 653
689 692 711
1093
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Apache County Resident Mortality by Year 2011 – 2020*
Pima County Office Of The Medical Examiner – Annual Report 2020
108
Rev: 04/30/2021
5
17
14
12
17
19
18
26
14
35
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Apache County Deaths Reported to the PCOME 2011 – 2020
29
4
2
Apache County Deaths by Type of Exam 2020
Autopsy
Jurisdiction Declined
External
Pima County Office Of The Medical Examiner – Annual Report 2020
109
Rev: 04/30/2021
16
6
3
3
3
Apache County Deaths by Manner of Death 2020
Natural
Accident
Suicide
Homicide
Undetermined
13
4
3
3
3
2
4
Apache County Deaths by Type of Death 2020
Cardiovascular
Firearms
Motor vehicle
Overdose
Undetermined
Exposure
Other
Pima County Office Of The Medical Examiner – Annual Report 2020
110
Rev: 04/30/2021
GILA COUNTY
Gila County contracts with the Pinal County
Office of the Medical Examiner, who triages,
investigates and certifies deaths that fall under the
jurisdiction of the medical examiner (ME) in Gila
County. 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).
Fifteen deaths from Gila County were reported to the PCOME in 2020, 13 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 04/06/2021
682 655
696
747
814 832
723
754
813
972
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Gila County Resident Mortality by Year 2011 – 2020*
Pima County Office Of The Medical Examiner – Annual Report 2020
111
Rev: 04/30/2021
48
57
81
42
32
29
16
13
29
15
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Gila County Deaths Reported to the PCOME 2011 – 2020
13
2
Gila County Deaths by Type of Exam 2020
Autopsy
External
Pima County Office Of The Medical Examiner – Annual Report 2020
112
Rev: 04/30/2021
5
4
4
1
1
Gila County Deaths by Manner of Death 2020
Natural
Accident
Homicide
Undetermined
Suicide
3
3
2
7
Gila County Deaths by Type of Death 2020
Firearms
Blunt Force
Cardiovascular
Other
Pima County Office Of The Medical Examiner – Annual Report 2020
113
Rev: 04/30/2021
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).
Eight deaths from Greenlee County were reported to the PCOME in 2020, 7 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 04/06/2021
71
64
43
52
69
52
65 66
70
80
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Greenlee County Resident Mortality by Year 2011 – 2020*
Pima County Office Of The Medical Examiner – Annual Report 2020
114
Rev: 04/30/2021
4
6
12
9
13
8
4
3
8 8
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Greenlee County Deaths Reported to the PCOME 2011 – 2020
7
1
Greenlee County Deaths by Type of Exam 2020
Autopsy
External
Pima County Office Of The Medical Examiner – Annual Report 2020
115
Rev: 04/30/2021
3
3
1
1
Greenlee County Deaths by Manner of Death 2020
Accident
Suicide
Natural
Homicide
4
2
1
1
Greenlee County Deaths by Type of Death 2020
Firearms
Overdose
ATV
Embolism
Pima County Office Of The Medical Examiner – Annual Report 2020
116
Rev: 04/30/2021
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).
Forty-four deaths from Navajo County were reported to the PCOME in 2020, 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 04/06/2021
899 897
976 937 907
1010
1059
1137
1192
1715
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Navajo County Resident Mortality by Year 2011 – 2020*
Pima County Office Of The Medical Examiner – Annual Report 2020
117
Rev: 04/30/2021
29
36
33 33
30
50
43
40
37
44
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Navajo County Deaths Reported to the PCOME 2011 – 2020
44
Navajo County Deaths by Type of Exam 2020
Autopsy
Pima County Office Of The Medical Examiner – Annual Report 2020
118
Rev: 04/30/2021
15
9
9
9
2
Navajo County Deaths by Manner of Death 2020
Natural
Accident
Suicide
Homicide
Undetermined
9
5
5
5
4
3
2
2
2
2
5
Navajo County Deaths by Type of Death 2020
Hanging
Cardiovascular
Chronic Alcohol
Overdose
Firearms
Infection
Motor Vehicle
Diabetes
Sharp Force
Exposure
Other
Pima County Office Of The Medical Examiner – Annual Report 2020
119
Rev: 04/30/2021
PINAL COUNTY
Pinal County appointed a Medical Examiner in
December 2016 and maintains its own Medical
Examiner’s office staffed to conduct death
scene investigations, transport remains, perform
examinations and triage deaths reportable to the
ME as stated in A.R.S §11-593 above. 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).
Six deaths from Pinal County were reported to
the PCOME in 2020, 2 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 04/06/2021
2380 2440 2457
2629
2968 2991
3110
3147
3330
4272
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Pinal County Resident Mortality by Year 2011 – 2020*
Pima County Office Of The Medical Examiner – Annual Report 2020
120
Rev: 04/30/2021
304 308
223
200
264
236
29 24
8 6
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Pinal County Deaths Reported to the PCOME 2011 – 2020
2
1
3
Pinal County Deaths by Type of Exam 2020
Autopsy
External
Jurisdiction Declined
Pima County Office Of The Medical Examiner – Annual Report 2020
121
Rev: 04/30/2021
2
1
Pinal County Deaths by Manner of Death 2020
Suicide
Natural
1
1
1
Pinal County Deaths by Type of Death 2020
Hanging
Overdose
Infection
Pima County Office Of The Medical Examiner – Annual Report 2020
122
Rev: 04/30/2021
YUMA COUNTY
Yuma County contracts with, and appoints the
pathology group at Yuma Regional Medical
Center to serve as Medical Examiner for 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 prior to July 1, 2020. The
PCOME discontinued this arrangement after
July 1, 2020. The Yuma County Medical
Examiner’s Office historically issued its own
Annual Report. Please reference that report, if
it is still being published, for details concerning
deaths occurring in Yuma County that are not
referred to the PCOME.
Eleven deaths from Yuma County were
reported to the PCOME in 2020, ten of which
required autopsy examinations. Some pertinent statistics regarding these deaths are
detailed in the tables below.
*Arizona Department of Vital Statistics as of 04/06/2021
1350 1386 1320
1425 1427
1506 1491
1631 1631
2432
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Yuma County Resident Mortality by Year 2011 – 2020*
Pima County Office Of The Medical Examiner – Annual Report 2020
123
Rev: 04/30/2021
18 18
15
16
5
16
13
16
18
11
2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Yuma County Deaths Reported to the PCOME 2011 – 2020
10
1
Yuma County Deaths by Type of Exam 2020
Autopsy
Jurisdiction Declined
Pima County Office Of The Medical Examiner – Annual Report 2020
124
Rev: 04/30/2021
5
2
2
1
Yuma County Deaths by Manner of Death 2020
Homicide
Accident
Natural
Suicide
4
2
1
1
1
1
Yuma County Deaths by Type of Death 2020
Firearms
Blunt Force
Overdose
Cardiac
Fire
Neoplasm
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