Surge in autopsies a mystery

By Mike Gordon
Advertiser Staff Writer

There is no clear explanation for it, but the number of deaths being investigated by the Honolulu Medical Examiner is climbing at a record pace this year.

Victims of car crashes, suicides, homicides, drownings, drug overdoses and falls — a lot of falls — are among the 981 fatalities so far this year.

That's 128 more than a year ago.

The medical examiner handles about 1,500 cases a year. This year, Chief Medical Examiner Dr. Kanthi von Guenthner expects to investigate more than 1,600 cases.

She has never seen anything like it in 18 years in the Honolulu medical examiner's office.

"We are bringing in more cases than ever before," von Guenthner said. She doesn't know why, exactly.

The department investigates and performs autopsies, when necessary, on unnatural deaths. Those make up just a portion of total O'ahu deaths, around 6,100 for each of the past two years.

"It's a mixture of things," von Guenthner said. "We have had a definite increase in drug deaths. But it's an overall, across-the-board thing, more deaths. Just look at the drownings."

There have been 13 drowning deaths since June 10.

Of drug-related deaths, more than half — 33 out of 51 cases — have involved crystal methamphetamine.

Susan Siu, the medical examiner's chief investigator, has tried to figure out what is driving the increase. But all it leaves her with is a headache and the occasional nightmare.

"I feel traumatized," she said. "Everybody here is exhausted."

As Siu flips through her notes looking for a trend, the falls seem to jump at her.

"We get so many falls," Siu said. "There is more of an elderly population, and they are falling accidentally. They are falling from trees. A guy fell from a mango tree yesterday."

There have been about 32 accidental falls so far this year, not including two teenagers who fell off their skateboards and a construction worker who fell off a scaffold.

Fall-related deaths are common among people 65 and older. The man who fell out of his mango tree was 69.

"It's by far the leading cause of injury death among the elderly — about one-third of all deaths," said Dan Galanis, epidemiologist for the state Health Department's Injury Prevention and Control Program.

But Galanis can't explain what's happening this year. His most current statistics are for the year 2000.

Traffic fatalities are about the same as last year. As of Monday, there were 40 fatalities, one ahead of this time last year.

Homicides usually do not account for a large part of the caseload, and this year appears no different. There have been 10 homicides this year, compared with 14 at this point in 2001. Last year there were 26 homicides, three more than in 2000.

Meanwhile, the caseload piles up.

"I can't have anyone sit down and count this," von Guenthner said, tired after a day that began at 6:30 a.m. "Everyone is just so busy."

Reach Mike Gordon at mgordon@honoluluadvertiser.com or 525-8012.