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Information RE Loss of Rights: County Medical Examiner's Office.

Dr. John Howard, Pierce County Medical Examiner,
3619 Pacific Ave., Tacoma, WA. 98409 -- 253 798 6494)
-- his supervisor --
John Ladenburg, Pierce County Executive --

After I received the call that my husband had died, I immediately was contacted by a representative of the Pierce County Medical Examiner's Office. This robot-like person asked me the crucial question "Does your husband have a local physician here?" Because I was in shock, I didn't think about the fact that Rose Red, the mini-series that David had been shooting, would have provided a doctor. I answered "no" -- and immediately this stranger began telling me what would happen to my husband's body. When I said "no" to her question, all control over David's remains shifted to the local coroner's office. Very briefly, what this meant was the following:

1. The representative informed me, when I said that my daughter and I would be flying up from Los Angeles to Seattle to visit and claim David's body, that we would not be allowed to see him at all. Period.

2. When I asked (of course) to speak to the Medical Examiner's office to appeal this outrageous ruling, I was told by this person (Ryan Thiel) that he "was not available". (I later was told that an employee of the Med Ex Office, Ed Duke, was the Medical Examiner -- I was under this impression for days and when I spoke to Ed Duke, thought he was the Examiner. At NO TIME that evening or in the weeks to follow, did the actual Medical Examiner, John Howard, make any effort to contact me. Although I was calling this office almost daily and requesting that he call me, he never responded. It is a stated policy of that office, that the Medical Examiner be available to bereaved families.)

3. I was not told that I could have gotten a court order to stay the autopsy -- John Howard himself told the Seattle Post Intelligencer reporter, Hector Castro, that I had this right. I WAS NEVER INFORMED OF THIS RIGHT.

4. The autopsy was done the next morning without my approval. David's body was very poorly embalmed by a funeral home used by the Medical Examiner's office and finally flown, two days later, to L.A. -- to Forest Lawn.

5. The list goes on -- the autopsy report was "misfiled" for nearly a month. Though I called every few days to ask about it, Ed Duke finally looked at his computer and discovered it had been finalized a month earlier.

6. The autopsy was poorly done. Doctor friends of mine here in LA read the report and said it was so awkwardly written that I should get a pathologist to look at it. I did ask a renowned pathologist, who very generously aided me in getting the few slides the Pierce Cty. Med Ex office made (along with wet tissue samples) to LA for his perusal. (He told me that about 24 slides were necessary, the PCMEO kept only four or five -- the rest were thrown away or so badly-stored that they were unusable. The pathologist told me that these local coroner's offices are "a national scandal" and that they should be part of university hospitals. These coroner's offices have complete control over their little fiefdoms -- the job of coroner is usually a political appointment -- sometimes these people are not even doctors, rather sheriffs or county employees.

The pathologist discovered that David had had a previous heart attack -- something the Pierce Cty Med Ex Office had entirely missed in their autopsy procedure -- they'd called the scar tissue of this heart attack "fibrosis". This was, obviously, very important information. Also, the pathologist here researched the possibility that David had had a rare genetic condition called Right Ventricular Dysplasia -- this was finally proven not to be the case -- but the Pierce Cty. Med Ex office missed the "clue" that it might be there. If it had been present, both my daughter and stepson would have been seriously affected by this finding.

The pathologist had so few samples and slides to work from that his efforts were nothing less than heroic.

Although John Howard never saw fit to contact me, he is now saying that I never asked to talk to him! Does it make sense that someone in my position would NEVER ask to speak to the so-called "final" authority on her husband's body? While I was asking Ryan Thiel, on the very night of my husband's death, to put me in touch with the Medical Examiner -- Ed Duke, of their office, was talking to the press and telling them that David had died of a "heart attack". I have quotes from him that were published everywhere, including the LA Times. I was told that the cause of my husband's death had to be determined, that was why we could not see him -- I was told it would take "weeks" to determine the cause. The press reported David's death at length, John Howard was VERY aware of our case -- and yet this petty tyrant of the Death Business, refused to answer my calls -- or pick up the phone and call me. He has said (since I have begun to make this public) that he would not change any of his actions, that he would do nothing differently and that I am on a "soapbox". He told the press that survivors sometimes get "agitated" if allowed to view a dead body of a loved one and have to be taken away.

There is much more to say -- but the public should also know, that the day after David died (October 10, 2000), the Seattle Post Intelligencer ran an article about callous notification of survivors by local coroner's offices -- and the Pierce County Medical Examiner's office was the offender. ALSO, before John Howard took over as Medical Examiner, the Pierce County Office was in litigation over the passing around and making public of AUTOPSY PHOTOGRAPHS -- this was a huge scandal and I believe that the previous medical examiner resigned over it. When John Howard finally answered one of my letters, months after my repeated requests to speak to him (by the way the Medical Examiner's own policy, as stated in their literature is that the medical examiner be available to bereaved families -- when I was told that he was not "available" that "he doesn't talk to families" they were violating their own policy!) he actually said that they were never in litigation over that lawsuit. I wrote back to him citing the court case and he did not respond.

I will add more here, but for now -- I would like people to know these "DMV's of Death" exist and that you or someone you love can be taken away, without recourse, by these organizations. If you say "no" to the question about a physician, these people come between you and the one you've lost -- you will have no more to say about how the body is treated. Please join me in writing to local representatives to investigate these organizations -- and to suggest their relocation within university hospitals.

Thank you for your interest.

Carol Muske Dukes

"Years Later, John Howard continues his "standard" treatment of those who are trying to change this inhuman "system"

Date: September 21, 2009 2:13:11 PM HST
Subject: Email to NAME

Dear Susan Siu:

You co-authored an email to the National Association of Medical Examiners (NAME) in December 2008 in which you expressed concerns about the Honolulu Medical Examiner’s Office. Your concerns were forwarded to NAME’s Ethics Committee and NAME’s Standards, Inspection, and Accreditation Committee for consideration.

The Ethics Committee reviewed the complaint and deliberated the matter. The committee does not find any specific ethics complaints against any particular pathologist at the Honolulu M.E.O. that warrants further investigation. The matter is now considered closed.

The Honolulu Medical Examiner’s Office underwent NAME inspection for accreditation this year. Your concerns were considered prior to and during that inspection. Following a review process, the accreditation status of the office will be posted on the NAME web site (


John Howard, M.D. NAME President

From: Kalona808
Sent: 9/21/2009 2:51:53 P.M. Hawaiian Standard Time
Subj: Re: Email to NAME

Mr Howard

This comes as no surprise to me at all. As I am sure you noticed I didn't bother to follow up because I was clear your agency would ignore and do nothing to correct the awful wrong going on there. The complaint was made over a year ago. If your agency had any pride or integrity these issues would have been addressed. But as I mentioned it is clear that is not nor was the case from your response.

Also looking and reading about your own history and complaints made about you by others spoke great volumes to me about your lack of genuine character and ability to even recognize wrong doing.

I'm sure your trip to Hawaii was well enjoyed and certainly couldn't possibly have any reflect on your lack of findings.

The real loser here is those who needed a system to count on. I will always do my best to ensure others are aware of the lack of credibility your agency has shown for their concerns. You mentioned that you are a non profit. I will have to look into that more and see what the rules are for an agency like yours. Seems to me there would be a serious integrity and bias issue with such a status. I'm confident I am not the first to see that. Let's hope there are real experts out there that are willing to question how and why you would take over a year to investigate such serious issues that were bought to your attention.

I certainly hope none of your loved ones will ever have to experience such poor treatment as you have condoned and practiced.

Thank you for wasting the time and hopes of those who thought just maybe this time you would find the human side of those who suffer such grave losses and correct those issues. But not this time. So sad and so bad for them. But Mr Howard I do believe that life is real and those who wrong will at some time in some have to suffer the consequences. In your case I can only hope that your continued non actions some day will cost you at very least a career you by no means earned.






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