TABLE OF CONTENTS INTRODUCTION 1 -SUMMARY OF CONTENTS 2 -DEATHS REPORTABLE TO THE CORONER 3 INVESTIGATIONS, CORONER CASES AND AUTOPSIES 6

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3 TABLE OF CONTENTS INTRODUCTION 1 -SUMMARY OF CONTENTS 2 -DEATHS REPORTABLE TO THE CORONER 3 INVESTIGATIONS, CORONER CASES AND AUTOPSIES 6 -SUMMARY OF REPORTABLE DEATHS 7 -SUMMARY OF INVESTIGATIONS 5-YEARS 8 -DISPOSITION OF REPORTABLE DEATHS 9 -AGE AND SEX OF DECEDENTS 10 MANNER OF DEATH 11 -DEFINITION OF CAUSE AND MANNERS OF DEATH 12 -COMPARISON OF DEATHS BY TYPE 13 -INVESTIGATIONS BY TYPE OF DEATH 14 -NATURAL DEATHS BY THE MONTH 15 -NATURAL DEATHS BY CAUSE 16 -MISCELLANEOUS ACCIDENTAL DEATHS BY CAUSE 17 -COMPARISON OF ACCIDENTAL DEATHS BY CAUSE 18 -MISCELLANEOUS ACCIDENTAL DEATHS 5-YEARS 19 -COMPARISON OF UNDETERMINED DEATHS BY CAUSE 20 -MOTOR VEHICLE DEATHS BY MODE 21 -MOTOR VEHICLE DEATHS BY TYPE 22 -MOTOR VEHICLE DEATHS BY MONTH 23 -BLOOD ALCOHOL LEVELS IN MOTOR VEHICLE DEATHS 24 -BLOOD ALCOHOL LEVELS CHART IN VEHICLE DEATHS 25 -BLOOD ALCOHOL AND NON BLOOD ALCOHOL DEATHS 26 -MOTOR VEHICLE DEATHS 5-YEARS 27 -HOMICIDES BY MODE 28 -HOMICIDES BY JURISDICTION 29 -HOMICIDES BY THE MONTH 30 -HOMICIDES 5-YEARS 31 -SUICIDES BY MODE 32 -SUICIDES BY THE MONTH 33 -SUICIDES 5-YEARS 34 SPECIAL SUMMARIES 35 -TEEN SUICIDES 36 -DEATHS DUE TO ILLICIT DRUGS 37 -DEATHS DUE TO GUNSHOT WOUND(S) 38 INDIGENT BURIALS 39 -INDIGENT BURIALS SUMMARY 40 -INDIGENT BURIALS 5-YEARS 41

4 INTRODUCTION 1

5 2014 ANNUAL REPORT OF THE CORONER In San Joaquin County, the Sheriff and the Coroner are one and the same. The San Joaquin County Sheriff s Coroner Division is comprised of one Sergeant, three Deputy Sheriff-Coroner Investigators, two Secretaries, a Forensic Pathologist and two Medical Technicians. During the 2014 calendar year, 4894 deaths were recorded in San Joaquin County. Of that number, 2560 or about 52.3%, were reported to the Coroner s Office pursuant to California Government Code Section 27491, which directs the Coroner to inquire into and determine the circumstances, manner, and cause of those reportable deaths. This represents a 2.8% decrease over 2013 when 2634 deaths were reported to the Coroner. After investigation, 708 deaths, or about 27.7% of the cases reported to the Coroner, resulted as actual coroner cases with the final cause of death signed by the Coroner or his delegated authority. This represents an increase of 4.8% from The remaining 1852 cases were referred to the attending physicians for signing of the death certificates. Of the 708 deaths certified by the Coroner s Office, 493 or about 69.6% required an Autopsy, to determine the cause of death. Of these cases investigated, about 35.9% were found to be deaths due to natural causes. Of the natural deaths investigated by the Coroner, about 65.3% were cardiac related. Accidental deaths comprised about 42.7% of investigated deaths. Of the accidental deaths, 31.6% were due to motor vehicles. Vehicle accidents were consistent with 96 in both 2013 and Alcohol was found to be present in the post mortem blood in about 28.1% of all motor vehicle deaths. Suicides accounted for about 10.4% of the investigated deaths, and firearms were the instruments of death in about 33.8% of those cases. There were 72 homicides investigated by the San Joaquin County Coroner s Office in 2014, an increase of about 35.8% over Firearms were the major instruments of death in about 81.9% of all homicides. There were 6 deaths of undetermined classification investigated by the Coroner. In these investigations the cause or manner of death could not be determined. During 2014, the Coroner s Office processed 106 indigent cases in which the decedents had insufficient funds for interment, a 1.8% decrease over

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9 INVESTIGATIONS CORONER CASES AND AUTOPSIES 6

10 SUMMARY OF REPORTABLE DEATHS 2014 AUTOPSY INSPECTION INVESTIGATION REFERRAL TOTAL JANUARY FEBRUARY MARCH APRIL MAY JUNE JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER TOTAL AUTOPSY: INSPECTION: INVESTIGATION: REFERRAL: TOTAL: A FULL EXAMINATION, BOTH EXTERNAL AND INTERNAL, TO DETERMINE THE PATHOLOGICAL CAUSE OF DEATH. THE DEATH CERTIFICATE IS SIGNED BY THE CORONER 493 A TERM USED BY THE CORONER S OFFICE WHEN THERE IS SUFFICIENT MEDICAL DATA TO DETERMINE THE CAUSE OF DEATH BY PHYSICAL INSPECTION OF THE BODY AND WITHOUT AN AUTOPSY. THE FINAL DEATH CERTIFICATE IS SIGNED BY THE CORONER. 163 A TERM USED BY THE CORONER S OFFICE WHEN THE DEATH CERTIFICATE IS SIGNED BY THE CORONER AFTER A FULL INVESTIGATION, AND REVIEW OF MEDICAL RECORDS WITHOUT THE PRESENCE OF THE BODY. 52 A TERM USED BY THE CORONER S OFFICE FOR A DEATH THAT WHEN AFTER INVESTIGATION IS RELEASED TO A PRIVATE PHYSICIAN FOR THE SIGNING OF THE DEATH CERTIFICATE INDICATES TOTAL NUMBER OF AUTOPIES, INSPECTIONS, INVESTIGATIONS, AND REFERRALS

11 CORONER INVESTIGATIONS AUTOPSY INSPECTION AND INVESTIGATION REFERRAL TOTAL

12 DISPOSITION OF REPORTABLE DEATHS Referral 72.3% Autopsy 19.3% Investigation 2.0% Inspection 6.4% Total Reportable Deaths:

13 CORONER INVESTIGATIONS AGE AND SEX OF DECEDENTS Male Female unk CORONER INVESTIGATIONS SEX OF DECEDENTS 2014 MALE FEMALE TOTAL 0-1 YEARS YEARS YEARS YEARS YEARS YEARS YEARS YEARS YEARS YEARS YEARS UNKNOWN TOTAL

14 MANNER OF DEATH 11

15 Definition of Cause and Manners of Death Reference: National Association of Medical Examiners Guide Cause Manner The medical reason for the death as determined by a Forensic Pathologist or Licensed Physician. The category or classification of death based on the available information concerning the circumstances surrounding a death. The Manner of Death is used only in the United States for statistical purposes and is not legally binding. The preponderance of medical and/or investigative evidence (greater than a 50:50 chance) is the standard used when determining Manner of Death. The Manners of Death used in California are listed below. Natural Deaths due solely or nearly totally to a disease and/or the 254 natural aging process. Accident Suicide Homicide Undetermined Deaths due to an act, injury or poisoning where the outcome was unintentional. 302 Deaths due to an injury or poisoning as a result of an intentional, self-inflicted act committed to do self harm or cause the death of one s self. 74 Deaths due to a volitional act committed by another person to cause harm, fear or death. Intent is a common element but is not required for this classification. 72 Used when the information pointing to one manner of death is no more compelling than one or more competing manners of death after thorough consideration of all available information. 6 As an example, the Cause of Death is Gunshot Wound of the Head, but the preponderance of available information is not sufficient to certify the Manner of Death as either an accident, suicide, or homicide. Total Indicates the total number of all Manners of Death as 708 certified by the Coroner s Office. 12

16 COMPARISON OF DEATHS BY TYPE NATURAL ACCIDENT (MISC) ACCIDENT (MOTOR VEH) SUICIDE HOMICIDE UNDETERMINED REFERRAL TOTAL % CHANGE FROM PREVIOUS YEAR 9.35% 8.50% 3.40% % -2.8% TOTAL DEATHS IN SAN JOAQUIN COUNTY % INVESTIGATED BY CORONER 58% 61% 61% 57% 52.3% 13

17 COMPARISON OF DEATH INVESTIGATIONS BY TYPE OF DEATH 2014 Accident (Motor Veh) 13.28% Suicide 10.45% Accident (Misc) 29.38% Natural 35.88% Homicide 10.17% Undetermined 0.85% Total: 708 Deaths (Actual Coroner Cases) 14

18 NATURAL DEATHS BY THE MONTH JAN MAR MAY JUL SEP NOV 2014 JANUARY 30 FEBRUARY 18 MARCH 15 APRIL 19 MAY 19 JUNE 25 JULY 17 AUGUST 15 SEPTEMBER 22 OCTOBER 20 NOVEMBER 21 DECEMBER 33 TOTAL

19 COMPARISON OF NATURAL DEATHS BY CAUSE Hepatic 8.3% Cardiac 65.3% Central Nervous System 8.3% Respiratory 6.3% Other 8.7% Digestive System 0.8% Malignancy 1.6% S.U.I.D.* 0.8% NATURAL DEATHS BY CAUSE 2014 CARDIAC 166 DIGESTIVE SYSTEM 2 RESPIRATORY 16 CENTRAL NERVOUS SYSTEM 21 SUDDEN UNEXPLAINED INFANT DEATH* 2 MALIGNANCY 4 HEPATIC 21 Other: Endocrine, Hematologic, Immune, Renal and 22 Misc. TOTAL

20 MISCELLANEOUS ACCIDENTAL DEATHS BY CAUSE ASPHYXIA. 18 DROWNING 11 CHOKED ON FOOD/OBJECT 3 POSITIONAL ASPHYXIA 0 ASPHYXIA 4 DRUG(S)/TOXIC SUBSTANCES. 144 O.D. ILLICIT DRUGS/DRUG ABUSE 43 OVERDOSE OF ALCOHOL 5 OVERDOSE PRESCRIPTION DRUG(S)/MED(S) 21 CHRONIC IV DRUG ABUSE 3 COMBINED ALCOHOL AND DRUGS 72 BURNS/SMOKE INHALATION RESIDENTAL FIRE 0 BURNS 1 FALL DOWNSTAIRS 0 TO GROUND 24 TO FLOOR 2 FROM HEIGHT 4 AGAINST OBJECT 4 OTHER MISC ACCIDENT... 9 INDUSTRIAL ACCIDENTS 2 ENVIRONMENTAL EXPOSURE 2 THERAPEUTIC COMPLICATION 5 ELECTROCUTION 0 OTHER 0 TOTAL

21 COMPARISON OF MISCELLANEOUS ACCIDENTAL DEATHS BY CAUSE Drugs 69.9% Falls 16.5% Other 4.4% Asphyxia 8.7% Burns 0.5% MISCELLANEOUS ACCIDENTAL DEATHS BY CAUSE 2014 ASPHYXIA 18 DRUGS 144 FALLS 34 BURNS 1 OTHER 9 TOTAL

22 MISCELLANEOUS ACCIDENTAL DEATHS MISCELLANEOUS ACCIDENTAL DEATHS BY MONTH AND YEAR JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC TOTAL

23 COMPARISON OF UNDETERMINED DEATHS BY CAUSE Other/Unknown 86% Native American Remains 14% UNDETERMINED DEATHS BY CAUSE 2014 NATIVE AMERICAN REMAINS 1* OTHER/UNKNOWN CIRCUMSTANCES 6 TOTAL 7* *During the 2014 calendar year 1 set of remains was located that was determined to be Native American Remains. These remains were not calculated in the total deaths within San Joaquin County as they were of archaic origin. Arrangements were made with the Native American Heritage Commission for the remains to be reinterred in compliance with the Native American Grave Protection and Repatriation Act. 20

24 COMPARISON OF MOTOR VEHICLE ACCIDENTAL DEATHS Automobile 67.7% Truck 2.1% Pedestrian 17.7% Motorcycle 11.5% Misc. 1.0% MOTOR VEHICLE ACCIDENTAL DEATHS 2014 AUTOMOBILE 65 TRUCK 2 PEDESTRIAN 17 MOTORCYCLE 11 MISC 1 TOTAL 96 21

25 MOTOR VEHICLE ACCIDENTAL DEATHS 2014 AUTOMOBILE AUTO OVERTURN 13 AUTO VS AUTO 18 AUTO VS FIXED OBJECT 17 AUTO VS TRUCK 8 AUTO VS UNKNOWN 0 AUTO INTO WATER 9 AUTO VS TRAIN 0 AUTO VS BICYCLE 0 FALL FROM MOVING VEHICLE 0 MOTORCYCLE MOTORCYCLE VS AUTO 3 MOTORCYCLE VS TRUCK 1 MOTORCYCLE OVERTURN 1 MOTORCYCLE VS FARM VEHICLE 0 MOTORCYCLE VS MULTI VEHICLES 0 MOTORCYCLE VS TRAIN 0 MOTORCYCLE VS FIXED OBJECT 6 PEDESTRIAN.. 17 PEDESTRIAN VS FARM EQUIPMENT 0 PEDESTRIAN VS AUTO 13 PEDESTRIAN VS TRUCK 2 PEDESTRIAN VS TRAIN 2 TRUCK TRUCK OVERTURN 0 TRUCK VS AUTO 1 TRUCK VS FIXED OBJECT 1 TRUCK VS TRUCK 0 TRUCK INTO WATER 0 TRUCK VS BICYCLE 0 MISC. 1 TOTAL

26 MOTOR VEHICLE DEATHS JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC 2014 MOTOR VEHICLE DEATHS MONTHLY COMPARISON January 14 February 4 March 4 April 10 May 15 June 4 July 6 August 6 September 10 October 9 November 10 December 4 Total 96 23

27 BLOOD ALCOHOL LEVELS IN MOTOR VEHICLE DEATHS California Government Code Section provides that the Coroner shall test for alcohol and barbiturate levels in all motor vehicle deaths where the decedent was fifteen (15) years of age, or older, and died within twenty-four (24) hours of the accident. It gives the Coroner discretion for testing to determine possible amphetamine level. It further provides that such tests shall also be performed on decedents less than fifteen (15) years of age, if the surrounding circumstances indicate the possibility of alcohol, barbituric acid, or amphetamine derivative consumption. During 2014, ninety six (96) people died in San Joaquin County as a result of motor vehicle accidents, this represents a corresponding number from Blood samples were obtained and submitted for toxicological study in about 94.8% of these cases. California Vehicle Code, section (a) states that it is unlawful for any person who is under the influence of an alcoholic beverage or any drug to drive a vehicle. Section (b) states that it is unlawful for any person who has a blood alcohol of 0.08% or more, by weight, of alcohol in his or her blood to drive a vehicle. Alcohol was present in the blood in about 28.1% of the cases. The blood alcohol level was at or above 0.08% in about 20.2% of all motor vehicle deaths, a decrease of about 2% from year Results showed that about 19.8% of the ninety six (96) persons tested for blood alcohol levels were presumed intoxicated beyond the legal limit to operate a vehicle in California. Particularly significant was the fact that of the tested ninety one (91) drivers of motor vehicles in 2014, nineteen (19) of the drivers, or about 21.1% had blood alcohol levels at or above the level presumed to be under the influence of alcohol. Also noted was the fact that there were three (3) alcohol deaths reported for drivers under the age of 21 years. 24

28 BLOOD ALCOHOL LEVELS IN MOTOR VEHICLE DEATHS Neg % % % %.20% & Over OF THOSE TESTED NEGATIVE % % % %.20% & Over NO TEST GIVEN DRIVER PASSENGER PEDESTRIAN MOTORCYCLIST BICYCLIST UNKNOWN TOTAL

29 BLOOD ALCOHOL LEVELS IN MOTOR VEHICLE DEATHS Alcohol 28.1% No Alcohol 71.9% 2014 ALCOHOL 27 NO ALCOHOL 69 TOTAL 96 26

30 MOTOR VEHICLE DEATHS FIVE-YEAR COMPARISON January February March April May June July August September October November December Totals

31 Gunshot Wound(s) 81.94% COMPARISON OF HOMICIDES BY MODE OF DEATH Male Female Total GUNSHOT WOUND(S) BEATING/BLOW(S) TO BODY INCISED/CUT WOUND(S) STRANGULATION OTHER (Fire and MVA) Total Incised/Cut Wound(s) 6.94% 2014 HOMICIDES Beating/Blow(s) to Body 6.94% Strangulation Other 2.78% 1.39% MALE FEMALE TOTAL GUNSHOT WOUND(S) BEATING/BLOW(S) TO BODY INCISED/CUT WOUND(S) STRANGULATION OTHER (Fire and MVA) Total

32 HOMICIDES BY JURISDICTION Stockton Police 70.83% Other 1.39% Tracy Police 1.39% San Joaquin Sheriff 13.89% Lathrop 1.39% Lodi Police 5.56% Manteca Police 5.56% HOMICIDES BY JURISDICTION 2014 STOCKTON POLICE 51 SAN JOAQUIN SHERIFF 10 MANTECA POLICE 4 LODI POLICE 4 TRACY POLICE 1 LATHROP POLICE 1 OTHER-Out of County 1 Total 72 29

33 HOMICIDES BY THE MONTH JAN MAR MAY JUL SEP NOV 2014 JANUARY 5 FEBRUARY 5 MARCH 6 APRIL 3 MAY 5 JUNE 5 JULY 6 AUGUST 13 SEPTEMBER 10 OCTOBER 9 NOVEMBER 2 DECEMBER 3 TOTAL 72 30

34 SAN JOAQUIN COUNTY HOMICIDES FIVE-YEAR COMPARISON Homicide

35 COMPARISON OF SUICIDES BY MODE OF DEATH Hanging/Asphyxia/Suffocate 37.84% Overdose 13.51% Gunshot Wound(s) 33.78% Jump 4.05% Burn 2.70% Poison 0.00% Incised/Cut Wound(s) 4.05% Vehicle/Train 4.05% Drowning 0.00% 2014 Suicides Male Female Total GUNSHOT WOUND(S) HANGING/ASPHYXIA/SUFFOCATION INCISED/CUT WOUND(S) VEHICLE / TRAIN OVERDOSE DROWNING POISON BURN JUMP Total

36 SUICIDES BY THE MONTH JAN MAR MAY JUL SEP NOV 2014 January 5 February 4 March 12 April 3 May 7 June 3 July 8 August 7 September 5 October 9 November 8 December 3 Total 74 33

37 SAN JOAQUIN COUNTY SUICIDES FIVE-YEAR COMPARISON SAN JOAQUIN COUNTY SUICIDES FIVE-YEAR COMPARISON SUICIDE

38 SPECIAL SUMMARIES 35

39 TEENAGE SUICIDES In 2014 there were 3 teenage suicide investigated by the Coroner s Office. The month of occurrence, gender, age, and method of each case is as follows: MONTH GENDER Age MODE March Female 19 Gunshot Wound March Male 16 Pedestrian Vs Train October Male 19 Overdose 36

40 DRUGS AND ALCOHOL SUMMARY In 2014 there were 154 deaths investigated by the Coroner s Office which were caused by an overdose of illicit drugs, alcohol or pharmaceuticals, (pg. 16 & 31). These deaths are now tracked in more detail and by specific drug type. The classification of these deaths was primarily accidental. Although 154 deaths were directly caused by an overdose, a significant number of deaths included illicit drugs or alcohol as contributory or not directly related to the cause of death. The numbers below represent the total number of these decedents that had the substances appear in their toxicology reports. Many decedents may have a combination of several substances. METHAMPHETAMINE/AMPHETAMINE 57 PHARMACEUTICALS 102 HEROIN 9 COCAINE 14 METHADONE 32 PCP (Phencyclidine) 2 MDMA/MDA 1 (MDMA-Methylenedioxymethamphetamine MDA-Methylenedioxyamphetamine) ALCOHOL 34 MARIJUANA 20 Although Methadone is a pharmaceutical, it was not actually prescribed to many of the decedents and was obtained through other means. It was included along with this special summary for that reason. 37

41 TOTAL DEATHS FROM GUNSHOT WOUNDS (FIREARMS) In 2014 there were 84 deaths investigated by the Coroner s Office, which were due to gunshot wounds (firearms). This represents an increase of about 18% from These deaths were classified as follows: HOMICIDE 59 (70.2%) SUICIDE 25 (29.8%) ACCIDENTAL 0 (0.0%) UNDETERMINED 0 (0/0%) TOTAL 84 38

42 INDIGENT BURIALS 39

43 INDIGENT BURIALS Under the provisions of California Health and Safety Code Section 7104, the county of residence of any indigent is responsible for the interment. The Coroner s Office administers the indigent burials budget for San Joaquin County. During 2014 the Coroner s Office processed 106 indigent cases at a cost of approximately $32,120. This was 2 less cases than in 2013, a decrease of $1,350. In 2013, the indigent cremation contract was renewed. The cost per indigent decedent is currently $ There is an increased cost for decedents that are oversized. In August of 1988, because of funding limitations placed on the County s General Fund, the Board of Supervisors adopted a policy of cremating all deceased indigents. Exceptions to the policy are at the discretion of the Sheriff Coroner. 40

44 SAN JOAQUIN COUNTY INDIGENT BURIALS FIVE-YEAR COMPARISON SAN JOAQUIN COUNTY INDIGENT BURIALS FIVE-YEAR COMPARISON TOTAL INDIGENT DEATHS