Steve Moore Sheriff-Coroner Public Administrator

OFFICE OF ========SHERIFF-CORONER = COUNTY OF SAN JOAQUIN 7000 Michael N. Canlis Blvd. French Camp, California 95231-9781 Steve Moore Sheriff-Coroner Public Administrator April 1, 2014 Honorable Members of the Board of Supervisors County of San Joaquin Board Chambers, 6th Floor. 44 N. San Joaquin Street, Stockton CA 95202 Dear Board Members: The 2013 Annual Report of the Office of Coroner, which contains statistical data of the activities of this office, is forwarded to you for your review and information. This report catalogs the activities of the San Joaquin County Coroner's Office for the calendar year 2013, and offers a full accounting of the cases and medical inquiries into the causes and manners of death of any coroner's case within the San Joaquin County Coroner's jurisdiction. Your Board again is to be recognized for the great level of support and assistance provided to this office as we work to raise the quality of the services provided to our citizens. We also wish to express our gratitude to all members of the medical community, as well as our governmental agency partners who have provided assistance throughout the year. Sincerely, CD-32

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

INTRODUCTION 1

2013 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 2013 calendar year, 4635 deaths were recorded in San Joaquin County. Of that number, 2634 or about 56%, 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 10.4% decrease from 2012 when 2942 deaths were reported to the Coroner. After investigation, 675 deaths, or about 25.6% 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 1.9% from 2012. The remaining 1959 cases were referred to the attending physicians for signing of the death certificates. Of the 675 deaths certified by the Coroner s Office, 510 or about 75.5% required an Autopsy, to determine the cause of death. Of these cases investigated, about 40.1% were found to be deaths due to natural causes. Of the natural deaths investigated by the Coroner, about 62.7% were heart related. Accidental deaths comprised about 41.3% of investigated deaths. Of the accidental deaths, 34.4% were due to motor vehicles. Vehicle accidents were up from 64 in 2012 to 96 in 2013. Alcohol was found to be present in the post mortem blood in about 33.4% of all motor vehicle deaths. Suicides accounted for about 9.9% of the investigated deaths, and firearms were the instruments of death in about 35.8% of those cases. There were 53 homicides investigated by the San Joaquin County Coroner s Office in 2013, a decrease of about 42.7% over 2012. Firearms were the major instruments of death in about 86.8% of all homicides. There were 5 deaths of undetermined classification investigated by the Coroner. In these investigations the cause or manner of death could not be determined. During 2013, the Coroner s Office processed 108 indigent cases in which the decedents had insufficient funds for interment, a 96% increase over 2012. 2

OFFICE OF =========SHERIFF-CORONER = COUNTY OF SAN JOAQUIN 7000 Michael N. Canlis Blvd. French Camp, California 95231-9781 Steve Moore Sheriff-Coroner Public Administrator April 1, 2014 TO: SUBJECT: Hospital Administrators, Physicians, Emergency Medical Services and Funeral Directors. Deaths Which Should Be Reported to the Coroner By law, the Coroner is directed to administer and direct investigation of death which occurs under questionable circumstances. The California Health and Safety Code (Section 102850) and the Government Code (Section 27491) set forth the legal requirements for reporting deaths to the Coroner. Section 102850 of the Health and Safety Code states a physician, funeral director, or any other person shall immediately notify the Coroner when he or she has knowledge of a death which occurred, or has charge of a body in which death occurred: a. without medical attendance, b. during the continued absence of the attending physician, c. where the attending physician is unable to state the cause of death, d. where suicide is suspected, e. following an injury or an accident, or f. under such circumstances as to afford a reasonable ground to suspect that the death was caused by the criminal act of another. Section 27491 of the Government Code, as amended by the 1961 session of the State legislature, directs the Coroner to inquire into and determine the circumstances, manner, and cause of the following deaths which are immediately reportable: 1. All violent, sudden or unusual deaths. 2. No physician in attendance. 3. Wherein the deceased had not been attended by a physician in the twenty days before death. 4. Related to or following known or suspected self-induced or criminal abortion. 5. Known or suspected homicide. 3 CD-32

OFFICE OF SHERIFF-CORONER = COUNTY OF SAN JOAQUIN 7000 Michael N. Canlis Blvd. French Camp, California 95231-9781 Steve Moore Sheriff-Coroner Public Administrator 6. Known or suspected suicide. 7. Accidental poisoning (food, chemical, drug, therapeutic agents). 8. Known or suspected as resulting in whole or in part from or related to accident or injury either old or recent. 9. Deaths due to drowning, fire, hanging, gunshot, stabbing, cutting, exposure, starvation, acute alcoholism, drug addiction, strangulation, or aspiration. 10. Deaths associated with a known or alleged rape or crime against nature. 11. Deaths in prison or while under sentence. 12. Deaths known or suspected as due to contagious diseases and constituting a public hazard. 13. Deaths from occupational disease or occupational hazards. 14. All deaths of unidentified persons. 15. Where the suspected cause of death is Sudden Infant Death Syndrome. 16. Deaths of patients in State mental hospitals serving the mentally disabled and operated by the State Department of Mental Health. 17. Deaths of patients in State hospitals serving the developmentally disabled and operated by the State Department of Developmental Services. 18. Deaths under such circumstances as to afford a reasonable ground to suspect that the death was caused by the criminal act of another. We hope that this information will be helpful to you. If any additional information is desired, please contact the Coroner's Office at 468-4300. 4 CD-32

INVESTIGATIONS CORONER CASES AND AUTOPSIES 5

SUMMARY OF REPORTABLE DEATHS 2013 AUTOPSY INSPECTION INVESTIGATION REFERRAL TOTAL JANUARY 42 3 3 217 265 FEBRUARY 40 6 6 185 237 MARCH 44 7 2 161 214 APRIL 34 14 4 156 208 MAY 33 9 4 162 208 JUNE 43 7 4 145 199 JULY 49 14 4 154 221 AUGUST 39 17 4 171 231 SEPTEMBER 44 11 1 147 203 OCTOBER 46 5 3 174 228 NOVEMBER 35 11 4 144 194 DECEMBER 61 15 7 143 226 TOTAL AUTOPSY: INSPECTION: 510 119 46 1959 2634 A FULL EXAMINATION, BOTH EXTERNAL AND INTERNAL, TO DETERMINE THE PATHOLOGICAL CAUSE OF DEATH. THE DEATH CERTIFICATE IS SIGNED BY THE CORONER 510 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. 119 INVESTIGATION: 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. 46 REFERRAL: TOTAL: 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. 1959 INDICATES TOTAL NUMBER OF AUTOPIES, INSPECTIONS, INVESTIGATIONS, AND REFERRALS. 2634 6

CORONER INVESTIGATIONS 3500 3000 2500 2000 1500 1000 500 0 2009 2010 2011 2012 2013 2009 2010 2011 2012 2013 AUTOPSY 485 563 605 512 510 INSPECTION & 150 115 102 185 165 INVESTIGATION REFERRAL 1816 1943 2137 2245 1959 TOTAL 2451 2621 2844 2942 2634 7

DISPOSITION OF REPORTABLE DEATHS Autopsy 19.4% Inspection 4.5% Investigation 1.7% Referral 74.4% Total Reportable Deaths: 2634 8

CORONER INVESTIGATIONS AGE AND SEX OF DECEDENTS 120 100 80 60 40 Male Female 20 0 0-1 2-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89 90+ unk CORONER INVESTIGATIONS SEX OF DECEDENTS 2013 AGE GROUPS MALE FEMALE TOTAL 0-1 10 5 15 2-9 6 4 10 10-19 17 6 23 20-29 54 7 61 30-39 56 21 77 40-49 71 29 100 50-59 111 47 158 60-69 87 37 124 70-79 30 20 50 80-89 24 14 38 90+ 8 10 18 Unknown 1 1 (DOE) adults TOTAL 475 200 675 9

MANNER OF DEATH 10

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 271 natural aging process. Accident Suicide Homicide Undetermined Deaths due to an act, injury or poisoning where the outcome was unintentional. 279 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. 67 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. 53 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. 5 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 675 certified by the Coroner s Office. 11

COMPARISON OF DEATHS BY TYPE 2009-2013 2009 2010 2011 2012 2013 NATURAL 260 246 226 257 271 ACCIDENT (MISC) 192 218 228 195 183 ACCIDENT (MOTOR VEH) 61 77 83 64 96 SUICIDE 56 63 72 79 67 HOMICIDE 63 68 93 94 53 UNDETERMINED 3 6 5 8 5 REFERRAL 1816 1943 2137 2245 1959 TOTAL 2451 2621 2844 2942 2634 % CHANGE FROM PREVIOUS YEAR TOTAL DEATHS IN SAN JOAQUIN COUNTY -4.03% +9.35% +8.5% +3.4% -10.4% 4342 4493 4627 4791 4635 % INVESTIGATED BY CORONER 56% 58% 61% 61% 57% 12

COMPARISON OF DEATH INVESTIGATIONS BY TYPE OF DEATH 2013 Accident (Misc) 27.11% Undetermined 0.74% Homicide 7.85% Natural 40.15% Accident (Motor Veh) 14.22% Suicide 9.93% Total: 675 Deaths (Actual Coroner Cases) 13

NATURAL DEATHS BY THE MONTH 40 35 30 25 20 15 10 5 0 JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC 2013 JAN 26 FEB 25 MAR 20 APR 20 MAY 13 JUN 20 JUL 33 AUG 16 SEP 23 OCT 19 NOV 20 DEC 36 TOTAL 271 14

COMPARISON OF NATURAL DEATHS BY CAUSE Central Nervous System 4.1% Respiratory 8.1% Hepatic 8.9% Other 12.2% Digestive System 2.6% Malignancy 0.4% S.U.I.D 1.1% Cardiac 62.7% NATURAL DEATHS BY CAUSE 2013 CARDIAC 170 DIGESTIVE SYSTEM 7 RESPIRATORY 22 CENTRAL NERVOUS SYSTEM 11 SUDDEN UNEXPLAINED INFANT 3 DEATH MALIGNANCY 1 HEPATIC 24 Other: Endocrine, Hematologic, Immune, 33 Renal and Misc. TOTAL 271 15

MISCELLANEOUS ACCIDENTAL DEATHS BY CAUSE ASPHYXIA. 22 DROWNING 8 CHOKED ON FOOD/OBJECT 4 POSITIONAL ASPHYXIA 1 ASPHYXIA 9 DRUG(S)/TOXIC SUBSTANCES... 119 O.D. ILLICIT DRUGS/DRUG ABUSE 83 OVERDOSE OF ALCOHOL 2 OVERDOSE PRESCRIPTION DRUG(S)/MED(S) 20 CHRONIC IV DRUG ABUSE 3 COMBINED ALCOHOL AND DRUGS 11 BURNS/SMOKE INHALATION... 2 RESIDENTAL FIRE 2 BURNS 0 FALL... 31 DOWNSTAIRS 3 TO PAVEMENT 1 TO GROUND 20 TO FLOOR 1 FROM HEIGHT 3 AGAINST OBJECT 3 OTHER MISC ACCIDENT... 9 INDUSTRIAL ACCIDENTS 0 HYPOTHERMIA (COLD RELATED) 0 THERAPEUTIC COMPLICATION 3 ELECTROCUTION 0 OTHER 6 TOTAL.. 183 16

COMPARISON OF MISCELLANEOUS ACCIDENTAL DEATHS BY CAUSE Asphyxia 12.02% Other 4.92% Burns 1.09% Falls 16.94% Drugs 65.03% MISCELLANEOUS ACCIDENTAL DEATHS BY CAUSE 17 2013 ASPHYXIA 22 DRUGS 119 FALLS 31 BURNS 2 OTHER 9 TOTAL 183

MISCELLANEOUS ACCIDENTAL DEATHS 250 200 150 100 50 0 2009 2010 2011 2012 2013 MISCELLANEOUS ACCIDENTAL DEATHS BY MONTH AND YEAR 2009-2013 2009 2010 2011 2012 2013 JAN 16 13 23 18 16 FEB 24 12 10 14 17 MAR 17 18 18 23 13 APR 17 17 24 21 11 MAY 16 23 19 13 14 JUN 14 21 13 16 19 JUL 17 21 19 14 16 AUG 11 19 16 19 17 SEP 23 20 16 9 15 OCT 13 16 21 21 14 NOV 12 20 26 12 13 DEC 12 18 23 15 18 TOTAL 192 218 228 195 183 18

COMPARISON OF UNDETERMINED DEATHS BY CAUSE Other/Unknown 100% Indian Remains 0% UNDETERMINED DEATHS BY CAUSE 2013 INDIAN REMAINS 0 OTHER/UNKNOWN CIRCUMSTANCES 5 TOTAL 5 19

COMPARISON OF MOTOR VEHICLE ACCIDENTAL DEATHS Truck 13.5% Pedestrian 21.9% Automobile 55.2% Misc. 3.1% ATV 0.0% Motorcycle 6.3% MOTOR VEHICLE ACCIDENTAL DEATHS 2013 AUTOMOBILE 53 TRUCK 13 PEDESTRIAN 21 MOTORCYCLE 6 MISC 3 TOTAL 96 20

MOTOR VEHICLE ACCIDENTAL DEATHS 2013 AUTOMOBILE... 53 AUTO OVERTURN 6 AUTO VS AUTO 8 AUTO VS FIXED OBJECT 14 AUTO VS TRUCK 13 AUTO VS UNKNOWN 0 AUTO INTO WATER 9 AUTO VS TRAIN 0 AUTO VS BICYCLE 2 FALL FROM MOVING VEHICLE 1 MOTORCYCLE.... 6 MOTORCYCLE VS AUTO 1 MOTORCYCLE VS TRUCK 3 MOTORCYCLE OVERTURN 1 MOTORCYCLE VS FARM VEHICLE 0 MOTORCYCLE VS MULTI VEHICLES 1 MOTORCYCLE VS TRAIN 0 MOTORCYCLE VS FIXED OBJECT 0 PEDESTRIAN.. 21 PEDESTRIAN VS FARM EQUIPMENT 1 PEDESTRIAN VS AUTO 15 PEDESTRIAN VS TRUCK 1 PEDESTRIAN VS TRAIN 4 TRUCK.... 13 TRUCK OVERTURN 2 TRUCK VS AUTO 9 TRUCK VS FIXED OBJECT 2 TRUCK VS TRUCK 0 TRUCK INTO WATER 0 TRUCK VS BICYCLE 0 MISC. 3 TOTAL. 96 21

MOTOR VEHICLE DEATHS 16 14 12 10 8 6 4 2 0 JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC 2013 MOTOR VEHICLE DEATHS MONTHLY COMPARISON JAN 5 FEB 4 MAR 6 APR 9 MAY 11 JUN 5 JUL 7 AUG 15 SEP 6 OCT 11 NOV 8 DEC 9 TOTAL 96 22

BLOOD ALCOHOL LEVELS IN MOTOR VEHICLE DEATHS California Government Code Section 27491.25 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 2013, ninety six (96) people died in San Joaquin County as a result of motor vehicle accidents, this represents a 50% increase from 2012. Blood samples were obtained and submitted for toxicological study in about 91% of these cases. California Vehicle Code, section 23152 (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 23152 (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 34.4% of the tested cases. The blood alcohol level was at or above 0.08% in about 27% of all motor vehicle deaths, a decrease of 12% from year 2012. Results showed that twenty six (26) of the eighty eight (88) 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 eighty eight (88) drivers of motor vehicles in 2013, twenty six (26) of the drivers, or about 30% 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 under the age of 18 years. 23

BLOOD ALCOHOL LEVELS IN MOTOR VEHICLE DEATHS 70 60 50 40 30 20 10 0 Neg..01-.03%.04-.07%.08-.12%.13-.19%.20% & Over OF THOSE TESTED BLOOD ALCOHOL IN MOTOR VEHICLE DEATHS 2013 Neg..01-.03%.04-.07%.08-.12%.13-.19%.20% & Over DRIVER 20 0 1 1 5 7 PASSENGER 19 2 3 0 1 0 PEDESTRIAN 8 1 0 2 1 8 MOTORCYCLIST 7 0 0 0 0 1 BICYCLIST 5 0 0 0 0 0 UNKNOWN 4 0 0 0 0 0 TOTAL 63 3 4 3 7 16 *when no toxicology was performed results listed in negative category 24

BLOOD ALCOHOL LEVELS IN MOTOR VEHICLE DEATHS Alcohol 34.4% No Alcohol 65.6% 2013 ALCOHOL 33 NO ALCOHOL 63 TOTAL 96 25

MOTOR VEHICLE DEATHS FIVE-YEAR COMPARISON 120 100 80 60 40 20 0 2009 2010 2011 2012 2013 MOTOR VEHICLE DEATHS FIVE-YEAR COMPARISON 2009 2010 2011 2012 2013 JAN 5 2 7 8 5 FEB 7 7 9 3 4 MAR 3 10 5 7 6 APR 3 3 6 3 9 MAY 3 2 5 9 11 JUN 6 8 5 10 5 JUL 10 7 7 3 7 AUG 5 7 3 5 15 SEP 12 12 9 5 6 OCT 1 9 5 2 11 NOV 3 8 9 1 8 DEC 3 2 13 8 9 TOTAL 61 77 83 64 96 26

COMPARISON OF HOMICIDES BY MODE OF DEATH Incised/Cut Wound(s) 1.89% Beating/Blow(s) to Body 5.66% Gunshot Wound(s) 86.79% Asphyxiation 5.66% Other 0.00% 2013 HOMICIDES MALE FEMALE TOTAL GUNSHOT WOUND(S) 41 5 46 BEATING/BLOW(S) TO BODY 1 2 3 INCISED/CUT WOUND(S) 1 0 1 ASPHYXIATION 1 2 3 OTHER (Fire and MVA) 0 0 0 TOTAL 44 9 53 27

HOMICIDES BY JURISDICTION Other 0.0% Tracy Police 0.0% San Joaquin Sheriff 26.4% Lathrop 1.9% Lodi Police 1.9% Manteca Police 0.0% Stockton Police 69.8% HOMICIDES BY JURISDICTION 2013 STOCKTON POLICE 37 SAN JOAQUIN SHERIFF 14 MANTECA POLICE 0 LODI POLICE 1 TRACY POLICE 0 LATHROP POLICE 1 OTHER-Out of County 0 TOTAL 53 28

HOMICIDES BY THE MONTH 8 7 6 5 4 3 2 1 0 JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC 2013 JAN 2 FEB 4 MAR 6 APR 4 MAY 3 JUN 5 JUL 3 AUG 5 SEP 7 OCT 4 NOV 4 DEC 6 TOTAL 53 29

SAN JOAQUIN COUNTY HOMICIDES FIVE-YEAR COMPARISON 100 90 80 70 60 50 40 30 20 10 0 2009 2010 2011 2012 2013 2009 2010 2011 2012 2013 HOMICIDE 63 68 93 94 53 30

COMPARISON OF SUICIDES BY MODE OF DEATH Overdose 16.42% Hanging 32.84% Asphyxia/Suffocation 2.99% Incised/Cut Wound(s) 4.48% Drowning 1.49% Vehicle/Train 4.48% Poison 0.00% Burn 0.00% Jump 1.49% Gunshot Wound(s) 35.82% 2013 SUICIDES MALE FEMALE TOTAL GUNSHOT WOUND(S) 19 5 24 HANGING 19 3 22 INCISED/CUT WOUND(S) 2 1 3 VEHICLE / TRAIN 2 1 3 OVERDOSE 4 7 11 DROWNING 1 0 1 POISON 0 0 0 ASPHYXIA/SUFFOCATION 2 0 2 BURN 0 0 0 JUMP 1 0 1 TOTAL 50 17 67 31

SUICIDES BY THE MONTH 12 10 8 6 4 2 0 JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC 2013 JAN 1 FEB 1 MAR 8 APR 8 MAY 5 JUN 5 JUL 9 AUG 6 SEP 4 OCT 5 NOV 5 DEC 10 TOTAL 67 32

SAN JOAQUIN COUNTY SUICIDES FIVE-YEAR COMPARISON 90 80 70 60 50 40 30 20 10 0 2009 2010 2011 2012 2013 SAN JOAQUIN COUNTY SUICIDES FIVE-YEAR COMPARISON 2009 2010 2011 2012 2013 SUICIDE 56 63 72 79 67 33

SPECIAL SUMMARIES 34

TEEN SUICIDES In 2013 there was 1 teenage suicide investigated by the Coroner s Office. The month of occurrence, sex, age, and method of each case was as follows: Month Gender Age Method October Female 15 years old Hanging 35

DRUGS AND ALCOHOL SUMMARY In 2013 there were 130 deaths investigated by the Coroner s Office which were caused by an overdose of illicit drugs, alcohol or pharmaceuticals, (pg. 16). These deaths are now tracked in more detail and by specific drug type. The classification of these deaths was primarily accidental. Although 130 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 decedents that had the substances appear in their toxicology reports. Many decedents may have a combination of several substances. METHAMPHETAMINE/AMPHETAMINE 46 PHARMACEUTICALS 67 HEROIN 27 COCAINE 10 METHADONE 22 PCP (Phencyclidine) 0 MDMA/MDA 0 (MDMA-Methylenedioxymethamphetamine MDA-Methylenedioxyamphetamine) ALCOHOL 31 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. 36

TOTAL DEATHS FROM GUNSHOT WOUNDS (FIREARMS) In 2013 there were 71 deaths investigated by the Coroner s Office, which were due to gunshot wounds (firearms). This represents a decrease of about 34% from 2012. These deaths were classified as follows: HOMICIDE 46 (65%) SUICIDE 24 (34%) ACCIDENT 1 (1%) UNDETERMINED 0 (0%) 37

INDIGENT BURIALS 38

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 2013 the Coroner s Office accepted 108 indigent cases, however not all indigent cases were completely processed within the calendar year. The cost of the cremation services in 2013 was approximately $33,470. This was an increase of 53 cases from the calendar year 2012, an increase of $14,777. In the 2013 calendar year the indigent cremation contract was renewed, however the cost per indigent cremation increased to $342.50. Additionally the cost of transportation and storage adds approximately $452 per case. This creates a total cost to the county per indigent burial of approximately $794.50. This is a total cost to the county for indigent burials of $85,806 in the 2013 calendar year. 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. 39

SAN JOAQUIN COUNTY INDIGENT BURIALS FIVE-YEAR COMPARISON 150 100 50 0 2009 2010 2011 2012 2013 SAN JOAQUIN COUNTY INDIGENT BURIALS FIVE-YEAR COMPARISON 2009 2010 2011 2012 2013 INDIGENT BURIALS TOTAL 68 60 56 55 108 40