Medical examiner loses county contract

After 10 years as the county medical examiner conducting autopsies, Dr. Rexene Worrell’s latest contract bid was denied by county commissioners Tuesday.

Worrell predicted Nye County will pay more for autopsies by entering into a memorandum of understanding County Manager Pam Webster suggested would be with Clark County. There were 44 or 45 autopsies in the past year in the county, she said.

The purchasing department recommended not to award the bid to Worrell. It cited a requirement in the scope of work the medical examiner have a minimum of three years of board certified forensic pathology experience, qualifications Worrell doesn’t have.

Worrell said there’s no requirement to be board certified in forensic pathology in Nevada. But she said the state board governing physicians does require her to attend continuing education to maintain her license.

“The drafter of this proposal has written requirements that are higher than what is required by the Nevada State Board of Medical Examiners. Was this a cut and paste error or was it intentionally written to disqualify me after 10 years of service? In fact, they also made reference where the bidder is required to submit reports in a format acceptable to the chief medical examiner, a position that does not even exist in Nye County. This clearly demonstrates someone without complete knowledge in forensic medicine drafted this bid,” Worrell said.

Nye County Purchasing Director Judy Dodge was shocked to hear of the requirements, Worrell said, charging someone has a personal agenda.

“In all my years of acting as an expert witness in forensic pathology, there has never been a time my qualifications have been challenged either by the prosecution nor the defense counsel. I have many years of experience with thousands of autopsies under my belt, hundreds of homicides,” Worrell said. “There has never, not once in 10 years working for this county, have I been questioned regarding my work.”

Worrell said Chief Prosecutor Kirk Vitto and other attorneys continuously remarked about her stellar work. She said she’s certified by the American College of Forensic Examiners as a level four forensic examiner.

“I ask you to reconsider the bid. I have been doing an exemplary job for your county. It is going to cost you a tremendous amount of money to start moving those cases to Clark County,” Worrell said.

She said Clark County would charge $2,500 per autopsy. Webster said that’s for a complete autopsy, there are other levels of evaluation like a visual inspection or toxicology.

A year ago Worrell’s contract was on the consent agenda for routine approval with a list of other items when it was pulled for discussion. Worrell’s fee was $1,850 per autopsy, or $300 transportation fee to take a body to Las Vegas. When county commissioners originally contracted with Worrell in 2003, it was over concerns the Clark County coroner’s fee per autopsy was going up from $3,300 to $3,800.

Worrell said she’s available to answer calls from Nye County deputies 24 hours a day with several hundred calls per year. She said if an autopsy is not needed, she often has to sign the death certificate.

Webster said they received an outreach from Clark County to offer the service. But Clark County wasn’t able to respond to the request for proposals because of indemnification issues, she said.

Nye County District Attorney Brian Kunzi said he was instrumental in pushing for the change, after a conversation with Clark County Coroner Michael Murphy during a trip to Carson City, who is already doing autopsies for Lincoln County.

Sheriff Tony DeMeo, who serves as the county’s official coroner, said he was never consulted about the plan.

“No one’s contacted me as a coroner to ask for my input to ask for anything, how we’re going to manage, how we’re going to send a deputy down to Clark County,” DeMeo said. “I think before someone makes a decision, somebody should ask for my input.”

The sheriff said a Nye County commissioner contacted a Clark County commissioner who contacted Murphy. But DeMeo said he was sure the sheriff’s department could work something out to make sure their job as investigators is done with the change.

Worrell performed autopsies in a building she rented. At one time she used a former candy store on Highway 372 which later burned down.

While commissioners debated terminating Worrell’s contract, Webster said they still didn’t have all the details how a memorandum of understanding with Clark County would work. There are different ways to transport the body without using the sheriff’s department and different degrees of autopsies, she said.

Kunzi said his staff drew up an agreement with Clark County that could be ready for a special conference call next Thursday.

In a letter detailing her qualifications, Worrell said she had a pathology residence with the Cook County Medical Examiner in Chicago. She was appointed a Clark County deputy medical examiner in September 2001 and handled over 120 homicides and 1,000 forensic cases in Clark County.

In 2003 Worrell submitted a bid to become the medical examiner for southern Nye County and began a private autopsy service in Las Vegas. In 2007 she submitted a bid to become a medical examiner in Mojave County, Arizona. Worrell said she handled 578 forensic cases in Nye County over 10 years.