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Medical Examiner Scores High

Chicago’s top forensic pathologist overcomes hurdles
By Scott Warner

When he took over as Chicago’s chief medical examiner in September 2012, Stephen Cina, MD, faced, shall we say, a grave situation. He was hired by Cook County Board President Toni Preckwinkle following a scandal in which photos emerged showing dozens of cadavers stacked in the facility’s overcrowded cooler. The department was heavily criticized for major backlogs, as well as being mired in the past, with employees still using paper ledger books. The County Medical Examiner’s office lost its national accreditation. President Preckwinkle hired Dr. Cina with this mandate: “Fix it.”

Fast forward to today. On March 1, Dr. Cina’s office celebrated full accreditation by the National Association of Medical Examiners after rigorous scrutiny. It is now the only medical examiner’s or coroner’s office in Illinois to have full accreditation, and is the third busiest medical examiner’s office in the nation.

To say that his job is challenging is quite an understatement. But Dr. Cina felt he was up to the challenge. Trained as a forensic pathologist, Dr. Cina is one of only approximately 500 forensic pathologists in the nation. He was working as chief administrative officer at the University of Miami Tissue Bank, when he learned about the medical examiner crisis in Chicago. “I contacted human resources, and told them that I could help.” He also said that he had grown to love Chicago through his visits here for conferences held by the College of American Pathologists.

President Preckwinkle was convinced. She hired Dr. Cina and helped support his office by guiding the County to invest in additional staffing and equipment; forensic pathologists and trainees went from six to a projected 18 by this July; a $1.4 million state-of-the-art cooler was installed, and the office now uses a cloud-based management system that tracks each case from the moment it is called in until the decedent is released to a funeral home. Dr. Cina also uses social media to track down families of victims and post facial pictures of unidentified deceased. “Most important, we want to assure those whose loved ones pass through our office that the deceased are treated with dignity and respect,” Dr. Cina says.

Dr. Cina also wants health care professionals to know that his office is freestanding, and not influenced by politics or the police. ”Foremost, we are physicians. It’s our job to learn as much as we can to help the living, like examining sudden unexpected death in young people; compiling data of how many people die from gunshots, where they died, what drugs they might have been using, data that can help police.”

He also wants to clarify a misconception, held by many, that the medical examiner’s office is the county morgue, a place to store bodies, or a repository for autopsies. He encourages physicians to embrace the role of signing death certificates for their older patients who die what appears to be a natural death. ”Not every death needs an autopsy nor will most natural deaths in older people get one,” he says. “Physicians can always call our office to discuss their cases. We want to be a resource for them.”

Career Highlights

A native of Brooklyn, New York, Dr. Cina received his BA from Johns Hopkins University in Baltimore and his MD from Vanderbilt University School of Medicine in Nashville. He completed a fellowship in forensic pathology in Maryland, and served as a major in the United States Air Force Medical Corps. He then served in various medical examiner positions in Texas, Colorado, and Florida before coming to Chicago. He is a diplomate of both the American Board of Pathology, and the American Board of Medicolegal Death Investigators, and currently serves as vice president of the National Association of Medical Examiners. Dr. Cina also serves as professor in the Department of Pathology at Rush Medical College, and is an adjunct professor of pathology at Northwestern University Feinberg School of Medicine.

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