2003 Medical Examiner’s annual report on deaths in King County

KING COUNTY, WASHINGTON - Today, Public Health - Seattle & King County's Medical Examiner's Office released its annual report documenting investigated deaths and death trends for calendar year 2003. Of the 1,815 deaths investigated by the Medical Examiner, there were 93 homicides, 179 fatal traffic crashes, 482 other kinds of fatal accidents (injuries), 217 suicides and 220 drug/poison deaths.

“The Medical Examiner investigates all sudden, unexpected, suspicious and violent deaths that occur in King County,” said Dr. Alonzo Plough, Director of Public Health - Seattle & King County. “By better understanding the circumstances and risk factors that lead to deaths, we are better able to prevent early and unintentional deaths.”

“The King County Medical Examiner’s Office provides an important service to our residents and gives us insight into ways to prevent many deaths and improve the health of our community,” said King County Executive Ron Sims.

“Our staff offers countless hours of time to grieving family members who want to understand exactly how and why their loved one died, which is important for closure,” said Dr. Richard Harruff, Chief Medical Examiner. “These investigations also assist families in finding closure by expediting settlement of insurance claims and estates and by assuring that appropriate criminal and civil actions are taken.”

The full report is available online at: www.metrokc.gov/health/examiner. All deaths investigated by the Medical Examiner occurred in King County, including deaths where the incident leading to the death occurred outside of King County. In such cases, the injured person most often was transported to a hospital in King County, where the death occurred. The Medical Examiner does not investigate deaths of King County residents who die in another county.

Key findings

Of all King County deaths (13,090) in 2003, 7,609 or 58% were reported to the Medical Examiner. Based on review of the circumstances surrounding the death, the Medical Examiner investigated 1,815 of these reported deaths.

The Medical Examiner investigated:

217 suicides. One hundred and one (47%) of the suicides were by the use of firearms. Thirty-six (17%) were due to hanging, and 34 (16%) were due to drugs/poisons. There were 14 suicides of youths 19 years of age and younger.

In order to reduce the incidence of youth and adult suicides, Public Health recommends educating parents, peers, children of elderly parents, and professionals that care and provide services for children and the elderly about the warning signs of suicide and available resources. Public Health is a partner in the LOKITUP Campaign, and the campaign partners recommend storing all firearms locked and unloaded to help reduce suicide risk, particularly among youth.

220 drug-caused deaths in 2003 (159 accidents, 29 suicides, and 32 undetermined manner), similar to 2002 when there were 216 drug-caused deaths. There were 85 opiate and 59 cocaine involvement deaths, most often in combination with other drugs and alcohol. The 85 opiate deaths in 2003 were a decrease from 2002 (101) but an increase from 2001 (64). The 59 cocaine deaths in 2003 were a decrease from 2002 (82) but an increase from 2001 (46).

Public Health’s Needle Exchange Program provides education and training to heroin users and their families to recognize overdose signs and risk co-factors and to increase skills for employing life saving response strategies. Overdose victims are much more likely to survive an overdose event when by-standers or observers call 911 for emergency medical assistance.

93 homicides. Seventy-seven of the homicides were the result of incidents that occurred within King County. Fifty-two (56%) of the homicides were due to the use of firearms, and 16 (17%) were the result of stabbing.

179 fatal traffic crashes, either motor vehicles, motorcycles, pedestrians, or bicycle riders. One-hundred-twelve deaths were due to traffic crashes in King County. Of motor vehicle occupants killed, 76 were drivers, and 37 were passengers. Of the 76 vehicle driver deaths, 45 were either not wearing seat belts or it is not known if they were wearing seat belts. There were 39 pedestrians, 24 motorcycle riders and 2 bicyclists killed in 2003.

The King County Traffic Safety Coalition, a multi-agency group spearheaded by Public Health’s Violence & Injury Prevention Unit, works to alleviate the leading causes of traffic fatalities. These causes include speed, impaired driving and failure to wear seat belts. Coalition efforts include organizing interagency DUI (driving under the influence) emphasis patrols, increasing public awareness of traffic safety issues, and reducing the number of DUI-related crashes on Highway 99 and other roads.

482 other kinds of fatal accidents or unintentional injuries. Ninety-nine of these cases were the result of incidents that occurred outside of King County. The most common cause of accidental death was falls (205); 166 of these deaths caused by falls occurred in the age group 70 years and over. The next most common cause of accidental death was drugs and poisons (159). Drowning (27) and burns (19) were also common causes of unintentional injuries.

Public Health's Emergency Medical Services Division and local fire departments are working to reduce seniors falling in the home, which can result in fractures that subsequently lead to fatal health complications while convalescing. It is especially important that those who work with seniors and seniors themselves recognize that fall-related risks increase with age.

Also, Public Health’s Violence & Injury Prevention Unit chairs the Seattle-King County Drowning Prevention Coalition. The Coalition uses a multi-faceted approach to prevent drowning deaths. They promote these primary messages: know the water, know your limits, and wear a lifejacket when wading, swimming or boating in or around open water. The coalition also recommends diligent supervision of children around all water, swimming at lifeguarded pools and beaches, and appropriate fencing of all swimming pools.

775 deaths due to natural causes that came under the Medical Examiner's review. Four-hundred-fifty cases were due to cardiovascular disease. There were 14 cases of Sudden Infant Death Syndrome (SIDS).

Work by Public Health - Seattle & King County and other researchers have shown that putting infants to sleep on their backs, not their stomachs, decreases the risk of SIDS. Since the "Back to Sleep" recommendations were first published in 1992, the SIDS rate in King County has dropped significantly.

69 deaths classified as undetermined manner. Deaths were classified as undetermined manner if it could not be established whether the death was intentional or accidental. Thirty-two of these were caused by drug overdoses.

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