Answers to Frequently Asked Questions

General FAQs

Where is the Harris County Institute of Forensic Sciences (HCIFS) located?
Our address is: 1861 Old Spanish Trail, Houston Texas, 77054. We are located in the Texas Medical Center situated between Fannin and Almeda streets. The Institute's main telephone number is: (832) 927-5000.
What are your office hours?
The hours of operation for the Harris County Institute of Forensic Sciences are: 8:00 a.m. - 5:00 p.m. Monday - Friday. The office is closed on all Harris County holidays.
What should I do now?
First you need to select a funeral home and notify the Funeral Director that the death is being handled by the HCIFS. The legal next-of-kin must also sign a Release Form, at the funeral home, authorizing the HCIFS to release the body to the funeral home that they have selected.
Who can I speak to about the death?
You may contact us at: (832) 927-5000, with any questions that you may have.
Is it necessary for me to identify the body at the HCIFS Office?
In most cases visual identification of the body is not necessary. We only require a family member to come to our facility when the remains are those of an unidentified person (“John or Jane Doe”), or when the identification has not been previously confirmed.
How can I find out the cause of death?
Call (832) 927-5000 during business hours, 8:00 a.m. to 5:00 p.m., Monday through Friday.
How can I receive death benefits if my loved one's cause and manner of death is pending?

Issuing a death certificate (pending or otherwise) is the responsibility of the person in charge of interment, usually the family's chosen funeral home.  The law requires that the death certificate be filed "not later than the 10th day after the date of death" (Texas Health and Safety Code Sections 193.002-193.003).

"Pending" is a temporary classification of the cause and manner of death that is assigned by the medical examiner when further information or testing is required to classify the cause and manner of death. Once the cause and manner of death are determined, the medical examiner's office will file an amendment to the pending death certificate with the state registrar. The family can then order a certified copy of the amended death certificate through their selected funeral home or directly from the Texas Department of State Health Services Vital Statistics Unit.

However, in the meantime, as the investigation is progressing, a "pending" death certificate will be available.  The "pending" death certificate is still legal proof of death. Some insurance companies and financial institutions may accept a pending death certificate for the purposes of paying benefits or handling other accounts, but this varies based on each family's specific institution, account/s or circumstance/s.

How can I retrieve my loved one's personal property?
To inquire about personal property call our office during our normal business hours of 8:00 a.m. to 5:00 p.m., Monday through Friday, at (832) 927-5000. Personal property is released to the funeral home of the family’s choice after the funeral home provides us with a signed release form from the next-of-kin.
Is an autopsy required?
In most cases an autopsy is necessary. By Texas Law, (CCP Art. 49.25) the Medical Examiner is mandated to determine the cause and manner of death in all cases of accident, homicide, suicide, and undetermined death. In cases of natural death, when the person is NOT under a doctor’s care, or the person passes away in less than 24 hours after admission to a hospital, the Medical Examiner must be notified, as an autopsy may be required.
Why was an autopsy NOT done?
In about 25% of the cases we receive, there is a high degree of medical certainty as to the cause of death. For example, the person may have a known infection, cancer or heart disease. If the circumstance of this person’s death does not indicate foul play, the pathologist may choose to do only an external examination to assure no violence has taken place.
Will I have to pay for an autopsy?
There is no charge to the public for an autopsy.
Is there anything that can be done to get the body released sooner?
When a death is reported to the Harris County Institute of Forensic Sciences, it is assigned a case number. The cases are processed in the order in which they arrive. In the majority of cases, bodies are examined and released within 24 hours or less. However, when the HCIFS office has a heavy caseload, it may take as long as 72 hours for a body to be released. Delays tend to happen most frequently on weekends and holidays.
Why is it taking so long?

In many cases the cause of death is evident at the time of autopsy. In these cases the death certificate is generated immediately. In other cases the cause of death may not be apparent from anatomic (grossly visible) findings. In these instances the pathologist must await additional studies. For example, in some cases the pathologist may realize that the person has an infection (pneumonia for example) but he may wait for the results of cultures to find which microorganism(s) is involved. In other instances drug toxicity may be suspected and so the pathologist must await results from the toxicology laboratory. In some instances, the cause of death may be readily apparent at the time of autopsy, but the manner of death is not known. An example of the latter is a person dying in a house fire from smoke inhalation and burns. We can see soot in the airway, and we can see burns. However, we cannot tell from autopsy what started the fire. That answer must come from the arson investigation (which is outside the purview of the medical examiner). As manner of death (homicide, suicide or accident) will then hinge on that determination, we must await conclusion of the investigation. Other examples of the latter are head injuries where nobody saw the traumatic incident, and some close range gunshot wounds (where gunshot residue analysis, range determination, firearms examination, and police investigation may all be necessary to arrive at a determination between suicide, homicide or accident).

The need for toxicology studies is one of the most frequent reasons for delay in death certificate completion. Toxicology in the medical examiner setting is different than drug testing that is done in the hospitals. Hospitals will simply do screening tests for types and categories of drugs ("opiates" for example). Because clinicians have the advantage of a living patient with symptoms to evaluate, they do not need to know quantities (if a sedative toxicity is suspected from clinical symptoms and opiates are detected on a drug screen, then the person is treated for opiate toxicity). The medical examiner however will need to know which specific drug(s) within the drug class or category (for example, whether "opiates" is morphine, heroin, hydrocodone, etc) are involved. Also, the medical examiner will need to know the quantity of those drugs in multiple biological samples (blood, liver, gastric contents, etc) in order to put the death into perspective. In other words, postmortem levels must be interpreted in light of tissue distribution/redistribution of drugs, gastric quantity and so forth in order to know 1) is this a toxic level? and 2) is this an accident or suicide? Furthermore, in order for accredited forensic toxicology laboratory results to be considered legally valid the results must be confirmed by two types of tests. Toxicology tests will take longer if multiple drugs are involved, if unusual drugs are involved, or if the person is decomposed.

Finally, one must consider the possibility that the pathologist's initial suspicions are not confirmed. For example, if the pathologist suspects drug toxicity but the initial toxicology report reveals only low levels of drugs or no drugs at all. In these cases, the pathologist may submit additional tissues to reevaluate specific parts of the heart muscle or brain, while at the same time consulting with the toxicologist to pursue testing for more unusual or exotic drugs that weren't originally analyzed, while at the same time asking the police to return to the scene of death to ascertain more information, or perhaps to interview additional witnesses. Each death is different, and the findings in each case are different. Additional follow-up is determined as results are obtained. Obviously in such multi-step investigations the process may be lengthy, and the requisite time necessary may not be entirely under the control of the pathologist.

How can I get a copy of the Certificate of Death?
The Certificate of Death is compiled in two sections; the medical portion is completed by the HCIFS, the final portion is completed by the funeral home. Once the Certificate of Death is completed, it is the responsibility of the funeral home to file the document with the state of Texas. For additional information regarding Certificates of Death please visit their web page at
What is the history of the Medical Examiner or Coroner?
The office of the Coroner or “Crowner” dates back to medieval days when the crowner was responsible for looking into deaths to be sure that duties (taxes) were paid to the King. Today, the coroner’s main duty is to inquire into the cause and manner of a death, and to complete the death certificate.
What is the difference between a Medical Examiner and a Coroner?

In general, a medical examiner is a physician, trained in death investigation, typically sub-specialized in Forensic Pathology. When one refers to a "medical examiner system" one is usually referring to a system in which the physicians (Forensic Pathologists) are the death investigation authorities for a specified geographic jurisdiction. Within that jurisdiction, the medical examiners review deaths, decide which cases meet their criteria for further investigation, and perform autopsies when indicated.

In Harris County, the Commissioners Court appoint the Chief Medical Examiner. The Chief Medical Examiner must be a physician, licensed to practice medicine in the State of Texas and be certified by the American Board of Pathology in Anatomic and Forensic Pathology. The Chief Medical Examiner serves continuously and can only be removed for cause.

In contrast, a Coroner typically refers to an elected official, who serves as the authority for death investigation, but may not have any medical training. Thus, a coroner typically has to have a contract with some forensic pathologist, or medical examiner office in some nearby jurisdiction to perform autopsies when an autopsy is required. In Texas, some counties rely on Justices of the Peace to fulfill the role of coroner.

Over the years, the terminology has become blurred, in part because of ignorance, and in part because of system evolution issues. So, for example, in Los Angeles, CA the Coroner's Office is, in fact, a medical examiner's office, for all practical purposes.

Each state has different laws and each jurisdiction operates differently, but these are the basic differences between a medical examiner and a coroner.

What is a medical examiner?

What is a medical examiner?
A medical examiner is a physician, hence, the title medical examiner. The medical examiner is authorized by state statute with the investigation and examination of persons dying suddenly, unexpectedly, or from physical or chemical injury. The responsibility of the medical examiner is to determine cause and manner of death, and to document and preserve evidence as it relates to the decedent.
What is a pathologist?
A pathologist is a physician trained in the medical specialty of pathology. Pathology is the branch of medicine that deals with the diagnosis of disease and causes of death by means of laboratory examination of body fluids (clinical pathology) cell samples, (cytology) and tissues (pathologic anatomy).
What is a forensic pathologist?
The forensic pathologist is a subspecialist in pathology whose area of special competence is the examination of persons who die sudden, unexpected or violent death. The forensic pathologist is an expert in determining cause and manner of death. The forensic pathologist is specially trained: to perform autopsies to determine the presence or absence of disease; to interpret injuries and injury patterns; to interpret effects of poisoning; to evaluate historical and law-enforcement investigative information relating to manner of death; to collect medical evidence, such as trace evidence and secretions, and to document evidence of sexual assault. The forensic pathologist must have a working knowledge of other non-medical disciplines, including: toxicology, firearms (wound ballistics), trace evidence, forensic serology and DNA technology. The forensic pathologist acts as the case coordinator for the medical and forensic scientific assessment of a given death, making sure that the appropriate procedures and evidence collection techniques are applied to the body. At death scenes, forensic pathologists bring their expertise to bear upon the interpretation of scene findings, in the assessment of the consistency of witness statements with injuries, and in the interpretation of injury patterns or patterned injuries.
How does the forensic pathologist use the history?

Death investigation always begins at the scene. The scene investigation may give clues as to drugs or toxins which may be related to the cause of death. Some poisonous agents are not detected on routine drug screens therefore the pathologist must have knowledge of medications and toxins in order to request the specific analytical tests needed to detect them. An example would include the "sniffing" or "huffing" of aerosol propellants, a risky activity which has been frequently reported in teenagers. Sniffing of propellant substances can cause sudden death by precipitating lethal cardiac arrhythmias. A special analysis (gas chromatography by head space analysis) is required to detect the chemicals in the blood. In other cases there may be sufficient natural disease to account for death but the individual may in fact have died of a drug overdose or other subtle cause. In the case of drowning and suffocation the autopsy findings are not specific and police investigation is critical to the understanding of the death.

In the examination of skeletal or severely decomposed remains, the forensic pathologist will frequently consult another doctor with special expertise in analysis of bones, a physical anthropologist. If sufficient skeletal parts remain, the pathologist or anthropologist may be able to determine the age, race and sex of the individual and sometimes estimate the length of time since death. Occasionally, specific markings on the bones may enable the pathologist to come to a conclusion as to the cause of death.

What is an autopsy?

An autopsy is an examination of a dead body. In the course of an autopsy the body is examined multiple times; first as it is received, then again after it is unclothed, and yet again after being cleaned (any loose dirt, blood or other foreign substances are removed). At each step, identifying features, injuries or other unusual features are documented with multiple modalities (i.e. photographs, verbal and/or diagram). The body is then opened, and each organ is examined, in turn, for the presence of injuries or pre-existing natural disease.

In the course of an autopsy, samples of various organs, tissues and body fluids are retained for additional ancillary studies, if warranted. The ancillary studies include microscopic examination (Histology), drug testing (Toxicology), and microbiology (bacterial and viral culture). Additionally, depending on the type of case, other items of evidence may also be retained: foreign objects (bullets, knife blades or tips, ligatures, etc.), scalp hair (for comparison to hair on a suspect weapon or vehicle), fingernail scrapings (for analysis of blood and/or foreign DNA), sexual assault swabs, gunshot residue test swabs, and so on. The HCIFS is also very active in the collection of trace evidence from dead bodies (collected under visible and alternate light sources).

What types of deaths are investigated by the Institute of Forensic Sciences?
The types of deaths that we investigate are specified in the Texas Code of Criminal Procedure Section 49.25. These cases include: all deaths that are not natural, that is, all deaths resulting from physical or chemical injury. Such deaths fall into the categories of AccidentHomicide and Suicide. An interval of survival between an injury and consequent death does not preclude a death from being a medical examiner case. For example, if a person is involved in a car crash and consequently becomes quadriplegic, then dies from pneumonia ten years later as a result of the quadriplegia, the case is still a medical examiner case and will be classified as an Accident, resulting from the car crash. Sudden unexpected deaths are also medical examiner jurisdiction. This includes individuals of any age, without significant medical history to explain their demise, based on natural disease. A variety of cases fall into this category, including crib deaths, deaths of athletes, and middle-aged and older individuals dying in a variety of circumstances.
What is the importance of performing an autopsy in someone in whom the cause of death is "obvious"?
The importance of examining people in whom the cause of death appears obvious is several fold. In the case of shootings or other fatal assaults the forensic pathologist, during the course of the examination, may recover bullets or other important trace evidence. In the case of motor vehicle occupants, it is important to determine who was driving and to assess driver factors, vehicle factors or environmental factors that might have caused or contributed to the crash.
Does every death investigated by the HCIFS require an autopsy?

The medical examiner law in Texas (Texas Code of Criminal Procedures section 49.25) is very clear with respect to which deaths fall under the jurisdiction of the medical examiner i.e. in which cases the medical examiner has the duty and responsibility of determining cause and manner of death. However, the law does not specify what elements must be included in that death investigation. In many cases, a medical examiner will be satisfied that an autopsy is not necessary, after discussion with police at the scene, with family, and/or with the decedent's personal physician and that adequate medical information exists to explain the cause, mechanism and circumstances of the person's demise and that injury or foul play have been ruled out. In such cases, a medical examiner may elect to perform an "external examination" rather than a complete autopsy.

An external examination will include photography of the body as it is received; photography of the body unclothed and cleaned, documentation (photography, diagram and verbal description) of any identifying features, etc., collection of samples for potential toxicology analysis and potential DNA analysis. Most traumatic deaths are autopsied; however, in some instances where the decedent has been hospitalized for a substantial time prior to death and where injuries, cause and mechanism of death, and circumstances are clear (and there is no suspicion of homicide), the person may not be autopsied. The latter category primarily consists of victims of motor vehicle crashes who have been hospitalized for weeks or months. Certain types of cases, especially homicide and suicide, are typically autopsied regardless of the duration of post-injury survival. Importantly, the medical examiner retains final discretion in all cases within medical examiner jurisdiction, and each case is decided on a "case-by-case" basis. 

Are all autopsies complete?

If the medical examiner determines that an autopsy is necessary, a complete autopsy (including examination of all internal organs and brain), will be undertaken. Limited autopsies (e.g., "chest only," "head only," "chest and abdomen only") are common in hospital pathology, but are inadequate in medical examiner practice.

Of course, the specifics of a particular anatomical and/or toxicological examination will vary depending on the nature of the case. In other words, the specifics of an examination are tailored to the question(s) being answered.

I am in high school now… I have an interest in forensics... what advice do you have for me?
The route to becoming a forensic pathologist is long. In the 13 post-graduate years outlined below, one must remain open-minded to other fields, and carefully consider all options, all along the way. As for advice... the best advice is simply "keep your grades up."
Is being a forensic pathologist really like the television shows CSI or Crossing Jordan?

These popular TV series certainly glamorize all aspects of forensics. (Come to think of it, the TV series even glamorize the crimes the forensic personnel are setting out to solve). Our job is really much more mundane, smelly and adversarial than what's portrayed on TV. Further, technical inaccuracies abound in the TV shows, particularly with regard to the time frame in which tests are ran. The TV shows all also take liberties with character development, where single characters assume the roles of multiple police detectives, crime scene analysts, and pathologists. More disturbing is the mindset portrayed on Crossing Jordan, in which the pathologist sets out to "prove" somebody's innocence or guilt…our role is neutral (the latter philosophy is more accurately presented on the original CSI).

Having said that though, the interest generated from those shows have been terrific for the forensic community. We have seen a deluge of bright young folks interested in our field who probably would otherwise have no idea of what we do. The fact that you're reading this is an example of that. The TV shows are also worth watching from another standpoint as well: entertainment. After all, the story lines are generally pretty good, even if some of the details are bogus.

What is a typical day like for a forensic pathologist?

There is no typical day. Obviously we spend much of our time performing autopsies. But that's just the beginning. We frequently attend death scenes, testify in court, lecture to medical students and residents, give hands-on training to physicians-in-training, meet one-on-one with families, meet with lawyers on civil and criminal matters, give depositions, and the list goes on.

The variety extends to cases as well. Many of the cases that find their way to the newspapers are homicides…gunshots, stabbings, beatings, etc. But then there are natural deaths: sudden unexpected deaths in babies for example, where mourning parents are desperately awaiting answers (is there an underlying genetic or metabolic abnormality?) or simply closure; natural deaths in adults (is there an infectious or hereditary disease that the rest of the family should be worried about?); motor vehicle crash victims (is there an underlying reason for the crash: heart disease, brain abnormality, drug or alcohol impairment?), and again the list goes on.

How does one become a forensic pathologist?
  1. After high school the future forensic pathologist attends undergraduate college for 4 years and receives a bachelors degree.
  2. After undergraduate college the aspiring forensic pathologist spends 4 years in medical school, earning an M.D. or D.O. degree.
  3. After medical school there are several routes by which one may become a forensic pathologist. 
      • One may spend 4 years training in anatomic & clinical pathology followed by 1 year of fellowship in forensic pathology.
      • A second option is to train for 3 years in anatomic pathology and train for 1 year in forensic pathology. The fellowship training in forensic pathology involves practical (on-the-job) experience supervised by trained forensic pathologists. The forensic pathology fellow actually performs autopsies and participates in death investigation. To become certified, one then must pass an examination given by the American Board of Pathology certifying special competence in forensic pathology.


Do all COVID deaths come to Harris County Institute of Forensic Sciences?

No. The HCIFS has no jurisdiction over deaths due to documented, diagnosed natural disease (such as deaths due to infectious disease like COVID-19). Individuals who are in the hospital for more than 24 hours before death, and who succumb to the effects of COVID-19, are not reportable to the medical examiner. Therefore, HCIFS would have no way of tracking those deaths.

In cases where no diagnosis was made by a physician, and we may suspect the death was caused by COVID-19, we determine jurisdiction based on the details of the circumstances, the decedent's history and the medical examiner law (Texas Code of Criminal Procedure, 49.25). When warranted, we are following the guidance of the CDC, and our local health departments to collect samples and submit for testing. Testing is not done at the HCIFS. When we do identify a death caused by COVID-19, that information is provided to the respective health department, and the cause of death would be public, as in any other case.

We average 4,500 autopsies every year. Contrast that with 29,877 Harris County death certificates filed in 2019. To get data on all Harris County deaths, contact They have death data from all 254 Texas counties.

Is your testing procedure capturing all COVID cases?
We are testing cases where the history or circumstances suggest the death resulted from a respiratory pathogen.  In those specific cases we screen for flu at the same time that we submit samples for SARS-CoV2 testing. Testing for the latter is done either through the Houston Health Department, or through a private laboratory, depending on the case. Regardless, positive test results for SARS-CoV2 are communicated to the family of the decedent, and to the appropriate local health department (city of Houston or Harris County) for follow-up. Our testing process is robust therefore, undercounting would be rare.
Do you wear special PPE?
We’ve always worn full universal precautions when interacting with decedents or interacting with samples: full gloves in the morgue, and in the autopsy suite we wear full N95 gear, protective gowns, shoe coverings, face coverings, and shields. Since March 2020 our death investigators wear full universal precautions when they’re at a scene.
What is your capacity?
The HCIFS has a long history of preparation for continuity of medical examiner and crime laboratory operations under all variety of circumstances, including mass fatality incidents and response during a pandemic. We have strong relationships with our local and state partner agencies that will assure that we are able to respond appropriately to an increase in cases. We are monitoring the current COVID-19 situation and are comfortable that we can continue to provide uninterrupted services to the community while protecting the health and safety of our staff and adhering to guidance from our local officials.