http://publications.tnsosfiles.com/acts/110/pub/pc0493.pdf 

This is the link to the language of the final 2017 bill. In 2018, the bill was amended to clarify that the law exclusively applies to cases where the manner of death has been initially classified as a suicide.  For more information, please refer to the Office of the State Chief Medical Examiner.

https://publications.tnsosfiles.com/acts/111/pub/pc0343.pdf

This is the link to the final language of Public Chapter 343 [HB1005/SB620 (2019)] which further amends legislation related to manner of death classification in suicides.

Why Did We Need This Law?

Under Tennessee law, determination by a county medical examiner that a manner of death is suicide can only be changed by the medical examiner who performed the autopsy. Until June 13, 2017, there was no formal process in law by which a family could dispute the medical examiner’s determination that the manner of death of their loved one was by suicide. There was no process to present additional information to a county medical examiner that might change his/her opinion that their loved one’s death was suicide and get the manner of death box changed to “accidental” or “undetermined.” There was no obligation for a medical examiner to receive or consider other evidence, or even respond to the concerns of a grieving family.

Public Chapter 493, brought by two Williamson County Republican legislators, Rep. Glen Casada and Sen. Jack Johnson, changes all that. The new law creates a fair and expedient way for family members to have the manner of death of a loved one which was initially labeled as suicide reconsidered and perhaps changed.

The law, located in the State Code at TCA 68-3-502, requires the Tennessee Department of Health to maintain a notice of the next of kin’s rights on its website. The Department has merely posted a copy of the law. Here is a link to it: http://publications.tnsosfiles.com/acts/110/pub/pc0493.pdf. To help navigate the public through the process created by the new suicide reconsideration law, the family which initiated the bills to change the law are providing this step by step guide.

To seek reconsideration, follow these steps:

Step 1 – What to File to Start the Process.

The next of kin must submit an affidavit of written request for reconsideration to the county medical examiner who signed the death certificate, the chief medical examiner of the regional forensic center where the autopsy was performed, and the commissioner of health. The written reconsideration request must state the nature and reasons for the reconsideration. It must be submitted within one year from the date the death certificate was filed with the State Office of Vital Records. That date is located on the death certificate in block 25, right next to the signature of the medical examiner.

To find the county medical examiner’s address, use the Tennessee Department of Health’s Licensure Verification tool found at https://apps.health.tn.gov/Licensure/ .

To find the address of the chief medical examiner of the regional forensic center where the autopsy was performed, that information is posted on the Department of Health’s webpage at https://www.tn.gov/health/health-program-areas/oscme/regional-forensic-centers.html .

The address for the Tennessee Commissioner of the Department of Health is John J. Dreyzehner, MD, 710 James Robertson Parkway, Nashville, TN 37243.

Remember, the affidavit must include the reasons why you disagree that your loved one’s death was a suicide. You need to have the affidavit notarized.

It is recommended, but not required, that the affidavit be mailed via certified mail, return receipt requested. It is also strongly recommended that you include your telephone number and email address so the medical examiner can get in touch with you easier to set up a meeting.

Step 2 – Meeting with Medical Examiner to Reconsider Suicide Determination.

The county medical examiner who signed the death certificate has thirty (30) days to hold an in-person meeting with the next of kin seeking the reconsideration. At the next of kin’s request, the meeting may be held telephonically, for instance, if the next of kin lives a long way from the location of the medical examiner. The meeting is the opportunity for the next of kin to present all evidence to the medical examiner as to why the manner of death was not suicide. Come prepared and include any supporting documentation or medical articles or treatises. Your reasons may not be medical reasons. You may have emails or other evidence that the deceased had future plans. Such evidence would negate that the deceased intended to take his/her own life. You may have statements from friends indicating that the deceased did not want to die. If the deceased had a long history of addiction to drugs and/or alcohol, that is extremely useful information to negate an intent to kill oneself. Addicts need more and more medicine to sustain their addiction. They may take a lot of pills not knowing their strength or interactions with other medications. They may obtain pills off the street with unknown ingredients. Taking drugs in those manners does not necessarily mean that a long time addict meant to kill himself/herself.

After the meeting with the next of kin, the medical examiner has 30 days in which to make a decision to leave suicide as manner of death or to change it to something else such as accidental or undetermined – conclusions that make more sense in the absence of clear evidence of suicide such as a suicide note or forensic evidence excluding other possibilities.

If the decision is to change it, the medical examiner has up to 30 additional days to file the change with the Tennessee Office of Vital Records. The change will consist of “suicide” being crossed out in box 30 and the new manner substituted in box 30.

If the decision is to leave suicide as manner of death, the next of kin can accept the decision or proceed to the Step 3.

Step 3 – Appeal to the Chief Medical Examiner of the Regional Forensic Center

If the decision is to proceed to Step 3, further reconsideration may be obtained from the chief medical examiner of the applicable regional forensic center. Submit a written request on a form provided by the Tennessee Department of Health. As of the date of this post, the Department had not posted a form to do this. Thus, a letter to the regional forensic center medical examiner should suffice. Contact information for each regional forensic center chief medical examiner can be found at  https://www.tn.gov/health/health-program-areas/oscme/regional-forensic-centers.html. Your request should include copies of all of the information that should be considered by the chief medical examiner to reverse the determination that the manner of death of your loved one was suicide.

The chief medical examiner has thirty (30) days to respond to the next of kin in writing with a decision that includes detailed reasons supporting the decision. The Commissioner of Health will be copied on this report.

If the chief medical examiner’s decision is to change manner of death, the chief medical examiner has up to 30 additional days to file the change with the Tennessee Office of Vital Records. The change will consist of “suicide” being crossed out in box 30 and the new manner substituted in box 30.

If the decision is to leave suicide as manner of death, the next of kin can accept the decision or proceed to the Step 4.

Step 4 - Mediation.

Step 4 is mediation between the next of kin and the chief medical examiner of the regional forensic center. The next of kin is responsible for hiring the mediator. The mediator must be certified under Rule 31 of the Tennessee Supreme Court. Here is a link to the Tennessee State Courts website where Rule 31 mediators are listed with their contact information: https://www.tncourts.gov/programs/mediation/find-mediator or call 615-741-2687 or toll free 800-448-7970.

If mediation leads to an agreement that the manner of death was suicide, no further action is necessary.

If mediation leads to an agreement that the manner of death was other suicide, then the chief medical examiner of the regional forensic center shall file an affidavit within thirty (30) days directing the office of vital records to amend the death certificate to reflect the new manner of death. The change will consist of “suicide” being crossed out in box 30 and the new manner substituted in box 30.