County Medical Examiner releases midyear and annual reports

The San Diego County Medical Examiner's Office released both midyear statistics comparing the first six months of 2020 to 2019 and its 2019 annual report.

"By releasing this level of data, we hope people can study risk factors and identify common issues and trends that could perhaps lead to discoveries and improvements in health that ultimately can save lives," Dr. Steven Campman, interim chief medical examiner of San Diego, said.

Looking first at midyear figures, the department investigated 1,751 deaths through June this year compared to 1,674 in the same months last year, a 5% increase.

The medical examiner's office investigates deaths that occur by accident, homicide, or suicide due to trauma or overdose, or undiagnosed or sudden, unexpected natural causes.

In cases where a person dies a natural death and is under a physician's care, that physician will certify the death and the person does not then go to the medical examiner for further investigation.

Despite it being a pandemic year, it should be noted that relatively few COVID-19 deaths are represented in the midyear statistics. Deaths resulting from contagious diseases that pose a risk to the public such as COVID-19 are reportable to the medical examiner but are considered natural deaths and are therefore not always investigated further by the department if the person was already under the care of a physician.

The deaths due to COVID-19 that the medical examiner sees are generally cases where the person had not sought any treatment for their illness, or the death was unexpected.

Through June, the department tested 104 decedents who had potential symptoms, signs, or risk factors for COVID-19 and seven came back positive for the virus, a 6.7 positivity rate.

The number of natural deaths did increase by 11% from 552 deaths in the first six months last year to 610 in the same time this year. Natural deaths in general are investigated by the department only when the death was sudden and unexpected or resulted from an undiagnosed medical condition.

In the midyear snapshot, accidental deaths make up the largest cause of cases, with 857 of 1,751 deaths from January through June. This is an increase of 2% compared to 838 in the first six months of 2019.

The category covers any kind of death from accidental injury or intoxication, including injuries from falls or car crashes, accidental drug overdoses, injuries from fires or environmental exposure such as hypothermia or hyperthermia, drowning and other unintentional injuries.

Within the accidental death category, unintentional overdose deaths due to illicit drugs, prescription medication and alcohol toxicity increased by 21% from 320 deaths in the first half of 2019 to 387 the first six months of this year.

Of those accidental overdoses, fentanyl-caused deaths increased by 126% comparing those same six months where there were 69 deaths in 2019 and 156 cases for the first six months of this year. Most often, overdose deaths from fentanyl are traced to counterfeit pills that resemble oxycodone or alprazolam.

The report also shows a decrease of 5% in the number of suicides, 198 this year compared to 209 in the same six months last year. Firearms were the leading method of death in 76 of the 198 deaths by suicide this year.

Homicides increased by 14% for the first half of the year, 59 compared to last year's 52. In this category, firearms were again the leading method of deaths, 32 of the 59 deaths.

2019 Year-end Report

For all of 2019, accidental deaths overall comprised 50% of all department investigations. Within that category, unintentional overdoses from drugs – both prescription or illegal – and alcohol were, at 39%, the leading cause of death. Accidental falls followed at 33% and then traffic-related fatalities at 19% were next as outlined in the department's annual report.

While more than 23,000 deaths occurred in San Diego County in 2019, the data in this report is based on some 3,347 cases investigated by the department.

Among the accidental overdose or acute toxicity deaths, the number of cases involving fentanyl was 151 compared to 92 in 2018, an increase of 63% from 2018 to 2019.

Generally, all accidental drug and alcohol overdoses increased by 12% from 577 cases in 2018 to 645 cases in 2019. Methamphetamine was a factor in 59% of accidental overdose deaths. The department investigated 379 methamphetamine overdose cases in 2019 compared to 328 the previous year, a 16% increase.

Also of note, the report stated that suicides decreased by 8% in 2019 with 428 cases compared to 465 the previous year. Homicides rose 11% to 113 cases in 2019 compared to 102 in 2018.

Deaths from falls increased by 12% with 545 cases in 2019 compared to 488 in 2018. Blunt head trauma and hip/femur fracture were the leading cause of death in falls. Traffic-related deaths decreased by 5% from 2018 which had 316 deaths while 2019 saw 301 deaths.

The 2019 Annual Report, 2020 midyear report and previous reports are available at https://www.sandiegocounty.gov/content/sdc/me/press/stats.html.