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Despite funding increases and legislative support, North Carolina’s Office of the Chief Medical Examiner remains backlogged due to a national shortage of pathologists and a surge in subpoenas requiring experts to testify in person.
Getting an autopsy report in North Carolina after someone dies can take months. Despite recent funding for the medical examiner’s office, prosecutors say the backlog of autopsies is slowing down justice.
Simply put, the state’s medical examiner’s office is overloaded. A huge influx in funding helped. But what’s straining the system isn’t the caseload now, it’s the courts.
Dorleen Richardson is waiting for an autopsy on her husband, Antony, who was killed by Johnston County deputies on Jan. 25 following a mental health crisis. Her garage is still riddled with bullet holes, reminding her of the day he died.
“His feet were there, and his body was there,” Richardson said pointing to the floor of her garage.
The Army veteran suffered from diagnosed PTSD. After an episode that lasted days, on Jan. 25, his family called 911.
Months later, the case is still under investigation. Dorleen Richardson is preparing to move out of the home they spent years saving for. The one thing holding her back is paperwork.
“Right now, the VA is waiting on medical records from the medical examiner. [It includes] his autopsy and his toxicology report [are] all pending, and they cannot give me any date or time … [The] only thing they tell me is that they are backlogged,” she said.
Veterans Affairs told WRAL Investigates it requires official evidence,”identifying a cause of death, such as a coroner’s report or death certificate, in order to determine eligibility to Survivors’ benefits. Family members generally have one year from the date of the Veteran’s passing to submit this information,” said Quinn Slaven, VA press secretary.
The OCME’s office told Richardson to keep checking in, but that it could be six months. Because her husband died in an officer-involved shooting that requires investigation, his body must be analyzed by the Medical Examiner’s Office.
Dr. Michelle Aurelius, who has been the North Carolina Medical Examiner for the past seven years, says they’re up against national trends like fewer people going into forensic pathology and the continued strain of opioid related deaths. But another aspect pulling on resources tightened its grip in the last year when the office saw a 53% increase in subpoenas, according to OCME data.
“So when I look at 2025, we had our experts at the OCME traveling over 5,000 miles, so that we could provide the expertise and the testimony that we need to on these cases,” Dr. Aurelius said.
While her forensic pathologists conduct autopsies for a third of North Carolina’s 100 counties, the medical examiner’s office has the state’s only post-mortem toxicology lab.
“We handle all those over 15,000 cases and samples. So that means that our forensic toxicology experts aren’t just focused on testifying in those 26 counties, they’re being pulled to other counties,” Dr. Aurelius said.
It’s a request that isn’t going away, says Seth Banks, who speaks for the state’s top prosecutors. He says it’s a defendant’s constitutional right to confront a witness.
“At this time, there is no case law that allows for Zoom testimony to happen in a serious homicide case, and so we need them to testify in those cases,” Banks said.
WRAL Investigates asked Banks if it was delaying justice to wait on autopsy reports. He said it was. He noted that there is a lack of forensic pathologists nationwide. But it doesn’t lessen the difficulty of asking a victim’s family for patience.
“I would say those conversations have happened more infrequently since 2023 which is at least some anecdotal evidence that the additional resources the legislature has allocated have helped. But with that said, we’ve still got a ways to go,” Banks said.
In 2023, the OCME’s office laid out a comprehensive plan to improve the office’s efficiency and lawmakers approved 2 million in additional funding – a 160% funding increase from five years earlier. They can also charge more than double the previous rate for an autopsy. Last year, the governor approved a budget that increased the medical examiner fee.
“Plus, one of the big holdups that we had was toxicology reports. So we hired, helped to hire new toxicologists so they could get toxicology reports back quickly,” said North Carolina state Sen. Jim Burgin, R-Harnett, Lee and Sampson counties.
Given those increased resources, Burgin is surprised to hear the OCME’s office is still backlogged.
“I want to look into it, because I think the legislature did what we’re supposed to do, and that’s identify issues and then fund resolutions to those issues. And I think we did our job on that,” Burgin said.
Data provided by OCME shows that of the 71 state-funded positions in 2024, there are 63 filled. It includes 11 forensic pathologists.
“Without that, we would not have come as far as we can, but we’re still in this state where we’re working through additional workload, additional complexities, being pulled to testify because we want to provide that service, of course, but it’s challenged when there’s too much work to do and not quite enough people to do it,” Aurelius said.
So what do they need to catch up? WRAL Investigates asked Dr. Kelly Kimple, Director of the NCDHHS Division of Public Health, this question.
“Well, at the end of the day, the work isn’t stopping, and it continues to change every day. And so the partnership that we have with our lawmakers, with those other partners of the system, that is what’s critical for us to work together to ensure we are meeting the needs of North Carolina,” Kimple said.
As they navigate those challenges, Richardson says she is stuck in limbo waiting for a piece of paper to determine what benefits she may have as a veteran’s widow.
“It’s holding up progress. It’s holding up benefits. It’s holding up your life. It’s holding up,” Richardson said.
Also worth noting, the daily caseload at the medical examiner’s office is 38% above the national average, according to OCME data. The continued strain of opioid related deaths and an increasing population mean the office will need more resources sooner rather than later.