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The Chester County, PA, Coroner’s Office – Then and Now – 334 Years

September 19, 2019 by admin

Written by CHRISTINA VANDEPOL, MD, Chester County, PA, Coroner, for the Chester County Medical Society

The office of Coroner goes way back – all the way back to at least 1194 in England, when Richard the LionHearted was seeking money to fund wars and crusades. English sheriffs who were supposed to represent the King’s interest in the shires were increasingly corrupt. Coroners (“Crowners”) were put in place not just to go to the scene of unexpected deaths, including murders, but to make sure the property of executed criminals went to the King and wasn’t “diverted” locally. While that’s no longer a coroner responsibility, coroners then and now investigated sudden, unexpected, and non-natural deaths, determined the cause and manner of death, and wrote death certificates.

Like so many American institutions, the U.S. coroner system began in Pennsylvania. The “Frame of Government for Pennsylvania,” written in 1682 by William Penn for the land he’d been granted by King Charles II, allowed for an appointed coroner. In 1684, Penn himself appointed Chester County’s first coroner, James Kanela (sometime written Kennerly), who was in office from 1685-1687. Since 1838 and continuing to the present, coroners have been elected officials. Whether headed by an appointed or elected Coroner, the Chester County Coroner’s Office (CCCO) has always functioned as a death investigation agency. County archives show that early coroners were paid to examine dead bodies to ascertain the cause of death and to hold inquests. The fee for viewing a dead body in 1814 was $2.75, approximately the cost of a week’s hotel stay in Washington, D.C. at the time. Today the position is salaried, with a current annual salary of approximately $75,000.

Medicolegal Investigation

Death investigation is at the intersection of legal and medical disciplines. In the United Kingdom, in fact, coroners are usually lawyers who head Coroner’s Courts, deciding cause and manner of death through inquests where evidence is presented by forensic pathologists and other medical or forensic experts. Prior to the 1960s, inquests were still common in Chester County and coroner inquests are still legal in our state. The purpose of coroner inquests isn’t to adjudicate guilt or innocence, but to establish the facts around a death so cause and manner of death and possible criminal intent can be determined. In most cases today autopsies, toxicological and other tests, and extensive medical records allow the probable cause and manner of death to be determined without an inquest. There remain, however, the occasional “undetermined” cases or controversial situations, like deaths in police custody, where an inquest, with deliberations transparent to the public, are a potentially useful tool.

Infrastructure

A striking example of what hasn’t changed much over time, at least in the last 75 years or so, is the facilities of the Coroner’s Office. Not so long ago, the CCCO was housed in one small office room in a West Chester building now occupied by the Mercato Restaurant. Next an office was provided at 313 W. Market St, the current home of most County administrative offices. Around 2016, the CCCO was moved into bigger but rather depressing administrative office space at the end of a long dim corridor in the basement of the Government Services Center. When visiting our office, you might be forgiven for wondering if the idea was “out of sight, out of mind.” While the administrative office has moved around, the same local hospital morgues and autopsy rooms have been in use since the 1960s. According to Dr. Harrop, who took office in 1966, before that autopsies were not infrequently conducted in the back of funeral parlors. Unfortunately, the current facilities don’t meet OSHA or state Department of Labor laws. The CCCO recently failed an accreditation audit in June 2019 because of the dismal state of its morgue and autopsy space.

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Filed Under: Magazine Articles

Advertise in our New Spring Township Publication

April 10, 2018 by admin

We are thrilled to announce that we have a new publication being released! It’s the Spring Township Parks and Recreation Guide!

As a reader in Spring Township, this is a publication you should be looking forward to because it’s specifically created with you in mind! Find out the latest news, events, activities, offers, and more! As an advertiser, we would hate for you to miss out on the opportunity of reaching more than 30,000 Wilson School District residents. The first magazine is being released this April!

Spring Township Magazine

About the Guide for Advertisers

This full-color Programming Guide, featuring Spring Township’s seasonal community events and activities, will be read by more than 50,000 engaged, community consumers throughout the greater Wilson School District area, reaching your target audience who live, work and play within steps, blocks, and miles of your business.

Readership – 50,000+…

includes family members, business owners, and employees who live, work and travel by your business every day!

Circulation – 18,500…

mailed to every Business and Resident within the greater Wilson School District boundary.

Available Ad Space

  • Back Cover
  • Inside Covers
  • Page One
  • Interior Full-Page
  • Bleed (8.625” W, 11.25”H)
  • Non-Bleed (7.375” W, 9.875” H)

Half-page

  • H (7.375” W, 4.835” H)
  • V (3.565” W, 9.875” H)

Quarter-page

  • (3.565” W, 4.835” H)

Eighth-page (BC)

  • (3.565” W, 2.25” H)

I Want My Ad in the Summer 2018 Issue!

Let us know you’re interested by June 15, 2018. All ad materials will be due by June 20, 2018. Alicia Lee and Joanie Berney be able to assist with any additional information.

Alicia Lee: 610.685.0914 x 210, or alicia@hofpubs.com
Joanie Berney: 610.685.0914 x 204, or joanie@hoffpubs.com

Don’t Miss Its Release

It’s specially designed to promote your business to every resident and business in your service area! We are excited about this new publication and we know it’s going to be a wonderful addition to the Spring Township community! Follow us on social media to be the first to see its debut!

Filed Under: News & Events

2017 Changes in School Vaccine Requirements

August 17, 2017 by admin

By Rotimi Adesina, M.D. (third year pediatric resident), and June Elcock-Messam, M.D.

The national immunization program aimed at protecting children and adolescents from vaccine preventable diseases continues to be one of the most impressive examples of preventive medicine in the United States. Organizations that collaborate over this program include the Advisory Committee on Immunization Practices (ACIP), the Committee on Infectious Diseases of the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP), and the American College of Obstetricians and Gynecologists (ACOG).

As breakthroughs continue to emerge within the fields of virology, immunology, and genetics, immunization guidelines are constantly being revised to stay up to date. You may have received a letter from your child’s school nurse or heard on the news that there are some changes to the vaccine requirements for school-aged children in the state of Pennsylvania that will go into effect in August 2017. If your child is not up to date on his or her immunizations according to these guidelines, your child may be excluded from school in September 2017. Currently, the vaccines listed below are needed for attendance in all grades.

Name of Vaccine Amount of doses needed to be considered up to date:

DTaP (tetanus, diphtheria, acellular pertussis) 4 doses, including one dose on or after 4 years old
IPV (Polio)… 4 doses, 1 dose on or after 4 years old
MMR (measles, mumps, rubella)… 2 doses
Hepatitis B… 3 doses
Varicella (chickenpox)… 2 doses or proof that child had the chickenpox

In addition to the above vaccines, for attendance in 7th grade your child must have two additional vaccines by the first day of school or risk exclusion.

Tdap (tetanus, diphtheria, acellular pertussis)… 1 dose
MCV (meningococcal conjugate vaccine)… 1 dose

For attendance in 12th grade, your child must have another dose of the MCV vaccine by the first day of school or risk exclusion.
MCV (meningococcal conjugate vaccine)… 1 dose

There are four scenarios that can occur when your child’s immunization history is reviewed by the school nurse:

  • If your child has received all of the above recommended doses of vaccines, you are in compliance and do not need to take any further action.
  • If your school-aged child is not up to date on his/her vaccines as listed above and is able to medically receive the recommended doses within the first five days of school, he or she MUST receive the needed vaccinations or risk being excluded from school.
  • If your child is not in compliance but it is too early to vaccinate him or her with the next dose in a particular series, a “medical plan” – a red and white card– must be provided to the school within five days or risk exclusion from school. This red and white card has to be signed by your medical provider and should contain a plan to bring your child up to date with the immunizations. This card can be downloaded here.
    School officials will then monitor this plan to ensure compliance in a timely manner.
  • If your child has a medical exemption or if you have a religious/philosophical issue, this information should be documented and provided to school officials.

If you have further questions about these changes, please contact your doctor immediately or call 1-877-PA-HEALTH. You can also google “28 pa.code ch.23 (school immunization)” to learn more about the Pennsylvania immunization requirements for attendance in school.

Some additional reputable immunization resources include:

The Children’s Hospital of Philadelphia (CHOP) Vaccine Education Center
The Centers for Disease Control and Prevention (CDC)
The Advisory Committee on Immunization Practices (ACIP)
The American Academy of Pediatrics (AAP) immunization guidelines
The American Academy of Family Practice (AAFP) immunization guidelines
The American College of Obstetricians and Gynecologists (ACOG)

Reprinted from the Delaware County Medical Society publication, Delaware County Medicine and Health, Summer 2017 issue

Read more content at dm.hoffmannpublishing.com

Filed Under: Uncategorized

Is There a Gender Bias in Medicine?

August 17, 2017 by admin

By Mian A. Jan, MD, FACC, FSAI
President of the Chester County Medical Society

I was reading TIME magazine recently and came across an article about the Supreme Court of the United States. Authors analyzed Supreme Court’s oral arguments from 2004 to 2015 and created a data set of all the interruptions by justices and advocates; data revealed female judges were much more frequently interrupted. Between 2011 and 2015 female judges were interrupted three times more as compared to male judges. I am not certain if that indicates a lack of respect for female judges but inference was that it does. It started me thinking that if there is a gender bias in the most respected group in the country, are we also guilty in medicine?

I recall that when my wife Amber started her practice about two decades ago, she would complain that when she walked into a patient’s room she was often asked if she was a nurse; although nursing is a most honorable profession, the fact is, that being a female puts you in a certain category. Although things have changed and it’s rare that this happens anymore, the data I reviewed still shows bias against female doctors.

The most recent data revealed that there are 608,685 male and 313,874 female doctors in the USA. Another 749 were listed as unspecified which I am not certain what that means, but let’s say those were gender unknown. A BMJ article reviewed compensation by gender and race, and the data revealed an annual compensation to be

• white male doctors 253,042 dollars
• black male doctors 188,230 dollars
• white female doctors 163,234 dollars
• black female doctors 152,784 dollars

It appears, at least in compensation, that there is a bias against both minorities and female doctors, but more so against females.

But as you look deeper, you find that they did not separate sub-specialty doctors from general physicians, and on average specialists make more, and there are more male specialists. But then is it gender bias that pushes woman into less lucrative specialties, because of home and family obligations.

The strange thing is, that despite perception that males make better doctors, the data does not support that. One of the largest studies published in JAMA which looked at 1.5 million Medicare hospital admissions over four years revealed that if your admitting physician was female, you were .4% less likely to die, and that would save 32,000 lives a year. The FDA has approved many therapies that cost more and save less lives. Although there were some issues with the study [they used the admitting doctor as owner of data but the majority of patients were taken care of by multiple doctors, both male and female], data does support that female doctors tend to follow guidelines more closely.

I believe that with the new generation, all kinds of biase, both gender and race, are disappearing. Hopefully, every physician, more importantly, will be looked at and respected on his or her own merit rather than his or her sex or skin color.

Mian A. Jan, M.D., is a practicing Cardiologist and President of Chester County Medical Society.
Contact Dr. Jan at 610-827-1543.

Reprinted from the Chester County Medical Society publication, Chester County Medicine, Summer 2017 issue.

For more content visit cm.hoffmannpublishing.com

Filed Under: Uncategorized

Lyme Disease

August 17, 2017 by admin

Lyme disease is a bacterial infection primarily transmitted by Ixodes ticks, also known as deer ticks, and on the West Coast, black-legged ticks. These tiny arachnids are typically found in wooded and grassy areas. The Centers for Disease Control and Prevention estimate that 300,000 people are diagnosed with Lyme disease in the United States every year. However, because diagnosing Lyme can be difficult, many people who actually have Lyme may be misdiagnosed with other conditions. Many experts
believe the true number of cases is much higher.

Warmer Winters May Increase Number of Cases

In 2015, there were 9,427 confirmed cases of Lyme disease reported in Pennsylvania, of which 396 of these confirmed cases were in Montgomery County. Due to back-to-back warmer winters, health officials are predicting that we may observe a bad tick season and therefore we could potentially see an increase in the number of cases of tick-borne illnesses. It is important to know that ticks infect most people when they are in the nymph stage (an immature stage) of development, because they are very small and difficult to see. The infected ticks can attach to any part of the human body but are often found in hard-to-see areas such as the groin, armpits, and
scalp (CDC, 2017). In most cases, the tick must be attached for 24 to 36 hours before the Lyme disease bacterium can be transmitted. Symptoms usually begin to appear within 3-30 days after a tick bite.

The most common symptom in most cases of Lyme disease is the Erythema Migrans (EM) rash, also called the “Bull’s Eye” rash that occurs around the bite area; however, this symptom varies widely, ranging between 30-80%.

Fatigue, fever, chills, muscle and joint pain are also common symptoms with Lyme disease. A blood test can help determine if someone is infected. Lyme disease can be treated by several weeks of antibiotics. If left untreated Lyme disease can affect the nervous system, joints and heart.

Take the Montgomery County Trail Challenge

Ticks should not prevent the community from continuing to be active. This summer, Montgomery County is promoting their Montgomery County Trail Challenge from May 6-December 3, 2017. The Trail Challenge allows for a family-friendly experience of exploring your community and benefiting your health by getting out on the trails. In support of this wonderful public health activity, Montgomery County Health Department (MCHD) has created a Lyme Disease Awareness Flyer to post on the trails and in the parks to keep the community informed of their risk and how to prevent disease.

Do not let a tick make you sick!
• Use repellent that contains at least 20 percent DEET on exposed skin and use products that contain 0.5% permethrin on clothing.
• Check for ticks daily. Be sure to check places like behind your knees, hair, and the ears. Thoroughly check your children, pets, clothing, and gear as well.
• Shower soon after being outdoors.
• Remove ticks found on body with fine tipped tweezers.
• Walk in the center of trails and avoid areas with high grass and leaf litter.
• Wear light-colored clothing, which will make it easier to see crawling ticks.
• Call your doctor if you get a fever or rash.

For more information on Lyme disease, please visit:
MCHD’s Lyme Disease web page, www.montcopa.org
CDC’s Lyme Disease web page , www.cdc.gov

WRITTEN BY LEONARD OLU-WILLIAMS, MPH, CHES
PUBLIC HEALTH INFO ANALYST, MONTGOMERY COUNTY HEALTH DEPARTMENT

Reprinted from the Montgomery County Medical Society publication, MCMS Physician, Summer 2017 issue.
Read more at mp.hoffmannpublishing.com

Filed Under: Uncategorized

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  • The Chester County, PA, Coroner’s Office – Then and Now – 334 Years
  • Advertise in our New Spring Township Publication
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