In the Beaufort County Coroner’s office, forensic pathologist Joni Skipper gestures while explaining how the new autopsy suite aids her team in determining a cause and manner of death. GWYNETH J. SAUNDERS

Sooner or later, many of Beaufort County’s residents and even some visitors will be brought to the one-story brick building on Old Shell Road in Port Royal. 

The Beaufort County Coroner’s office is one of the last stops for an individual who has died. The new autopsy suite that opened this past September gives the residents of Beaufort and surrounding counties quicker answers as to the cause of a loved one’s death. 

“Having the facility within the county reduces the amount of time it takes to get results for most cases,” said Dr. Joni Skipper, the county’s forensic pathologist. 

The cases that go to the coroner for autopsy are unaccompanied deaths, individuals that have died suddenly, died unexpectedly or may have died violently by suicide, accident or homicide.

Not every individual brought to the coroner’s facility requires an autopsy, according to Skipper. 

Those that are known to be a natural death, in which there is no suspicious sign of foul play, can be signed out by a physician who had been treating the individual prior to death.

“Our primary goal is to establish the cause and manner of death. But with every case, we want to rule out foul play,” Skipper said. “We want to make sure that no one did something to this person. And also, we’re getting families answers. I think that that’s why most of us do this job.”

Prior to opening the new facility, those who required an autopsy had to be transported to the Medical University of South Carolina in Charleston. It could take four or five days from the date of death to schedule the procedure.

Results can take up to 12 weeks, leaving family questions lingering, and perhaps delaying critical clues that law enforcement needs to help solve a case. According to the press release sent out when county council approved the Forensic Pathology Department along with the FY23 budget, “The addition of this department will cut down the waiting process to 24-36 hours for the autopsy and provide answers on the cause of death in 48 hours, barring the need for tissue or toxicology-related specimen processing.”

A primary benefit to having the service available within the county is that, in most cases, Skipper and her team can get an exam done fairly quickly, she said, “and have the body ready for release to the family that day.

MUSC is still a backup for the county coroner in the event someone is unavailable, or there are so many cases that the department can’t get to them in a timely manner.

“The odds are if that’s the case, then MUSC is going to be behind, as well, because they serve so many counties in the state. But I think already we’ve seen that we’ve made a difference here,” Skipper said. 

In addition to saving time, the proximity of the facility will save the county taxpayers $42,525 per year. Law enforcement agencies will save money because officers will no longer be required to travel to Charleston to observe autopsies or collect items used for evidence. Beaufort County averages 190 autopsies a year. It’s also expected that adjacent counties will be paying to use the Beaufort services about 50 times, according to the county.

Skipper explained that in basic terms a pathologist is a physician who is specially trained to examine body tissues, body fluids, and to diagnose or exclude illness. 

“Forensic pathologists are trained to perform post-mortem examinations or autopsies to determine the cause of death or a manner of death,” said Skipper. “In addition to performing the autopsies and generating an autopsy report, we also are called to testify to these findings when those cases go to trial.”

A cause of death is the specific illness or injury that is directly responsible for a death. A gunshot wound to the head is a cause of death. Acute myocardial infarction, or heart attack, is a cause of death. 

The manner of death is something used to give some information about the circumstances surrounding the death. 

“There are five manners: natural, accident, suicide, homicide, and, in a very small number of cases, undetermined. Either we don’t have enough information because of the investigation or the condition of body decomposition,” the pathologist said. 

About 5% of cases are designated undetermined, according to Skipper. There might be competing manners of death, as in the case of a gunshot wound to the head: Was it a suicidal gunshot, or was it accidental, or was it a homicide? 

“If there’s not enough information for us to determine which of the three, we call it undetermined,” she said. “Another undetermined cause of death would be if I have skeletal remains. We may request a forensic anthropologist to examine the skeletal remains to look for trauma. If they don’t find any, anatomically I don’t have what I need to make a diagnosis.”

Skipper said in examining individuals, there are obvious anatomic findings and there are subtle anatomic findings. If she has to autopsy an otherwise healthy person with no disease or injury found at autopsy, she will send specimens for toxicology tests. The results may come back as fentanyl as the cause.

“At the time of the autopsy, I don’t have a cause of death, so there are additional procedures, additional tests that we perform to help establish that cause of death. Toxicology is one of those services,” said Skipper.

That is one example of the many pieces that go into determining how a person died.

“Everybody has a part to play. We depend on the investigators to provide us investigative information from the scene, from circumstances, and interviews with family or witnesses as to what may have happened,” she said.

All of that information combined with the autopsy findings and any additional tests will result in determining the cause or manner of death. 

“None of this can be done in a vacuum. All of the different pieces have to be considered,” said Skipper. “It’s a very challenging job. It’s interesting every day because I never know what I’m going to have.”

Gwyneth J. Saunders is a veteran journalist and freelance writer living in Bluffton.