State of the Practice: Medical Examiners and Toxicology Testing in Texas

Medical examiners (MEs) are authorized to investigate motor vehicle crash fatalities to determine how alcohol and/or drugs contributed to the crash. In Texas, law enforcement notifies the ME's office (when one is present in the county) of fatal crashes. Depending on the circumstances, a formal investigation of the crash death may include an autopsy and toxicological testing. The 12 Texas counties currently operating with an ME's office are Bexar, Collin, Dallas, Ector, El Paso, Galveston, Harris, Lubbock, Nueces, Tarrant, Travis, and Webb. Tarrant, Denton, Parker, and Johnson Counties have been established as an ME district, meaning they serve as the ME office for their home county while also serving multiple counties without a designated ME office. There are 133 counties that do not have an ME office but have access to ME services through interagency agreements. In 2018, the Texas A&M Transportation Institute (TTI) was tasked to identify issues that adversely affect MEs and justices of the peace (JPs) who report blood alcohol concentration (BAC) toxicology results for fatally injured drivers. TTI surveyed MEs to better understand their experiences reporting BAC toxicology results of fatally injured drivers to the Texas Department of Transportation's (TxDOT's) Crash Records Section. This survey focused on current BAC testing and reporting practices for fatal crashes, as well as evaluation of current TTI ME educational activities.