The Medical Examiner differs from the Coroner in that a Coroner is usually associated with the Sheriff in most California Counties. The Coroner is usually not a physician, and is not trained in medicine, Forensic Medicine or Forensic Science. A Medical Examiner is required to be a physician, certified by the American Board of Pathology in the medical specialty of Forensic Pathology, and experienced in the Forensic Sciences. There is no Coroner in San Francisco. The Coroner is an ancient position that was first established in Great Britain in 1164. The Medical Examiner System is a modern replacement.
The Office of the Chief Medical Examiner practices Forensic Medicine and Forensic Science for the City and County of San Francisco. The Chief Medical Examiner is required, by law, to determine the cause, circumstances and manner of death for those cases found to be under the Office's legal jurisdiction. Those deaths that are due to natural disease are not reportable to the Medical Examiner, and the responsible treating physician can properly complete the Death Certificate. However, all deaths in which there is some reason to believe that the death is not due to a natural disease process, is a homicide, suicide, accident or one of the many types of deaths mentioned by law, must be reported to the office. Only Medical Examiners can investigate and sign the Death Certificate if the death is related to a homicide, suicide, accident, a patient with no attending physician, an industrial related death, an unidentified person or where there is some medical reason to consider that the death might be due to a contagious disease.
In addition to the work that is performed in accordance with the various sections of local, State and Federal Laws, examination of living persons is performed for a number of purposes. The Forensic Laboratory Division of the Office of the Chief Medical Examiner performs alcohol, drug and poison analysis for the County. This work includes analysis of blood, urine and other biological specimens in cases of driving under the influence of alcohol or drugs, drug-facilitated crimes including sexual assault, and other human performance casework. The results of any examination or testing are often presented as expert testimony in the criminal courts of the County.