ABMDI Board (F-ABMDI) common mistakes
ABMDI Board (F-ABMDI) · Understand the traps and how to avoid them.
Begins scene processing and directs removal of the decedent without first verifying and stating the legal basis for jurisdiction - e.g., treating a death pronounced in an emergency department, on a reservation, on federal property, or across a county line as a routine case for the investigator's own office.
Investigators default to the habit of 'call comes in, go work it,' and the reportability and jurisdiction screen is treated as a dispatcher function rather than an investigator's independent duty; pronouncement location and incident location are often not asked at all.
What to do instead
Before touching the scene, state aloud and record four data points: where the incident/injury occurred, where death was pronounced, where the body now lies, and which statute or office policy confers authority. If any point falls outside the office's authority, stop, notify the office of record, and document the referral, the time, and the person notified.
Declines or releases a case as 'natural, private physician will sign' without screening it against the statutory reportability criteria (unattended by a physician, dead on arrival, death within 24 hours of admission, history of recent injury or fracture, institutional or custodial setting, hospice death with unexpected circumstances).
A plausible medical history supplied by a family member creates a false sense of certainty, and declining a case is faster and less confrontational than accepting one; investigators also fear appearing to second-guess a treating physician.
What to do instead
Run every call through a written reportability checklist rather than a clinical impression. If any criterion is met, accept jurisdiction and document which criterion triggered acceptance; if the case is released, document the specific criterion considered and the basis for release, and obtain the name of the certifying physician.
Produces a scene record consisting of a handful of body-only photographs with no scale, no establishing/overall views, no written contemporaneous notes, and no sketch or measurements of the room, furniture, or body position relative to fixed points.
The investigator is focused on the decedent and feels pressure from family, police, or the transport service to move quickly; photographs seem self-explanatory at the time, and the gap only becomes visible months later when the report is challenged.
What to do instead
Use a fixed sequence for every scene: approach/establishing, overall room from each corner, mid-range of the decedent in context, close-up with and without an ABFO-type scale, then the same sequence after any change. Maintain a running time-stamped scene log and complete a not-to-scale sketch with at least two measured baselines before removal.
Documents only the decedent as currently lying and never records what first responders changed - body moved for CPR, clothing cut, windows opened, medications or drug paraphernalia moved or removed, or a weapon picked up - nor the original position, lividity, and rigor as first encountered.
Responders have usually been on scene far longer than the investigator, and the altered scene is simply what is encountered; investigators are reluctant to interrogate colleagues and assume the changes are obvious or unimportant.
What to do instead
Interview each responder individually and ask specifically what was moved, opened, cut, administered, or removed and at what time. Photograph and describe the position of the body and the pattern of lividity and rigor as found, record the alterations verbatim in the report, and note any item that left the scene and its current location.
Records property as generic categories ('jewelry,' 'cash,' 'medications,' 'phone') rather than itemized descriptions with identifying features, and releases property to family at the scene without a witnessed, signed receipt or secure seal and labeling.
Property handling is treated as clerical work performed under time pressure, and investigators assume photographs of the jewelry or the serial number will be recoverable later; family requests at the scene feel unkind to refuse.
What to do instead
Photograph each item in place, then inventory it line by line with material, color, inscriptions, serial or model numbers, and quantity. Package, seal, and label with case number, date, time, and initials, and never release property at the scene except against a signed, witnessed receipt with an itemized list and the recipient's relationship and identification recorded.
Accepts the decedent's identity from a family member or a name on a door and then writes the identity into the report and the death certificate without recording an objective identification method (fingerprint comparison, dental or radiographic comparison, photo identification of the face and distinguishing marks, DNA) or the name of the person who made it.
Most decedents are who the paperwork says they are, and identification is treated as a formality already settled by the responding agency; investigators also confuse visual recognition by a relative with an objective identification of the body.
What to do instead
State in the report exactly which method established identity, who performed it, when, and what it was compared against. Record and photograph distinguishing marks (scars, tattoos, surgical hardware, dentition). Where no objective method exists, mark the identification as presumptive pending confirmation and specify the confirmation step ordered.
Commits to a manner of death from the scene impression and then writes and defends that manner - calling a hanging a suicide before the history and toxicology return, calling an overdose 'accidental' before the prescription record is reviewed, or calling an injury death 'natural' because a cardiac condition exists.
Scene appearance is vivid and satisfying as an explanation, and premature closure relieves pressure to chase records, witnesses, and toxicology that take weeks; once the manner is in the draft report, changing it feels like admitting error.
What to do instead
Hold manner open until the record is complete, and write the rationale for the manner as an explicit statement of the facts relied on and the alternatives excluded. Record which items are outstanding (toxicology, medical records, interviews) and set a review date; mark any pending manner as pending rather than defaulting to undetermined.
Describes injuries only by organ or region ('head trauma,' 'bruises on the arms') without number, dimensions, shape, pattern, color, or relationship to a possible implement, and does not distinguish antemortem from postmortem injury or from therapeutic intervention (defibrillator pads, IV sites, CPR fractures).
Investigators reproduce the clinical language they hear from responders instead of describing what they see; pattern and measurement feel like the pathologist's job, and postmortem change is often mistaken for injury by an examiner without injury-documentation training.
What to do instead
For each injury record location, size in centimeters, shape and pattern, color, margination, and whether it is antemortem, and photograph it with a scale alongside a comparison object where a pattern is suspected. Explicitly list medical interventions performed and where, so those marks are not later read as injury.
Completes the cause-of-death statement with a mechanism or a non-sequential list - 'cardiac arrest,' 'respiratory failure,' 'exsanguination' as the underlying cause, or two unrelated conditions entered on the same line - so that the underlying cause cannot be recovered from the certificate.
Mechanisms are what the chart and the responders say, they are technically true, and they feel safer than naming a disease or injury the investigator cannot personally confirm; training on the causal sequence is brief and rarely revisited.
What to do instead
Write a single chain using 'due to' from the immediate cause back to the underlying cause, one entity per line, ending in the disease or injury that initiated the sequence, and keep mechanisms off the certificate. Test the entry by reading it aloud: if the last line is a mechanism or the lines are not causally linked, rewrite it before signing.
Discusses identifiable case details, decedent photographs, or opinions about manner with media, on personal social media, or with other families, and accepts gifts, meals, or gratuities from funeral homes, transport services, or involved parties.
The work is compelling and small jurisdictions blur professional and personal relationships; investigators also use informal conversation with colleagues to process difficult scenes without noticing that a lobby, a group chat, or a dinner table is not a secure setting.
What to do instead
Apply a stated rule: case information is shared only on a documented need-to-know basis through office channels, photographs never leave the case file or secure system, and any gift, outside employment, or relationship with a funeral home, transport provider, or involved party is disclosed in writing to the office. When a request comes from media, refer it to the office's designated spokesperson and document the referral.