Companion Cases in a Large Urban Medical Examiner's Office

Companion death cases, as defined in this study, include 2 or more deaths that occur at the same location or 1 death at a specific location combined with 1 or more individuals transported from that same location to a hospital where death was pronounced within 1 hour of arrival. These types of cases can have multiple causes and manners of death. The Wayne County Medical Examiner's Office conducted a retrospective study of companion death cases that came into the office from mid 2007 to the end of 2014. The purpose of the study was to identify and examine patterns of companion death cases in a large urban area that would assist future companion death case investigations. Three hundred fifty deaths were found to be companion cases, including 135 pairs (2 connected deaths in the same location), 20 trios, and 5 quartets. Approximately 49% of companion case deaths were homicides. Approximately 30% of companion case deaths were traumatic accidental deaths. Around 14% of companion case deaths that were from the same scene location had different manners of death, including suicide, homicide, natural, and indeterminate. The remainder of companion death cases were either drug related or natural. Through this study, we have identified a pattern to these companion death cases and have concluded that it is important to conduct a thorough medicolegal death investigation of such cases to establish and elucidate the true circumstances surrounding these deaths.