MICHIGAN ASSOCIATION OF MEDICAL EXAMINERS … · MICHIGAN ASSOCIATION OF MEDICAL EXAMINERS 2005...
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MICHIGAN ASSOCIATION OF MEDICAL EXAMINERS
2005 EXECUTIVE COMMITTEEJohn C. Maino, MD, Chair1715 Lansing Ave. Suite 648Jackson, MI 49203-2135Phone: (517) 788-4482Alternate Phone: (517) 780-7264Fax: (517) 768-5823Email: [email protected] Expiration: 2005Assistant: Jill Glair @ (517) 788-4482
Stephen Cohle, MDKent County Chief Medical Examiner700 Fuller NEGrand Rapids, MI 49503Phone: (616) 336-3021Fax: (616) 336-3943Email: [email protected] Expiration: 2005
Joyce deJong, DO1215 E. Michigan Ave.Lansing, MI 48912Phone: (517) 364-2561Fax: (517) 372-0581Email: [email protected] Expiration: 2006
Carl Hawkins, MDMackinac County Chief Medical Examiner220 Burdette St.St. Ignace, MI 49781Phone: (906) 643-0466Fax: (906) 643-0464Email: [email protected] Expiration: 2007
Brian Hunter, MD1215 E. Michigan Ave.Lansing, MI 48912Phone: (517) 364-2561Fax: (517) 372-0581Email: [email protected] Expiration: 2006
Rubin Ortiz – Reyes, MD1200 N. Telegraph Rd.Pontiac, MI 48341Phone: (248) 858-5097Fax: (248) 452-9173Term Expiration: 2005
Daniel Remick, MDM2211 MSI, Box 06021301 Catherine Rd.Ann Arbor, MI 48109-0602Phone: (734) 763-6454Fax: (734) 763-6476Email: [email protected] Expiration: 2006
Dennis Smallwood, DOSanilac County Chief Medical Examiner171 North Dawson StreetSandusky, MI 48471Phone: (810) 648-4098Fax: (810) 648-2646Email: [email protected] Expiration: 2007
Richard Tooker, MDKalamazoo County Chief Medical Examiner3299 Gull RoadKalamazoo, MI 49048-1295Phone: (269) 373-5190Fax: (269) 373-5191Email: [email protected] Expiration: 2007
COUNTY NAME TELEPHONE2000 Population
ALCONA Greg Hanert, DO (989) 724-652611,719 311 Lake St. Fax (989) 724-9975
PO Box 218Harrisville, MI 48740
ALGER Christine Krueger, MD (906) 387-43389,862 1514 Sand Point Road Fax (906) 387-2825
Munising, MI 49862
ALLEGAN Joyce deJong, DO (517) 364-2561105,665 1215 E. Michigan Ave. Fax (517) 372-0581
Lansing, MI 48912 [email protected]
ALPENA Robert Coombs, MD (989) 358-682431,314 1063 US 23 North Fax (989) 356-6180
Alpena, MI 49707
ANTRIM Dewey Benson, DO (231) 377-778423,110 PO Box 1043 Fax (231) 377-7786
Bellaire, MI 49615
ARENAC Cesar Casten, MD (989) 846-953317,269 529 East Cedar Fax (989) 846-1015
Standish, MI 48658
BARAGA Cary Gottlieb, MD (906) 524-33388,748 Baraga County Memorial Hospital Fax (906) 524-7147
770 North MainL’Anse, MI 49946
BARRY Jeffrey P. Chapman, MD (269) 945-360656,755 1005 West Green Street Fax (269) 945-0405
Hastings, MI 49058
BAY Howard F. Hurt, DO (989) 895-4009110,157 Bay County Health Department Fax (989) 895-4014
1200 Washington AvenueBay City, MI 48708
STATE OF MICHIGANCHIEF MEDICAL EXAMINERS 2005
October 2005 1
COUNTY NAME TELEPHONE2000 Population
BENZIE Matthew A. Houghton, Jr, DO (231) 334-818415,998 PO. Box 116 Fax (231) 334-8185
Glen Arbor, MI 49636
BERRIEN Robert Clark, MD (269) 983-8313162,453 1234 Napier Ave. (269) 983-8495
St. Joseph, MI 49085 Fax (269) 983-8258
BRANCH Troy Davis, DO (517) 542-321745,787 413 N. Chicago St. Fax (517) 542-3409
Litchfield, MI 49252
CALHOUN Mehmet B. Ismailoglu, MD (269) 969-8891137,985 391 South Shore Drive, Suite 214 Fax (269) 969-6193
Battle Creek, MI 49015
CASS Robert M. Knox, DO (269) 663-828851,104 27082 West Main Fax (269) 663-2426
PO Box 628Edwardsburg, MI 49112
CHARLEVOIX Reed Freidinger, MD (231) 547-448826,090 14730 Park Avenue Fax (231) 547-4488
Charlevoix, MI 49720 [email protected]
CHEBOYGAN Donald Ramsey, DO (231) 627-560126,448 748 South Main Street
Cheboygan, MI 49721
CHIPPEWA James C. Terrian, MD (906) 635-156838,543 508 Ashmun, Suite 120 Fax (906) 635-1701
Sault Ste. Marie, MI 49783
CLARE Elmer Shurlow, DO (989) 386-965931,252 4927 East Herrick Road Fax (989) 386-7686
Clare, MI 48619
CLINTON Donald L. Porter, MD (989) 224-233864,763 901 South Oakland Street Fax (989) 224-5608
St. Johns, MI 48879
October 2005 2
COUNTY NAME TELEPHONE2000 Population
CRAWFORD William H. McNamara, MD (989) 348-767114,273 1010 North Down River Road, West Fax (989) 348-8414
Grayling, MI 49738
DELTA Steven A. Dosh, MD (906) 789-442738,520 3409 Ludington, Suite 203 Fax (906) 789-4406
Escanaba, MI 49829
DICKINSON Robert Anderson, MD (906) 774-131327,472 Dickinson County Health Care System Fax (906) 776-5572
1721 South Stephenson AvenueIron Mountain, MI 49801
EATON Robert L. Leeser, MD (517) 543-0600103,655 123 Lansing Street, Suite 3 Fax (517) 543-9533
Charlotte, MI 48813
EMMETT Carl W. Hawkins, MD (906) 643-046631,437 220 Burdette St. Fax (906) 643-0464
St. Ignace, MI 49781
GENESEE Gary Johnson, MD, MPH (810) 257-3155436,141 Genesee County Health Department Fax (810) 257-3147
630 South Saginaw Street [email protected], MI 48502-1540
GLADWIN James Sullivan, DO (989) 426-452126,023 105 East Fifth Street Fax (989) 426-1475
Gladwin, MI 48624
GOGEBIC Charles N. Iknayan, MD (906) 932-620717,370 N10561 Grand View Lane (906) 932-2525
Ironwood, MI 49938 Fax (906) 932-9766
GRAND TRAVERSE Matthew A. Houghton, JR., DO (231) 334-818477,654 PO Box 116 Fax (231) 334-8185
Glen Arbor, MI 49636
GRATIOT Lewis Sandel, MD (989) 463-242242,285 245 East Warwick Drive Fax (989) 463-2640
Alma, MI 48801
October 2005 3
COUNTY NAME TELEPHONE2000 Population
HILLSDALE Lawrence E Dasch, MD (517) 254-475446,527 8591 Blount Rd. Fax (517) 254-4842
Hillsdale, MI 49242
HOUGHTON Dong Feng Liu, MD, PhD (906) 483-142736,016 Department of Pathology Portage Hospital Fax (906)483-1433
500 Campus Dr., [email protected], MI 49930
HURON Richard Lockard, MD (989) 375-227336,079 40 North Main Street Fax (989) 375-4552
Elkton, MI 48731
INGHAM Dean Sienko, MD (517) 887-4318279,320 5303 South Cedar Street, PO Box 30161 Fax (517) 887-4310
Lansing, MI 48909 [email protected]
IONIA James D. Banner, DO (989) 584-3971 Ext. 21961,518 406 East Elm Street Fax (989) 584-2331
Carson City, MI 48811-0879
IOSCO Richard Payea, MD (989) 362-214127,339 PO Box 392 Fax (989) 362-7740
1195 Tawas Beach RoadEast Tawas, MI 48730
IRON Nasseem F. Rizkalla, MD (906) 265-900113,138 1500 West Ice Lake Road Fax (906) 265-2634
Iron River, MI 49935
ISABELLA Elmer Shurlow, DO (989) 386-965963,351 4927 East Herrick Road Fax (989) 386-7686
Clare, MI 48619
JACKSON John Maino, II, MD, FACEP (517) 788-4482158,422 1715 Lansing Avenue Suite 648 Fax (517) 768-5823
Jackson, MI 49202
KALAMAZOO Richard Tooker, MD (269) 373-5190238,603 3299 Gull Road Fax (269) 373-5191
Kalamazoo, MI 49048-1295
October 2005 4
COUNTY NAME TELEPHONE2000 Population
KALKASKA Richard Hodgman, MD (231) 258-777716,571 419 South Coral Fax (231) 258-7611
Kalkaska, MI 49646
KENT Stephen Cohle, MD (616) 336-3021574,335 Office of Chief Medical Examiner Fax (616) 336-3943
700 Fuller, NEGrand Rapids, MI 49503
KEWEENAW David Gilbert, MD (906) 289-45172,301 11314 Middle Point Rd. Fax (906) 289-1040
Eagle Harbor, MI 49950
LAKE Paul Wagner, DO (231) 873-567511,333 611 East Main Street Fax (231) 873-4805
Hart, MI 49420
LAPEER Charles Franckowiak, DO (810) 667-350187,904 Lapeer County Health Department Fax (810) 667-1551
1800 Imlay City Rd.Lapeer, MI 48446
LEELANAU Matthew A. Houghton Jr., DO (231) 334-818421,119 PO Box 116 Fax (231) 334-8185
Glen Arbor, MI 49636
LENAWEE Patricia Lamb, MD (517) 264-476098,890 320 Springbrook Ave. Fax (517) 266-2547
Adrian, MI 49221
LIVINGSTON Joyce deJong, DO (517) 548-4170156,951 300 S. Highlander Way Fax (517) 552-2196
Howell, MI 48843
LUCE James C. Terrian, MD (906) 293-51077,024 14150 Hamilton Lake Rd. Fax (906) 293-5453
Newberry, MI 49868
MACKINAC Carl W. Hawkins, MD (906) 643-046611,943 220 Burdette St. Fax (906) 643-0464
St. Ignace, MI 49781
October 2005 5
COUNTY NAME TELEPHONE2000 Population
MACOMB Daniel J. Spitz, MD (586) 469-5214788,149 Macomb County Medical Examiners Office Fax (586) 469-6636
43525 Elizabeth Rd. [email protected]. Clemens, MI 48043
MANISTEE Michael Barna, MD (231) 398-115324,527 Office of Chief Medical Examiner Fax (231) 398-1469
1465 East Parkdale AvenueManistee, MI 49660-0397
MARQUETTE Randolph Smith, MD (906) 225-305064,634 Marquette General Hospital Fax (906) 225-3849
420 West Magnetic StreetMarquette, MI 49855-0220
MASON Marc E. Keen, MD (231) 845-236228,274 Clinical Laboratory Fax (231) 845-3849
One Atkinson DriveLudington, MI 49431
MECOSTA Paul Wagner, DO (231) 873-567540,553 611 East Main Street Fax (616) 873-4805
Hart, MI 49420
MENOMINEE Paul A. Haupt, DO (906) 863-789725,326 1100 Tenth Street Fax (906) 863-5762
Menominee, MI 49858
MIDLAND J. Daniel Cline, MD (989) 631-619082,874 2706 Louanna Fax (989) 631-3499
Midland, MI 48640
MISSAUKEE Gregory P. Lambourne, MD (231) 839-728214,478 1866 South Morey Rd. Fax (231) 839-7222
Lake City, MI 49651
MONROE Carl J. Schmidt, MD (734) 240-7910145,945 2353 South Custer Rd. Pgr (800) 991-7017
Monroe, MI 48161-9769 Fax (734) 240-7816
MONTCALM James D. Banner, DO (989) 584-3971 Ext. 21961,266 406 East Elm Street Fax (989) 584-2331
Carson City, MI 48811-0879
October 2005 6
COUNTY NAME TELEPHONE2000 Population
MONTMORENCY Michael McNamara, DO (989) 786-487710,315 3040 Bourn Street Fax (989) 786-2187
Lewiston, MI 49756
MUSKEGON Joyce deJong, DO (231) 724-6246170,200 209 E. Apple Ave. Fax (231) 724-6674
Muskegon, MI 49442
NEWAYGO Richard W. Peters, MD (231) 739-360147,874 Department of Pathology Fax (231) 733-6745
1500 East Sherman Blvd. [email protected], MI 49444
OAKLAND L.J. Dragovic, MD (248) 858-50971,194,156 1200 North Telegraph Road, Bldg. 28 Fax (248) 452-9173
Pontiac, MI 48341-0438
OCEANA Rudy Ochs, DO (231) 873-567526,873 611 East Main Street Fax (616) 873-4805
Hart, MI 49420
OGEMAW James Hall, MD (989) 345-138721,645 150 North Burgess Fax (989) 345-2591
West Branch, MI 48661
ONTONAGON Cary Gottlieb, MD (906) 524-33387,818 Baraga County Memorial Hospital Fax (906) 524-7147
770 North MainLanse, MI 49946
OSCEOLA Paul Wagner, DO (231) 873-567523,197 611 East Main Street Fax (616) 873-4805
Hart, MI 49420
OSCODA Wayne Wahl, MD (989) 848-22109,418 1910 East Miller Fax (989) 848-7139
PO Box 250Fairview, MI 48621
OTSEGO Michael McNamara, DO (989) 786-487723,301 3040 Bourn Street Fax (989) 786-2187
Lewiston, MI 49756
October 2005 7
COUNTY NAME TELEPHONE2000 Population
OTTAWA David A. Start, MD (616) 846-8360238,314 16920 Ferris Street Fax (616) 844-1778
Grand Haven, MI 49417 [email protected]
PRESQUE ISLE Michael Fairbanks, MD (989) 734-205214,411 555 North Bradley Highway, Suite A Fax (989) 734-7390
Rogers City, MI 49779
ROSCOMMON Howard Gregg, JR., DO (231) 876-729325,469 400 Hobart (231) 876-7296
Cadillac, MI 49601 Fax (231) 876-7497
SAGINAW Kanu Virani, MD (989) 792-6052210,039 Saginaw County Medical Exam Office Fax (989) 792-6053
111 S. Michigan Avenue [email protected], MI 48602
SANILAC Dennis A. Smallwood, DO (810) 648-409844,547 Sanilac County Health Department Fax (810) 648-2646
171 North Dawson Street [email protected], MI 48471
SCHOOLCRAFT James C. Terrian, MD (906) 293-51078,903 14150 Hamilton Lake Rd Fax (906) 293-5453
Newberry, MI 49868
SHIAWASSEE Brian Hunter, MD (517) 364-256171,687 1215 E. Michigan Ave. Fax (517) 372-0581
Lansing, MI 48912
ST. CLAIR David Hislop, MD (810) 982-4111164,235 3415 28th Street Fax (810) 985-2150
Port Huron, MI 48060 [email protected]
ST. JOSEPH John Robertson, MD (269) 659-426662,422 916 Myrtle Street Fax (269) 659-6592
Strugis, MI 49091
TUSCOLA Larry Cole, DO (989) 673-811458,266 Tuscola County Health Department Fax (989) 673-7490
1309 Cleaver RoadCaro, MI 48723
October 2005 8
COUNTY NAME TELEPHONE2000 Population
VAN BUREN Jason Tompkins, MD (269) 657-871976,263 205 South Kalamazoo Street Fax (269) 657-5161
Paw Paw, MI 49079
WASHTENAW Bader J. Cassin, MD (734) 477-6310322,895 Office of the Medical Examiner Fax (734) 477-6315
2215 Hogback RoadAnn Arbor, MI 48105
WAYNE Carl J. Schmidt, MD (313) 833-25042,061,162 Chief Medical Examiner Fax (313) 833-2534
1300 East WarrenDetroit, MI 48207
WEXFORD Howard Gregg, Jr., DO (231) 876-729330,484 400 Hobart Street (231) 876-7296
Cadillac, MI 49601 Fax (231) 876-7497
October 2005 9
Robert Anderson, MDDickinson County
(906) 774-1313
James D. Banner, DOIonia County
(989) 584-3971 Ext. 219
Montcalm County(989) 584-3971 Ext. 219
Michael Barna, MDManistee County(231) 398-1153
Dewey Benson, DOAntrium County(231) 377-7784
Warren E. Bontrager, MDOscoda County(989) 848-2260
Bader Cassin, MDWashtenaw County
(734) 477-6310
Cesar Casten, MDArenac County(989) 846-9533
Jeffrey P. Chapman, MDBarry County
(269) 945-3606
Robert Clark, MDBerrien County(616) 983-8313
J. Daniel Cline, MDMidland County(989) 631-6190
Stephen Cohle, MDKent County
(616) 336-3021
Larry Cole, DOTuscola County(989) 673-8114
Robert Coombs, MDAlpena County(989) 358-6824
Lawrence E Dasch, MDHillsdale County(517) 254-4754
Joyce deJong, DOAllegan County(517) 364-2561
Livingston County(517) 548-4170
Muskegon County(231) 724-6246
Steven A. Dosh, MDDelta County
(906) 789-4427
L.J. Dragovic, MDOakland County(248) 858-5097
Michael Fairbanks, MDPresque Isle County
(989) 734-2052
Charles Franckowiak, DOLapeer County(810) 667-3501
Reed K. Freidinger, MDCharlevoix County
(231) 547-4488
October 2005
CHIEF MEDICAL EXAMINERSQQuuiicckk RReeffeerreennccee LLiisstt
1
David Gilbert, MDKeweenaw County
(906) 289-4517
Cary Gottlieb, MDBaraga County(906) 524-3338
Ontonagon County(906) 524-3338
Howard Gregg, Jr., DORoscommon County
(231) 876-7293
Wexford County(231) 876-7293
James Hall, MDOgemaw County(989) 345-1387
Paul A. Haupt, DOMenominee County
(906) 863-7897
Carl W. Hawkins, MDEmmett County(906) 643-0466
Mackinac County(906) 643-0466
David Hislop, MDSt. Clair County(810) 982-4111
Jason Hodges, MDAlcona County(989) 724-6526
Richard Hodgman, MDKalkaska County(231) 258-7777
Matthew A. Houghton Jr., DOBenzie County(231) 334-8184
Grand Traverse County(231) 334-8184
Leelanau County(231) 334-8184
Brian Hunter, MDShiawassee County
(517) 364-2561
Howard F. Hurt, DOBay County
(989) 895-4009
Charles N. Iknayan, MDGogebic County(906) 932-2525
Mehmet B. Ismailogliu, MDCalhoun County(616) 969-8891
Gary K. Johnson, MD, MPHGenesee County(810) 257-3155
Marc E. Keen, MDMason County(231) 845-2362
Robert M. Knox, DO Cass County
(269) 663-8288
Patricia Lamb, MDLenawee County(517) 264-4760
Gregory P. Lambourne, MD Missaukee County
(231) 839-7282
October 2005 2
Robert L. Leeser, MDEaton County
(517) 543-0600
Dong Feng Liu, MD, PhDHoughton County(906) 483-1427
Richard Lockard, MD Huron County (989) 375-2273
John C. Maino, II, MD, FACEPJackson County(517) 788-4482
Michael McNamara, DOMontmorency County
(989) 786-4877
Otsego County(989) 786-4877
William H. McNamara, MDCrawford County(989) 348-7671
Troy Davis, DOBranch County(517) 639-3223
Rudy Ochs, DOOceana County(231) 873-5675
Christine Kruefer, MDAlger County
(906) 387-4220
Donald Ramsey, DOCheboygan County
(231) 627-5601
Richard Payea, MDIosco County
(989) 362-2141
Richard W. Peters, MDNewago County(231) 739-3601
Donald L. Porter, MDClinton County(989) 224-2338
Nasseem F. Rizkalla, MDIron County
(906) 265-9001
John Robertson, MDSt. Joseph County
(269) 651-4373
Lewis Sandel, MDGratiot County(989) 463-2422
Elmer Shurlow, DOClare County
(989) 386-9659
Isabella County(989) 386-9659
Dean Sienko, MDIngham County(517) 887-4318
Dennis A. Smallwood, DOSanilac County(810) 648-4098
Randolph Smith, MDMarquette County
(906) 225-3050
Daniel J. Spitz, MDMacomb County(586) 469-5214
October 2005 3
Carl J. Schmidt, MDMonroe County(734) 240-7910
Wayne County(313) 833-2504
David A. Start, MDOttawa County(616) 846-8360
James Sullivan, DOGladwin County(989) 426-4521
James C. Terrian, MDChippewa County(906) 635-1568
Luce County(906) 293-5107
Schoolcraft County(906) 293-5107
Richard Tooker, MDKalamazoo County
(269) 373-5190
Jason Tompkins, MDVan Buren County
(269) 657-8719
Kanu Virani, MDSaginaw County(989) 792-6052
Paul Wagner, DOLake County
(231) 873-5675
Mecosta County(231) 873-5675
Osceola County(231) 873-5675
October 2005 4
Robert L. Anderson, MDDickinson County Health Care System1721 S. Stephenson AvenueIron Mountain, MI 49801(906) 776-5580
Susan AtwoodSpectrum Health – Downtown Campus1840 Wealthy Street SEGrand Rapids, MI 49506(616) [email protected]
James D. Banner, DO406 East Elm StreetCarson City, MI 48811-0879(989) 584-3131
Joan M. BatesMusculoskeletal Transplant Foundation2203 Platt Rd.Ann Arbor, MI 48104(800) [email protected]
Bruce Beckman323 S. Fair St.Otsego, MI 49078(269) 694-4627
William A. Belding, MD W5460 Pine Dr.Norway, MI 49870(906) 563-7076
Dewey Benson, DOPO Box 1043Bellaire, MI 49615
Gary M. Berman, DDS9840 Haggerty RoadBelleville, MI 48111(734) [email protected]
Robert S. BladekOttawa County Medical Examiners Office602 MichiganHolland, MI [email protected]
Jerome Bond, MD1500 E Sherman Blvd.Muskegon, MI 49441(231) 739-3662
Kam Bradman2201 Boston Blvd.Lansing, MI 48910(517) 228-9533
Wayne Brigman3299 Gull Rd.Kalamazoo, MI 49048(269) 373-5190
John R. Bruni, MD551 First CourtNiles, MI 49120(269) 683-3056
Russell L. Bush, MD720 Fourth StreetLapeer, MI 48446-1447(810) [email protected]
Elaine Butts100 McMoran Blvd.Port Huron, MI 48060(810) 984-9710
Bader J. Cassin, MDPO Box 15249Detroit, MI 48215(313) [email protected]
October 2005
MAME MEMBERSHIP
1
Isabelle Chapello, DO10643 Valleywood Dr.Luna Pier, MI 48157(734) 848-5565
Jason Chatman700 Fuller Ave. NEGrand Rapids, MI 49503(616) 336-3021
Stephen D. Cohle, MDSpectrum Health – East Campus1840 Wealthy Street SEGrand Rapids, MI 49506(616) [email protected]
John Connolly7258 Kettle Lake SEAlto, MI 49302(616) 774-7774
Roberty Coombs, DO1063 US23 NorthAlpena, MI 49707(989) [email protected]
N. Joe Danna100 McMorran Blvd.Port Huron, MI 48060
Troy Davis, DO413 N. Chicago St.Litchfield, MI 49252(517) 542-3217
Paul R. Davison1840 Wealthy, SEGrand Rapids, MI 49506
Joyce DeJong, DO1215 E. Michigan Ave.Lansing, MI [email protected]
Mark Deming1301 Catherine Rd.Ann Arbor, MI 48109-0602(517) 423-4432
Robert Demski43 Christy Rd.Battle Creek, MI 49015(269) 965-2728
Mike DermyerLake County BuildingMedical Examiners OfficeBaldwin, MI 49304
Joe Doan1512 Clinton StreetAlconac, MI 48001(810) 794-9772
Steven A. Dosh, MD3409 Ludington Suite 203Escanaba, MI 49829(906) [email protected]
Ljubisa Dragovic, MD44 Beverly Rd.Grosse Pointe Farms, MI 48236(248) 858-4046
Ronald Dunfield1697 Lansing Ave.Jackson, MI 49201
Charles Franckowiak, DO1800 Imalay City RoadLapeer, MI 48446(810) [email protected]
Reed K. Freidinger, MD14730 Park AvenueCharlevoix, MI 49720(231) [email protected]
October 2005 2
Diana French2215 Hogback Rd.Ann Arbor, MI 48105
Timothy Freye PA-C4166 Jensen RoadFruitport, MI 49415
David Gilbert, MD11314 Middle Point Rd.Eagle Harbor, MI(906) [email protected]
Jill Glair1440 Munith Rd.Jackson, MI 49201(517) [email protected]
Ruth Grant1215 E. Michigan Ave.Lansing, MI 48912(517) 483-2562
Howard W. Gregg Jr., DO101 Birchwood LaneCadillac, MI 49601(231) 876-7293
K.P. Gunaga, PhDSt. Lawrence Hospital/Toxicology1210 West Saginaw StreetLansing, MI 48915
James R. Hall, MD150 North Burgess StreetWest Branch, MI 48861(989) 345-1387
Paul A. Haupt, DO1100 Tenth StreetMenominee, MI 49858(906) 863-7897
Carl W. Hawkins, MD220 Burdette St.St. Ignace, MI [email protected](906) 643-0466
Laurie HiltsLake County BuildingMedical Examiner’s OfficeBaldwin, MI 49304
David M.C. Hislop, MD5030 Lakeshore Rd.Alconac, MI 48001(810) [email protected]
Gary Holowitz1111 DelawareMarysville, MI 48043
Brian Hunter, MD1215 E. Michigan Ave.Sparrow Forensic ServicesLansing, MI 48909(517) 364-2452
Charles N. Iknayan, MDE6385 Gheller DriveBessemer, MI 49911(906) [email protected]
Janie JerniganP.O. Box 255St. Helen, MI [email protected](231) 876-7293
Marc E. Keen, MDMemorial Medical Center of West MichiganOne Atkinson DriveLudington, MI 49431(231) 845-2362
October 2005 3
Matthew Kempf7230 Holton Duck Lake Rd.Holton, MI 49425
Scott Krebill4900 Rogers Rd.Parma, MI 49269
George Krymowski, MD741 Lakewood LaneMarquette, MI 49855(906) [email protected]
Richard Lockard, MD6 N Main StreetElkton, MI 48731(989) 375-2273
Jean Lockard, RN40 N Main StreetElkton, MI 48731
John C. Maino, II, MD1715 Lansing Ave. Suite 648Jackson, MI 49203-2135(517) [email protected]
Michael Markey, MD1215 E. Michigan Ave.Lansing, MI 48909(517) 364-2549
Steve Miller1697 Lansing Ave.Jackson, MI 49203-2135(517) 788-4482
Peter Noble4095 Jeanola Dr. NWGrand Rapids, MI 49544
Ruben Ortiz-Reyes, MD1200 N. Telegraph Rd.Pontiac, MI 48341(248) 858-5097
Bernardino B. Pacris, MD1200 North Telegraph RoadPontiac, MI 48341(248) 858-5097
Mary M. Palmateer3415 28th StreetPort Huron, MI 48060(586) [email protected]
Waldemar A. Palutke, MD9425 Whispering Sands DriveWest Olive, MI 49460(810) 858-5097
Richard PerrinLake County BuildingMedical Examiners OfficeBaldwin, MI 49304
Richard W. Peters, MD1500 E. Sherman Blvd.Muskegon, MI 49444(231) 739-3601
Timothy RakerMarysville Police Department1111 DelewareMarysville, MI 48040
Daniel G. Remick, MDM2210 Medical Science I, Box 06021301 Catherine RoadAnn Arbor, MI 48109-0602(734) [email protected]
Richard Rich, RN3226 Nazareth Rd.Kalamazoo, MI 49048(269) 345-6658
Rob Schultz301 W. UptonRead City, MI 49677
October 2005 4
Peter K. Shireman, MD500 East Sherman BoulevardPO Box 358Muskegon, MI 49443-0358(231) [email protected]
Elmer Shurlow, DO4927 E. Herrick Rd.Clare, MI 48617(989) [email protected]
Dean G. Sienko, MD5303 South Cedar StreetLansing, MI 48911-3800(517) [email protected]
Lawrence R. Simson Jr., MDP.O. Box 490Haslett, MI 48840(517) [email protected]
Roger Simpson2215 Hogback Rd.Ann Arbor, MI 48105(734) 477-6363
Dennis A. Smallwood, DOSanilac County Health Department171 North Dawson StreetSandusky, MI 48471(810) [email protected]
Randolph E. Smith, MD420 West Magnetic StreetMarquette, MI 49855-0220(906) 225-3050
Ashod Sonnad, MD1380 E. Main St.PO Box 619Edmore, MI 48829-0619(989) 427-3511
Ellen Spaulding4914 ChurchillLeslie, MI 49251(517) 589-8388
Daniel Spitz, MD34051 Gratiot Ave.Suite 202Clinton Township, MI 48035(586) 791-6700
Werner U. Spitz, MD23001 Greater Mack AvenueSt. Clair Shores, MI 48080(810) [email protected]
David A. Start, MD1840 Wealthly SEGrand Rapids, MI 49506(616) 774-7499
Robert G. StudabakerConstantine Police Department115 White Pigeon StreetConstantine, MI 49042
James Sullivan, DO105 East Fifth StreetPO Box 427Gladwin, MI 48624(989) 426-4521
Patricia Tackitt1300 E. Warren Ave.Detroit, MI 48207(517) 324-7330
Paul K. Tam, MDDepartment of Pathology1234 Napier Ave.St. Joseph, MI 49085-2428(616) 982-4853
Bradley Tennant1000 Wall StreetAnn Arbor, MI 48105
October 2005 5
Richard Tooker, MD3299 Gull RoadKalamazoo, MI 49001-1295(269) 383-8818
William L. TroutMarysville Police Department1111 DelawareMarysville, MI 48040
Deborah M. TubbSaginaw County Governmental Center111 S. Michigan Ave.Saginaw, MI 48602(989) [email protected]
Scott VanSickle100 McMorranPort Huron, MI 48060(810) 984-9711
Allan Warnick, DDS31632 Schoolcraft RoadLivonia, MI 48150(313) 425-6920
Kanubhai Virani, MD6189 Beachwood CourtWest Bloomfield, MI 48324(989) 758-3819
Barry C. Weeks1115 ResortPleasant Lake, MI 49572
Mark Wilk121 S. Second St.St Ignace, MI 49781(906) 643-6516
Stephen Zonts1112 Backus St.Jackson, MI 49202
October 2005 6
October 2005
According to the “Michigan Required Request Law” the next of kin must be given the option of organand tissue donation if the descendent is medically suitable.
ORGAN DONORS 1. Present or pending declaration of deathAge: No Limit 2. Mechanical ventilation and intact cardiovascular system for heart
beating organ donors3. Non-heart beating organ donors require ME release prior to death4. No absolute age or medical rule outs
TISSUE DONORS AGE TIME LIMITS
EYES 5 to 75 years 12 hoursBONE 12 years / no upper age limit 24 hours if cooledHEART VALVES Full Term and 7lbs to 55 years 24 hours if cooledVEINS 15 to 55 years 12 hoursSKIN 15 to 75 years 24 hours if cooled
LEGAL CONSENT
Consent for organ and tissue donation will be obtained by Gift of Life Michigan from the legal next ofkin on all cases.
MEDICAL EXAMINER
A Medical Examiner’s case DOES NOT preclude donation. Post autopsy cases DO NOT preclude dona-tion. The transplant agency or hospital designee will obtain clearance from the County Medical Examinerprior to any surgical recovery of organ or tissue. When the Medical Examiner’s duties require an autopsyprior to tissue recovery special arrangements will be discussed with the Medical Examiner.
MEDICATIONS
One or more of the following medications may be used during the donation process and detected bypathological examination:
A broad spectrum of Antibiotics Dopamine NiprideAqueous Pitressin Heparin RegitineDecadron Insulin ThyroxinDesmopressin Lasix Papavarin in vein recoveryDexamethasone Levophed EpinephrineDobutamine Mannitol A wide range of cardiac medications
CRITERIA FOR ORGAN AND TISSUE DONATION
October 2005
Dear Medical Examiner:
Thank you for allowing the Gift of Life to recover anatomical gifts from the body of ______________________________ . Care has been taken to complete the donation withaccepted medical standards. As indicated below, we have provided fluid specimens andpertinent documentation associated with the decedent. If any questions or commentsshould arise from this donation, please call 1-800-482-4881 24 hours a day.
Thank you,
Gift of Life Michigan
Eyes/Corneas ______ Femur ______ Fascia Lata ______
Heart ______ Fibula ______ Saphenous Vein ______
Kidneys ______ Humerus ______ Skin ______
Liver ______ Pelvis ______ Radius ______
Lungs ______ Ribs ______ Ulna ______
Pancreas ______ Tibia ______ ____________ ______
Intestines ______ Achilles Tendon ______
The following specimens and documentation were collected by:
Name: Initials:
Signature: Date/Time:
______________ Consent Form ______________ Chart Copy
______________ Clotted Blood ______________ Bile Specimen
______________ Urine Specimen ______________ Other: _______
______________ Vitreous Specimen ______________ Other: _______
* * * * * *This form will be completed by the Gift of Life recovery team
and will be attached to the body after donation.* * * * * *
LIFE PROGRAM
The LIFE Program has been designed for Medical Examiners andMedical Examiner Investigators involved in death investigation when the decedent may be a candidate for donation. This innovativeprogram provides families the opportunity to consider eye and tissuedonation when death occurs outside a health-care facility. Families areable to make an informed decision regarding donation under the guid-ance of a trained donation coordinator.
For further information and assistance in implementing this program in your office, please contact the Gift of Life Michigan at 1-800-482-4881.
GIFT OF LIFEAND
GIFT OF SIGHT
October 2005
Tissue / Eye Donor Worksheet
1. County: _________________________ Case Number: ____________________________________
2. Name of Decedent: ________________________________________________________________
3. Sex: _______________ 4. Race: __________________ 5.DOB: __________________________
6. DOD:________________________________ 7. TOD:____________________________________
8. Refrigeration Time: ______________ 9. Funeral Home: __________________________________
10. Circumstances of death/history include location, time of accident/incident, as well as,
sustained injuries.
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
11. Probable Cause of Death: __________________________________________________________
____________________________________________________________________________________
12. Decedent’s approximate Height: ________________ 13. Weight: __________________________
14. Next of kin: Name:________________________________________________________________
Phone:________________________________________________________________
15. Has Condolence Card been given to family? YES NO
16. Autopsy? YES NO
17. Any restrictions? __________________________________________________________________
18. First Responder Contact Info (EMS, paramedics, police, etc): ______________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
*Exclusions defined on reverse side of form
Please phone or fax information to Gift of LifePhone: 1-800-482-4881 Fax: 734-973-0124
October 2005
The Gift of Life * Gift of Sight
Rule Out Criteria
Age:
• Females – acceptable up to & including 75
Males – No Age Limit
CDC High Risk Behaviors:
• Knowledge or evidence of (circle all that apply):
• Known IV Drug Users
• Hepatitis
• HIV/AIDS
• Sex In Exchange for Money or Drugs
• Inmate of Correctional System if Greater than 72 hrs in Last 12 Months
• Non Therapeutic Needle Marks
• Males that have had sexual relations with other males within last 5 years
Medical Conditions:
• If unknown Time of Death, Last Seen Alive Time (no greater than 15 hours)
• Rabies
• Creutzfeldt-Jakob Disease (Bovine Spongiform Encephalopathy)
• Hemophilia
• Active Tuberculosis or Malaria
• Leukemia or Lymphoma
• Active Cancer (except for eye alone donors)
• Multiple Open Fractures
October 2005
LIFE PROGRAM
MEDICAL EXAMINER / INVESTIGATOR REFERRAL PROCESS
Step 1: Offer the CONDOLENCE CARD which suggests the option of tissueand eye donation.
Step 2: Request the family’s permission to be contacted by a Gift of Life orGift of Sight representative.
Step 3: Call the Gift of Life Michigan at 1-800-482-4881, 24 hours a day, andask to speak with a screening coordinator. In situations when offering
the Condolence Card is not feasible, a Gift of Life and Gift of Sightrepresentative can directly contact the family to offer the option of donation.
Step 4: Provide the information on the MEDICAL EXAMINER / INVESTIGATOR REFERRAL WORKSHEET along with any additional information that will assist our agencies in their efforts to determine donor suitability, as well as, offering the option of donation to the family.
October 2005
MEDICAL EXAMINERQUALITY IMPROVEMENT FORM
Dear _______________ Medical Examiner/Investigator:
Gift of Life Michigan had an organ/tissue/eye donation that also involved a medicalinvestigation by your office. Please assist us by checking off the most appropriateresponses below to let Gift of Life know your evaluation of our service to your office:
Decedent’s Name: ____________________ Date of Donation: ____________________________
PROCESS ELEMENT YES NO N/A COMMENTDid your office receive timelytelephone communication from Giftof Life regarding the release oforgans/tissue/eyes?
Were blood tubes and otherspecimens labeled and deliveredproperly to your office?
Were copies or original documentsprovided by Gift of Life as requestedby your office?
Did your office receive timelytelephone communication from Giftof Life regarding the availability ofthe body following organ/tissue/eyerecovery?
Are there any other proceduralmatters that Gift of Life needs toaddress with your office?
Please fax return this document to Gift of Life at 734-973-3133. If further discussionregarding this case is required, please call 1-800-482-4881, 24-hours a day.
Thank you,
Gift of Life MichiganManagement and Staff Gift of Life # ____________________
Revised: 9/9/04Reviewed: 10/05
Gift of Life Michigan2203 Platt Road • Ann Arbor, MI 48104 • (734)973-1577 • (800)482-4881 • Fax: (734)973-3133