ODESSA, Mo. (KMIZ)
Joy Chance fondly remembers May 24.
Her husband, Dustin, surprised her with a weekend camping trip to Majestic Oaks Campground in Miller County. It was their favorite hobby -- staying nights out in the wilderness, fishing, hiking and sitting around a campfire.
Those memories are framed as photos around Joy’s home in Odessa, two hours northwest of the Lake of the Ozarks-area campground. Dustin smiles back in them. He teaches Joy’s children to fish. She says he treated like his own.
May 24 is a day she wishes she had the chance to relive.
“It was the day that I wish I could do over, because I would have told him a lot more stuff,” she said.
The pair went to bed after having a few drinks and listening to music. Joy said she doesn’t know why she woke up in the middle of the night, but at some point she discovered Dustin had stopped snoring. In fact, he had stopped breathing altogether.
In a panic, she called for an ambulance. Law enforcement reports from the Miller County Sheriff’s Department show that around 5 a.m., first responders arrived to try and revive Dustin. They were not successful. Dustin had died.
Joy said Dustin had no known medical problems. He had been treated years ago for high blood pressure, and his job laying asphalt sometimes made that worse. He had gone through no long hospitalizations and never complained that day of any lingering pains or problems.
Much of this she relayed to Miller County Coroner Tim Bradley, who came to do his duty of determining the cause and manner of death. Bradley ruled out the possibility that Dustin’s death was criminal. He had spent that day almost exclusively with Joy and did not see any signs of trauma to his body. After learning Dustin’s medical history and his previous use of alcohol, Bradley decided Dustin died of natural causes.
Bradley filled out Dustin’s cause of death on the death certificate as “undiagnosed sleep apnea.” He would not order an autopsy. Joy said that decision leaves her confused and angry.
“I kept telling him that I didn’t understand how Dustin could have just been doing all this just hours ago and now he’s dead,” Joy said. “And so I begged for an autopsy, and he told me that he couldn’t justify it because we’re a poor county.”
An autopsy is a procedure involving a forensic pathologist dissecting a body and testing various organs. Those tests can detect unseen diseases or conditions, and can help a coroner and family learn more about how a person may have died.
Kathleen Little, executive director of the Missouri Coroners' Association, said an autopsy can help notify a family of a possible genetic disorder that they could be at risk of having.
“When someone suddenly dies unexpectedly, you have no medical records to back up a diagnosis, you want to give the family answers,” Little said.
Dustin’s relatively young age and dying with no known medical problems would have made him a prime candidate for an autopsy, Little said. She also questioned Bradley’s use of the term “undiagnosed” on Dustin’s death certificate. She had never seen that term appear on any death certificate in her work in the coroner or pathology field.
“I don’t feel like it’s been handled well,” Little said of Chance’s situation. “I think there’s a lot of unanswered questions that the family is left with.”
A hasty mistake
Bradley told ABC 17 News he made a mistake in putting “undiagnosed sleep apnea” on the death certificate. Last Tuesday, a week after ABC 17 News started asking questions, Bradley requested a change to the cause of death from sleep apnea to “hypertension.”
“When I went to finish up my report and do the death certificate, I was just glancing at my notes real quick,” Bradley said. “Forgot all I had going on that day. I got in a hurry and put the wrong thing down on the death certificate and, you know, I had to make a correction to it since then.”
Bradley said he usually only requests autopsies for death in which he believes something criminal occurred. Miller County only budgets for three autopsies a year, or $6,000, and Bradley had paid for his third autopsy of the year on May 24, just one day before Dustin’s death.
State law only requires that a coroner order an autopsy for children under 1 year old. There are few guidelines outside of that, something Bradley, Little and Joy all feel is an issue.
Miller, like many other counties in mid-Missouri, uses the University of Missouri’s pathology department for autopsies. The hospital in Columbia charges $1,750 per autopsy. Records from the hospital show Miller County has spent $12,250 this year on autopsies -- more than double the county’s budget for the procedures.
Bradley said the county has not yet turned him down for the funds to perform one. Those cases have had a possible criminal aspect, he said.
“If I had more money budgeted, I’d probably order more autopsies, without a doubt,” Bradley said.
“And you think Dustin would have been one of them?” asked reporter Lucas Geisler.
“He might have been, yeah,” Bradley said.
Small counties, little money
Little said she frequently hears county coroners worry about ordering autopsies because of the cost to the county. County commissions, she said, are reluctant to provide the money to coroners to perform them. Coroners' offices are not making counties money.
“I don’t think that anyone should put a price tag on what it costs to get family answers in the worst situation of their life,” Little said.
Joy will never get those answers. Dustin was cremated shortly after Bradley’s decision not to get an autopsy. She was never told the price of getting a private autopsy at University Hospital -- she said she would have tried to borrow money to have it done.
“He doesn’t understand how it feels, of not knowing how he died, and every day wondering if you could have gotten him up sooner, if things would have been different,” Joy said. “And I don’t think it’s right he got to make that decision.”
Bradley said he was sorry his decision upset her. While he thought the issue with Dustin’s death certificate was a fluke that won’t happen again, he did vow to make a change to his policy on ordering autopsies.
“I don’t care how hard of a time I have, or how big of a fight I get into, anyone under the age of 40 will get an autopsy,” Bradley said. “I know I’ve got to be responsible, but at the same time, I’m not going to put someone else through this, I’m not going to take a chance.”