The Cadaver King and the Country Dentist

by Radley Balko

  Morris found himself in an ethical quandary. Hayne’s claims actually helped Morris’s client. But Morris also knew Hayne was wrong. He had previously hired three separate toxicologists, all of whom definitively told him that amitriptyline wasn’t a factor in the man’s death.

  “He’s just too smart to not have known. I think he calculated. I remember that he first seemed unprepared for the deposition. But as it got going, he seemed to assess the situation—the attorneys, the parties, what was at stake. Then he tailored his testimony on the fly to fit what he was observing. It was a remarkable thing.”

  The two men made small talk after the deposition. When Morris mentioned his love of cars, Hayne asked if Morris wanted to see his. Morris agreed and followed Hayne to the parking lot.

  “It was an all-black car—I think it was a Dodge Charger—that he had souped up to look like an undercover police car,” Morris says. “Here was this short, kinda fat, sixty-something-year-old man, and he’s driving a car with decked-out rims, radios, and one of those spotlights that you can control from inside the car.”

  Morris knew that Hayne frequently testified in criminal cases, almost always for prosecutors. “It looked so out of character. Here’s this little bit geeky guy driving around in this muscly, not-so-undercover cop car. It was definitely the car of a guy with a complex.”

  Morris says he initially couldn’t put his finger on what bothered him about it all. The following morning, he read an op-ed in the Wall Street Journal detailing Hayne’s mammoth workload, questionable methods, and testimony he had given in several cases that other experts said was dubious.

  “A chill went down my spine,” Morris says. “I thought, That’s it. I started to see the big picture. Prosecutors in the South—they have this sort of jockish way about them. They’re macho. You got the sense that Hayne latched onto them because he liked associating with them. I’m sure he made a lot of money over the years. But he also got to be one of the guys. He got to drive the cool car. And they had a smart guy who would play ball.” (Hayne has consistently denied that he would “play ball” for prosecutors).

  It was all of that, combined with Hayne’s intellect, that Morris found particularly alarming. “I’m not some left-winger. I’m a pretty solid conservative, almost across the board. But I started wondering how many innocent people this guy might have put in prison. It was a terrifying thought.” According to Morris, attorneys on both sides of the nursing home case agreed that Hayne’s testimony was way off base. The case was settled out of court.

  Almost nine years and hundreds of cases later, Morris still remembers that encounter with Hayne. “The guy was brilliant. He also managed to be both insecure and an egomaniac. I remember thinking that seemed like a really dangerous combination in an expert witness.”

  Steven Timothy Hayne was born in Los Angeles, California, on August 30, 1941. He went to high school in the Bay Area. In 1967, at age twenty-six, he enrolled in Contra Costa College in San Pablo, California. After two years he transferred to North Dakota State University to study agriculture. About his choice of transfer school, Hayne has explained that his decision was simple: “Their application was one sheet, one side, and I decided that’s the kind of school I wanted to go to. I liked their attitude.” Before completing his undergraduate degree, Hayne transferred to the University of North Dakota medical school in 1972, where he studied for two years before transferring again, to the medical school at Brown University in Rhode Island. This time, expediency gave way to prestige. He would later tell attorneys in a deposition, “I didn’t want to graduate with a degree from the University of North Dakota. I wanted an Ivy League degree.” He completed medical school in the spring of 1976.

  According to his trial and deposition testimony over the years, Hayne’s first postgraduate internship followed that same year at the Letterman Army Medical Center at the Presidio in San Francisco, where he specialized in pathology. After completing his internship and rotations at medical institutions in the Bay Area, he was named chief of pathology at the Blanchfield Army Hospital in Fort Leavenworth, Kansas. He then moved around for a few years, from the military hospital in Fort Campbell, Kentucky, to a position as a reference pathologist at Shoals Medical Laboratories in Alabama, then to medical director of Rankin Medical Center laboratory in Brandon, Mississippi, just east of Jackson. He received his Mississippi medical license in 1985 and obtained his certification in clinical and anatomical pathology from the American Board of Pathology soon after.

  Hayne began regularly performing autopsies for the state of Mississippi in late 1986 or very early 1987. It was a propitious time to get started. Thomas Bennett had just quit the medical examiner post in frustration, the second state medical examiner in only a few years to do so. The state had reverted to administering autopsies the way it had for decades, but in an ever-increasing atmosphere of need. If the county coroner believed a suspicious death required an autopsy, he or she would hire a private pathologist. At the start of Hayne’s career, the fees that came with these referrals were around $400 for the autopsy itself, plus $200 per hour for preparation and time in court. Toward the end, the autopsy fee was around $1,000, and he was charging $350 or more per hour for testimony. He’d also get additional money for lab work and analysis.

  Each county was responsible for paying the doctors it hired for autopsies. All the while, the problem of too few qualified medical examiners to handle an increasing number of autopsies wasn’t just intractable, it was getting worse. This was the context in which Hayne rose to prominence.

  Where other pathologists in Mississippi saw forensic autopsies as a burden that cost them time and money, Steven Hayne found a way to make them profitable. The secret was to do a lot of them. Hayne began his forensic pathology career in Mississippi with just a few autopsies per month, but his workload quickly escalated. In 1988, two years after moving to the state, he did 320. By the early 1990s, he was doing 1,200 per year—about 80 percent of the state’s annual autopsy referrals. The number continued to rise from there, peaking in 2007 at 1,857 autopsies. Assuming he worked every day of the year, that’s five per day.

  To put these numbers into perspective, the National Association of Medical Examiners (NAME), the leading professional organization for forensic pathologists, recommends a medical examiner do no more than 250 autopsies per year. If a physician exceeds 325 in a year, NAME won’t certify the lab where that doctor works, regardless of any other factors. In a 2001 deposition, Hayne admitted that in 1998 alone, over a period of just a few weeks, he performed 375 autopsies. He had done more autopsies in eleven weeks than NAME’s uppermost limit for a year.

  But according to Hayne, performing autopsies wasn’t his only job. For most of his tenure in Mississippi, he also held two other professional responsibilities: medical director of the Rankin County Medical Center laboratory and medical director of a kidney care facility and research lab. Over the years he also held titles at various labs and hospitals and consulted in civil cases, including performing private autopsies and testifying in court.

  Hayne has tried to explain away his workload by claiming a near superhuman capacity for labor. “I normally sleep no more than two to three hours a day. I also work seven days a week, not five days a week. I don’t take holidays. I don’t take vacations.… So I work at a much more efficient level and much harder than most people. I was blessed with that and cursed with that, but that’s what I carry with me, and I do work very, very hard,” he said while testifying in a 2003 murder trial. He also testified, “I do not require much sleep. I choose to work.” When asked about NAME’s claim that after more than 350 autopsies doctors are prone to carelessness and mistakes, Hayne countered, “I have an ability to stay alert. I have an ability to work long hours, and I don’t think I make those [i.e., errors], and I think my record stands for itself.” He would repeat this claim in other trials throughout his career when questioned about his workload.

  Because Hayne held two other full-time positions (or at
least positions that were supposed to be full-time), he typically conducted all of his autopsies at night, generally between the late evening and the wee hours of the morning. His penchant for knocking out eight to ten autopsies at hours when most people are sleeping only added a layer of macabre to his lore.

  Some back-of-the-envelope math shows just how busy Hayne had to have been. Add up even the low estimates Hayne at various points has claimed he spent on continuing education, court testimony, his two salaried jobs, and just a few hours of sleep, and it leaves about three hours per autopsy, assuming 1,500 autopsies per year. That’s the absolute minimum most professional groups say is necessary. But that would have left Hayne with no time—zero hours—for vacations, days off, weekends off, or sick days. It doesn’t account for meals, commuting, socializing, showering, other personal health and grooming, time with his spouse, parenting, or a single hobby or interest. It assumes he didn’t mow his own lawn, watch TV, go to the movies, or take a trip to the grocery store. And it doesn’t account for the dozens of journal articles and conference presentations that he claims to have researched and written.

  Incredible as they are, even those numbers don’t tell the whole story. Hayne also did private autopsies and consulting for civil cases. He has testified in depositions for some of those cases. Beginning in the early 1990s, Hayne also became the go-to medical examiner for several parishes in Louisiana, adding still more to his autopsy total. In fact, in a 2012 deposition, Hayne acknowledged that there were “a couple” years where he topped two thousand autopsies.

  As for how he managed it all, Hayne claims he simply never took time off. “I guess I am a workaholic,” he said in 2012. “I don’t go on vacations, don’t take weekends, don’t take holidays.… Just the way I am. I don’t go to barbecues and stuff.”

  Hayne was able to dominate Mississippi’s autopsy referrals by being all things to all the important people. Whereas other pathologists in the state reluctantly agreed to perform autopsies, Hayne embraced them and actively sought out referrals. While law enforcement officials found other pathologists reluctant, off-putting, and unhelpful, Hayne made himself available to police and prosecutors, enthusiastically testified in court, and—most importantly—worked with prosecutors to help them win convictions they believed were justified.

  Medical examiners are supposed to be impartial finders of fact. But the incentives built into the system are clear. After a suspicious death, the coroner, district attorney, or police official takes the body to a medical examiner for autopsy. In most cases, they then tell the medical examiner what they thought happened. The medical examiner who returns with opinions that back up their hunch earns favor and gets more referrals. The medical examiner who says, “No, that isn’t what happened,” or—the more likely scenario—“There just isn’t enough conclusive evidence for me to say that this is what happened” makes the sheriff’s or prosecutor’s job more difficult, and perhaps makes them think twice before using the same doctor the next time. There needn’t even be any intent to deceive or distort findings. It’s human nature; if they have a choice in which medical examiner to use, over time prosecutors and police will gravitate toward the expert who makes their jobs easier. A properly designed system would work to eliminate these sorts of biases and misaligned incentives. The Mississippi system fed them.

  The ways in which prosecutors and other law enforcement officials have described Hayne over the years provides further evidence of the problem. For example, John T. Kitchens, a former district attorney, state judge, and longtime Hayne defender, told the New York Times in 2013, “I’m sure there’s a lot of people that don’t like Hayne, but from a prosecutor’s standpoint I don’t know anybody who didn’t like him. He was always so helpful and useful to law enforcement.” When Hayne finally came under fire in the late 2000s, law enforcement officials wrote letters to show their support for him. Like Kitchens, many described what a great witness he had been. One prosecutor recalled a case in which, upon hearing Hayne testify, one juror whispered to another, “He must be some kind of genius.” The prosecutor also feared that criticism of Hayne would lead to the courts being “overloaded with convicted killers making fruitless claims of wrongful convictions.” Another prosecutor noted he was “completely satisfied with Hayne’s work,” and noted Hayne’s ability to make “several court appearances in one day.” Still another seemed downright distraught at the prospect of losing Hayne. “It has always been a source of great comfort to me that Dr. Hayne would be a witness in our murder cases,” he wrote. “It is a big concern to me that I might have to go through the rest of my career as a prosecutor without Dr. Hayne performing our autopsies.”

  Prior to Hayne, the perverse incentives in the referral process were less important. There were no forensic pathologists in the state, and the clinical pathologists didn’t particularly want referrals. That system still had lots of problems, but they were different problems. Crimes were going unsolved; they weren’t being “solved” with questionable expertise. With a little funding, the Mississippi legislature could have followed the lead of Florida, Maryland, and a number of other states by implementing a modern, accountable, well-funded medical examiner system. It was just never a priority.

  Shortly after Hayne moved to Mississippi from Alabama in the mid-1980s, he visited with Rankin County coroner Jimmy Roberts. After that meeting, Roberts began sending Hayne autopsy referrals. It began a partnership that would last for two decades. The two men would make money together, and they’d become among the most powerful figures in the state.

  Roberts was first elected Rankin County coroner in 1981. In an interview with the Clarion-Ledger shortly after he was sworn in, Roberts gave a preview of the debate that would unfold in the years to come. At the time, the reform-minded Faye Spruill was serving as Mississippi’s first state medical examiner. Roberts, described by the paper as “tall and fragile-looking,” insisted that the coroner was still a critical public office. He told the paper that under Spruill’s proposed reforms, the counties wouldn’t get a good return on the tax dollars they’d be sending to Jackson. “By keeping money in the county, it can be better accounted for,” the article read, paraphrasing Roberts. As it would turn out, by “be better accounted for,” Roberts meant “benefit Jimmy Roberts.”

  While working with an established, influential elected coroner like Roberts, Hayne began to get more autopsy referrals from other coroners across the state. The relationship also helped Roberts. In the late 1980s, Roberts opened his own morgue and embalming business in the town of Pearl. As Hayne collected more and more referrals, Roberts would charge the other counties a fee when Hayne used the morgue to do those autopsies. Roberts would also get transportation costs for picking up bodies and bringing them to his facility. One former coroner recalls Roberts getting $150 per autopsy for use of his morgue, plus up to $2 per mile for transporting bodies. Once the body was in his morgue, he also became the practical choice to provide the family of the deceased with embalming services. It was a convenient arrangement.

  “After the autopsy, he’d say to the funeral director or family, ‘Well, as long as I’ve got the body, why don’t I embalm him?’” says another longtime former coroner. “He made a lot of money hauling bodies all over the state.” By 2005, one consultant estimated that Hinds County alone (the largest in the state) was paying Roberts and Hayne $2 million per year for autopsies, facilities rental, and the transport of bodies.

  With Jimmy Roberts in his corner, it didn’t take Hayne long to corner the market on Mississippi autopsies. Unlike the reluctant doctors with whom coroners and prosecutors had to deal with in the past, Hayne gladly worked with cops, DAs, and coroners. He was cooperative and agreeable, didn’t complain about testifying, and produced results (if not full reports) in a respectable period of time.

  Hayne quickly made a name for himself, and it paid off. In June 1987, he was appointed interim state medical examiner. In announcing the appointment, the public safety commissioner touted Hayne’s n
umerous published articles, his time as a pathologist for the military, and his impressive résumé.

  There was one problem. The state medical examiner was required by state law to be certified in forensic pathology by the American Board of Pathology (ABP), the discipline’s nationally recognized certifying organization. This was part of the recent efforts to modernize the state’s death investigation system. Hayne was certified in clinical and anatomical pathology, which deals with determining deaths by natural causes such as disease, heart attack, or stroke. He was not certified by ABP in forensic pathology, which concerns deaths that have implications for the legal system.

  But the state was desperate to fill the position. And the state officials whose opinions mattered clearly wanted Hayne. The public safety commissioner requested a legal opinion from the state attorney general, asking whether an uncertified pathologist could be appointed state medical examiner if a certified candidate wasn’t available. (Faye Spruill was the only board-certified forensic pathologist in the state at the time. She didn’t want the job, nor was anyone going to offer it to her.) The attorney general’s office answered that it could be done, at least on an interim basis. That’s how Steven Hayne became Mississippi’s third state medical examiner.

  The arrangement didn’t last long. In February 1988, eight months after he was appointed, Hayne resigned. He said no one had asked him to step down, but he was doing so in order to clear the way for the appointment of a permanent, board-certified state medical examiner.

  With Hayne out of the state medical examiner’s office—and the office essentially defunct—the last few years of the 1980s spawned yet another public debate about the state of Mississippi’s death investigation system. In August 1988, a legislative oversight group called the Joint Committee on Performance Evaluation and Expenditure Review (PEER) published a study and audit of the coroner system. The group found that the state medical examiner’s office was understaffed and underfunded, that the state’s autopsy facilities were woefully inadequate, and that county coroners were often unqualified, uncooperative, and deficient in their duties. It described the coroner system as outdated and inefficient, found that thousands of deaths were going uninvestigated or misinvestigated, and concluded that the entire process was corrupting the administration of justice.