Mike Tyler knows his wife's death certificate by heart, but the one word he can't understand is typed under cause of death -- "pending."
"This isn't right. And it just keeps getting worse every day." said Tyler.
The Salem, Massachusetts, man found his wife Cherly Ann slumped over the coffee table, dead in their living room in August, 2014. Questions haunt him. Did the overnight nurse choke while he slept? Did she have a heart attack or die of a condition that could put her autistic son at risk? Was there anything Tyler could have done to save her?
"There's just too many things running through my mind," said Tyler.
Tyler has been waiting for the Massachusetts Medical Examiner's office to tell him how his wife died...for almost 18 months. He says the ME's office tells him they're waiting on a toxicology report. The Executive Office of Public Safety Tuesday told NECN the case was closed in November, after 15 months, but a spokesperson says it is unclear why Mr. Tyler was not notified of the update.
"If it's still sitting on somebody's desk, and I keep thinking why and listening to their excuses. Who do these people have to answer to?," said Tyler.
Public Safety Secretary Daniel Bennett oversees the Office of the Chief Medical Examiner. He admits just-released numbers show the office is still struggling under an unacceptable backlog. "All I can say to them is we're making the best efforts we can," he said.
In an annual report to legislators, Chief Medical Examiner Henry Nields says the caseloads for medical examiners is too high and death certificates and autopsy reports aren't being finished fast enough.
According to state data, In 2015, the office performed 2,618 autopsies, but they have failed to complete nearly 63 percent of the autopsy reports. Death certificates are pending for about 30 percent of cases. The year has just begun, so there will likely be some improvement in those numbers.
"Every day they do the autopsies. Every day the terrible part of the job is being done. It's getting that paperwork done. That is the weakest part," said Bennett.
Bennett blames chronic under-staffing and a national shortage of medical examiners. A 2008 review recommended the office should have 17 full-time examiners, but there are only 9 full-time examiners with the OCME and four part-time. National standards say medical examiners should handle no more than 250 autopsies per year, but the state ME's are doing an average of 319 autopsies. The national standard is to finish 90 percent of autopsy reports in 90 days, but the office is only meeting that standard 25 percent of the time.
"That's not acceptable. Families won't accept that and they shouldn't have to," said Sen. Karen Spilka.
Senate Ways and Means Chair Karen Spilka -- has constituents who have been waiting years to learn the cause of death for a loved one.
"We know it's something where we need to make more progress faster," said Massachusetts Governor Charlie Baker.
In recent months, Bennett says the office has hired assistants to help triage cases and ease paperwork burden for the MEs and they are seeing positive results. He also points to marked progress in toxicology analysis. According to state data by the end of the fiscal year, turnaround time had been reduced by 58 percent and continues to improve.
"I think that early indications are that we're doing it better," said Bennett.
Mike Tyler who is waiting for one of those toxicology reports agrees.
"A year and a half. I've been patient long enough," said Tyler.
Secretary Bennett says they hope to lure more medical examiners to Massachusetts by increasing salaries from what he calls the lower end to the higher end.