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Michael Hall for County

Commissioner Precinct  4

Repeated Turnover at Nueces County’s Medical Examiner Office Signals a Breakdown in Oversight

Updated: Dec 15, 2025

The Nueces County Medical Examiner’s Office plays a critical role in public safety, criminal justice, and public health. Families rely on it for truthful determinations of cause and manner of death. Law enforcement depends on it for credible forensic evidence. Courts depend on it for reliability and professionalism.


Yet over the last five years, Nueces County has experienced extraordinary instability in this office, marked by multiple chief medical examiners, lawsuits, a costly settlement, and repeated resignations. Together, these events point not to isolated mistakes, but to systemic failures in oversight.


A Pattern of Turnover and Controversy


Since roughly 2020, Nueces County has cycled through multiple chief medical examiners, many serving short and troubled tenures:

  • Dr. Adel Shaker, chief medical examiner through 2020–2021, presided over an office later found to have serious credentialing and compliance problems.

  • Dr. Timothy Fagen was appointed in 2022 but resigned after just over a year amid allegations of unethical conduct and internal conflict.

  • Dr. Rajesh Kannan succeeded Fagen and resigned after roughly 14 months.

  • In late 2024 / early 2025, Dr. Diane-Ngam H. Trang was appointed as the newest chief medical examiner, becoming the third permanent chief in less than three years.

This degree of churn in such a sensitive office is not normal and it is not harmless.


The 2020–2021 Lawsuit: What Went Wrong


The most serious warning sign emerged during 2020–2021, when dozens of families discovered that autopsies and death certifications for their loved ones may have been performed or supervised by a physician who did not hold a valid Texas medical license.


Key facts from the lawsuit:

  • 32 families filed suit against Nueces County.

  • The lawsuit alleged that autopsies were conducted or overseen by Dr. Ray Fernandez, who was not properly licensed in Texas at the time.

  • Families claimed violations of civil rights, fraud, misrepresentation, and improper handling of human remains.

  • Plaintiffs argued that the county failed to ensure licensed, qualified professionals were conducting death investigations, calling into question the validity of autopsy findings.

In short, families were told official causes of death that may not have been legally or medically valid.



The $300,000 Settlement and a Public Apology


Rather than contest the claims in court, Nueces County opted to settle the lawsuit for $300,000 in 2021.


The settlement included:

  • $300,000 paid to the families

  • A formal public apology issued by the county

  • Commitments to policy and procedural changes within the Medical Examiner’s Office

Importantly, the settlement did not include an admission of legal liability but it did acknowledge that serious failures had occurred.



This settlement represented not just a financial cost, but a loss of public trust, especially among families who rely on the county for dignity, transparency, and accuracy in death investigations.



Why This Was an Oversight Failure, Not Just a Staffing Issue


The presence of an unlicensed physician performing or supervising autopsies should never have made it past basic safeguards. Credential verification is a minimum requirement, not an aspirational goal.


That such a failure occurred points to deeper problems:

1. Inadequate Vetting

The county failed to ensure all medical personnel were properly licensed and authorized to practice in Texas, something that should have been verified before duties were assigned.


2. Weak Ongoing Oversight

Even after hiring, there appeared to be insufficient monitoring to catch and correct the issue before dozens of families were affected.


3. Commissioners Court Responsibility

The Medical Examiner’s Office ultimately reports up through county leadership. The Commissioners Court controls budgets, approves contracts, and holds final authority over department heads.


When an office collapses into lawsuits, resignations, and settlements, the question must be asked: Where was the oversight before the crisis?


Continued Instability After the Settlement


One might expect the 2021 lawsuit and settlement to serve as a turning point. Instead, instability continued:

The Cost to the Public


The consequences of these failures are real:

  • $300,000 in taxpayer money paid to settle avoidable litigation

  • Families left questioning whether official causes of death were accurate

  • Law enforcement and courts potentially relying on compromised forensic work

  • Erosion of trust in county leadership and governance


And perhaps most troubling: no clear evidence that structural oversight failures have been fully addressed.

What Accountability Should Look Like


If Nueces County is serious about restoring confidence, the Commissioners Court should:

  • Require independent credential audits for all medical examiner staff

  • Implement public performance reporting for the office

  • Establish clear hiring standards and tenure expectations for chief medical examiners

  • Communicate openly with the public when failures occur, not after lawsuits force the issue


Oversight is not optional when public health, justice, and human dignity are at stake.

The Bottom Line


The repeated turnover at the Nueces County Medical Examiner’s Office and the costly 2020–2021 lawsuit that preceded it are not isolated events. They are symptoms of governance gaps that continue to put the county at risk. Stability, competence, and accountability should be the baseline for an office entrusted with the dead and the living alike. Until Commissioners Court treats oversight as a responsibility rather than a formality, residents have reason to remain concerned.

Sources and Further Reading

 
 
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