The late August arrest of a lab analyst has exposed lax supervision in the San Francisco medical examiner's office, according to former employees. (Alex Emslie/KQED)
A lab analyst for the San Francisco medical examiner's office had driven more than 700 miles east toting a sealed bag of drug evidence before he was pulled over for speeding in Washington County, Utah.
During the Aug. 31 traffic stop, sheriff’s deputies discovered a bag containing “a large crystal looking item,” along with other baggies with suspected crystal meth and white powder.
Deputies also found suspected meth pipes and 14 unidentified pills elsewhere in the car. There was also paperwork from the San Francisco Office of the Chief Medical Examiner. The analyst, Justin Volk, was arrested and charged with a misdemeanor for possession and intent to distribute drugs.
Several former employees of the San Francisco medical examiner said the apparent theft of drug evidence should have been prevented by the office’s own protocols.
Those procedures, however, were not followed in recent years, according to two former employees who worked with Volk. Each one spoke to KQED on the condition of anonymity because they feared that speaking out could lead to reprisal in their current jobs.
The former colleagues who worked at the toxicology lab until recently said the lab’s supervisors allowed illicit drugs to pile up in the evidence room, let protocols lapse designed to prevent evidence mishandling and ignored Volk’s increasingly erratic behavior.
“Mr. Volk is just the tip of the iceberg with respect to poor management and bad forensic policy,” one former employee said. “He is a reflection of the unregulated and unmonitored management at the office.”
Volk is on administrative leave and under investigation, according to the city administrator’s office, which oversees the medical examiner.
Failure to Secure and Destroy Illicit Drugs
When a person dies in a sudden, violent or unexpected way, investigators for the medical examiner’s office often collect and store any drugs found at the scene.
Security for that kind of evidence is crucial, according to Dr. Nikolas Lemos, the former chief toxicologist for the office, who established rules when he was hired in 2003 on how to treat drug evidence.
“We actually implemented very strict protocols for the medical examiner's investigators to account for every pill, every syringe, every crystal they brought into the office,” Lemos said.
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Investigators were supposed to create an inventory of the drugs, seal them into ziplock bags and drop them into a secure slot that could only be opened by technicians in the toxicology lab.
During Lemos’ tenure, two lab employees had to be present to retrieve the drugs from the locker, and they were supervised in the process.
“I was always present when junior staff were removing medications and pills,” Lemos said. “I was pretty much like a hawk because I knew that the temptation is great. And the fact is that without supervision, you could just mishandle the evidence.”
The protocols also included boxing up the evidence and in most cases setting a date for destruction after a year.
All of this took place in the lab, in plain sight of staff.
Lemos said the protocols were designed to prevent even well-trusted staff members from having access to drug evidence without supervision.
“I cannot imagine a worse situation than when you are about to destroy medications or pills or drugs, you let somebody into the vault by themselves and they just take whatever they want,” Lemos said. “The supervisor and the chief toxicologist both should be there, taking turns, hands-on supervising this process from start to end.”
Lemos resigned in 2016, alleging that he had been been pressured by supervisors to engage in “unlawful practices” at the office. He reached a $100,000 settlement with San Francisco in 2018 for wrongful termination.
According to one source, the office abandoned many of Lemos’ protocols after he left.
Former colleagues said that Volk’s immediate supervisors, Dr. Luke Rodda and Sue Pearring, had received a number of complaints about the lab technician’s behavior over the last three years.
Whistleblower complaints about specific incidents of lax oversight at the lab, such as the illegal transport of drug evidence in 2017, had also been filed with the city controller, according to a former employee, but no disciplinary action was taken.
KQED sent a list of the former employees' specific allegations to the city administrator's office, the city's chief medical examiner, the city controller and Rodda and Pearring. None commented on those allegations.
The city administrator deferred questions about the toxicology lab’s protocols for drug disposal to the city controller, which launched a review of drug evidence procedures after Volk’s arrest. The controller is expected to make the findings of that review publicly available in mid-October.
The medical examiner’s current protocols require that two staff members log and sort drug evidence. After a year, that evidence should be “sorted and sent for disposal” by a pair of employees with different job classifications.
Volk worked at the lab for 13 years, and during most of that time carried his own workload and got along well with his colleagues, two former co-workers said. But three years ago, his behavior began to change.
Sources close to Volk, including someone who helped train him, said that he was chronically tardy, arriving to work hours late on multiple days of the week, and that he would disappear for hours in the middle of his shift.
Despite repeated complaints to management about how Volk was forcing other employees to pick up the slack, his erratic behavior appeared to former employees to go unpunished.
Volk was at one point required to clock in for his shifts, but that “did not change the behavior,” the former employee said.
The employees were not aware of any other actions taken by supervisors to address problems with Volk.
Access to Drug Evidence Without Oversight
Volk was “highly favored,” according to former co-workers, who said supervisors allowed him to work alone in the toxicology lab outside of normal work hours, including on weekends. Other lab employees were told they had to get approval in advance to do that and could not enter the lab alone.
One section of the toxicology lab contains cubicles and offices. Toxicologists perform tests in another section, and a third, glass-enclosed room holds evidence, including illicit drugs. The evidence room is locked, according to former employees, but anyone with a badge to enter the lab can open it.
“During the week, there are plenty of people around who might observe someone going into the evidence stacks,” one source said, “but on the weekend, a person could retrieve drugs from evidence without being detected.”
Another source said that a security camera in the evidence room was not focused on the section where the drugs were kept.
Backlog of Controlled Substances
The scheduled destruction of drugs also fell by the wayside after Lemos’ departure, according to former staff.
“Pharmaceutical is actual evidence,” one former staff member said. “It wasn’t anything that was regularly tested by the lab, and ultimately just sat there and was an afterthought.”
The lab was moved to a new facility in 2017, and drugs that were no longer required to be stored were destroyed before the move.
That was the last time any drug evidence was destroyed, according to staff.
“It's been three or four years since anything has been tossed out,” one former toxicologist said. “We shouldn't have a room piling up full of illicit drugs. We know that there's a lure to having that kind of stuff on hand and we just don't want to hold on to it any longer than we have to.”
Workers said they repeatedly urged lab supervisors Rodda and Pearring to destroy the drug evidence that was years past the date required for storage. The task was “not a priority for the office,” they were told.
A number of high-ranking people within the medical examiner’s office have resigned in the last decade over complaints of mismanagement and poor standards.
In 2013, death investigations were lagging, and some families were waiting six months to a year for results.
The office lost its accreditation with the National Association of Medical Examiners in January 2017.
Dr. Judy Melinek, a forensic pathologist, quit working for the office several years ago because, she says, the morale was low at the time and the credibility of the office had suffered.
“I left, because I saw that it was going to impact not just my work product, but my reputation,” Melinek said.
She continued, “The repeated problems are management problems. At some point, we have to either have a grand jury inquiry or someone has to look into the operations of the office and make major changes, because this seems to come up every few years.”
Following the arrest of Volk, San Francisco Public Defender Manohar Raju demanded a review of all criminal cases and convictions that relied on lab work performed by the accused lab analyst.
“Justice simply cannot happen when the Medical Examiner’s employees — tasked with providing objective and unbiased scientific evidence and opinion — lack integrity,” Raju said in a statement on Sept. 11.
In a letter that same day to San Francisco Mayor London Breed, District Attorney Chesa Boudin estimated that Volk was involved in “testing, collection and preservation of evidence in more than 2,500 law enforcement investigations” comprised of 500 death investigations, 1,200 sexual assault cases and 800 DUI investigations.
A spokesperson for the DA said Monday that the office is still investigating the Volk case.
"Our office’s ability to prosecute cases is substantially undermined when individual law enforcement officers, or staff at the medical examiner’s office, engage in serious or potentially criminal misconduct,” the DA's office said in a statement after Volk’s arrest.
Boudin requested a supplemental budget appropriation of $455,731 to “review every case this analyst was involved in to ensure that no conviction or punishment has been improperly tainted,” and to handle an anticipated surge of appeals of prior convictions.
San Francisco Supervisor Aaron Peskin has called for a hearing to consider ways to restructure the medical examiner’s office to strengthen the integrity and efficiency of death investigations in San the city.
“There is no question that problems in the medical examiner's office have plagued San Francisco now for many years,” Peskin said. “It is time to bring about structural reform.”
Volk posted $10,000 bail the same day he was arrested in Utah and was released.
The San Francisco DA has so far not charged Volk with any crimes that may have occurred in the city.