The forensic investigators conduct the initial phase of the investigation of each death reported to the Medical Examiner. Most of the vital information-gathering and record-keeping functions required for death investigations are performed by investigation personnel. Under the supervision of a chief investigator, the forensic investigators coordinate their findings with autopsy and laboratories throughout the entire investigative process.

Investigations require a great deal of contact with the public and other governmental agencies. Investigators are on duty 24 hours a day for seven days a week. A typical death investigation begins with a telephone report of a death which meets the criteria for "reportable deaths". This call initiates a detailed inquiry into the facts and circumstances surrounding the death such as medical history, condition of the body and demographic information. The immediate report determines if the case is within the Medical Examiner’s jurisdiction.

When the circumstances are appropriate, one or more forensic investigators conduct an on scene investigation in cooperation with police authorities. The forensic investigator is trained in areas such as death investigations, evidence identification, post mortem physiological changes, traumatic injuries and medical-legal documentation.

In complex cases, the investigators request a pathologist to conduct a preliminary medical examination at the scene. Interviews of witnesses and relatives, photographs, police reports and any other pertinent accounts are collected on the scene of the incident.

In non-jurisdictional cases where the death does not fall within the Medical Examiner's jurisdiction, the body is released to a funeral director designated by the relatives of the decedent.

If the case falls within the Medical Examiner’s jurisdiction, the body is transported to this office for further examination.  Many such cases undergo at least an external examination and may have further routine toxicological tests. The pathologist decides whether an autopsy should be performed based on the nature of the case and a review of the initial death report.

Investigators may request clinical and hospital records, private physician’s reports, police investigative reports, statements from acquaintances and any other case related data. Inquiries may be made with the FBI, the Social Security Administration, the Veterans Administration, or other governmental agencies for identification purposes and to facilitate notification of the next of kin.

All case information is recorded in a case file identified by the name of the decedent and an assigned case number. The reports of the various medical and toxicological exams, laboratory and X-ray studies, autopsy results, and any other special records are added to the case file as they become available.

Investigations must process any personal effects of the decedents and any necessary or supplemental reports or forms and release the remains to funeral directors. Investigators issue the Death Certificate for all cases under the jurisdiction of the Medical Examiner. The original Death Certificate is sent to the PA State Bureau of Vital Statistics via the Funeral Director.