The total number of deaths reported to the Pierce County Medical Examiner's Office in 2004 was 1,429. This represents 27% of the 5,203 deaths that occurred in Pierce County in 2004. Each reported case received basic investigative review. Jurisdiction was declined in 756 cases. Jurisdiction was assumed in the remaining 673 cases and further investigation was conducted. Postmortem examinations by Forensic Pathologists (autopsies and external inspections, including non-human remains) were conducted in 419 cases. The pathologist were able to review and certify the remaining cases following investigation and medical history review. In 61 cases the decedent's private physician certified the death. The determination of manner of death is made by the Medical Examiner for death certification purposes based on the preponderance of available evidence.