An audit of past rulings by a controversial medical examiner found that 36 cases of police custody deaths deemed accidents should have instead been classified as homicides. 

The comprehensive review of 87 determinations regarding deaths resulting from police use of force stretched back 16 years from 2003 to 2019. It highlights the often questionable conclusions the Office of the Chief Medical Examiner (OCME) used to determine that police were not culpable.  

Maryland Attorney General Anthony Brown, whose agency managed the audit of former Chief Medical Examiner Dr. David Fowler, said the audit was disturbing and that the reclassified cases warranted further scrutiny. 

“These findings are of great concern and demand further review,” Brown wrote in the preface of the report. 

The report is simply an audit. It does not formally reclassify any of the cases that have been reviewed. Normally, changing an autopsy determination requires a hearing in front of a judge.

The push to examine Fowler’s past rulings came after he testified at the murder trial of former Minneapolis police officer Derek Chauvin. Chauvin was charged with murder after video surfaced of him sitting on George Floyd’s neck for roughly nine minutes. Floyd later died at a nearby hospital.  

The case sparked outrage and nationwide protests.  

Fowler testified that Floyd did not die from positional asphyxiation, the result of the downward pressure of Chauvin’s knee. Instead, he attributed carbon monoxide poisoning from a nearby tailpipe to be the primary cause. 

The testimony sent shockwaves through the medical community. An open letter penned by roughly 450 medical experts called for a review of Fowler’s rulings in light of his testimony. The pushback prompted the state to undertake a comprehensive audit, the findings of which were released in a 90-page report. 

But prior to Fowler’s testimony and the subsequent review of his rulings, family members of victims and activists had been calling attention to his determinations. TRNN also consulted an independent pathologist to review Fowler’s cases

Among them is the death of a 19-year-old Eastern Shore resident, Anton Black. 

Black died after police chased him to his mother’s home. The body camera showed officers lying atop the former track star, who weighed 160 pounds at the time of the arrest. Fowler ruled the death an accident due to an underlying heart abnormality and bipolar disorder, a decision his family said did not reflect the evidence. 

The Real News consulted noted pathologist Dr. Cyril Wecht to review the case. Wecht said Black’s death was not the result of an accident, but police use of force. 

“This is a classical case of positional asphyxiation in which somebody is placed face down, and then someone leans on his back, presses down on his back, and he’s tasered, after several minutes, and then he goes limp,” Wecht told TRNN. 

Black’s family eventually won a $5 million settlement of a wrongful death suit against the state. Sonia Kumar, senior staff attorney at the Maryland chapter of the ACLU, who was lead counsel on the lawsuit, released a statement calling the audit result long overdue. 

“This report vindicates what family members and communities—mostly Black and Brown Marylanders—have been saying for decades: that the entire system has been complicit in making police-involved deaths seem inevitable,” Kumar wrote. 

The audit also includes other cases covered by TRNN. 

Among them is the death of Tyrone West. West was pulled over in 2013 in North Baltimore after officers stopped his car for a broken taillight. Officers dragged him out of his vehicle and beat him for roughly an hour. West died later at a nearby hospital.

Fowler ruled his death was accidental, the result of dehydration and an underlying heart condition. Prosecutors also declined to press charges.  

But Tyrone’s sister Tawanda Jones fought back. She started a series of protests known as West Wednesdays that have continued every week since her brother’s death in 2013. 

Jones noted that the first protests were staged outside Fowler’s office. 

“That’s where West Wednesday started, at his office. And now the right is finally coming out. I am just overwhelmed.”

Now she is calling for the prosecutor to reopen her brother’s case. 

“Yes absolutely, I am going to keep pushing forward.” 

While Fowler’s police custody cases were more widely scrutinized, TRNN has also explored how his less notable rulings negatively impacted Baltimore residents

In our Hidden Victims series, we examined how Fowler’s unusual classification of large numbers of deaths as unclassified or ‘undetermined’ impacted cases with suspicious circumstances that might have warranted further investigation

The series examined multiple cases, including the death of a woman who was found buried under a pile of mulch, which were ruled undetermined. It also explored how investigations into the past deaths of women who suffered from addiction might have overlooked evidence of foul play

Critics say Fowler’s misclassifications were purposeful, with the aim to lower the number of homicide cases in a city where political careers are made or broken by the murder rate. Other sources say the primary goal of his questionable findings was to protect police officers from accusations of wrongdoing. But families like Tawanda’s are simply seeking closure and justice. 

“I’ve been fighting for my brother and other families for so long. I just want the truth to be known.”

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Senior Investigative Reporter & Capitol Hill Correspondent
Stephen Janis is an award-winning investigative journalist, author, and documentary filmmaker whose work has shaped accountability journalism in Baltimore and beyond. As a Capitol Hill Correspondent and senior reporter at The Real News Network, he continues to uncover the systems behind inequality, corruption, and power while turning complex investigations into stories that inspire reform and public engagement.

His first feature documentary, The Friendliest Town, was distributed by Gravitas Ventures and received an Award of Distinction from The Impact Doc Film Festival and a Humanitarian Award from The Indie Film Fest. He co-created and co-hosts The Police Accountability Report, which has reached more than fifty million viewers on YouTube and helped spark national conversations on policing and transparency. His work has also appeared on Unsolved Mysteries (Netflix), Dead of Night (Investigation Discovery), Relentless (NBC), and Sins of the City (TV One).

Stephen has co-authored several books on policing, corruption, and the roots of violence, including Why Do We Kill: The Pathology of Murder in Baltimore and You Can’t Stop Murder: Truths About Policing in Baltimore and Beyond. He also co-hosts the true crime podcast Land of the Unsolved, which investigates cold cases through a lens of justice and accountability.

Before joining The Real News Network, Stephen worked as an investigative producer for WBFF Fox 45, where his reporting earned three Capital Emmys. Known for embracing technology as a tool for social awareness, he uses data analysis, digital production, and emerging storytelling platforms to connect investigative journalism with younger audiences while maintaining its integrity and depth.

Stephen’s work is grounded in clarity, empathy, and a belief that journalism should not only expose the truth but empower people to act on it.

Senior Investigative Reporter & Capitol Hill Correspondent

Taya Graham is an award-winning investigative journalist, documentary filmmaker, and Capitol Hill Correspondent whose work bridges rigorous reporting with deep community impact. As the host of The Police Accountability Report at The Real News Network, she has become a trusted voice for transparency in policing and governance, using a mix of field reporting, data analysis, and citizen storytelling to expose systemic injustices. The show has garnered more than 50 million views across platforms, drawing a national audience to issues of accountability and reform.

Her work spans platforms and audiences, from producing Truth and Reconciliation, the acclaimed WYPR podcast exploring race and justice, to co-directing the award-winning documentaries The Friendliest Town and Tax Broke. Her five-year investigation into Baltimore’s tax incentive system (TIFs and PILOTs) revealed how corporate subsidies perpetuate inequality, sparking legislative action and community advocacy.

In addition to her reporting, Taya played a key role in shaping The Real News Network’s internal policies and labor framework, including helping draft the language around the organization’s AI policy in its collective bargaining agreement. Her work ensured that innovation and worker protections coexist, setting a model for how newsrooms can adopt technology responsibly.

Taya’s career began at The Afro-American Newspaper and Historic Black University Morgan State Radio, where she honed her craft in public service storytelling. She continues to lead with the belief that journalism should not only inform but empower—meeting new audiences where they are and inspiring them to engage in the democratic process.