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Fagen out as Nueces County Medical Examiner after a little more than a year

He submitted his resignation to Nueces County commissioners Wednesday, effective immediately, after coming from Travis County in 2022.

CORPUS CHRISTI, Texas — Nueces County Medical Examiner Dr. Timothy Fagen has resigned effective immediately. The resignation comes less than two weeks after a scathing retirement notice from Forrest Mitchell, the former Director of Operations for the Nueces County Medical Examiner's Office, in which he called Fagen's recent behavior "unethical."

In that notice, Mitchell alleged that Fagen ordered Mitchell to withhold information from county commissioners about out-of-county autopsies.

Nueces County Precinct 4 Commissioner Brent Chesney said Wednesday that commissioners court accepted the resignation tendered a little more than a year after he succeeded Dr. Adel Shaker.

Deputy Chief Medical Examiner Dr. Rajesh Kannan will step in as interim medical examiner while commissioners search for a new ME.

Fagen was the highest-paid medical examiner in Texas, with a base salary of $500,000.

Fagen second Nueces County ME ousted in 2 years

Fagen was seen as a stabilizing choice for the office after Shaker and Shaker's former deputy Dr. Sandra Lyden were arrested last year on charges that included:

  • Prohibited practice by a physician.
  • Unprofessional or dishonorable conduct by a physician.
  • Failure to delegate general authority.
  • Practicing without a license.
  • Tampering with government records with the intent to defraud or harm another person.

Essentially, Shaker was accused of letting Lyden perform autopsies even while knowing she did not have the proper license to conduct autopsies in Texas.

Rather than stabilizing the ME's office, Fagen will leave it empty again after a little more than a year on the job. Prior to Nueces County, he served as an assistant ME at the Travis County Medical Examiner's Office. Fagen has practiced medicine for almost 20 years. 

Out-of-county autopsies led to Fagen's ouster

Fagen's resignation comes two weeks after commissioners requested a cost analysis for out-of-county autopsies, which had decreased by 20-40 percent since Fagen took over the department. He made changes last October to the autopsy fee structure.

Mitchell delivered the presentation to county commissioners but alleged that Fagen required him to make unethical changes. 

"[Dr. Fagen] requested that I remove significant portions of that memorandum before presenting it to Commissioner's Court, which would have likely jeopardized the current doctor commission structure and the out-of-county contract work performed by this office," Mitchell wrote. "I strongly believe it is improper to withhold this type of information from our elected officials."

Writing to Fagen, Mitchell also said, "You have a personal financial interest in the doctors' commission from Nueces County, which influences the official position of this office... I believe your behavior has been unethical and constitutes an improper influence on a public policy which would violate my own personal ethics and integrity."

Mitchell retired on July 31, three days after his letter.

On Wednesday, Nueces County officially voted to end out-of-county autopsies altogether.

"We as a county are not currently making money on [out-of-county autopsies]," Chesney said. "We have a great deal of exposure and liability when we do out-of-county autopsies as has been advised by our counsel that if one of those goes awry then certainly we as Nueces County are going to be included in that. Our statutory duty is only to Nueces County; that's the law."

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