Medical examiners in Maryland miscategorized dozens of deaths that happened in police custody over the past two decades, according to a report released by state officials on Thursday.

At least 36 of those deaths should have been called homicides, the report said. Instead, medical examiners had classified them as accidental, or as a result of natural or undetermined causes.

The report, 70 pages long, capped a yearslong audit that revisited medical examiners’ reports over 17 years ending in 2019 — a time period matching Dr. David R. Fowler’s tenure as Maryland’s chief medical examiner — and found evidence of racism and pro-police bias.

Anthony Brown, Maryland’s attorney general, said at a news conference on Thursday that medical examiners had been less likely to call a death a homicide if the person who died was Black, or if he or she had died after being restrained by police officers.

“These findings have profound implications across our justice system,” Mr. Brown said. “They speak to systemic issues rather than individual conduct.”

Dr. Fowler did not immediately respond to a request for comment on Thursday. He was not solely responsible for the decisions made by medical examiners during his tenure, and in the past he has defended the work of the pathologists in his office.