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Handling the Dead in a Mass Fatality Incident. Kathy Taylor, Ph.D. Forensic Anthropologist King County Medical Examiner’s Office. Medico-legal Investigation System. Medical Examiner: Appointed position held by a board certified forensic pathologist.
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Handling the Dead in a Mass Fatality Incident Kathy Taylor, Ph.D. Forensic Anthropologist King County Medical Examiner’s Office
Medico-legal Investigation System • Medical Examiner: Appointed position held by a board certified forensic pathologist. • Coroner: Elected position held by the election winner (no forensic background required) • Coroner/Prosecutor: Usually an elected position in which the county prosecutor also serves as coroner.
RCW 68.050 • ME has jurisdiction over deaths: • Of individuals in apparent good health without medical attendance for 36 hours preceding death. • Caused by unlawful or unnatural means. • Involving suspicious circumstances. • Caused by any violence whatsoever. • Caused by contagious disease. • Resulting in unclaimed bodies
Cause & Manner of Death Cause the injury or disease process responsible for a death Manner Natural Accidental Suicide Homicide Undetermined
Duties in MFI • Document, tag, map, and recover bodies from scene. • Perform postmortem examinations, certify cause and manner of death. • Establish positive identification on all remains (whole or fragmentary). • Identifying and communicating with NOK • Release bodies to funeral homes for disposition.
Special Concerns in MFI • Processing large number of fatalities (postmortems, data entry, tracking of bodies, identification of whole or fragmentary remains, generating death certificates) • Obtaining antemortem data necessary to establish positive identification • Communication • Continuing normal service to county
Body Recovery • Must consider if scene is a CRIME SCENE • Bodies may be fragmentary or decomposed • Body recovery may not be immediate in a large scale MFI • Handle the public’s concern over “bodies sitting around” • Coordinate efficient method of body recovery so that bodies are not “lost in the system” • Maintain the public’s trust in the system
Identifying the Dead • Coordinating with law enforcement or other agencies an effective system of reporting missing (unaccounted for) persons. • Collecting antemortem records on the missing. • Collecting DNA samples if necessary. • Matching body parts and positively identifying each individual. • Decision whether to identify each body part.
Methods of Positive Identification • Scientific Identification • Fingerprints • Comparative Dental/medical radiography • DNA • Visual (unlikely in MFI) • Photo ID comparison (MFI dependent)
Communication with NOK • Who are the dead? • Who are the NOK and LNOK? • Communication is long term – from the recovery through the examination process and beyond the disposition • MUST ESTABLISH AND MAINTAIN A TRUST IN THE SYSTEM!!!
Family Assistance Center (FAC) • A reception center for family and friends of disaster victims • It provides a safe and protected (from media) environment for family. • It assures family access to information (provided to family before its provided to the media) • Provides KCMEO access to family members to obtain information necessary for identification.
Location of FAC • Hotel, church, convention center, school • The location must be accessible, away from the disaster, and have adequate resources (space, private rooms, telephone lines, restrooms, FAX and copy machine, televisions and radios, medical personnel) • The location must be secured so that media and others cannot infiltrate
Staffing of FAC • Medical Examiner or DMORT personnel to obtain identification information on decedents • Translators • Counselors • Chaplains • Medical personnel • Security personnel • Others (depends on “disaster specific needs)
Determining Cause and Manner • Forensic Autopsies: • Facility • Staff • Storage of bodies??? • Death certificates • Filing and processing
DMORT • Disaster Mortuary Operational Response Team • Requires a Presidential Disaster Declaration • Resources and personnel to establish mobile morgue and handle processing of large numbers of fatalities. • WMD team for decontaminating victims. • NOTE: DMORT operates under the umbrella of the local jurisdiction.
Disposition • Releasing bodies to funeral homes at request of NOK • Finding NOK • Unclaimed bodies • Indigent status • How do you handle a large number of bodies that may be unclaimed???
Frustrations • The ME will NOT have confirmed numbers available until after positive identification. • The ME will NOT call someone deceased until positive identification is established. • The NOK will be frustrated that answers are not immediate. The FAC is designed to help them through the process.
ME frustrations cont. • Families being incorrectly informed of MEO procedures and time frames. • Other agencies or media insisting on answers we cannot provide immediately (i.e. who is dead and how many are dead).
ME Frustrations • Movement of bodies prior to ME notification or without ME consent (IN VIOLATION OF RCW!!!) • Loss of information because of mishandling of bodies (i.e. location) • Removal of property or other identifiers • Other agencies reporting fatality numbers or names of deceased individuals.
TAKE HOME MESSAGES • The public must have trust in the system • A community must care for and respect the dead • No agency acts independently in a disaster. • Even if the coroner/ME is not part of public health, the public health system will face challenges related to the dead in an MFI