Handling the Dead Handling the Dead in a Mass Fatality in a Mass Fatality

IncidentIncidentKathy Taylor, Ph.D.Kathy Taylor, Ph.D.

Forensic AnthropologistForensic Anthropologist

King County Medical Examiner’s King County Medical Examiner’s OfficeOffice

Medico-legal Investigation Medico-legal Investigation SystemSystem

Medical Examiner: Appointed Medical Examiner: Appointed position held by a board certified position held by a board certified forensic pathologist.forensic pathologist.

Coroner: Elected position held by Coroner: Elected position held by the election winner (no forensic the election winner (no forensic background required)background required)

Coroner/Prosecutor: Usually an Coroner/Prosecutor: Usually an elected position in which the county elected position in which the county prosecutor also serves as coroner.prosecutor also serves as coroner.

RCW 68.050RCW 68.050

ME has jurisdiction over deaths:ME has jurisdiction over deaths: Of individuals in apparent good health Of individuals in apparent good health

without medical attendance for 36 without medical attendance for 36 hours preceding death.hours preceding death.

Caused by unlawful or unnatural means.Caused by unlawful or unnatural means. Involving suspicious circumstances.Involving suspicious circumstances. Caused by any violence whatsoever.Caused by any violence whatsoever. Caused by contagious disease.Caused by contagious disease. Resulting in unclaimed bodiesResulting in unclaimed bodies

Cause & Manner of Cause & Manner of DeathDeath

CauseCause the injury or disease process responsible the injury or disease process responsible

for a deathfor a death

MannerManner NNaturalatural AAccidentalccidental SSuicideuicide HHomicideomicide UUndeterminedndetermined

Duties in MFIDuties in MFI

Document, tag, map, and recover bodies Document, tag, map, and recover bodies from scene.from scene.

Perform postmortem examinations, Perform postmortem examinations, certify cause and manner of death.certify cause and manner of death.

Establish positive identification on all Establish positive identification on all remains (whole or fragmentary).remains (whole or fragmentary).

Identifying and communicating with NOKIdentifying and communicating with NOK Release bodies to funeral homes for Release bodies to funeral homes for

disposition.disposition.

Special Concerns in MFISpecial Concerns in MFI

Processing large number of fatalities Processing large number of fatalities (postmortems, data entry, tracking of (postmortems, data entry, tracking of bodies, identification of whole or bodies, identification of whole or fragmentary remains, generating death fragmentary remains, generating death certificates)certificates)

Obtaining antemortem data necessary Obtaining antemortem data necessary to establish positive identificationto establish positive identification

CommunicationCommunication Continuing normal service to countyContinuing normal service to county

Body RecoveryBody Recovery

Must consider if scene is a CRIME Must consider if scene is a CRIME SCENESCENE

Bodies may be fragmentary or Bodies may be fragmentary or decomposeddecomposed

Body recovery may not be immediate in a Body recovery may not be immediate in a large scale MFIlarge scale MFI

Handle the public’s concern over “bodies sitting Handle the public’s concern over “bodies sitting around”around”

Coordinate efficient method of body recovery so Coordinate efficient method of body recovery so that bodies are not “lost in the system”that bodies are not “lost in the system”

Maintain the public’s trust in the systemMaintain the public’s trust in the system

Identifying the DeadIdentifying the Dead

Coordinating with law enforcement or other Coordinating with law enforcement or other agencies an effective system of reporting agencies an effective system of reporting missing (unaccounted for) persons.missing (unaccounted for) persons.

Collecting antemortem records on the Collecting antemortem records on the missing.missing.

Collecting DNA samples if necessary.Collecting DNA samples if necessary. Matching body parts and positively Matching body parts and positively

identifying each individual.identifying each individual. Decision whether to identify each body part.Decision whether to identify each body part.

Methods of Positive Methods of Positive IdentificationIdentification

Scientific IdentificationScientific Identification FingerprintsFingerprints Comparative Dental/medical Comparative Dental/medical

radiographyradiography DNADNA

Visual (unlikely in MFI)Visual (unlikely in MFI) Photo ID comparison (MFI Photo ID comparison (MFI

dependent)dependent)

Communication with Communication with NOKNOK

Who are the dead?Who are the dead? Who are the NOK and LNOK?Who are the NOK and LNOK? Communication is long term – from Communication is long term – from

the recovery through the the recovery through the examination process and beyond the examination process and beyond the dispositiondisposition

MUST ESTABLISH AND MAINTAIN MUST ESTABLISH AND MAINTAIN A TRUST IN THE SYSTEM!!!A TRUST IN THE SYSTEM!!!

Family Assistance Center Family Assistance Center (FAC)(FAC)

A reception center for family and friends A reception center for family and friends of disaster victimsof disaster victims

It provides a safe and protected (from It provides a safe and protected (from media) environment for family.media) environment for family.

It assures family access to information It assures family access to information (provided to family before its provided to (provided to family before its provided to the media)the media)

Provides KCMEO access to family Provides KCMEO access to family members to obtain information necessary members to obtain information necessary for identification.for identification.

Location of FACLocation of FAC

Hotel, church, convention center, schoolHotel, church, convention center, school The location must be accessible, away The location must be accessible, away

from the disaster, and have adequate from the disaster, and have adequate resources (space, private rooms, resources (space, private rooms, telephone lines, restrooms, FAX and telephone lines, restrooms, FAX and copy machine, televisions and radios, copy machine, televisions and radios, medical personnel)medical personnel)

The location must be secured so that The location must be secured so that media and others cannot infiltratemedia and others cannot infiltrate

Staffing of FACStaffing of FAC Medical Examiner or DMORT personnel Medical Examiner or DMORT personnel

to obtain identification information on to obtain identification information on decedentsdecedents

TranslatorsTranslators CounselorsCounselors ChaplainsChaplains Medical personnelMedical personnel Security personnel Security personnel Others (depends on “disaster specific Others (depends on “disaster specific

needs)needs)

Determining Cause and Determining Cause and MannerManner

Forensic Autopsies:Forensic Autopsies: FacilityFacility StaffStaff Storage of bodies???Storage of bodies???

Death certificatesDeath certificates Filing and processingFiling and processing

DMORTDMORT

Disaster Mortuary Operational Response Disaster Mortuary Operational Response TeamTeam

Requires a Presidential Disaster Requires a Presidential Disaster DeclarationDeclaration

Resources and personnel to establish Resources and personnel to establish mobile morgue and handle processing of mobile morgue and handle processing of large numbers of fatalities.large numbers of fatalities.

WMD team for decontaminating victims.WMD team for decontaminating victims. NOTE: DMORT operates under the NOTE: DMORT operates under the

umbrella of the local jurisdiction. umbrella of the local jurisdiction.

DispositionDisposition

Releasing bodies to funeral homes at Releasing bodies to funeral homes at request of NOKrequest of NOK

Finding NOK Finding NOK Unclaimed bodies Unclaimed bodies Indigent statusIndigent status

How do you handle a large number How do you handle a large number of bodies that may be unclaimed???of bodies that may be unclaimed???

FrustrationsFrustrations

The ME will NOT have confirmed The ME will NOT have confirmed numbers available until after positive numbers available until after positive identification.identification.

The ME will NOT call someone deceased The ME will NOT call someone deceased until positive identification is until positive identification is established.established.

The NOK will be frustrated that answers The NOK will be frustrated that answers are not immediate. The FAC is designed are not immediate. The FAC is designed to help them through the process.to help them through the process.

ME frustrations cont.ME frustrations cont.

Families being incorrectly informed Families being incorrectly informed of MEO procedures and time frames.of MEO procedures and time frames.

Other agencies or media insisting on Other agencies or media insisting on answers we cannot provide answers we cannot provide immediately (i.e. who is dead and immediately (i.e. who is dead and how many are dead).how many are dead).

ME FrustrationsME Frustrations

Movement of bodies prior to ME Movement of bodies prior to ME notification or without ME consent (IN notification or without ME consent (IN VIOLATION OF RCW!!!)VIOLATION OF RCW!!!)

Loss of information because of Loss of information because of mishandling of bodies (i.e. location)mishandling of bodies (i.e. location)

Removal of property or other identifiersRemoval of property or other identifiers Other agencies reporting fatality Other agencies reporting fatality

numbers or names of deceased numbers or names of deceased individuals.individuals.

TAKE HOME MESSAGESTAKE HOME MESSAGES

The public must have trust in the system The public must have trust in the system A community must care for and respect A community must care for and respect

the deadthe dead No agency acts independently in a No agency acts independently in a

disaster. disaster. Even if the coroner/ME is not part of Even if the coroner/ME is not part of

public health, the public health system public health, the public health system will face challenges related to the dead will face challenges related to the dead in an MFIin an MFI