The unfortunate truth is – no matter how well prepared a jurisdiction is, no matter how well equipped and staffed, and no matter how good emergency plans are – bad things happen. Unlike most planning efforts, the goal of mass fatality planning is not to save lives, but rather to reunite decedents with their loved ones. These secondary victims are at the heart of such planning, which includes understanding the procedure for processing human remains – staging, decontamination, storage, examination,entification, and release – following a mass fatality incident.
Staging Area & Morgue
Initially, first responders may take the remains to an on-site staging area to facilitate the other response activities as well as the medical examiner (ME)/coroner’s recovery team activities. The staging area allows the recovery team to access remains in the cold zone rather than expose team members to hazards such as fires or hazardous materials spills. This procedure also helps avoid compromising any ongoing investigations.
Emergency planners should involve MEs/coroners in the pre-planning process so issues – for example, determining who is responsible for decontaminating human remains – can be resolved off-scene before the incident occurs. In addition, timing is important for two key reasons: (a) ME/coroner resources do not have to wait on-scene for lengthy forensics to be completed; and (b) investigators have ample time to perform their duties.
A formal morgue could hold the remains until the pathologist’s examination,entification, and release to the legal claimant are complete. This facility(s) could be on-site or at the ME/coroner’s office. Another option is a portable morgue system, which can be deployed to the scene by trailer. The capacity of the existing facility would dictate the need for an on-site versus off-site morgue. For instance, an office that has storage for 40 remains could not expand its operation to provide for 200+ remains from an incident such as a large aircraft collision.
Examination,entification & Release
During the examination andentification phases of processing, ME/coroner staff must be able to access the remains in order to perform their tasks. Remains that are fragmented need to be examined andentified separately before being reunited with other fragments of the same decedent.
The process ofentifying remains, in effect, is the act of making a connection between a livingentity and its deceased remains, which involves documenting details from the remains and collecting information about the person during his or her life. Typically, staff members will photograph, fingerprint, and dentally chart the remains. In addition, they may take a set of X-ray images. Through expert analysis, staff members then compare a record or image taken during the life of the decedent with the same type of record collected at the ME/coroner’s office. The goal of this standard process is to have the materials available forentification without having to access the remains multiple times.
Onceentified and fragments reunited, the remains can be released to the claimant. Determining who has the legal right to claim remains is based on jurisdictional statutes and practices, which should be under the direction of legal counsel. When bad things happen, it is important to have a framework in place for responders to understand the ME/coroner’s responsibilities, provide accurate information to the public, and bring closure to the incident.
Joseph Cahill is the director of medicolegal investigations for the Massachusetts Office of the Chief Medical Examiner. He previously served as exercise and training coordinator for the Massachusetts Department of Public Health and as emergency planner in the Westchester County (N.Y.) Office of Emergency Management. He also served for five years as citywide advanced life support (ALS) coordinator for the FDNY – Bureau of EMS. Before that, he was the department’s Division 6 ALS coordinator, covering the South Bronx and Harlem. He also served on the faculty of the Westchester County Community College’s paramedic program and has been a frequent guest lecturer for the U.S. Secret Service, the FDNY EMS Academy, and Montefiore Hospital.