Morgue Operations in Mass Fatality Incidents What is a mass fatality event What is your prime federal resource Purpose of morgue operations Recovery Mobile morgue Refrigeration Antemortem data collection Security Cemetery operations No.
Download ReportTranscript Morgue Operations in Mass Fatality Incidents What is a mass fatality event What is your prime federal resource Purpose of morgue operations Recovery Mobile morgue Refrigeration Antemortem data collection Security Cemetery operations No.
Morgue Operations in Mass Fatality Incidents What is a mass fatality event What is your prime federal resource Purpose of morgue operations Recovery Mobile morgue Refrigeration Antemortem data collection Security Cemetery operations No infrastructure situations Technological Accident Terrorist Act Human negligence Acts of Nature Mass Fatality Incidents Simply put – they are simultaneous multiple deaths which: Overwhelm local resources Require outside professional and logistical help D M O R T isaster ortuary perational esponse eams DMORT U.S. Department of Health and Human Services (HHS) Office of the Assistant Secretary for Preparedness and Response (ASPR) Office of Emergency Management (OEM) National Disaster Medical System (NDMS) What can DMORT do? Recovery Expertise Postmortem Examinations Antemortem Data Collection Victim Identification Custodial Management Activated through Federal disaster declaration (Stafford Act) Aviation Disaster Family Assistance Act Memorandum of Understanding (MOU) Public Health Act Disaster Mortuary Operational Response Team Deployments EVENT YEAR LOCATION DECEDENTS Cemetery flood 1993 Hardin, MO 769 Cemetery flood 1994 Albany, GA 405 Bombing 1995 Oklahoma City, OK 168 Hurricane Marilyn 1995 U.S. Virgin Islands 11 United Express 5925 1996 Quincy, IL 14 Comair 3272 1997 Monroe, MI 29 Korean Air 801 1997 Guam 225 Floods 1998 Del Rio, TX 12 Amtrak derailment 1999 Bourbonnais, IL 11 Tornadoes 1999 Oklahoma City, OK 47 Cemetery flood 1999 Tarboro, NC 230 Egypt Air 1999 Providence, RI 219 Alaska Air 2000 Ventura, CA 88 Executive Air 2000 Wilkes-Barre, PA 19 United 93 2001 Somerset, PA 44 World Trade Center 2001 New York, NY ~2800 American 587 2001 New York, NY 265 Tri-State Crematory 2002 Noble, GA 339 US Airways Express 2003 Charlotte, NC 21 The Station Nightclub 2003 West Warwick, RI 100 The Columbia Shuttle 2003 Texas 7 American 5966 2004 Kirksville, MO 13 Hurricanes Katrina/Rita 2005 Gulf Coast ~2500 Comair 5191 2006 Lexington, KY 49 Hurricanes Gustav/Ike 2008 Texas/Louisiana Coasts ~45 Continental 3407 2009 Buffalo, NY 50 Earthquake/tsunami 2009 American Samoa 32 Earthquake 2010 Haiti ~212,000 Tornadoes 2011 Joplin, MO 142 Morgue Operations In Mass Fatality Incidents Medical Examiner/Coroner is in charge of human remains Role of Morgue Operations To receive, Identify, Determine manner and cause of death, Possibly prepare for final disposition, And return decedents to their next of kin, In the utmost dignified and professional manner possible. Morgue personnel positions Team Management – Team Commander – Deputy Team Commander – Administrative Officer – – – – – Forensic Personnel – – – – – – Pathologist Odontologist Dental Assistant Anthropologist Fingerprint specialist Photographer/videographer Morgue Personnel Mortuary Officer Body tracker Xray technician Medical records technician Supply officer Support Personnel – – – – – – – Mental Health/CISD Specialist Communications manager Safety Officer Equipment operator Team Physician/PA/Nurse Security officer Computer operator Morgue Operations Should be simple Standard stations for documentation, examination, and release Success relies on teamwork and focus on consistency in documentation and examination Morgue organization and flow is modified to meet the needs of the disaster Morgue Flow Morgue flow depends on – condition/completeness of the remains – morgue facility/layout Modular system allows flexibility for the incident and the incident morgue Morgue Flow Body/Remains Storage Remains Triage Family Assistance Center Antemortem data collection DNA reference sample collection Identification Section Compares antemortem and postmortem information Admitted, Number assigned VI data entry Family notification Remains Documentation Photography Body/remains radiography Personal Effects Postmortem Data Collection Autopsy/Pathological exam Anthropological examination Fingerprint examination Dental examination DNA specimen collection Release Identification Method postmortem information antemortem information comparison Unique biological information identification Identification Methods Positive ID Methods DNA Finger/Foot Print Odontology Pathology/Medical Implants, medical devices Radiology Fractures Bone pattern Exclusion Presumptive ID Methods Personal Effects Portable Visual Grief Tattoos, body piercing Common now Incident Morgue Located as close to the scene as possible Hot and cold running water, showers, restrooms and appropriate drainage Heat/air conditioning and ventilation Electricity Parking, communications capability, space for privacy and breaks Capable of being secured Possible Incident Morgue Sites Coroner/ME Office Hangars Warehouses National Guard armories Portable buildings/tents Incident Morgue St. Gabriel, LA Town Hall, Former School, Warehouse Incident Morgue Carville, LA Custom Built Recovery Disaster Portable Morgue Unit DPMU Contains all major components for identification and return of human remains DPMU Portable modular morgue Equipment for forensic disciplines Support equipment – generators, hot water heaters, sinks, telephones Site search/recovery equipment Computers for administrative support DPMU Features Containerized and palletized Transportable by truck or plane Mission ready at all times DPMU requirements 8000 sq ft facility – Non porous flooring or disposal flooring Two 400-600 sq ft offices Rest rooms Water source Electrical feed – 110 volt – 300 amps total Drainage 8000 lb forklift – 6 ft forks – 10’x10’x10’ 2000 lb forklift inside facility Tractor trailer accessible site DPMU Section Equipment Partitions and supports Electrical/plumbing Information Resources – Family Assistance Center – Morgue Operations Admitting / Triage Photography Personal Effects Personal Protective / Biohazard Equipment Anthropology Odontology Fingerprint Radiology – Dental X-Ray – Full Body X-ray Pathology Embalming Casketing and Release DNA Credit Card Refrigeration Refrigeration Family Assistance Center Provide comfortable place for families to gather Away from disaster site Easily accessible Easy to find Provide creature comforts to family No media in closed areas Agencies at the FAC NTSB FBI SEMA FEMA ME/Coroner DMORT/mortuary Insurance representatives Police agencies Red Cross Salvation Army Clergy organizations Counseling organizations Political representatives Company representatives Others Mortuary Functions at Family Assistance Center Conduct interviews for antemortem data collection Collect DNA reference samples Notification of positive identification to survivors through the medical examiner/coroner Coordinate release of remains to next of kin Information Resources Victim Identification Program Computer program to coordinate: – Antemortem data collection – Postmortem data collection – Identification reports – Body tracking – With dental identification package Victim Identification Program Antemortem section – Interview form – Track identifying characteristics – Provides reporting for: » Morgue Section Leaders » Local Authorities (Coroner/ME, EMA) » Federal Authorities (NTSB, FBI, FEMA) – Provides reports on: » Age/Sex data » Unique biological/personal features Scars, tattoos, surgeries, implants » Personal effects/jewelry Victim Identification Program Postmortem section – Provides section forms to be completed during operation – Collects postmortem findings from all sections – Provides long term storage for collected data » Including digitized photos and x-rays Victim Identification Program Data Comparison – Compare antemortem and postmortem identifying characteristics – Dental program compares the teeth – Neither program makes an identification Operational Security Protect your outer perimeter Secure your inner perimeter What happens in the morgue, stays in the morgue Allow no unauthorized photographs Restrict access to morgue workers only Cemetery Operations Operations with limited infrastructure For Further Info www.phe.gov/Preparedness/responders/ ndms/teams/Pages/dmort www.dmort3.org