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DMORT- SOP's DMORT- SOP's NTSB ActivationNTSB Activation

James KramerJames Kramer

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DestinyDestiny

• Watch your wordsWatch your wordsThey become actionsThey become actions

• Watch your actionsWatch your actions They become They become habitshabits

• Watch your habitsWatch your habits They become your They become your charactercharacter

• Watch your characterWatch your character It becomes your It becomes your destinydestiny

Author UnknownAuthor Unknown

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IntroductionIntroduction

Synopsis of SOP’sSynopsis of SOP’s

Delineate the general procedures Delineate the general procedures used for DMORT operations when used for DMORT operations when activated under an interagency activated under an interagency agreement with the NTSBagreement with the NTSB

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DHS, NTSB Interagency Agreement regarding DMORT support

“HHS/ASPR will ensure that NDMS has in place and available for review by NTSB a set of standard operating procedures (SOP’s) dictating the handling of remains, the management of data pertaining to victims, the process of documenting the remains of victims, the methods used to identify victims, associated medico-legal interpretations, including cause and manner of death determinations (in case requested by NTSB pursuant to its authority at 49 USC 1131, 1132 and 1134), the process of working with family members of the deceased to gather ante-mortem information and next-of-kin contact information, and the procedures used to re-associate, embalm, and release remains, and the production of final reports documenting each identification and medico legal interpretation. NDMS procedures for all these activities must be consistent with those accepted by the forensic community. DMORT teams are expected to train to these standards. These SOPs should be updated every three years. NDMS services and SOPs shall be in accordance with the NTSB Federal Family Assistance Plan for Aviation Disasters (subject to periodic NTSB revision, as warranted, and available online at http://www.ntsb.gov/Family/family.htm, provided that NTSB will advise NDMS in writing of any revisions to the plan immediately after such revisions are made).

Paul Slezdick, NTSB

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SOP’s SynopsisSOP’s Synopsis

• DMORT operates in support of the local DMORT operates in support of the local medico-legal authority in transportation medico-legal authority in transportation accidents involving fatalitiesaccidents involving fatalities

• Family expectationsFamily expectations• Non-scientific ID misidentificationNon-scientific ID misidentification• Finances should not be an obstacleFinances should not be an obstacle• Forensic TechniquesForensic Techniques• Interagency agreement between the Interagency agreement between the

NTSB and the NDMS for use of the NTSB and the NDMS for use of the DMORT team for transportation accidentsDMORT team for transportation accidents

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January 2005January 2005 NTSB, Homeland Security, NTSB, Homeland Security,

FEMA,NDMS, DMORTFEMA,NDMS, DMORT• Handling RemainsHandling Remains• Data ManagementData Management• DocumentationDocumentation• Methods of IDMethods of ID• Interpretations Interpretations

including cause including cause and manner of and manner of deathdeath

• Ante mortem Ante mortem InformationInformation

• NOKNOK• Procedures to re-Procedures to re-

associate, embalm associate, embalm and releaseand release

• Final ReportsFinal Reports• Deviation from Deviation from

SOPSSOPS• After Action ReportsAfter Action Reports

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Victim IdentificationVictim Identification

Dignity to familiesDignity to familiesFragile trustFragile trustIdentification of victims Identification of victims Accurate information to familiesAccurate information to familiesLegal responsibility of medical examiner Legal responsibility of medical examiner

and coroner well established in United and coroner well established in United StatesStates

DMORT system allows for disaster victim DMORT system allows for disaster victim identification to be managed at a identification to be managed at a consistent level anywhere in the USconsistent level anywhere in the US

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Unique Nature of Unique Nature of Transportation AccidentsTransportation Accidents

• Federal Law-NTSB is required to Federal Law-NTSB is required to investigate all aviation accidents and investigate all aviation accidents and significant accidents in other modes of significant accidents in other modes of transportation such as rail, marine, transportation such as rail, marine, highway, hazardous materials and highway, hazardous materials and pipeline incidents.pipeline incidents.

• NTSB investigations lead to a NTSB investigations lead to a determination of probable cause of the determination of probable cause of the accident and the issuance of safety accident and the issuance of safety recommendations to prevent future recommendations to prevent future accidents and to mitigate injury.accidents and to mitigate injury.

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Unique Nature of Unique Nature of Transportation AccidentsTransportation Accidents

• Aviation Disaster Family Assistance Act of Aviation Disaster Family Assistance Act of 1996 the NTSB has certain federally 1996 the NTSB has certain federally mandated requirements for managing mandated requirements for managing support to family memberssupport to family members

• NTST Office of Transportation Disaster NTST Office of Transportation Disaster Assistance (NTSB-TDA) focus on the needs Assistance (NTSB-TDA) focus on the needs of family members. These needs directly of family members. These needs directly involve the medical examiner or coroner involve the medical examiner or coroner and local law enforcement.and local law enforcement.

• NTSB-TDA will ask the ME/C to brief NTSB-TDA will ask the ME/C to brief families about victim identification efforts families about victim identification efforts and can support the ME/C in these and can support the ME/C in these briefings if necessary.briefings if necessary.

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Jurisdictional Jurisdictional ResponsibilityResponsibility

• The ME/C is the legal authority to The ME/C is the legal authority to conduct victim identification, determine conduct victim identification, determine cause and manner of death, manage cause and manner of death, manage death certification, and is responsible for death certification, and is responsible for other medico legal activities. In the other medico legal activities. In the event of a transportation disaster the event of a transportation disaster the ME/C maintains these responsibilities. ME/C maintains these responsibilities. In transportation disaster, no federal In transportation disaster, no federal agency can subsume these agency can subsume these responsibilities.responsibilities.

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Procedure if event Procedure if event CriminalCriminal

• In the event that the cause of the In the event that the cause of the transportation disaster is determined to transportation disaster is determined to be criminal, the FBI will take over be criminal, the FBI will take over responsibility for investigation.responsibility for investigation.

• The local ME/C will maintain jurisdiction The local ME/C will maintain jurisdiction for victim identification, although the FBI for victim identification, although the FBI may request additional testing or may request additional testing or documentation.documentation.

• Family assistance activities, such as Family assistance activities, such as briefings, will become the responsibility of briefings, will become the responsibility of the FBI Office for Victim Assistance.the FBI Office for Victim Assistance.

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Initial MeetingsInitial Meetings Local & Federal Response Local & Federal Response

AgenciesAgencies• Assure ME/C, local Assure ME/C, local

law enforcement law enforcement jurisdictional jurisdictional responsibility is responsibility is understood & understood & maintainedmaintained

• Assessment of ME/C Assessment of ME/C needs to complete needs to complete victim identificationvictim identification

• Overview of Overview of NTSB/DMORT SOPNTSB/DMORT SOP

• Ensuring ME/C and law Ensuring ME/C and law enforcement enforcement understand understand complexities of victim complexities of victim identificationidentification

• Asses facilities for Asses facilities for incident morgueincident morgue

• ME/C, law enforcement ME/C, law enforcement role in family briefingsrole in family briefings

• NTSB requirementsNTSB requirements• Potential costs and Potential costs and

reimbursement issuesreimbursement issues

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ME/Coroner Role in NTSB ME/Coroner Role in NTSB Family Meetings/Questions Family Meetings/Questions • Why is recovery taking so long?Why is recovery taking so long?• How will families be notified?How will families be notified?• When will personal effects be returned to the family?When will personal effects be returned to the family?• What method is used to identify the families’ love What method is used to identify the families’ love

one?one?• Will DNA be used in identification?Will DNA be used in identification?• What is the condition of the body?What is the condition of the body?• Will an autopsy be performed?Will an autopsy be performed?• How do families know the information is accurate?How do families know the information is accurate?• May families obtain copies of the ME/C report?May families obtain copies of the ME/C report?• Why are the identifications taking so long?Why are the identifications taking so long?

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Fatality Management Fatality Management ConsiderationsConsiderations

• Four factors impact the processing of Four factors impact the processing of remains and identification of decedents:remains and identification of decedents:

1.1. Number of fatalitiesNumber of fatalities

2.2. Decedent population (open or closed)Decedent population (open or closed)

3.3. Availability of ante mortem informationAvailability of ante mortem information

4.4. Condition of remains (complete or Condition of remains (complete or fragmentary remains), and associated fragmentary remains), and associated commingling of remains.commingling of remains.

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Fatality Management Fatality Management ConsiderationsConsiderations

Number of fatalitiesNumber of fatalities1.1. Number of deceased drives the Number of deceased drives the

amount of resources needed to amount of resources needed to search, recover and identify the search, recover and identify the dead.dead.

2.2. Most transportation disasters, the Most transportation disasters, the number of dead will be limitednumber of dead will be limited

3.3. As the number of decedents As the number of decedents increase, the resources needed to increase, the resources needed to manage and process them increasesmanage and process them increases

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Decedent PopulationDecedent Population

• Closed Population – the number of victims Closed Population – the number of victims and their names are known.and their names are known.

• Open Population – one in which neither the Open Population – one in which neither the number of victims nor their names are number of victims nor their names are known.known.

• Simpson and Stehr, 2003, “Victim Simpson and Stehr, 2003, “Victim Management and Identification after the Management and Identification after the World Trade Center Collapse,”World Trade Center Collapse,”

www.colorado.edu/hazards/sp/sp39/www.colorado.edu/hazards/sp/sp39/sept11book_ch4_simpson.pdfsept11book_ch4_simpson.pdf

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Ante mortem informationAnte mortem information

• Often more time consuming and Often more time consuming and complex to obtain than post mortem complex to obtain than post mortem information.information.

• Age, socioeconomic status, cultural Age, socioeconomic status, cultural practices and religious beliefs of the practices and religious beliefs of the decedent and the family impact ante decedent and the family impact ante mortem record availabilitymortem record availability

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Condition of RemainsCondition of Remains

• Whole bodies easier to processWhole bodies easier to process• Fragmented remains present more complex Fragmented remains present more complex

issuesissues• Unique identifiers dental work, fingerprintsUnique identifiers dental work, fingerprints• DNA analysis used to identify body parts that DNA analysis used to identify body parts that

have no unique physical identifierhave no unique physical identifier• DNA analysis does not always result in a DNA DNA analysis does not always result in a DNA

profileprofile• Unidentifiable remains are referred to as Unidentifiable remains are referred to as

common tissue- families must be informed of common tissue- families must be informed of the existence of such tissue and be involved the existence of such tissue and be involved with what will happen with it.with what will happen with it.

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Family/NOK Family/NOK ConsiderationsConsiderations

• Nature of victim identification Nature of victim identification requires involvement of next-of-kin requires involvement of next-of-kin in decisions about certain aspects of in decisions about certain aspects of issues regarding decedent remainsissues regarding decedent remains

• The ME/C is responsible for asking The ME/C is responsible for asking these questions, documenting the these questions, documenting the answers and following the requestsanswers and following the requests

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Death Notification andDeath Notification andNotification of Notification of IdentificationIdentification

• The ME/C will notify the NOK when the The ME/C will notify the NOK when the decedent has been identified.decedent has been identified.

• Challenges:Challenges:1.1. Location of NOKLocation of NOK2.2. Whole bodies/Nearly wholeWhole bodies/Nearly whole3.3. Fragmented remainsFragmented remains

-first identification-first identification-subsequent identification-subsequent identification

-no further notification-no further notification

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Identification Identification Decedents vs. Remains Decedents vs. Remains

• The ME/C is responsible deciding The ME/C is responsible deciding upon the primary goal for the upon the primary goal for the identification efforts: whether to identification efforts: whether to identify each decedent or to identify identify each decedent or to identify all remains.all remains.

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Use of DNAUse of DNA• DNA is an essential component of the DNA is an essential component of the

identification processidentification process

• DNA analysis can:DNA analysis can:1.1. Identify the victimsIdentify the victims2.2. Associate fragmented remainsAssociate fragmented remains3.3. Assist in ongoing medical and legal investigationsAssist in ongoing medical and legal investigations

• Limits to DNALimits to DNA1.1. TimeTime2.2. Reference samples requiredReference samples required3.3. Destructive test and small remains may be Destructive test and small remains may be

consumed entirely in the process thus leaving consumed entirely in the process thus leaving nothing to return to the familynothing to return to the family

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Records ManagementRecords Management

• The ME/C is provided all original The ME/C is provided all original records of the DMORT process, records of the DMORT process, including postmortem forms, ante including postmortem forms, ante mortem records, and any associated mortem records, and any associated documentation.documentation.

• Copy of the data entered into the Copy of the data entered into the VIP databaseVIP database

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Field ResponseField Response

• National Incident ManagementNational Incident Management• Incident CommandIncident Command

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NDMS/DMORTNDMS/DMORTAssessment TeamAssessment Team

• DMORT Team LeaderDMORT Team Leader• DMORT DPMU LeaderDMORT DPMU Leader• DMORT FACDMORT FAC• FEMAFEMA• MST operations representativeMST operations representative

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DMORTDMORTCode of ConductCode of Conduct

• All NDMS personnel are guided by the All NDMS personnel are guided by the DHS/FEMA Standards of ConductDHS/FEMA Standards of Conduct

• When activated into Federal service When activated into Federal service DMORT personnel are federal employees DMORT personnel are federal employees representing the US Governmentrepresenting the US Government

• Subject to federal criminal conflict of Subject to federal criminal conflict of interest statusinterest status

1.1. Title 18, US Code Section 201-208Title 18, US Code Section 201-208

2.2. Hatch Act Title 5 US Code Sections 7321-Hatch Act Title 5 US Code Sections 7321-73267326

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Accident Site OperationsAccident Site Operations

• The search for and recovery of The search for and recovery of remains and other pertinent remains and other pertinent materials from accident sites materials from accident sites requires a standardized approach to requires a standardized approach to ensure that the location of materials ensure that the location of materials within the scene is documentedwithin the scene is documented

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Search and RecoverySearch and Recovery• For most transportation accidents, the FBI For most transportation accidents, the FBI

Evidence Response Team provides personnel and Evidence Response Team provides personnel and management for the search and recovery of management for the search and recovery of human remains, personal effects and accident human remains, personal effects and accident related wreckage.related wreckage.

• For incidents not involving the FBI ERT, search For incidents not involving the FBI ERT, search and recovery efforts will require local/state and recovery efforts will require local/state resources and DMORT personnel. resources and DMORT personnel.

• The ME/C, the investigative law enforcement The ME/C, the investigative law enforcement agency and the NTSB investigator will determine agency and the NTSB investigator will determine the level of documentation required at the scene.the level of documentation required at the scene.

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DecontaminationDecontamination

• Standard DMORT teams are not Standard DMORT teams are not equipped or trained to process equipped or trained to process chemically contaminated remains. chemically contaminated remains. Chemically contaminated remains Chemically contaminated remains are unsafe to process in the incident are unsafe to process in the incident morgue and must be decontaminated morgue and must be decontaminated before removal from the incident site before removal from the incident site to avoid cross contamination of other to avoid cross contamination of other areas and people.areas and people.

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Temporary MorgueTemporary Morgue

• In some transportation disaster, an In some transportation disaster, an area will be designated as the area will be designated as the temporary or holding morgue. This temporary or holding morgue. This morgue is where remains are held morgue is where remains are held until transport to the incident until transport to the incident morgue. Some initial examination morgue. Some initial examination and documentation of remains may and documentation of remains may take place in this morgue.take place in this morgue.

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TransportationTransportationIncident MorgueIncident Morgue

• Transportation of remains from the Transportation of remains from the crash site or temporary morgue to crash site or temporary morgue to the morgue site will be professional the morgue site will be professional and dignified. Care should be taken and dignified. Care should be taken to ensure all remains are properly to ensure all remains are properly bagged, tagged, inventoried and bagged, tagged, inventoried and placed in a refrigeration trailer or placed in a refrigeration trailer or other appropriate vehicle for other appropriate vehicle for transportation to the morgue.transportation to the morgue.

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Incident Morgue Incident Morgue OperationsOperations

• The DPMU is a packaged system The DPMU is a packaged system containing all forensic equipment, containing all forensic equipment, instrumentation, support equipment and instrumentation, support equipment and administrative supplies required to operate administrative supplies required to operate an incident morgue facility under field an incident morgue facility under field conditions or support an existing morgue conditions or support an existing morgue facility. The DPMU carries computers and facility. The DPMU carries computers and related equipment to support the Family related equipment to support the Family Assistance Center and Information Assistance Center and Information Resource Center in the management of Resource Center in the management of postmortem and ante mortem information.postmortem and ante mortem information.

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SectionsSections

• AdmittingAdmitting• Personal EffectsPersonal Effects• PhotographyPhotography• PathologyPathology• AnthropologyAnthropology• DentalDental

• FingerprintsFingerprints• DNADNA• EmbalmingEmbalming• RadiologyRadiology• Casketing & ReleaseCasketing & Release• Personal Protection Personal Protection

EquipmentEquipment

(de-gown and disposal)(de-gown and disposal)

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Morgue SecurityMorgue Security

• The DPMU is federal property. For The DPMU is federal property. For liability, safety, and security liability, safety, and security concerns, access to the morgue is concerns, access to the morgue is controlled the NDMS through the controlled the NDMS through the MST commander. The ME/C will MST commander. The ME/C will work with the MST commander to work with the MST commander to ensure access of appropriate ensure access of appropriate personnel from the ME/C office.personnel from the ME/C office.

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Personal Protective Personal Protective EquipmentEquipment

• All individuals directly involved with All individuals directly involved with human remains need protection human remains need protection from blood-borne and aerosol-from blood-borne and aerosol-transmissible pathogens.transmissible pathogens.

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Photography PolicyPhotography Policy• For security and privacy, taking photographs within the For security and privacy, taking photographs within the

morgue is restricted. For historical and training morgue is restricted. For historical and training purposes, certain candid photographs will be allowed. purposes, certain candid photographs will be allowed.

• A candid photograph is any photograph taken within A candid photograph is any photograph taken within the morgue/storage secured area for any purpose other the morgue/storage secured area for any purpose other than being part of the identification process and filed in than being part of the identification process and filed in a folder with an associated Morgue Reference Numbera folder with an associated Morgue Reference Number

• With the advent of cellular phone/camera technology, With the advent of cellular phone/camera technology, cellular phone use in the morgue is prohibited. No cell cellular phone use in the morgue is prohibited. No cell phones may be removed from its holder while in the phones may be removed from its holder while in the morgue. EXCEPTION: NDMS issued cellular morgue. EXCEPTION: NDMS issued cellular telephones, which do not contain cameras.telephones, which do not contain cameras.

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Radiography of RemainsRadiography of Remains

• In certain situations, particularly In certain situations, particularly those involving fragmentary those involving fragmentary remains, it may be necessary to remains, it may be necessary to radiograph the bag or container radiograph the bag or container holding the remains before the holding the remains before the triage process. triage process.

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Triage of RemainsTriage of Remains

• Interdisciplinary section consisting of a Interdisciplinary section consisting of a pathologist, anthropologist and odontologistpathologist, anthropologist and odontologist

1.1. Separate human tissue from other materialSeparate human tissue from other material2.2. Identify associated remains from non-Identify associated remains from non-

associated remainsassociated remains3.3. Assign probative value to fragmented remainsAssign probative value to fragmented remains4.4. Initially separate out tissues that are less likely Initially separate out tissues that are less likely

to provide evidence of personal identityto provide evidence of personal identity5.5. Enter remains into admitting for assignment of Enter remains into admitting for assignment of

a morgue numbera morgue number

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Chain of CustodyChain of Custody

• Establishing and maintaining a Establishing and maintaining a chain-of-custody for personal effects, chain-of-custody for personal effects, wreckage, and other pertinent wreckage, and other pertinent materials verifies the integrity of the materials verifies the integrity of the evidence.evidence.

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Personal EffectsPersonal Effects• In a transportation accident, large amounts of In a transportation accident, large amounts of

unassociated and associated clothing, jewelry unassociated and associated clothing, jewelry and personal effects are scattered throughout and personal effects are scattered throughout the crash site.the crash site.

• Airline accidents the air carrier is responsible Airline accidents the air carrier is responsible for identifying and returning PE to the for identifying and returning PE to the appropriate family members.appropriate family members.

• Generally, a third party company will be Generally, a third party company will be contracted by the air carrier to recover, contracted by the air carrier to recover, process, clean and return personal effects to process, clean and return personal effects to the families.the families.

• PE associated with the remains will be PE associated with the remains will be managed by the ME/C according to their usual managed by the ME/C according to their usual office procedures.office procedures.

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Wreckage or Other Wreckage or Other EvidenceEvidence

• Establishing and maintaining a chain-Establishing and maintaining a chain-of-custody for material other than of-custody for material other than remains and personal effects will assist remains and personal effects will assist in accident investigation. If morgue in accident investigation. If morgue personnel encounter material such as personnel encounter material such as aircraft wreckage, wiring, computer aircraft wreckage, wiring, computer components, etc., they should be components, etc., they should be documented and transferred to the documented and transferred to the appropriate section for processing.appropriate section for processing.

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Admitting & NumberingAdmitting & Numbering

• The system used to number remains The system used to number remains entering the morgue process should entering the morgue process should be simple and use whole numbers. be simple and use whole numbers.

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EscortsEscorts

• Escorts accompany human remains Escorts accompany human remains through the mortuary process and through the mortuary process and ensure proper documentation is ensure proper documentation is complete and attached at each complete and attached at each morgue station.morgue station.

• Escorts are responsible for the Escorts are responsible for the collection and safe keeping of all collection and safe keeping of all papers and examination records papers and examination records kept.kept.

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PhotographyPhotography

• Photography of remains is an Photography of remains is an essential and standard process for essential and standard process for forensic examination. Each body or forensic examination. Each body or numbered fragment will be numbered fragment will be photographed. DMORT typically photographed. DMORT typically relies on the local jurisdiction medico relies on the local jurisdiction medico legal or law enforcement personnel to legal or law enforcement personnel to take photographs. DMORT personnel take photographs. DMORT personnel can take photographs if required.can take photographs if required.

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RadiologyRadiology

• The radiologist, xray technologist The radiologist, xray technologist conducts radiographic examinations conducts radiographic examinations to detect evidence; provides to detect evidence; provides postmortem radiographs for postmortem radiographs for comparison with ante mortem comparison with ante mortem clinical radiographs; and assists clinical radiographs; and assists pathologist, anthropologist, and pathologist, anthropologist, and odontologist in the interpretation of odontologist in the interpretation of radiographs.radiographs.

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Flight Crew RadiographyFlight Crew Radiography

1.1. Complete full body radiographsComplete full body radiographs2.2. Special attention to extremities, Special attention to extremities,

particularly the hands and feetparticularly the hands and feet3.3. AP and lateral views of hands and AP and lateral views of hands and

feet. Coned views if possible.feet. Coned views if possible.4.4. Radiographs will be taken with Radiographs will be taken with

boots or shoes on the feetboots or shoes on the feet5.5. Additional views after removal of Additional views after removal of

boots or shoesboots or shoes

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OdontologyOdontology

• The Dental Team Leader is responsible The Dental Team Leader is responsible for the dental exam. The Odontology for the dental exam. The Odontology section is comprised of the ante section is comprised of the ante mortem section, postmortem section mortem section, postmortem section and the dental comparison section. and the dental comparison section. Dental personnel may also be asked to Dental personnel may also be asked to support search and recovery of dental support search and recovery of dental evidence at the accident sceneevidence at the accident scene

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PathologyPathology

• The examination and documentation The examination and documentation of remains in the Pathology Section of remains in the Pathology Section can provide detailed information can provide detailed information assisting in identification, defining assisting in identification, defining injury patterns and determining injury patterns and determining cause and possibly manner of death. cause and possibly manner of death. DMORT forensic pathologists are DMORT forensic pathologists are available to assist the local medico available to assist the local medico legal authority as needed.legal authority as needed.

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Flight Crew GuidelinesFlight Crew Guidelines

• The NTSB under the Independent Safety The NTSB under the Independent Safety Board Act of 1974 can order autopsies and Board Act of 1974 can order autopsies and other tests to be performed where other tests to be performed where necessary to investigate an accidentnecessary to investigate an accident

• Under the US 49 Code of Federal Under the US 49 Code of Federal Regulations 831.10 the NTSB is authorized Regulations 831.10 the NTSB is authorized to obtain, with or without reimbursement, a to obtain, with or without reimbursement, a copy of the report of autopsy performed by copy of the report of autopsy performed by State or local officials on any person who State or local officials on any person who dies as a result of having been involved in a dies as a result of having been involved in a transportation accident with the transportation accident with the jurisdiction of the board.jurisdiction of the board.

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FAA Toxicology KitFAA Toxicology Kit

• The FFA Civil Aerospace Medical The FFA Civil Aerospace Medical Institute (CAMI) is responsible for Institute (CAMI) is responsible for providing NTSB investigators with providing NTSB investigators with toxicological testing on remains from toxicological testing on remains from accident under NTSB jurisdiction. They accident under NTSB jurisdiction. They will provide the “ToxBox” to the ME/C will provide the “ToxBox” to the ME/C for sample collection for testingfor sample collection for testing

• www.faa.gov/education_research/www.faa.gov/education_research/med_humanfacs/aeromedical/med_humanfacs/aeromedical/forensictoxicology/forms/index.cfmforensictoxicology/forms/index.cfm

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AnthropologyAnthropology

• The anthropology section should The anthropology section should consist of at least two forensic consist of at least two forensic anthropologists and one assistant to anthropologists and one assistant to serve as scribe.serve as scribe.

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DNA Specimen DNA Specimen CollectionCollection

• In most NTSB responses, the DOD DNA In most NTSB responses, the DOD DNA Registry referred to as the Armed Forces Registry referred to as the Armed Forces DNA Identification Laboratory or AFDIL DNA Identification Laboratory or AFDIL will conduct DNA identification effortswill conduct DNA identification efforts

• These guidelines provide uniformity for These guidelines provide uniformity for DOD DNA Registry/AFDIL personnel to DOD DNA Registry/AFDIL personnel to conduct operations in field environments, conduct operations in field environments, sample human remains for specimens, and sample human remains for specimens, and submit sample to the Armed Forces DNA submit sample to the Armed Forces DNA Identification Laboratory for analysis.Identification Laboratory for analysis.

• Family reference specimen collection is Family reference specimen collection is not the responsibility of the AFDIL not the responsibility of the AFDIL membersmembers

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VIP/Data ManagementVIP/Data Management

• A central repository, known as the A central repository, known as the Information Resource Center (IRC) will be Information Resource Center (IRC) will be created for the collection, recording and created for the collection, recording and storage of ante mortem and postmortem storage of ante mortem and postmortem information. The VIP manages this information. The VIP manages this information.information.

• All records and data are kept secure and All records and data are kept secure and confidentialconfidential

• DMORT personnel trained in VIP, WinID3 and DMORT personnel trained in VIP, WinID3 and Office Suite handle data management.Office Suite handle data management.

• Network support and troubleshooting is the Network support and troubleshooting is the responsibility of the DPMU team.responsibility of the DPMU team.

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Records LibraryRecords Library

• The File Manager will maintain a The File Manager will maintain a records library in the IRC. Records records library in the IRC. Records are evidence and property of the are evidence and property of the medical examiner or coroner. No medical examiner or coroner. No records or information will be records or information will be distributed to unauthorized distributed to unauthorized personnel.personnel.

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Management of Mission Management of Mission RecordsRecords

• Because NTSB and DMORT work under Because NTSB and DMORT work under the jurisdictional requirements of the the jurisdictional requirements of the ME/C, original records produced by ME/C, original records produced by DMORT will be provided to that office. DMORT will be provided to that office. Records and/or information collected Records and/or information collected and/or generated by DMORT will be and/or generated by DMORT will be copied for long-term archival storage at copied for long-term archival storage at NDMS Headquarters. NDMS Headquarters.

• In the event of a legal challenge or other In the event of a legal challenge or other requirement, these records should be requirement, these records should be made accessible to NTSB staff and made accessible to NTSB staff and DMORT forensic scientists for a period of DMORT forensic scientists for a period of time after the deployment.time after the deployment.

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Identification ProceduresIdentification ProceduresProper positive identification is necessary for Proper positive identification is necessary for

notification of the legal next-of-kin, resolving estate notification of the legal next-of-kin, resolving estate issues and criminal/civil litigation, and the issuance of issues and criminal/civil litigation, and the issuance of

death certificates.death certificates.

• Prints (fingerprints, Prints (fingerprints, handprints, toe prints, handprints, toe prints, and footprints)and footprints)

• OdontologyOdontology• RadiologyRadiology• DNA AnalysisDNA Analysis

• Permanently installed Permanently installed medical devices with medical devices with recorded serial numbersrecorded serial numbers

• Distinctive physical Distinctive physical characteristics (eg. ears, characteristics (eg. ears, scars, moles, tattoos) for scars, moles, tattoos) for which there is appropriate which there is appropriate ante mortem ante mortem photographic photographic documentation may be documentation may be used in an exclusionary used in an exclusionary capacity.capacity.

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DMORT Identification Summary Report

Date:Morgue Reference Number(s)

is/are identified as

Name

The identification results from scientific analysis and comparison of ante mortem andPostmortem data. The specific discipline(s) involved certify the identification by signing below.Supporting identification documents accompany this form Print Name Signature

Pathology ______________________________________________Odontology____________________________________________________________Anthropology__________________________________________________________Prints_________________________________________________________________DNA_________________________________________________________________

Was DNA analysis requested? Yes NoHas DNA analysis been completed? Yes No

Does DNA result concur with this identification? Yes No

ME Name_______________________________-Signature_______________________Jurisdiction_______________________________Date______________Time_________

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Death CertificationDeath CertificationDeath NotificationDeath Notification

• The documentation of the The documentation of the identification, the cause and manner of identification, the cause and manner of death, and final disposition are death, and final disposition are required by law and used for vital required by law and used for vital statistics and the initiation of probate. statistics and the initiation of probate. The death certificate is the legal The death certificate is the legal instrument for this documentation. The instrument for this documentation. The ME/C is responsible for all legal ME/C is responsible for all legal documentation pertaining to death documentation pertaining to death certification.certification.

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Final PreparationFinal PreparationDisposition of RemainsDisposition of Remains

• Remains of decedents must be handled Remains of decedents must be handled with the utmost respect and care.with the utmost respect and care.

• DMORT team members will ensure DMORT team members will ensure that all human remains, (identified, that all human remains, (identified, unidentified, common tissue, or any unidentified, common tissue, or any other types of remains) are stored with other types of remains) are stored with dignity, prepared with professionalism, dignity, prepared with professionalism, and transported with consideration.and transported with consideration.

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Final Identification Final Identification ReviewReview

• The integrity of the identification The integrity of the identification process and morgue operations process and morgue operations demands that remains be reviewed demands that remains be reviewed before release from the morgue. This before release from the morgue. This review should include an examination review should include an examination of the identification methods used, a of the identification methods used, a physical examination of the remains, physical examination of the remains, and the proper re-association of and the proper re-association of remains for that decedent.remains for that decedent.

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EmbalmingEmbalming

• Thorough disinfection, preparation, and Thorough disinfection, preparation, and minor reconstructive surgery procedures minor reconstructive surgery procedures are accomplished on each body or part are accomplished on each body or part of boy when authorized by the of boy when authorized by the appropriate next-of-kin or legal appropriate next-of-kin or legal authority. Next-of-kin may contract with authority. Next-of-kin may contract with a funeral home to perform this function. a funeral home to perform this function. Next-of-kin or legal authority may Next-of-kin or legal authority may authorize cremation as the finals means authorize cremation as the finals means of disposition.of disposition.

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CremationCremation

• If chosen by the legal next-of-kin, If chosen by the legal next-of-kin, cremation is an acceptable form of cremation is an acceptable form of final disposition. Next-of-kin or legal final disposition. Next-of-kin or legal authority may contract with a authority may contract with a funeral home/crematory for funeral home/crematory for cremation services.cremation services.

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Funeral Home ContactFuneral Home Contact

• To coordinate the shipping of To coordinate the shipping of remains and any NOK remains and any NOK considerations, the receiving funeral considerations, the receiving funeral home must be contacted and home must be contacted and information exchanged.information exchanged.

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Transportation of Transportation of Decedents from MorgueDecedents from Morgue

• This section coordinates the This section coordinates the transport of released human remains transport of released human remains from the morgue to a designated from the morgue to a designated location, such as an airport for location, such as an airport for transport to the receiving funeral transport to the receiving funeral home.home.

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Incident MorgueIncident MorgueDemobilizationDemobilization

• Once incident morgue operations have ceased, Once incident morgue operations have ceased, all remains have been released, or there is a all remains have been released, or there is a requirement to close the morgue operation, a requirement to close the morgue operation, a standard process will be used to ensure the standard process will be used to ensure the morgue site is cleaned, the DPMU is packed, morgue site is cleaned, the DPMU is packed, and that all remains have been accounted for. and that all remains have been accounted for.

• The incident morgue facility must be turned The incident morgue facility must be turned back to the owner or agent of the owner with no back to the owner or agent of the owner with no trace of biological contamination.trace of biological contamination.

• The facility must be restored back to its original The facility must be restored back to its original condition.condition.

• NDMS/Owner or agent walk-through to ensure NDMS/Owner or agent walk-through to ensure the cleanliness and condition of the facility is the cleanliness and condition of the facility is satisfactory.satisfactory.

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After Action ReportAfter Action Report

• After action reports (AAR) are After action reports (AAR) are critical for documenting the critical for documenting the deployment. AAR documentations deployment. AAR documentations helps in future planning and helps in future planning and response, indicates lessons learned, response, indicates lessons learned, and may be useful in legal and may be useful in legal challenges to the identification challenges to the identification process.process.

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Internet ResourcesInternet ResourcesMass FatalitiesMass Fatalities

• Department of DefenseDepartment of Defense– www.ecbc.army.mil/hld/dl/MFM_Capstone_August_200www.ecbc.army.mil/hld/dl/MFM_Capstone_August_200

55– www.afip.org/Departments/oafme/dna/index.htmlwww.afip.org/Departments/oafme/dna/index.html– www.edgewood.army.mil/downlaods/reports/coroner_gwww.edgewood.army.mil/downlaods/reports/coroner_g

uide.pdfuide.pdf

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Internet ResourcesInternet ResourcesMass FatalitiesMass Fatalities

• Department of JusticeDepartment of Justice– Mass Fatality Incidents: Guide for IDMass Fatality Incidents: Guide for ID– www.ojp.usdoj.gov/nij/pubs-sum/199758.htwww.ojp.usdoj.gov/nij/pubs-sum/199758.ht

mm– Identifying Victims Using DNAIdentifying Victims Using DNA– www.ncjrs.org/pdffiles1/nij/209493.pdfwww.ncjrs.org/pdffiles1/nij/209493.pdf– FBI Disaster SquadFBI Disaster Squad– www.fbi.gov/hq/lab/disaster/disaster.htmwww.fbi.gov/hq/lab/disaster/disaster.htm– Providing Relief to Families After Mass Providing Relief to Families After Mass

FatalityFatality– www.ojp.usdoj.gov/ovc/publications/bulletins/prfmf_11_2001/welcome.htmlwww.ojp.usdoj.gov/ovc/publications/bulletins/prfmf_11_2001/welcome.html

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Internet ResourcesInternet ResourcesMass FatalitiesMass Fatalities

• National Transportation Safety National Transportation Safety BoardBoard

• www.ntsb.gov/Family/family.htmwww.ntsb.gov/Family/family.htm• Federal Family Assistance Plan for Aviation Federal Family Assistance Plan for Aviation

DisastersDisasters• www.ntsb.gov/publictn/2000/spc0001.htmwww.ntsb.gov/publictn/2000/spc0001.htm• Responding to an Aircraft Accident-How to Responding to an Aircraft Accident-How to

Support the NTSB (For Police and Public Safety Support the NTSB (For Police and Public Safety Personnel)Personnel)

• www.ntsb.gov/Family/LEO_brochure.pdfwww.ntsb.gov/Family/LEO_brochure.pdf

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Internet ResourcesInternet ResourcesMass FatalitiesMass Fatalities

Articles and PublicationsArticles and Publications

• World Trade Center Individual World Trade Center Individual IdentificationIdentification

• www.cmj.hr/2003/33/3/12808716.pdfwww.cmj.hr/2003/33/3/12808716.pdf

• After Action Report Station Nightclub FireAfter Action Report Station Nightclub Fire• www.hari.org/EmergencyPreparedness.shtmlwww.hari.org/EmergencyPreparedness.shtml

• Handling of Disaster Victim Humana Remains: Handling of Disaster Victim Humana Remains: A Quick Guide for Health Care Workers, A Quick Guide for Health Care Workers, Medical Examiners and Funeral ServicesMedical Examiners and Funeral Services

• www.femors.org/ssl/docs/www.femors.org/ssl/docs/FEMORS_Handling_of_Disaster_Victim_Human_RemaiFEMORS_Handling_of_Disaster_Victim_Human_Remains.pdfns.pdf

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