Mass Fatality Planning Special Considerations:

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Mass Fatality PlanningSpecial Considerations

• A View From the Morgue

Kenneth P. Hermsen, D.D.S., M.S. Forensic Dental
Consultant, Douglas County Coroners Office Team
Leader, Nebraska Forensic Dental Identification
Team Co-Chair, OMMRS Mass Fatality Response
Subcommittee
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"Show me the manner in which a Nation or
community cares for its dead and I will measure
with mathematical exactness the tender mercies
of its people, their respect for the law of the
land, and their loyalty to high ideals.
William Ewart Gladstone (1809-1898)
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Disclaimer
Some of the experiences and operations discussed
in this presentation describe operations
performed by the Disaster Mortuary Operational
Response Team. The descriptions and opinions
presented here are strictly the presenter's and
are not to be taken as representing those of
DMORT, NDMS, or the U.S. Department of Health
and Human Services
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Planning Pyramid
FAC Considerations
Operations Support
Transportation Lights
Lodging Water Sanitary
facilities Electricity
Operations Planning
Morgue location Operations plan Identify morgue
personnel
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County Coroner
Morgue Operation
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County Coroner
Family Assistance Center
Morgue Operation
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County Coroner
Information Resource Center
Family Assistance Center
Morgue Operation
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County Coroner
Information Resource Center
Family Assistance Center
Morgue Operation
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County Coroner
Information Resource Center
Family Assistance Center
Morgue Operation
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County Coroner
Information Resource Center
Family Assistance Center
Morgue Operation
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County Coroner
Information Resource Center
Family Assistance Center
Morgue Operation
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County Coroner
Information Resource Center
Family Assistance Center
Morgue Operation
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County Coroner
Information Resource Center
Family Assistance Center
Morgue Operation
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County Coroner
Information Resource Center
Family Assistance Center
Morgue Operation
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American Airlines Flight 5966 Kirksville, MO
October, 2004
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Mortuary Annex Site at Kirksville
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County Coroner
Information Resource Center
Family Assistance Center
Morgue Operation
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Information Resource Center

• Located in close proximity to the morgue
• Central collection site for all antemortem and
  postmortem data
• Where all records related to the operation are
  stored and filed

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Information Resource Center
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County Coroner
Information Resource Center
Family Assistance Center
Morgue Operation
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Family Assistance Center at Kirksville
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Family Assistance Center

• Located at a site AWAY from the morgue and
  disaster site
• Provides for the families physical and emotional
  needs
• Provides the morgue with essential information
  regarding the deceased victims

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Mankinds most universal experiences
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Although death is a universal experience,
reaction to the death of a loved one (grief) is
very personal and varies greatly

• Nature of the Individual
• Circumstances
• Social/Cultural Influences
• Religious beliefs

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Although death is a universal experience,
reaction to the death of a loved one (grief) is
very personal and varies greatly

• Nature of the Individual
• Circumstances
• Social/Cultural Influences
• Religious beliefs

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Nature of the Individual
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Although death is a universal experience,
reaction to the death of a loved one (grief) is
very personal and varies greatly

• Nature of the Individual
• Circumstances
• Social/Cultural Influences
• Religious beliefs

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Circumstances
Predictable Loss
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Circumstances
Sudden Loss
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Although death is a universal experience,
reaction to the death of a loved one (grief) is
very personal and varies greatly

• Nature of the Individual
• Circumstances
• Social/Cultural Influences
• Religious beliefs

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Social/Cultural Influences

• Cultural background can significantly affect how
  an individual understands and approaches the
  grief process.
• Many cultures have developed rituals to help
  people through the grief process.
• On occasion, rituals and social issues can
  conflict with the realities of the mortuary
  operation
• Guam- KAL

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Korean Airline Flight 801 Agana, Guam August 6,
1997 Fatalities 228 Survivors 26
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Although death is a universal experience,
reaction to the death of a loved one (grief) is
very personal and varies greatly

• Nature of the Individual
• Circumstances
• Social/Cultural Influences
• Religious beliefs

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For the devout of any religion, adhering to
their religious customs is extremely important
and often an integral part of dealing with their
grief
Unfortunately, the realities of the disaster can
conflict with religious customs
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AA Flight 5966

• Location Kirksville, Missouri
• Date Tuesday, October 19, 2004
• Time 740p.m. CST
• Plane British Aerospace Jetstream 32
  Twin-Turboprop
• Conditions Dense Fog
• Departure St Louis, Missouri
• Crash Occurred 4 miles from runway on
• instrument approach
  
• Injuries 13 Fatal, 2 serious

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Realities of a Disaster
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Realities of a Disaster

• Time

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Realities of a Disaster

• Time
• Set-up 12 to 24 hours after incident
• Survivors take priority at incident site
• Transportation from incident site
• Law enforcement issues/crime scene
• This can be an issue with religions that require
• burial within 24 hours or by sundown the
• next day

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Realities of a Disaster

• Time
• Identification issues

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Realities of a Disaster

• Identification issues
• Autopsy/dissection may be required to aid
  identification
• Unassociated/ fragmented remains

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Realities of a Disaster

• Time
• Identification issues
• Laws governing disaster operations

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Realities of a Disaster

• Time
• Identification issues
• Laws governing disaster operations
• Exceptions to the morgue operations plan

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Realities of a Disaster

• Exceptions to the morgue operations plan
• Every plan should have a mechanism to alter the
  plan on-site as required
• Most plans call for one method of identification
  and preparation of the remains
• Security issues-very limited access to the morgue
• Safety issues-the morgue can be an unsafe place
  for untrained personnel

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Conclusions

• FAC and morgue personnel need to be informed and
  sensitive to the cultural, social and religious
  issues concerning the families and victims
• Disaster plans should have a mechanism in place
  to appropriately deal with sensitive issues,
  identifying personnel that have the authority to
  make binding decisions

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Questions?
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Thank you