Strategies for Expedited Answers: Crime Labs Leading the Charge in Proactive DVI Engagement
In a time where disasters can lead to mass fatalities, accurate and timely identification of victims is pivotal. This session explores the value of forensic DNA analysis, interdisciplinary collaboration, and preparedness bring to DVI. Forensic DNA analysts, planning and working in unison with medical examiners, odontologists, fingerprint examiners, and anthropologists to employ the best tools and strategies allow for the most effective, fast, and accurate response. Director Angelo Della Manna and Chief Medical Examiner, Dr. Ed Reedy, discuss their experiences and best practices to ensure a forensic laboratory’s unique capabilities and resources are fully utilized, including the development of comprehensive plans and collaboration mechanisms with medical examiners, to optimize victim identification outcomes. This discussion highlights the potential of a unified approach to ensure response times, efficient resource utilization, and coordination meet the various challenges that arise during an event. In this session, you will gain valuable insights into how identification practices differ in disaster events compared to criminal casework and databasing and the steps, resources, and technologies that can make a significant difference in the lives of victims and their families in a time of crisis.
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So my name is Angelo Delamana. I'm the director of the Alabama Department of
Forensic Sciences
and the Alabama Department of Forensic Sciences is the state's only
internationally accredited
forensic laboratory and medical examiner system and in regards to a mass fat
ality event or
DVI application we would be the agency that is responsible for both supporting
the medical
examiners and their efforts to identify victims of a mass fatality event as
well as the providing
the forensic pathologists necessary to conduct the postmortem examinations and
autopsies so that
victims can be identified and released to their loved ones in a timely manner.
The Alabama Department of Forensic Sciences is an active participant and stake
holder
within the state's mortuary response team or what's commonly referred to in the
United States as
SMORT. Each and every state has an SMORT team that would be responsible for
responding to a mass
fatality event that might occur as a result of a natural disaster and/or a
terroristic event.
Here in Alabama our SMORT team our agency is involved and provides not just a
medical
examiner expertise but also and equally as important the forensic laboratory
and DNA personnel
to respond to those events and one of the most important pieces to an effective
and efficient
SMORT response to any disaster is the proper planning, preparation, and
execution of annual
exercises to mimic what would occur in a variety of different scenarios within
a disaster and then
to have a debrief with each of the stakeholders that would respond to identify
where the challenges
are, where the resource needs are, and to try and eliminate any sort of pain
points in that gap
analysis so that when the disaster does occur we can respond efficiently and
effectively.
And so we as an agency provide those resources from both the DNA personnel, the
medical examiner
personnel as well as our IT or information technology staff so that we can
leverage our
technology expertise to aid the disaster response with the other stakeholders
so that victims can be identified in a timely manner. The key to having a
successful process
of a mass fatality incident is planning. You have to have a plan and you have
to train to the plan
and then you have to execute the plan. So my name is Edward Reedy, I'm the
Chief Medical
Examiner for the Alabama Department of Forensic Sciences. I'm in charge of 62
counties in the
state of Alabama as the Chief Medical Examiner and I supervise the other
medical examiners in the
state for all aspects of death investigation. We are actively involved in a
mass fatality or
mortality exercise and this has been practicing our plan that we have in place
with the Department
of Health. And the role of the medical examiner's office is of course to
autopsy and identified
individuals of a mass disaster who are victims and the primary focus of that
investigation would
be the identification of the individuals. So it's important to remember that a
mass fatality
incident is a multi-disciplinary approach. It's going to require investigators,
fingerprint
technicians, radiologists, dentists, DNA technicians as well as forensic path
ologists to conduct the
autopsy. So it's important to remember that it is not a single entity
performing all of these
functions. An agency's response to a disaster event has certainly changed over
the last
couple of decades. Here in Alabama we had a mass fatality event that involved a
trained
derailment that involved over 30 different decedents or victims that needed to
be identified.
Unfortunately at that time DNA testing was in its infancy and the forensic
laboratory
was almost an afterthought to the medical examiner's approach to aiding in the
timely
identification of the victims of that mass fatality event and it took weeks to
get each and every
one of those victims identified and then released to their loved ones. That
resulted in a significant
amount of stress and anxiety for not just the stakeholders involved who were
trying their best
to identify these individuals but also for the families who continued to wait
for their
loved one to be released to them. Conversely as technologies evolved and the
forensic
laboratories become more engaged and helped plan and prepare for mass fatality
events,
we then had a second mass fatality event in Alabama a little over 10 years ago
that involved
multiple decedents stretched out over 110 square miles that resulted from a
EF5 tornado and in that regard the DNA laboratory personnel responded, staff
the family assistance
center collected the information necessary, the reference samples necessary for
testing from the
family members as well as conducting the DNA testing upon the remains from the
post-mortem
or autopsies provided by the medical examiner and we routinely and regularly
were able to
identify each and every one of those victims in a matter of days by allowing
the forensic
laboratory to utilize the skill set that they have to complement and assist the
medical examiners
in using the skill set that they have so that the victims could be identified
in a timely manner
and then released to their loved ones. So having a plan ahead of time is
critical and also essential.
Different states will have different agencies as the lead on mass fatality
incidents. In some states
it's the public health department in other states, it's a dedicated emergency
response
team but everybody should need should know their place and their role during
either an exercise
or an actual incident and plans have to be drawn up ahead of time and trained
to every 18 to 24
months in my opinion. Not only is there a lot of personnel turnover, there's
also people forget
exactly what they're supposed to do, where they're supposed to go and it's
important to continually
train to the plan that you have written. Now this plan should also be a living
document, it needs
to be able to change as necessary. During the exercise, the planning process,
we might find that
things just don't work for one reason or another. The plan needs to be changed.
These plans can't be
set in zones so to speak, they need to be able to be flexible and adapt to any
necessary changes.
A really essential part of the plan that sometimes is forgotten is the Family
Assistance Center.
There's going to be a need to collect information on the victims that are
involved in the mass
fatality or mass disaster and to do that you have to set up a Family Assistance
Center. Family
Assistance Center needs to be manned or have personnel involved where they can
collect information
about the missing person or the suspected person who's involved in the incident
. This includes
their medical history, any implanted devices that might be present such as
artificial knees,
hips, pacemakers, any other artificial joints, anything significant that might
survive,
decomposition or fire. And then the family members should be asked to
contribute a DNA specimen.
This is so that we can have a family reference to compare to the samples that
we collect from
the victims themselves. So by being an active stakeholder in these exercises
that plan and
prepare for disaster incidents, one of the major benefits of the forensic
laboratory personnel
being engaged in those exercises and being an active and named stakeholder in
the response
is the ability to communicate in real time with the medical examiners. When
there is
potentially thermal injuries or fragmentation, the medical examiner may have a
series of questions.
What type of sample does a forensic laboratory prefer to conduct DNA testing on
when blood is
not available, for example? By being a named participant in the exercise, the
DNA personnel
can provide a prioritized list to the medical examiner. In this type of event,
we prefer muscle,
then tissue, then teeth, then bone, for example. And by developing those
relationships and fostering
external relationships with both the medical examiners and the other responding
stakeholders,
that educates the other stakeholders on what the forensic laboratory
capabilities are,
as well as what the best sample to conduct DNA testing on is so that all of
that can occur
efficiently and effectively with very little to no failures. I guess the major
challenge that
crime labs and other personnel involved in the identification process would
face
would be the sheer enormity of the number of people who were deceased. So it
can be quite a shock,
and those people need to be prepared to see some pretty gruesome things. During
a mass
disaster or a mass fatality, there's always going to be some decomposition
present,
some dismemberment and fragmentation, some burning. The smells are going to be
significant. All of
these things combined can provide just a sensory overload to people who are
unprepared for that type
of experience. The medical examiners are well acquainted with those type of
things, and they are
actually the key personnel to help guide the uninitiated through the process.
Unfortunately,
medical examiners are often in very short supply, and there may not be one
available or more available
to help people get ready for what they're about to see. DNA assistance should
be able to go into
the autopsy room to guide the medical examiner for the best sample for DNA
extraction. They would
know best whether it's a piece of muscle or bone or a tooth or blood. If blood
's not available,
maybe a cheek swab might be available. That's also a possibility. But
unpreparedness is often
a failure point in mass fatality incidents. In my own experience, during the
exercises that we've
conducted has been the discovery that we don't have enough people present to do
the jobs that
are required. That is one of the biggest, you might say, "Aha!" moments that we
've found is that we
really need more people than we had planned to have. The only way to discover
this is if you do a dry
run more than one time. It's very, very important to do the exercises on a
regular basis so that
people don't forget how they're supposed to do their jobs. Recently, we just
completed our annual
exercise related to disaster response. In this year's exercise, we mimicked a
plane crash that
occurred in a rural area. In that particular exercise, we were able to identify
a couple of
challenges that in the execution of the exercise, we're able to now modify our
existing plan so that
we can prepare better for any future incidents. Specifically in this exercise,
we recognized that
we were not fully utilizing the ability of our information technology section
to communicate with
families who would respond to the scene or to the Family Assistance Center to
provide information
about their loved one as well as family reference samples. We were able to
provide additional IT
resources in our plan now so that we could set up a voiceover IP internet phone
system. We could
set up a website that families and loved ones from around the state or around
the world could
get timely information. We could put on our website and our Family Assistance
Center protocol
specific information that we wanted the families when they come to the Family
Assistance Center to
be prepared and what they could provide. You know, a number of siblings,
pedigree of the family.
Do we have any reference samples from the individual believed to be a victim or
are we going to have
to try and identify them through sibling or parent-child relationships through
DNA testing? Things of
that nature were identified only through the exercise. These are the types of
things and challenges
that when you execute an exercise, you learn from that you just don't have the
ability to learn from
if you just write out a protocol on paper. During the identification process,
it actually occurs
in two phases. There's a preliminary identification where you get the first
positive identification of
remains whether it's by fingerprint, by dental or DNA. And then a statement can
be released to
the family is that we have identified part of your loved one or if the body is
intact, you can say
we have identified your loved one. But more often than not, as I mentioned
previously, there's going
to be a lot of fragmentation or burning. And we want to try to re-associate any
fragmented remains
back with the major portions of the body. The second phase would be where we've
identified
a dissociated portion back to the original DNA sequence or fingerprint or
whatever that we've
identified. And then we can go back to the family again and say we've found
these portions
and re-associated them. You want to take the remains of your loved one as we
have them or do you want
us to wait and continue to try to identify portions. And if you take them, what
do you want us to do
with those portions that are not yet identified? Those are all questions that
are going to become
up that are going to come up. And you have to be very, very clear to the
families about the process
of identification because some families are very, very particular about having
a complete set of
remains before they actually bury their loved one. In my estimation, I think
the biggest advancement
in technology that will prove to be a tremendous asset to a disaster response
event or a mass
fatality event is the implementation of rapid DNA testing into the S-MORT
response. Currently,
as families respond to a disaster incident and provide samples to help identify
their missing loved one, those samples are brought back to the forensic
laboratory.
Forensic DNA testing is conducted upon those samples. The resultant DNA
profiles are compared to
family reference samples. The pedigrees are determined and then that
information is provided
to the medical examiner to facilitate an ID. Currently, in the best case
scenario,
all of that testing and identification can occur in the most efficient way in
the span of two to
three days at best. By providing the resources and the advances in forensic DNA
technology to allow
rapid DNA testing to occur in a DVI environment, I can foresee where you would
have instruments
that could respond, mobile with the disaster team. Then, as the families are
providing the
information associated with their loved one, they are also providing an oral or
a buckle swab
at the scene at the family assistance center where that DNA sample is tested
within 90 minutes.
That resulting DNA profile can be compared to other people in the pedigree and
the remain samples
that are generated by the forensic laboratory personnel, which will result in a
much more timely
identification of the unidentified human remains. I can't emphasize this more.
You need to plan
for the event. You need to practice the event and practice to the event
repeatedly. And then,
when the event occurs, everybody knows what to do and how to do it. As a
forensic scientist
within the DNA section, I believe the single most important thing, an analyst
and/or a forensic
biology laboratory can do to aid in the preparation and planning and eventual
execution of a disaster
event that involves mass fatalities, is to reach out to the appropriate
entities who are managing
the SMORT response now and offer your expertise. That is the single most
important thing to do.
As a laboratory, do not wait for the medical examiner or the SMORT team to
reach out to the
laboratory and ask for your assistance. They may not know that you are able and
willing to offer
your expertise. This is the time to reach out to the appropriate stakeholders
within the
mass fatality event and offer your expertise. Offer to participate in the
annual exercise.
Offer to staff the Family Assistance Center. Offer to help train how to
properly identify,
preserve and collect the forensic evidence that might be present at a disaster
event.
Offer to help collect the family reference samples that are necessary
to conduct the DNA testing that will help identify their loved one. That to me
is the single most
important thing that a forensic laboratory can do to help prepare for an
effective disaster response.
You'll see that it's very rewarding. It provides your laboratory personnel an
opportunity to get
out of the laboratory and meet other stakeholders that they're going to have to
work with in a
disaster response. It benefits all involved, but the only way to do that is to
take that first step.
Reach out as a forensic laboratory. Offer your expertise. Offer to participate
in the annual
exercise. You'll see it's a tremendous benefit not just for your laboratory but
for everybody involved
in the disaster response event.
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