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NYC Medical Examiner’s Office Gets Ready for the Next Emergency

It is midnight on a Saturday and New York City Police, firefighters and emergency vehicles are responding to a possible explosion aboard a train at Penn Station. Injuries and casualties are heavy. Rescuers are desperately working to remove surviving passengers and identify those who did not.

Fictional scenario or nightmare come true?

For New Yorkers who ride the rails, the possibility of a terrorist attack on the City’s train system is still a recurring bad dream, and unfortunately, in light of the relatively recent attacks in London and Madrid, this scenario could be a reality. That is why between midnight and 4 pm, on Saturday, August 25th, the New York Office of Emergency Management held a multi-agency field exercise to assess how well the city would respond to a terrorist incident within New York City’s train system.

One of the agencies involved, New York City’s Medical Examiner’s Office (OCME), supplied its mobile command post for the exercise, a rapidly deployable DRASH shelter providing 249 square feet of usable space that includes independently-operational DC2E communications equipment. The shelter and communications equipment, supplied by Reeves EMS, became fully operational within an hour of the “incident,” providing an immediate environmentally controlled command area. The command post is one of several new improvements made by the Office to mitigate future man-made or natural disasters that could also involve radioactive or biologically contaminated casualties.

“The primary objective of the Medical Examiner’s Office is to recover remains in a dignified and respectful manner while ensuring the integrity of the victim’s identification,” says Frank DePaolo, director of the agency’s Special Operations Division. This means that, in the event of a major disaster, victims need to be recovered, identified and returned to their families as soon as possible. It also means that the related crime scene, including the medicolegal investigation needs to be done properly. In the past, the challenge has been how to safely and effectively conduct an investigation in a contaminated environment. To do this, the office has worked diligently since 9/11 with the NYPD Emergency Services Hazmat Unit to not only train its medical examiners, but also train members of the New York Police Department, the Federal Bureau of Investigation and other agencies involved in this type of crime scene investigation.

“In New York City, the Medical Examiner’s Office is the lead agency when it comes to fatality management,” says DePaolo. “We’ll step up as we have in the World Trade Center recovery operation. So far, we have trained about sixty people in our office to be fully competent to operate in a contaminated, crime scene environment. This includes pathologists, anthropologists, medicolegal investigators, mortuary technicians, autopsy technicians, DNA scientists, all who have been trained to work as a multi-disciplinary team in the field.”

According to DePaolo, another major element to achieving complete readiness is getting the right tools to build a system. On the Thursday before the Penn Station exercise, the Office set up part of its entire arsenal of equipment at an undisclosed location in New York City.

Taking center stage was a 97 foot long soft-walled shelter, comprised of a DRASH M Shelter System with four additional center sections, which would act as a field-disaster portable mortuary in case of a disaster. Here, decedents would be processed logically and expeditiously, protecting the integrity of the crime scene by moving down a track to different partitioned rooms that include triage, evidence collection, examination, photography and identification. A metal detector at the entrance would ensure that all victims would be scanned first to ensure that nothing on the remains could be detonated.
Side by side, an isolation shelter acts as an autopsy suite for contaminated victims. The shelter uses a HEPA filtration system to generate negative pressure that keeps contaminants from getting into the surrounding environment.

Both shelters are carried on trailers that provide an independently operational generator and environmental control system.

“… these are the most durable, rugged structures out there,” says DePaolo. “They have been used by the military for years in the field, and are perfect for this type of application.”

One of the office’s newest acquisitions is the purchase of a flexible command and control system that can be operated at the scene of an incident or at different locations if there are multiple incidents. The three part command system is comprised of the DRASH command shelter, a mobile command trailer with camera, satellite, cellular and remote video capabilities, and a special trailer that is used as a mobile field
communications unit. The DRASH system, which includes state-of-the-art communications equipment, has its own generator and environmental control capabilities, and can be deployed by itself or combined with the mobile command trailer, which can also be deployed independently. The mobile communications trailer is used in conjunction with the other equipment to support the Unified Victim Identification System (UVIS).

According to DePaolo, UVIS was developed as a result of lessons learned from the recent years’ disasters, such as 9/11 and the response to hurricane Katrina.

“In 9/11, about 25,000 missing person’s reports were generated,” says DePaolo. “They were collected by different agencies. In a large-scale disaster situation, you can’t have that. We need to be able to rapidly identify persons involved in the incident. This is only possible if we have a centralized system for the collection of missing persons’ information.”

According to DePaolo, UVIS has many features that allow for faster, more accurate victim identification. DePaolo says that the London subway bombing was a perfect example of efficient use of this type of system. The incident generated 131,000 calls in 24 hours. This resulted in about 4,000 missing person’s reports, which in the end enabled law enforcement officials to find out who was actually missing and who might be involved.

The system seems to be much improved since recent years. In New York City, friends and family can now report a missing person during an emergency disaster incident by calling 311. The 311 call center has sufficient staff who can access the UVIS system immediately following an incident and send information in real time to OCME and law enforcement  personnel on the scene so that they can begin identifying bodies.

In addition to the deployable mortuary, decontamination, command and communications equipment, special photography equipment will be used on the scene to enter a victim’s information directly into the UVIS system.

The recently acquired equipment is not only crucial to making sure that victims are properly identified, but also aids those personnel who sometimes spend months at a disaster scene.

“We got the funds for this system approved because our jobs are very unique,” says DePaolo. “First responders have a role. To properly process this type of crime scene, we often have to be at a scene for six weeks or even six months.”

Thursday’s equipment demonstrations were conducted with New York City’s Chief Medical Examiner Dr. Charles Hirsch and the OCME Chief of Staff Barbara Butcher in attendance, along with their supporting staff.

“We’re really proud to have been able to put together the finest, largest Medical Examiner’s Disaster Response capability in the country,” says Butcher. “With this equipment and our highly trained team of specialists, we stand ready to assist wherever needed in the United States.”



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