Washoe County Regional Medical Examiners Office Rural Preparedness

Washoe County Regional Medical Examiner’s Office Rural Preparedness Summit

RECOVERY in INCIDENT COMMAND

MASS FATALITY RESPONSE & RECOVERY In a mass fatality event, our duties remain the same, just on a much larger scale….

MASS FATALITY RESPONSE & RECOVERY OBJECTIVE OF HUMAN REMAINS RECOVERY • • • Participation in Unified Command Scene Evaluation and Investigation Locating, documenting and collecting of human remains, property and evidence at the incident site(s) Packaging and preservation of remains for identification process Chain of custody

MASS FATALITY RESPONSE & RECOVERY WHAT IS A MASS FATALITY? A Mass Fatality Event occurs when the number of deaths is 10 or greater, OR the number or condition of human remains interrupts the routine capabilities of the jurisdictional agency. Criminal element Chemical, Biologic, Radiologic, Nuclear, Explosive event Fragmentary remains Location of event Type(s) of remains

MASS FATALITY RESPONSE & RECOVERY TYPES OF MASS FATALITY EVENTS Natural Disasters Transportation Accidents Flooding Earthquake Tornado Planes Trains Automobiles Pandemic Terrorism Criminal Activity / Active Shooter

MASS FATALITY RESPONSE & RECOVERY FIVE LEVELS OF ACTIVATION Level One Anticipated deaths 10 or higher OR anticipated deaths less than 10 with Family Assistance Center Activation OR as directed by the Chief Medical Examiner No criminal or terrorist involvement No toxic or hazardous material Human remains generally intact Mutual Aid from one agency required Normal response system is functional if reinforced NNDVRT is possible, but not necessary

MASS FATALITY RESPONSE & RECOVERY FIVE LEVELS OF ACTIVATION Level Two Anticipated deaths 10 or higher OR as directed by the Chief Medical Examiner No criminal or terrorist involvement No toxic or hazardous material Human remains generally intact Mutual Aid from several agencies required Normal response system is functional with mandatory 12 hour shifts implemented NNDVRT is necessary

MASS FATALITY RESPONSE & RECOVERY FIVE LEVELS OF ACTIVATION Level Three Anticipated deaths 10 or higher OR as directed by the Chief Medical Examiner Criminal or terrorist activity is suspected There is risk of CBRNE hazards Human remains are fragmented but do not require decontamination Mutual Aid from outside the county is required Normal response system is functional with mandatory 12 hour shifts implemented NNDVRT is necessary Possible use of other ME/CO DVRT resources and/or private vendor assistance

MASS FATALITY RESPONSE & RECOVERY FIVE LEVELS OF ACTIVATION Level Four Anticipated deaths 10 or higher OR as directed by the Chief Medical Examiner Criminal or terrorist activity is suspected There is risk of CBRNE hazards Human remains are fragmented or require decontamination Mutual Aid (regional, state, and possibly federal – DMORT) is required Normal response system is functional with mandatory 12 hour shifts implemented NNDVRT is necessary Use of other ME/CO DVRT resources and/or private vendor assistance is likely The scope of destruction or level of difficulty is recovery is significant. It is difficult to locate and remove remains. This may be a catastrophic mass fatality event.

MASS FATALITY RESPONSE & RECOVERY FIVE LEVELS OF ACTIVATION Level Five Anticipated deaths 10 or higher There is a pandemic influenza or infectious disease of similar gravity Criminal or terrorist activity is suspected There is risk of CBRNE hazards Human remains are fragmented or require decontamination Mutual Aid (regional, state, and federal) is required Normal response system may not be functional. Mandatory 12 hour shifts are implemented for all those able to work. All NNDVRT capabilities are required Use of other ME/CO DVRT resources and/or private vendor assistance is required The scope of destruction or level of difficulty is recovery is significant. It is difficult to locate and remove remains. This is a worst case scenario catastrophic event.

MASS FATALITY RESPONSE & RECOVERY MANAGEMENT OF A MASS FATALITY INCIDENT Call Center Scene Response Transportation & Storage Morgue Operations Disaster Victim Recovery

MASS FATALITY RESPONSE & RECOVERY SCENE RESPONSE Scene Survey Recovery Documentation Number of Remains Condition of Remains Hazards and Other Concerns Photographic Written Transportation Refrigeration

MASS FATALITY RESPONSE & RECOVERY MORGUE OPERATIONS X-Ray Human Remains Processing Post Mortem Examination

MASS FATALITY RESPONSE & RECOVERY IDENTIFICATION Fingerprints Confirmation Dental of Presumptive Identification Comparison X-Ray Comparison DNA Comparison

Morgue Capabilities

Disaster Portable Mortuary Unit: Deployment

Decedent Transport Device

Storage Container

Electrical Generators

Recovery Trailer

Forensic Pathology

Command Post

Washoe County Led Statewide Initiative Mass Fatality Planning & Equipping: 2009 -2010 Developed mass fatality plans, trained coroner personnel, purchased medical examiner equipment.

Rural Trailers Each rural county was provided a trailer Each trailer contained Personal Protective Equipment such as gloves Each trailer contained basic recovery equipment such as backboards After WCMEO arrival, the trailer was utilized for basic recovery operations

Amtrak Accident

Amtrak Incident Mutual aid request from Sheriff Coroner

Amtrak Incident Regional Reno Support Fire REMSA Washoe SO FIS WCME

Reno Fire Department Automatic Aid of two Type I Fire Engines Chief Officer lent assistance to passengers and the Incident Command Assist REMSA, PIO Function

REMSA & Care Flight Responded 2 helicopters, 2 ambulances, and 1 supervisor unit Declared MCI Made emergency notifications (hospitals, health dept. , WCMEO, emergency manager

REMSA & Care Flight Compiled personnel to staff 5 additional ambulances and a supervisor who were en route to the scene when the incident was terminated. Per Banner Churchill Ambulance Dispatch, a total of 65 patients were transported, 8 of which were transported to Reno

Washoe County Sheriff’s Office Forensic Investigations Responded 3 forensic investigators Photographed, documented, and diagramed the accident scene Assisted with victim recovery Attended autopsies for photography and evidence collection

Washoe County Medical Examiner’s Office Interagency Support Mass Fatality Planning Recovery & Morgue Operations Identification Post Mortem Examinations

Washoe County Medical Examiner’s Office Notification by Hav. Bed: Washoe County Emergency Manager Mass Fatality Plan: Level Two Activation Mass fatality situation report WCMEO call tree Contact Incident Commander Formal request for Assistance Site Assessment

The Scene: Night & Day Site Assessment Recovery

Identification