Mass Disaster: Past and Present Current Trends: 5 th Annual Conference December 1, 2004 Nizam Peerwani, M.D. Chief Medical Examiner Tarrant-Denton-Parker.

Slides:



Advertisements
Similar presentations
Responding to the Threat of Bioterrorism: A Status Report on Vaccine Research in the United States Good Morning. Over the next 1 ½ hours of so I’ll be.
Advertisements

Emergency Responder Sensitive UNDERSTANDING THE DANGERS OF AGROTERRORISM Public Policy and Biological Threats.
Office of the Chief Medical Examiner (OCME) Flu Issues.
Criminalistics  Also known as Criminalistics  The application of science to the law.
GIS in a context of Bioterrorism Maria Styblińska University of Silesia Institute of Informatics.
P. Urbano per il Master in Medicina NBC Intervista ad Alibek EmergencyNet NEWS Service Special Report Wednesday, July 14, 1999 EmergencyNet Exclusive:
BIOTERRORISM health preparedness
National Transportation Safety Board FAA Airport Conference Hershey, PA 2008.
Decontamination During Human Biological Incidents Presented by The Ohio Department of Health Disaster Preparedness & Response Program.
Capability Cliff Notes Series PHEP Capability 5—Fatality Management What Is It And How Will We Measure It?
Forensic Pathology & Death Investigations in Pima County
The Science of Agroterrorism Bob L. Larson, DVM, PhD, ACPVM University Extension, Commercial Agriculture Program, Beef Focus Team University of Missouri,
The Vermont Medical Examiner System Paul L.Morrow, MD Forensic Pathologist, Glebe, NSW Former Chief Medical Examiner, VT USA.
Bioterrorism Preparedness Public health CBRN course Bonnie Henry, MD, FRCPC.
Northwest Center for Public Health Practice University of Washington School of Public Health and Community Medicine 1 Preparing for and Responding to Bioterrorism:
Introduction to Forensic Epidemiology
Overview of Terrorism Research at the CDC Dixie E. Snider, M.D., MPH. Associate Director for Science Presented at 2003 Medical Research Summit March 6,
What will be studied? What are the risks? Part II October 1, 2007 National Emerging Infectious Diseases Laboratories.
Information on Agro/Bio terrorism Potential Occurrences and Emergency Management of Animal Diseases.
What is Forensic Science?
Laboratory Response Network Spokane Regional Health District.
 Forensic science is the application of the science of physical anthropology to the legal process.  Not only does the scientist work with the deceased,
ONELEGACY AND CORONER’S CASES Christopher Rogers, M.D. Los Angeles County Coroner.
Bioterrorism MLAB 2434: Microiology Keri Brophy-Martinez.
Ohio Department of Health1 The State of Ohio Weapons of Mass Destruction BIO TERRORISM PROTOCOL PROCEDURES FOR LOCAL, STATE AND FEDERAL PERSONNEL AND AGENCIES.
Daniel Kollek, MD, CCFP(EM)
Careers in Forensic Science. 2 Copyright and Terms of Service Copyright © Texas Education Agency, These materials are copyrighted © and trademarked.
Handling the Dead in a Mass Fatality Incident Kathy Taylor, Ph.D. Forensic Anthropologist King County Medical Examiner’s Office.
US biosafety experiences during the last two decades: Lessons and achievements PETER PALESE MOUNT SINAI SCHOOL OF MEDICINE, New York BIOSECURITY, ISTANBUL,
Local Emergency Response to Biohazardous Incidents Dr. Elizabeth Whalen, MD Medical Director Albany County Health Department April 8, 2005 Northeast Biological.
Agricultural Investigations Law Enforcement Perspective.
Critical Infrastructure Protection Overview Building a safer, more secure, more resilient America The National Infrastructure Protection Plan, released.
BIOTERRORISM: SOUTH CAROLINA RESPONDS. OBJECTIVES l To understand the response to a bioterrorist act through use of the unified incident command system.
Criminalistics  Also known as Criminalistics  The application of science to the law.
DISASTER PREPAREDNESS.  Definition:  Any situation/event that overwhelms existing resources or ability to respond.
New Developments in Biothreats and Biosecurity Clifton R. Lacy, M.D. October 17, 2007.
Disciplines of Forensic Science Chapter 1. Disciplines of Forensic Science Criminalistics Digital & Multimedia Sciences Engineering Sciences Jurisprudence.
Public Health Preparedness Summer Institute for Public Health Practice August 4, 2003.
Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 19: Community Preparedness: Disaster and Terrorism.
Bernards Township Office of Emergency Management February 28, 2012.
Terrorism & Bioterrorism Communication Challenges Module 9.
DISASTER PREPAREDNESS.  Definition:  Any situation/event that overwhelms existing resources or ability to respond.
© 2014 The Litaker Group LLC All Rights Reserved Draft Document Not for Release or Distribution Texas Department of State Health Services Disaster Behavioral.
Text 1 End Text 1 Learning Module 5: Surveillance and Infection Control.
Community Health Nursing ASN 260 Chapter 12-Iggy Community Emergency Preparedness & response S. Tapp MSN BSN RN 1 ADN 260/RN 12.
CHLAMYDIA, RICKETTSIA AND MYCOPLASMA.
Ned Einsig III.  Domestic Intelligence & Security Service of the United States  Prime Federal Law Enforcement Organization  Jurisdiction on over 200.
By: David Gonzales. What is Bioterrorism?  A bioterrorism attack is the deliberate release of viruses, bacteria, toxins or other harmful agents used.
Diseases in Nature Conference John Herbold DVM, MPH, PhD, DACVPM, FACE Center for Biosecurity & Public Health Preparedness University of Texas School of.
Disaster Nursing. Bioterrorism and Weapons of Mass Destruction By: Brittney Mathis.
Careers in Forensic Science. Definitions Also known as Criminalistics The application of science to the law 2UNT in partnership with TEA, Copyright ©.
Disaster and Emergency Management Security Services.
Death Investigation in Wisconsin and The United States Michael A. Stier, MD Assoc. Prof. of Forensic Pathology UW School of Medicine & Public Health.
CJ in the USA Copyright 2011 Curriculum Technology, LLC. All Rights Reserved.
روش استاندارد انتقال نمونه هاي عفوني براساس الزامات بين المللي.
The National Oversight of Bioscience Researches in Korea : Biosafety & Biosecurity WK Seong, CK Yoo, JK Lee, JB Ahn, and TJ Son Division of Biosafety Evaluation.
Bioterrorism and Food Laws FST /25/02 by David Rasmussen.
Careers in Forensic Science
Disaster and Emergency Management
Family Assistance. Family Assistance Legislative Background Aviation Disaster Family Assistance Act of 1996 Foreign Air Carrier Family Support Act.
Bioterrorism: A Changing World and What You Can Do
Washoe County Regional Medical Examiner’s Office
Disaster Preparedness
Careers in Forensic Science
Biological agents that might be used as weapons of Bioterrorism
Crime Laboratories There are nearly 400 crime labs in US –Federal, state, county, and municipal (local) –Most function as part of a police department –Others.
Overview of Terrorism Research at the CDC
Careers in Forensic Science
Community College track: Emergency Operations
Science of Crime Scenes
Presentation transcript:

Mass Disaster: Past and Present Current Trends: 5 th Annual Conference December 1, 2004 Nizam Peerwani, M.D. Chief Medical Examiner Tarrant-Denton-Parker Counties, Texas Wednesday, December 1, 2004 Anthrax Bacilli Gram Stain Terrorism is the unlawful use of force or violence against persons or property to intimidate or coerce a government, the civilian population, or any segment thereof, in furtherance of political or social objectives -Federal Bureau of Investigation

December 1, 2004Mass Casualty Disposition2 Objectives Mass Fatality & Legal Authority at Local Level Role of Medical Examiner in Mass Fatality Event Types of Events resulting in Mass Fatalities and Human Identification “Bioterrorism” – a different model necessitating different approach

December 1, 2004Mass Casualty Disposition3 Definition Mass trauma is the term used to describe the injuries, death, disability, and emotional stress caused by a catastrophic event, such as a large- scale natural disaster or a terrorist attack Mass Fatalities: Any situation in which there are more human bodies to be recovered and examined that can be handled by the resources of the existing facility. Mass Fatalities in Tarrant-Denton-Parker: Is defined as any event where there are more than 10 casualties resulting from a single event

December 1, 2004Mass Casualty Disposition4 Legal Authority In Texas, the medical examiner is empowered by Statute of the Code of Criminal Procedures which requires a duly appointed medical examiner to conduct “inquest” or inquiry into certain types of death including: Deaths due to unnatural causes Unattended deaths Deaths that occur within 24 hours of admission

December 1, 2004Mass Casualty Disposition5 Medical Examiners in Texas 2003 For more information: Facts Texas has no State Medical Examiner (ME) Texas has a mixed ME and Coroner system 13 MEs in Texas MEs are located in 15 counties Population served by ME counties is ~ 13 million (58% of state) In Texas - Medical Examiners are: Appointed Physicians licensed by the State Board of Medical Examiners Trained and experienced in pathology, toxicology, histology, and other medicolegal sciences Appointed by the County Commissioners Court Source: Bureau of Epidemiology and Bureau of Vital Statistics

December 1, 2004Mass Casualty Disposition6 Tarrant County Medical Examiner’s District - Serves Tarrant, Parker and Denton Counties Jurisdiction 3,000 SM Population: 2.1 million Cities served: 60 Law Enforcement Agencies: 63 Inquests: 8,000/year (40% of all deaths)

December 1, 2004Mass Casualty Disposition7 Chief Medical Examiner Deputy Medical Examiners Histology Lab Technical and Administrative Director Forensic Death Investigation Forensic Toxicology Lab and Crime Labs Morgue and Evidence Forensic Dentist (Human ID Lab) Commissioners’ Court Table of Organization

December 1, 2004Mass Casualty Disposition8 Four Forensic Pathologists Forensic Anthropologist Forensic Dentist Forensic Toxicologists Criminalists Latent Print Examiner Forensic Death Investigators Full-service Toxicology Lab Reference Crime Lab (52 full-time employees)

December 1, 2004Mass Casualty Disposition9 1 st Major Terrorist Attack in the United States: April 19, 1995 Murray Federal Building: 5000 lbs of Ammonium Nitrate fertilizer in a Truck

December 1, 2004Mass Casualty Disposition10 National Defense Policy Against Terrorism: Counterterrorism The policy (June 21, 1995) evolved in the aftermath of Oklahoma Bombing on the 2 nd anniversary of the Waco Disaster on April 19,1995 President Homeland Defense FBI FEMA Crisis Management Consequence Management State/Local Agencies County Medical Examiners Role?

December 1, 2004Mass Casualty Disposition11 Role of Medical Examiner in Mass Fatality Event Assessment of the Event Death Scene Investigation Body Recovery Examinations Identification of Human remains Establishment of Cause and Manner of Death Protect Personal Property and Evidence Disposition of Remains to Loved Ones

December 1, 2004Mass Casualty Disposition12 Mass Casualty Involvement by Tarrant County Staff Delta Airline Crash at DFW Airport,1985 Delta Airline Crash at DFW Airport, 1986 Waco Disaster, 1993 International: Rwanda Genocide Investigation, 1996 Bosnia & Kosovo, Guatemala, 1997 – 2002 Afghanistan & Iraq Mass Graves,

December 1, 2004Mass Casualty Disposition13 Types of Mass Fatality Events Natural Man-Made Weather: Tornado, Flood Fire: Forest fire Earthquake Fire: Hotel, School, Church Transportation: Aircraft, Bus etc Industrial: Chemical Terrorism: Domestic or Foreign

December 1, 2004Mass Casualty Disposition14 Notification Emergency Operations Center (EOC) Police – Law Enforcement News Media

December 1, 2004Mass Casualty Disposition15 Koresh Compound on Thursday, April 22, 1993

December 1, 2004Mass Casualty Disposition16 “Bunker” Water Tower Kitchen/Dining Area

December 1, 2004Mass Casualty Disposition17

December 1, 2004Mass Casualty Disposition18

December 1, 2004Mass Casualty Disposition19 Modes of Identification Visual: Body Intact Fingerprints Dental Body X-Rays DNA

December 1, 2004Mass Casualty Disposition20 Fingerprint Comparison: AFIS

December 1, 2004Mass Casualty Disposition21 Dental

December 1, 2004Mass Casualty Disposition22 X-Ray Comparison

December 1, 2004Mass Casualty Disposition23 DNA A Definitive …For Identification: Genomic (STR) or Mitochondrial

December 1, 2004Mass Casualty Disposition Taught Us That We Remain Unprepared

December 1, 2004Mass Casualty Disposition25 Dense Smoke & Debris Several Days After The attack (September 15, 2001) Destruction May Be Widespread Recovery Efforts Can Be Extremely Hazardous

December 1, 2004Mass Casualty Disposition26 Shifting Paradigm

December 1, 2004Mass Casualty Disposition27 In a Bioterrorist Attack…. In most cases, the cause of death will be clearly established by Hospital or Public Health Department There will be involvement of FBI (as the lead law enforcement agency) All deaths will be classified as “homicides” Number of casualties will continue to arrive in reverse order The major responsibility of the medical examiner will be to: Take custody of the remains to establish the identity To issue Death Certificate Dispose remains to designated location or for burial

December 1, 2004Mass Casualty Disposition28 Category A/Diseases & Agents Anthrax (Bacillus anthracis) Botulism (Clostridium botulinum toxin) Plague (Yersinia pestis) Smallpox (variola major) Tularemia (Francisella tularensis) Viral hemorrhagic fevers (filoviruses [e.g., Ebola, Marburg] and arenaviruses [e.g., Lassa, Machupo]) Highest Priority Agents: Can be easily disseminated or transmitted from person to person May cause high mortality, and have the potential for major public health impact Might cause public panic and social disruption Require special action for public health preparedness

December 1, 2004Mass Casualty Disposition29 Category B Diseases & Agents Multstuberculosis Nipah virus Tick-borne encephalitis]) Melioidosis (Burkholderia pseudomallei) Psittacosis (Chlamydia psittaci) Q fever (Coxiella burnetii) Ricin toxin from Ricinus communis (castor beans) Staphylococcal enterotoxin B Typhus fever (Rickettsia prowazekii) Viral encephalitis (alphaviruses [e.g., venezuelan equine encephalitis, eastern equine encephalitis, western equine encephalitis]) Water safety threats (e.g., Vibrio cholerae, Cryptosporidium parvum) Second Highest Priority Agents include those that: are moderately easy to disseminate cause moderate morbidity and low mortality require specific enhancements of CDC's diagnostic capacity and enhanced disease surveillance

December 1, 2004Mass Casualty Disposition30 Category C Diseases & Agents Hantaviruses Multidrug-resistant tuberculosis Nipah virus Tick-borne encephalitis viruses Tick-borne hemorrhagic fever viruses Yellow fever Third Highest Priority Agents include emerging pathogens that could be engineered for mass dissemination in the future because of: availability ease of production and dissemination potential for high morbidity and mortality and major health impact.

December 1, 2004Mass Casualty Disposition31 Inexperience: Most medical examiners have no field experience Smallpox: Pustules & Early Scarring Anthrax: Vascular Thrombosis Anthrax Bacilli

December 1, 2004Mass Casualty Disposition32 Large-scale Act of Bioterrorism… Federal and/or State Emergency Local jurisdiction may be suspended and the medical examiner in a local area may play a supporting role only