U.S. Medical Examiner/Coroner capability to handle highly infectious decedents

Aurora B. Le, Erin G. Brooks, Lily A. McNulty, James R. Gill, Jocelyn J. Herstein, Janelle Rios, Scott J. Patlovich, Katelyn C. Jelden, Kendra K Schmid, John-Martin J Lowe, Shawn G. Gibbs

Research output: Contribution to journalArticle

Abstract

In the United States of America, Medical Examiners and Coroners (ME/Cs) investigate approximately 20% of all deaths. Unexpected deaths, such as those occurring due to a deceased person under investigation for a highly infectious disease, are likely to fall under ME/C jurisdiction, thereby placing the ME/C and other morgue personnel at increased risk of contracting an occupationally acquired infection. This survey of U.S. ME/Cs′ capabilities to address highly infectious decedents aimed to determine opportunities for improvement at ME/C facilities serving a state or metropolitan area. Data for this study was gathered via an electronic survey. Of the 177 electronic surveys that were distributed, the overall response rate was N = 108 (61%), with 99 of those 108 respondents completing all the questions within the survey. At least one ME/C responded from 47 of 50 states, and the District of Columbia. Select results were: less than half of respondents (44%) stated that their office had been involved in handling a suspected or confirmed highly infectious remains case and responses indicated medical examiners. Additionally, ME/C altered their personal protective equipment based on suspected versus confirmed highly infectious remains rather than taking an all-hazards approach. Standard operating procedures or guidelines should be updated to take an all-hazards approach, best-practices on handling highly infectious remains could be integrated into a standardized education, and evidence-based information on appropriate personal protective equipment selection could be incorporated into a widely disseminated learning module for addressing suspected or confirmed highly infectious remains, as those areas were revealed to be currently lacking.

Original languageEnglish (US)
JournalForensic Science, Medicine, and Pathology
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Coroners and Medical Examiners
Practice Guidelines
Communicable Diseases
Surveys and Questionnaires
Learning
Guidelines
Education
Infection

Keywords

  • Autopsy
  • Coroners
  • Forensic pathology
  • Highly infectious diseases
  • Medical examiners
  • Personal protective equipment

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Le, A. B., Brooks, E. G., McNulty, L. A., Gill, J. R., Herstein, J. J., Rios, J., ... Gibbs, S. G. (Accepted/In press). U.S. Medical Examiner/Coroner capability to handle highly infectious decedents. Forensic Science, Medicine, and Pathology. https://doi.org/10.1007/s12024-018-0043-2

U.S. Medical Examiner/Coroner capability to handle highly infectious decedents. / Le, Aurora B.; Brooks, Erin G.; McNulty, Lily A.; Gill, James R.; Herstein, Jocelyn J.; Rios, Janelle; Patlovich, Scott J.; Jelden, Katelyn C.; Schmid, Kendra K; Lowe, John-Martin J; Gibbs, Shawn G.

In: Forensic Science, Medicine, and Pathology, 01.01.2018.

Research output: Contribution to journalArticle

Le, Aurora B. ; Brooks, Erin G. ; McNulty, Lily A. ; Gill, James R. ; Herstein, Jocelyn J. ; Rios, Janelle ; Patlovich, Scott J. ; Jelden, Katelyn C. ; Schmid, Kendra K ; Lowe, John-Martin J ; Gibbs, Shawn G. / U.S. Medical Examiner/Coroner capability to handle highly infectious decedents. In: Forensic Science, Medicine, and Pathology. 2018.
@article{8ba8ddfe47284ab0896e70f625555e96,
title = "U.S. Medical Examiner/Coroner capability to handle highly infectious decedents",
abstract = "In the United States of America, Medical Examiners and Coroners (ME/Cs) investigate approximately 20{\%} of all deaths. Unexpected deaths, such as those occurring due to a deceased person under investigation for a highly infectious disease, are likely to fall under ME/C jurisdiction, thereby placing the ME/C and other morgue personnel at increased risk of contracting an occupationally acquired infection. This survey of U.S. ME/Cs′ capabilities to address highly infectious decedents aimed to determine opportunities for improvement at ME/C facilities serving a state or metropolitan area. Data for this study was gathered via an electronic survey. Of the 177 electronic surveys that were distributed, the overall response rate was N = 108 (61{\%}), with 99 of those 108 respondents completing all the questions within the survey. At least one ME/C responded from 47 of 50 states, and the District of Columbia. Select results were: less than half of respondents (44{\%}) stated that their office had been involved in handling a suspected or confirmed highly infectious remains case and responses indicated medical examiners. Additionally, ME/C altered their personal protective equipment based on suspected versus confirmed highly infectious remains rather than taking an all-hazards approach. Standard operating procedures or guidelines should be updated to take an all-hazards approach, best-practices on handling highly infectious remains could be integrated into a standardized education, and evidence-based information on appropriate personal protective equipment selection could be incorporated into a widely disseminated learning module for addressing suspected or confirmed highly infectious remains, as those areas were revealed to be currently lacking.",
keywords = "Autopsy, Coroners, Forensic pathology, Highly infectious diseases, Medical examiners, Personal protective equipment",
author = "Le, {Aurora B.} and Brooks, {Erin G.} and McNulty, {Lily A.} and Gill, {James R.} and Herstein, {Jocelyn J.} and Janelle Rios and Patlovich, {Scott J.} and Jelden, {Katelyn C.} and Schmid, {Kendra K} and Lowe, {John-Martin J} and Gibbs, {Shawn G.}",
year = "2018",
month = "1",
day = "1",
doi = "10.1007/s12024-018-0043-2",
language = "English (US)",
journal = "Forensic Science, Medicine, and Pathology",
issn = "1547-769X",
publisher = "Humana Press",

}

TY - JOUR

T1 - U.S. Medical Examiner/Coroner capability to handle highly infectious decedents

AU - Le, Aurora B.

AU - Brooks, Erin G.

AU - McNulty, Lily A.

AU - Gill, James R.

AU - Herstein, Jocelyn J.

AU - Rios, Janelle

AU - Patlovich, Scott J.

AU - Jelden, Katelyn C.

AU - Schmid, Kendra K

AU - Lowe, John-Martin J

AU - Gibbs, Shawn G.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - In the United States of America, Medical Examiners and Coroners (ME/Cs) investigate approximately 20% of all deaths. Unexpected deaths, such as those occurring due to a deceased person under investigation for a highly infectious disease, are likely to fall under ME/C jurisdiction, thereby placing the ME/C and other morgue personnel at increased risk of contracting an occupationally acquired infection. This survey of U.S. ME/Cs′ capabilities to address highly infectious decedents aimed to determine opportunities for improvement at ME/C facilities serving a state or metropolitan area. Data for this study was gathered via an electronic survey. Of the 177 electronic surveys that were distributed, the overall response rate was N = 108 (61%), with 99 of those 108 respondents completing all the questions within the survey. At least one ME/C responded from 47 of 50 states, and the District of Columbia. Select results were: less than half of respondents (44%) stated that their office had been involved in handling a suspected or confirmed highly infectious remains case and responses indicated medical examiners. Additionally, ME/C altered their personal protective equipment based on suspected versus confirmed highly infectious remains rather than taking an all-hazards approach. Standard operating procedures or guidelines should be updated to take an all-hazards approach, best-practices on handling highly infectious remains could be integrated into a standardized education, and evidence-based information on appropriate personal protective equipment selection could be incorporated into a widely disseminated learning module for addressing suspected or confirmed highly infectious remains, as those areas were revealed to be currently lacking.

AB - In the United States of America, Medical Examiners and Coroners (ME/Cs) investigate approximately 20% of all deaths. Unexpected deaths, such as those occurring due to a deceased person under investigation for a highly infectious disease, are likely to fall under ME/C jurisdiction, thereby placing the ME/C and other morgue personnel at increased risk of contracting an occupationally acquired infection. This survey of U.S. ME/Cs′ capabilities to address highly infectious decedents aimed to determine opportunities for improvement at ME/C facilities serving a state or metropolitan area. Data for this study was gathered via an electronic survey. Of the 177 electronic surveys that were distributed, the overall response rate was N = 108 (61%), with 99 of those 108 respondents completing all the questions within the survey. At least one ME/C responded from 47 of 50 states, and the District of Columbia. Select results were: less than half of respondents (44%) stated that their office had been involved in handling a suspected or confirmed highly infectious remains case and responses indicated medical examiners. Additionally, ME/C altered their personal protective equipment based on suspected versus confirmed highly infectious remains rather than taking an all-hazards approach. Standard operating procedures or guidelines should be updated to take an all-hazards approach, best-practices on handling highly infectious remains could be integrated into a standardized education, and evidence-based information on appropriate personal protective equipment selection could be incorporated into a widely disseminated learning module for addressing suspected or confirmed highly infectious remains, as those areas were revealed to be currently lacking.

KW - Autopsy

KW - Coroners

KW - Forensic pathology

KW - Highly infectious diseases

KW - Medical examiners

KW - Personal protective equipment

UR - http://www.scopus.com/inward/record.url?scp=85056299873&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85056299873&partnerID=8YFLogxK

U2 - 10.1007/s12024-018-0043-2

DO - 10.1007/s12024-018-0043-2

M3 - Article

JO - Forensic Science, Medicine, and Pathology

JF - Forensic Science, Medicine, and Pathology

SN - 1547-769X

ER -