1. Washoe County Regional Medical Examiner’s Office
Rural Preparedness Summit

2. RECOVERY in INCIDENT COMMAND

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

4. 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

5. 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

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

7. 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

8. 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

9. 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

10. 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.

11. 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.

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

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

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

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

16. Morgue Capabilities

17. Disaster Portable Mortuary Unit: Deployment

18. Decedent Transport Device

19. Storage Container

20. Electrical Generators

21. Recovery Trailer

22. Forensic Pathology

23. Command Post

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

25. 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

26. Amtrak Accident

27. Amtrak Incident
Mutual aid request from Sheriff Coroner

28. Amtrak Incident
Regional Support
Reno Fire
REMSA
Washoe SO FIS
WCME

29. 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

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

31. 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

32. 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

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

34. Washoe County Medical Examiner’s Office
Notification by HavBed: 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

35. The Scene: Night & Day
Site Assessment
Recovery

36. Identification