UF-based mass fatality response network will help local medical examiners cope with disasters

It's a medical examiner's worst nightmare - a disaster strikes, causing so many fatalities that local personnel are unable to perform all the necessary autopsies and identifications, leaving the community desperate for answers.

If Florida public health officials ever face such a situation, the statewide Florida Emergency Mortuary Operations Response System can mobilize teams of volunteer experts almost immediately, even if federal help is unavailable, said Program Director Bruce Goldberger, Ph.D., a University of Florida pathology associate professor.

"It's important to have FEMORS, because the alternative is unacceptable - nothing," said Goldberger, a forensic science expert.

Launched last July, FEMORS is a collaboration between UF and the state Department of Health and is currently based at UF's College of Medicine, Goldberger said. UF is the only state university in Florida with a death-investigation program.

FEMORS is one of the few state-run efforts of its type in the nation, and probably the most extensive, said Operations Director Larry Bedore. The network has about 150 members, including funeral directors, pathologists, anthropologists, forensic dentists and crime-scene analysts. For both natural and manmade disasters, FEMORS experts can assist the medical examiner who must determine the cause of death and identity of the deceased, and assist with communications to families and the public.

"We have to be ready for anything," said Bedore, former director of operations for two Florida medical examiner districts.

Under Florida law, medical examiners must determine the cause of any unnatural deaths occurring in their districts, he said. Florida has 24 medical examiner districts serving its 67 counties.

Initially funded by a one-year, $150,000 grant from the federal Centers for Disease Control and Prevention through the state Department of Health, FEMORS is part of a larger disaster-preparedness plan initiated by Gov. Jeb Bush after the terrorist attacks of Sept. 11, 2001.

"Governor Bush was concerned that if there were multiple simultaneous terrorist events in the United States, federal agencies might be strained to the limit," Bedore said. "So we're trying to be responsive to the governor's concerns and make sure resources are there to serve Florida's needs."

"Federal death-investigation agencies sometimes assist with mass-fatality situations at the request of state authorities," said Jim Hinson, administration and logistics supervisor with the Florida Department of Health's Office of Emergency Operations in Tallahassee.

But in Florida, FEMORS will now be the first option considered.

"FEMORS will give us more time to assess the situation and see if we need to request help from federal agencies," Hinson said. "Activated when Florida's governor declares a state disaster, FEMORS would send a three-person-go-team to meet with the area's medical examiner, visit the disaster scene and learn what assistance is needed," Goldberger said.

Appropriate experts would then respond, acting under the direction of the medical examiner, he said. Except for Bedore, Goldberger and Business and Finance Director Kelly House, all FEMORS members are volunteers, and would acquire temporary state employee status and pay while responding to a disaster.

While FEMORS would only be needed for large disasters, no specific number of fatalities would trigger the network�s involvement, Bedore said.

"The basic principle is that FEMORS could be needed whenever there's one more fatality than local resources can handle," he said. "It depends on the size of the community and the capacity of their medical examiner�s office."

"With its personnel base established, FEMORS seeks equipment," Goldberger said. "Later this year, the directors hope to secure $1.5 million to $2 million in additional federal funds to outfit a portable morgue capable of processing up to 100 bodies per day."

Covering 6,000 to 8,000 square feet once erected, the facility will require 1,400 items that will be stored in a centrally located warehouse, he said. FEMORS will transport only the items needed at each disaster scene.

"With this facility, in a worst-case scenario we would be able to handle a body from the time it arrives to the time it's embalmed and casketed," he said.

"The portable morgue is expected to be ready by spring 2004, but if FEMORS is activated before then, equipment and facilities would be borrowed or purchased through the Department of Health," Bedore said. "This fall, FEMORS teams will participate in disaster simulations conducted by other state emergency-response agencies," he said.

While FEMORS was formed to deal with tragedies, the network's existence should not be a cause for anxiety, Bedore said.

"It should give our residents comfort to know that trained people are ready to respond," he said. "Our focus is to bring dignity to the way Florida can respond to mass fatalities."