Federal, state and local public safety officials last weekend mobilized at the Missouri State Fairgrounds to host a Mass Fatality Field Training Exercise in the event of a catastrophic natural disaster or terrorist attack.
Agencies including the Federal Disaster Mortuary Response team and a relatively new state agency, the Missouri Mortuary Response Team (MoMORT) — made up of coroners’ office officials from Pettis and surrounding counties, medical teams from around the state and the Missouri State Highway Patrol — conducted the drill as part of the Missouri Disaster Response System to test how the agencies would process the victims of such a mass casualty situation. The exercise was directed by Pettis County Coroner Robert “Skip” Smith and Kevin Tweedy, deputy commander of the MoDRS.
There is an explosion at the Pepsi Grandstand at the Missouri State Fairgrounds with approximately 5,500 spectators in attendance. The explosion has killed scores and injured many others. After initial rescue operations to safely evacuate thousands of injured victims, recovery operations begin as investigators comb through the scene to find a cause for the explosion.
“You want to assess the situation immediately to determine what has happened, secure the scene and then take action to identify the victims,” Smith said.
An incident site is selected for use as a field morgue to identify and process the remains of those killed. The building or buildings selected must be at least 12,000 square feet, and could be as large as 30,000 square feet depending on the number of dead. For this drill, three buildings were used — the Agriculture Building, the Missouri Co-Op Building and the fire station at the fairgrounds. The incident command center becomes a small city, staffed with up to 350 pathologists, dental pathologists, anthropologists, X-ray technicians, anthropologists, other medical personnel and MSHP officers.
Local law enforcement agencies provide investigative and security teams at the disaster site. Coroners are also at the disaster scene to control the chain of custody of the bodies recovered. The bodies are then placed in refrigerated trucks, and taken to the field morgue to be processed and identified.
When a body arrives at the field morgue, many steps are taken to identify the victim. A body is tagged with a bar code when is arrives so it can be tracked through the identification process. The body bag of a victim is first X-rayed to determine if anything dangerous, such as an explosive or weapon, is on that person. The body is then fingerprinted and photographed and given to MSHP officers for the identification process.
“We look at all identifying marks on the body to establish the victim’s identity,” Smith said. “For example, if a person has a tattoo of an eagle, we photograph that image and scan it to a computer to see if we can establish an identification.”
The victims’ personal effects are then removed and bagged to be examined for evidence and eventually returned to the victims’ families. A dental pathologist then takes dental records for identification purposes. A pathologist does a visual exam of the body to see if a cause of death can be determined. In some cases, an autopsy is performed at the scene. DNA and toxicology are also collected.
Another X-ray is taken to determine the extent of the injuries the person sustained. The body is then re-bagged for further examination by MSHP officers. A funeral home is then called to collect the remains and return the bodies of the victims to their families.
“It’s really a sophisticated, coordinated effort by the different departments,” Smith said.
About 190 personnel were on hand for the weekend exercise at the state fairgrounds. State Fair Community College nursing students were used as actors to play the victims and injured. The actors were given a skit to perform, the details of which were not revealed to morgue personnel, so the team’s performance would be as real as possible, Smith said.
“The morgue had no clue to what to expect, and that how we wanted it,” he said.
Every piece of equipment the team needs is stored at “The Caves,” a large storage area in Kansas City. All materials are prepackaged, boxed and ready to use. Once local law enforcement gets word of this incident, the local coroner will notify the MoDRS, which activates and mobilizes the team. The team can typically be at the disaster site and set up the field morgue within a few hours of the disaster, Smith said.
Each team member is outfitted with a Hazmat suit and other protective gear. Everyone receives a medical examination before activation and is then re-examined two to three hours later.
“We want to check and recheck everyone’s vitals during this process,” Smith said. “Those suits get hot and people get dehydrated and fatigued.”
These mass casualty exercises are performed once a year in various parts of the state. Sedalia was chosen this year because of its proximity to the state fairgrounds, Smith said.
“It was a fantastic opportunity for Pettis County and the team’s commitment to handle things was very commendable. They did a great job,” he said.
The Missouri Mortuary Response Team was formed in 2011 after the City of Joplin was struck by a huge tornado and inflicted heavy damage and caused many casualties. The state system previously in place was a group of morticians and coroners, but they lacked the organization MoMORT has.
“It was poorly set up,” Smith said. “The federal government had a team already in place, but the state wanted to form their own to match or even improve upon the Federal Disaster Mortuary Team.”
Editor Tim Epperson can be reached at 660-826-1000 ext. 1485.