Comprehensive Notes on Disaster Victim Identification (DVI)
Disaster Victim Identification (DVI)
Overview of Disaster Victim Identification (DVI) by Dr. Cheryl Charlewood, a forensic pathologist.
DVI is a collaborative effort primarily led by a police task force. The lecture covers definitions, aims, types, sizes, background, planning, procedures, stages/phases, hazards, difficulties, and practicalities involved in DVI incidents.
Definitions and Aims of DVI
A disaster victim identification (DVI) incident involves the process of identifying human remains in mass casualty incidents, ranging from intact bodies to small fragments.
Why DVI is Performed:
- Respect for the deceased.
- Addressing forensic, humanitarian, and legal issues.
- Rights of the deceased: identification, examination, and return of remains to relatives for burial/cremation.
- Coroner's remit: identifying the deceased, determining how, when, why, and where they died.
- Issuance of death certificate.
- Finalization of practical matters like wills, inheritance, and insurance.
- Forensic investigations, including criminal inquiries for homicides.
- Accident inquiries for preventative measures.
- Intelligence gathering, particularly in terrorist-related events, to track down cells or individuals and gather information on future incidents.
Causes and Types of Mass Casualty Incidents
Mass casualty incidents can arise from various circumstances:
Natural Disasters:
- Hurricanes.
- Avalanches.
- Extreme heat or cold.
- Bushfires.
- Earthquakes.
- Disease (pandemics, post-disaster outbreaks).
Non-Natural Disasters:
- Accidental or deliberate actions.
- Terrorism.
- Travel incidents (accidents/deliberate acts involving transport).
- Building, mine, and dam collapses.
- Wars and mass graves.
- Migration events (deaths at sea or in transport containers).
Classification of DVI Incidents:
- Closed Disaster: Involves a known group of people with records of attendance (e.g., flight manifest, tour group, occupants of a building).
- Open Disaster: Involves an unknown number and identity of persons due to lack of records (e.g., public events, festivals, affecting whole regions/towns).
- Mixed Disaster: Combination of both open and closed disasters (e.g., 9/11 attacks in New York).
Variation in DVI Incidents
DVI incidents vary significantly in:
- Size and number of deceased.
- Location (confined vs. spread over large areas).
- Simultaneous events (e.g., bombings and shootings in Paris).
- Level of involvement (local, national, international).
Variations lead to different hazards, infrastructure needs, and involvement of interested parties (media, government).
Phases of a DVI Event
The phases of a DVI event provide structure and planning:
- Scene Phase
- Mortuary Phase
- Antemortem Phase
- Reconciliation Phase
- Debrief Phase
Phases overlap and run consecutively/simultaneously. For example, the scene phase may still be in progress when the mortuary and antemortem phases have started.
Background and Development of DVI Procedures
Interpol
- The International Criminal Police Organization, is the mainstay of DVI procedures and standards.
- Involves multiple specialists and responds globally.
- Guidelines developed by multinational police and specialists, followed across 194 member countries.
- Maintains standards for DVI procedures, promoting a consistent approach and international cooperation.
- Ensures all parties follow the same procedures and use the same documentation during international DVI events.
Australian and New Zealand DVI Committee (ADVIC)
- Develops and maintains plans and standards.
- Individual states and territories have local committees for managing DVI events.
- Produces standard documents for activation and response.
- Plans infrastructure, amenities, sites, and staffing.
- Conducts training exercises for police and specialists (desktop and practical).
Personnel Involved in DVI
DVI involves multidisciplinary personnel:
- Police: organization, resources, personnel, phase coordinators.
- Specialists: forensic pathologists, anthropologists, biologists, odontologists, ridgeologists (fingerprint specialists).
- Coroner and coronial staff.
- Other agencies: Australian Defence Force, international police and specialists.
- Emergency services (scene phase).
Documentation:
- Pink forms: postmortem forms.
- Yellow forms: antemortem forms.
- These are the main comparison forms used in the mortuary and antemortem phases.
Phase 1: Scene Phase
The scene phase relates to the event site, which varies in size and location. It may involve multiple locations.
Initial Actions:
- Initial meeting for a logical and organized approach.
- Evaluation of the scene: extent, condition, potential number of bodies/remains, property.
- Assessment of duration to process the scene.
- Assessment of hazards and their impact on recovery and investigation.
- Identification of required equipment/expertise.
Hazards at the Scene:
- Location and terrain.
- Weather.
- Risk of explosions and fire.
- Risk of falling debris.
- Toxic substances.
- Infection risks.
- Manual handling and sharp materials.
- Practical issues: sustenance and shelter.
Priorities:
- Recovery of live and injured individuals.
- Care and management of attending personnel.
- Security of the site.
- Collection of forensic evidence and identification-related evidence.
Procedures:
- Use grid/GPS reference with a marker to identify the location of recovered bodies/items.
- Manage media and security.
- Document the scene appropriately (pro formas, photographs).
- Transport and store remains in a temporary facility or designated mortuary.
Phase 2: Mortuary Phase
The mortuary phase involves the examination and documentation of remains and associated items.
Planning and Logistics:
- Meeting to plan requirements and consider coronial/family wishes.
- Decisions on using on-site/off-site temporary mortuary facilities.
- Organization of extra staffing and equipment.
- Management of business-as-usual (BAU) workload.
Mortuary Setup:
- Business-as-usual mortuary for smaller DVI situations (post mortem tables, clean/dirty areas).
- Temporary mortuaries for larger events (pre-existing buildings, temporary structures).
Procedures:
- Assign unique identifying number to remains at the scene.
- Recheck numbers at mortuary triage and assign new numbers if commingling is suspected.
- Mortuary team: examination and recording of remains and accompanying items.
- CT scanning: identify injury patterns, items of interest, commingled remains, assist dental examination.
- Decide on full/partial autopsies and necessary samples to be taken.
- Determine the cause of death.
- Document on Interpol pink forms.
- Record external and internal descriptors for identification.
- Take samples for identification and necessary investigations (toxicology).
- Record personal property on pink forms.
- Specialists (odontology, ridgeology) work on successive tables.
Identifiers:
- Primary identifiers: DNA, odontology, ridgeology (fingerprints).
- Secondary identifiers: medical devices (pacemakers), tattoos, metal implants.
Difficulties:
- Decomposition.
- Incineration.
- Sheer number of remains/fragments.
- Commingling of parts.
Hazards:
- Similar to scene phase, relating to the body and what could remain on/with the body.
Storage:
- Storage of remains before and after examination.
- Return of remains to funeral directors overseas.
- DVI body storage: mortuary fridges, refrigerated shipping containers, body storage tents.
Documentation:
- Filling in pink forms (digitally or on paper).
Aim:
- Fill in pink form data and take samples to attain primary and secondary identifiers.
- Aid coronial and forensic/criminal investigations.
Phase 3: Antemortem Phase
The antemortem phase involves the collection of data relating to missing persons on yellow forms.
Procedures:
- Set up a data collection center by the police authority for friends and family to provide/receive information.
- Collate and enter data into a database.
- Employ special police family liaison officers to assist families.
- Use social media to convey and attain personal data.
Data Collected:
- Dental records (panoramic OPG x-ray and charts) from dentists.
- DNA samples (hair, toothbrushes).
- Fingerprints (homes, records, passports).
Comparison:
- Compare antemortem data to postmortem data via the database.
- Forward matching criteria to the reconciliation center.
Phase 4: Reconciliation Phase
The reconciliation phase involves compiling a report of matching identification data in a reconciliation center.
Procedures:
- Use police officers with specialist help.
- Compare fingerprint data, dental findings, and DNA from antemortem and postmortem documentation.
- Assess primary identifiers (DNA, odontology, ridgeology).
- Use secondary identifiers to support identification.
- Do not use visual identification alone.
- Create an official comparison report and send it to the reconciliation board.
Reconciliation Board:
- Assess the comparison report.
- Consists of officials and specialists.
- Issues a certificate of identification if the report is accepted.
- Releases the remains.
Quality Control:
- Adhere to information, documentation, competency, protocols, and standards.
- Audit individuals and information.
- Check pink and yellow forms, comparison reports, and supporting data.
Phase 5: Debrief Phase
The debrief phase has two main facets:
Immediate Debrief:
- Debrief individuals on the ongoing situation.
- Promote good communication and improve processes.
Post-Event Debrief:
- Examine the entire operation and its learning points.
- Identify what was done well and what could have been done differently/better.
- Provide psychological debriefing for staff involved.
Temporary Arrangements
In some cases, a temporary arrangement must be made for storage of deceased to allow for later identification, involving:
- A temporary controlled burial site to limit decomposition.
- Numbering individuals and recording burial sites.
- Using coffins and placing markers on the surface.
Examples of Mass Casualty Incidents
- Suggests reviewing details of listed or known events to consider difficulties, hazards, and organizational issues in recovering, examining, and identifying human remains.
Conclusion
- Emphasis on the collaborative and multidisciplinary nature of DVI.
- Importance of following established phases and procedures.
- Commitment to respectful and accurate identification of victims in mass casualty incidents.