Mass disasters

A mass disaster is commonly construed as an event (air, naval, railway, or motorway accident, flooding, earthquake, and so on), resulting in a large number of victims that need to be identified and subject to medicolegal investigation. Furthermore, depending on which continent one comes from, innumerous protocols and procedures are available, the Interpol Disaster Victim Identification form being the most frequently used one in Europe. Whatever the case may be, the procedure is the same, and it consists of a meticulous collection of both antemortem and postmortem data. Consequently, the identification modalities to be applied will vary according to the quality of the antemortem data available and preservation conditions of the victims. This chapter gives general guidelines, common to most protocols, for the management—strictly from a medicolegal point of view—of victims of a mass disaster. As mentioned, intervention protocols may differ greatly depending on the country in which the disaster occurs; furthermore, medicolegal intervention in a mass disaster is dependant on local authorities, such as the magistrate's court, the police, local health authorities, and so forth. These authorities decide, in many countries, what should be done and when. For this reason, it is always wise for medicolegal services and departments to create (ahead of time) contacts and connections with local authorities in order to avoid a confused conduction of the emergency. At the scene of the accident or disaster, when conditions allow it, medicolegal staff should contribute to the recording of victims' position and condition just as at any “normal” scene of crime situation, although time constraints must be respected. Once the remains have been removed from the disaster site, the bodies should be brought to a morgue for medicolegal activity. While the above-mentioned preliminary procedures are carried out, a place at which to interview relatives of the victims must be established. On every cadaver or human remains, a full autopsy according to European standards should be performed, along with appropriate analysis and sampling from an odontological, genetic, anthropological, and a fingerprinting point of view according to the methods described in previous chapters. Adequate toxicological and histological sampling (if necessary) should also be performed for establishing (when necessary) manner and cause of death. Antemortem and postmortem data are then crossmatched in order to obtain best matches among the victims with every person that has been reported missing or who was on the passenger list. The modality of identification will depend on, in the end, the state of conservation and condition of the corpses and on the available antemortem documentation. It should always be kept in mind that visual identification on well-preserved cadavers in such cases should always be double-checked with another biological method.