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The Federal Emergency Management Agency confirmed Thursday that a Disaster Mortuary Operation Response Teams expert will be deployed to help address Maryland鈥檚 growing autopsy backlog, which is expected to grow up to 300 by next week.
Dr. Victor Weedn, Maryland鈥檚 chief medical examiner, said that聽聽on behalf of his office on the morning of Feb. 4.
Charlie Elison, a representative of Maryland鈥檚 regional FEMA office, wrote in an email Thursday morning that a full Disaster Mortuary Operation Response Team will not be deployed, but one subject matter expert will be made available to provide technical assistance to the Office of the Chief Medical Examiner.
The Maryland Department of Emergency Management submitted a request to FEMA for additional Disaster Mortuary Operation Response Team experts on Thursday.
FEMA鈥檚 Disaster Mortuary Operation Response Teams are typically used to assist state and local governments after natural disasters, terrorist attacks, transportation accidents and pandemics.
The state鈥檚 backlog of decedents waiting to be autopsied dates back to mid-December 2021.
Dr. Jinlene Chan, the deputy secretary of public health services for the Maryland Department of Health, told the House Appropriations Committee鈥檚 Health and Social Services Subcommittee on Wednesday afternoon that that she did not know the exact number of decedents waiting to be autopsied.
However, Chan was able to confirm the autopsy backlog was over 200.
At a meeting of the Postmortem Examiners Commission last week, Weedn said that 217 bodies were waiting to be autopsied 鈥� with the oldest cases having been held by the agency for two weeks. He projected the backlog would surpass 300 by next Wednesday.
Weedn said the backlog is driven by staffing shortages and exacerbated by an increase in homicides and overdoses.
The overflow is so great that state agencies are holding decedents at the Metro West Parking Garage on North Greene Street in Baltimore, about a mile from the Office of the Chief Medical Examiner. The state鈥檚 centralized coroner, the Office of the Chief Medical Examiner investigates and completes death certificates for people who die under suspicious circumstances or from unnatural causes and who are not in the care of a physician.
On one side of the expansive parking garage, white and silver vans shuttle patients and workers back and forth to the VA hospital down the road. On the other, a guard behind a metal garage door ushers white vans with blacked-out windows onto the Franklin-Mulberry Expressway.
According to the Board of Public Works聽聽for Feb. 16, the state is renting the Metro West Garage in Baltimore for $30,000 a month to store decedents waiting to be autopsied. The line item was also on the board鈥檚 previous agenda,听but action was delayed for two weeks.
Chan said Wednesday that the location is being used by the Office of the Chief Medical Examiner and the State Anatomy Board, which manages decedents who have donated their bodies to the state as a teaching tool for medical schools and other health programs.
Next week鈥檚 Board of Public Works agenda also has a line item to contract 鈥渦narmed security guard services鈥� for the temporary morgue at the Metro West Garage.
鈥淭he Office of the Chief Medical Examiner and State Anatomy Board is receiving an influx of cases due to COVID-19 which exceeds the current storage capacity,鈥� the item reads.
The 鈥榙riving factor鈥�
The Department of Health has opened hiring for 21 new positions at the Office of the Chief Medical Examiner, including assistant medical examiners, forensic investigators, assistant toxicologists and autopsy assistants, in an attempt to speed operations.
But the agency is already experiencing staggering staffing shortages.
According to Anne Wagner, a budget analyst for the Department of Legislative Services, the 鈥渄riving factor鈥� of the backlog is related to staffing shortages. She said that there was a 17% decrease in full-time-equivalent medical examiners in 2021 compared to the previous year.
Last week, Weedn said that he had only 10 assistant medical examiners on staff to complete autopsies, compared to 14 at the same time last year.
According to legislative analysts, the Office of the Chief Medical Examiner has had full accreditation from the National Association of Medical Examiners since March 19, 2021, when it was removed from a provisional accreditation status.
The accrediting agency鈥檚 policy is that medical examiners should complete no more than 325 autopsies per year.
Wagner told the subcommittee that the ratio of autopsies per medical examiner was up to 390 in 2021.
Weedn said last week that his office performed 627 autopsies in the month of January, about 50 more cases than the same time last year.
The state medical examiner鈥檚 office has received two previous 鈥減hase two鈥� violations, or infractions related to unmet staffing, investigation or morgue operation standards. One was for structural problems with the facility鈥檚 roof, the other for staffing shortages.
Violations can lead to demotions in or the revocation of an agency鈥檚 accreditation status.
But the National Association of Medical Examiners has stated that it will not downgrade or withdraw an office鈥檚 accreditation for deficiencies 鈥渞esulting from the direct and indirect impacts of the pandemic.鈥�
Chan said the Department of Health doesn鈥檛 know when the National Association of Medical Examiners plans to stop operating under the more relaxed COVID-19 accreditation policies.
The Office of the Chief Medical Examiner鈥檚 next self-evaluation is set for May of this year. A full inspection by the accrediting body isn鈥檛 scheduled to occur until May 2023.
In an email exchange, Dr. Barbara C. Wolf, the chair of the Inspection and Accreditation Committee for the National Association of Medical Examiners said that the Maryland鈥檚 office is currently accredited and will undergo a review of its status during the May self-evaluation.
鈥淎t that time deficiencies identified by the office鈥檚 inspector, if there are any, will be considered,鈥� she wrote.
Citing the National Association of Medical Examiners, Chan said that there are approximately 750 board-certified forensic pathologists available across the U.S. 鈥渨hich makes this a very difficult recruiting environment for all medical examiners鈥� and coroners鈥� offices in this country, including, of course, here in Maryland.鈥�
Wagner said that forensic investigators and autopsy assistants have the highest turnover rate. And Maryland is also feeling the sting of the national shortage of forensic pathologists.
Legislative analysts have recommended that lawmakers restrict funding next fiscal year for the Deputy Secretary of Public Health Services鈥� office until the agency submits a report about the Office of the Chief Medical Examiner鈥檚 accreditation status and employee recruitment and retention efforts.
Chan said the Health Department 鈥渞espectfully disagrees鈥� with the recommendation to restrict the flow of funds to her office. The agency鈥檚 written response to the budget analysis noted that the Department of Health submitted a report in 2021 with the same information.
Chan also said that the Department of Health is 鈥渄iscussing additional retention options鈥� with the Postmortem Examiners Commission and the Department of Budget and Management.
Separately, Del. Kirill Reznik (D-Montgomery) is聽聽this legislative session to impose minimum staffing requirements for the Office of the Chief Medical Examiner in an effort to avoid any accreditation violations.
Reznik鈥檚 bill will be heard in the House Health and Government Operations Committee next Wednesday.
