Coroner Stories

If I had my way, single people would never own hot tubs. But then I suppose someone would file a lawsuit because the right of single people to own a hot tub was being violated. So I suppose it’s alright if they own them, but there should be restrictions that keep single people from using hot tubs unless they are with someone.

My logic is that the only bodies I’ve ever had to pull out of hot tubs were single people who were alone at the time of using their hot tub. To my knowledge it’s never happened that a person has died in a hot tub and not been removed immediately by the people they were with or the responding paramedics. To my knowledge no one has ever said, “Wow, I can’t believe Jerry didn’t get out of the hot tub when I did last Thursday.”

In my experience, deaths involving hot tubs seem to fall into one of two categories—small children who manage to gain access to them and adults who die while using them. In the case of children, they are usually discovered fairly soon after falling in. The average time that a parent seems to become concerned about a missing child before actively searching for them is about 15-30 minutes (not a scientifically researched amount—just one I hear a lot). Of course it takes only minutes of submersion before irreversible damage has been done.

A key dynamic of a child drowning has kept me from ever having to remove a child from a spa (or even a swimming pool for that matter). That is to say, the person discovering the child in the water instinctively removes them from the water. I don’t think anyone put in that position would stop to consider the integrity of a potential crime scene or assume that the child was beyond saving. I know I wouldn’t.

When it comes to adults who die while using hot tubs, there is a different dynamic. The situation always seems to involve someone who “checks out” days before a friend or family member “checks up” on them. The end result is that the deceased has been decomposing in a small body of stagnant water for days. Decomp juice and purge from the body forms a frothy layer on the surface of the water resembling a pot of gumbo. The swarm of flies present makes one very conscious about whether their mouth is open or closed. The water’s color and transparency reminds me of combining all the different colors of Easter egg dye into one. This disgusting sight ensures that the person discovering the body never instinctively removes them from the water. Of course, neither do the police or paramedics—after all, they are well aware that’s my job.

One of my more recent experiences with a hot tub related fatality involved a gentleman who died days before he was found. He was in a seated position in the tub, but he had fallen forward to where he was face down in the water with his arms floating to the sides. The plan was for myself and the funeral director to raise the body back into a seated position using its arms—that worked fine. Next, the plan was to lift him at the armpits and pull him back until he was seated on the side of the tub. That too worked out fine.

The final step was to let him tip back and lower him onto the body bag as gently as possible. The skin at the area of the arm where the funeral director was holding the body slipped off and the full weight of the body jerked me forward. Somehow I managed to grab the side of the tub before falling face first on top of the body. Before I even had time to consider how fortunate I had been, I was splashed with what felt like a wall of water that the rigored legs of the body had kicked up as they left the hot tub. The only thing that prevented me from firing off a flood of expletives was the fact that my lips were busy keeping the water on my face from entering my mouth.

Comments had been down for a while by accident, but should be up and running now.

The following links are to some good articles discussing some of the issues I wrote about in my last post:

“Identifying Hurricane Dead Poses Unusually Daunting Challenges” by Shaila Dewan, The New York Times

“New Orleans begins collecting Katrina’s victims” © 2005 The Associated Press

“Investigators’ first priority: ID the dead” by John Fuquay, Clarion Ledger

“U.S. faces huge task to identify Katrina victims” Copyright 2005 Reuters Limited

“Identifying victims a grueling task” by Ann O’Neill, CNN

In order to appreciate the monumental task facing authorities in New Orleans and the surrounding area, here’s a scenario involving an event of a much smaller scale:

A flood rips through a much smaller town in the Mississippi Delta resulting in six fatalities. Rescue attempts during the first few hours of the flood lead to the discovery of two bodies. Body #1 was recovered from inside the cab of his pickup. A state driver’s license was located in the wallet found on the body and the photo matched the face of the deceased. Body #2 was recovered floating among vegetation. There was no identification present on the body, but fingerprints were taken and matched with those on file from a previous incarceration.

The remaining four bodies were not found until days after the flood because they had been washed to remote locations. The condition of all four of these bodies had been altered by the stages of decomposition, the effects of prolonged immersion, and animal activity. Being a small town, possible identities on the remaining four were surmised fairly easily based on missing person reports filed by surviving family members. Body #3 was identified using tattoos that were accurately described by the family.

The remaining three bodies had no form of identification. Visual identification even by an immediate family member was not possible because of the severe swelling to the facial tissues that occurs in the advanced stages of decomposition. Prolonged immersion had caused the epidermal layers of skin containing the fingerprints to separate from the dermis. These glove-like sections of skin tissue were either washed away or fed on by fish, turtles, or other creatures. The remaining printed images sometimes left behind on the dermis were insufficient for comparison.

Body #4 had extensive dental work and was identified using a postmortem dental comparison using antemortem dental charting and x-rays obtained from the deceased’s dentist. Body #5 was that of a young male in his early teens with no tattoos, no prints of file, and no dental work. Fortunately the deceased did have a cranial x-ray on file at an area hospital following a head injury the year before. A postmortem x-ray was taken and a positive identification was made using sinus pattern comparison.

Body #6 was the most difficult to identify. Authorities were unable to obtain prints from the deceased and there were no external identifying marks such as tattoos or scars present. The suspected family members of Body #6 reported that the deceased had not been to a dentist or a doctor in over twenty years. The body was recovered from a location that placed it in close proximity to the area it was last seen in. Based on the circumstances and the fact that there was only one person still unaccounted for, both family and law enforcement were willing to accept the identity of Body #6.

Ultimately though the burden of accurately identifying the dead falls on the shoulders of the person certifying the death, so the medical examiner/coroner must exhaust all available means of identification before resorting to a circumstantial identification. The decision was made to release the body to the family with the understanding that the identification was only circumstantial until a DNA comparison could be conducted. Tissue samples from Body #6 were submitted to a DNA lab along with buccal swabs obtained from immediate family members. Body #6 was positively identified several weeks later when DNA tests were completed.

Now let’s compare the above scenario with the reality of New Orleans:

Let’s say a flood rips through a much larger metropolitan area. Rescue attempts during the first few hours of the flood lead to the discovery of numerous dead bodies, but it is soon realized that collecting the dead should wait until the living are rescued. As a result, bodies that could have been fairly easily identified remain exposed to the elements and begin to decompose. The high temperatures ensure that the rate of decomposition is accelerated, and photographic and tattoo comparisons are no longer possible as everyone is the same color and similarly swollen. Fingerprints have been washed away from prolonged immersion or eaten away by critters that like small surfaces they can fit in their mouths.

A list of potential identifications of missing persons is almost impossible to come up with because the living have been scattered among cities all over the region. Dental and radiological exams can be conducted on the dead, but there is no guarantee that they’ve had dental work done or that the dentist or doctor’s office housing their records even exists anymore. A circumstantial identification pending a DNA test on one body or on a few bodies is manageable, but the reality is that there are likely going to be thousands of circumstantial identifications made in the coming days and weeks. Circumstantial identifications could likely become a necessary compromise for the time being. Ordinarily, medical examiners and coroners are tasked with determining cause and manner of death. In this instance and others like it, however, the primary concern is going to be accurately identifying the dead.