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Autopsies overwhelm medical examiner staff

Body bags, tags in short supply

Dr. Mark Flomenbaum heads the medical examiner's office. (JOHN TLUMACKI/GLOBE STAFF/FILE 2006)

State public safety officials said yesterday they are looking into problems at the medical examiner's office, which acknowledged that an increase in autopsies has recently led to a shortage of body bags, more autopsy-related injuries to staff, and on one occasion an overwhelmed plumbing system that resulted in blood and water pooling on the floor.

The Office of the Chief Medical Examiner has also told public safety officials that a shortage of space in the morgue at the agency's Albany Street headquarters in Boston has forced pathologists to store some bodies in a refrigerated truck ordinarily used to hold victims of disasters, parked behind the building. Responding to press inquiries, the office also acknowledged that there have been extensive delays in picking up some bodies at scenes of crimes or unattended deaths.

"We certainly are reviewing the situation," said Charles McDonald, a spokesman for the Executive Office of Public Safety, which oversees the state medical examiner's office and appointed an undersecretary for forensic sciences two years ago to help manage the troubled agency. "We certainly are concerned with regard to these issues that have been raised."

He said public safety officials are examining how the chief medical examiner, Dr. Mark A. Flomenbaum, has spent his budget since he took charge of the office in April 2005. Partly in response to a series of earlier scandals, state lawmakers increased the office's operating budget by 38 percent from $5.7 million in fiscal 2006, when he arrived, to $7.9 million in the current fiscal year.

Lawmakers on Beacon Hill said that the more recent problems stem from years of underfunding and that they hoped to find more money this year.

Flomenbaum, formerly the second-ranked forensic pathologist in the New York City medical examiner's office, declined to comment.

Almost two years ago, he took over what was widely regarded as one of the worst state medical examiner's offices in the country. The office had failed in some of its duties because of underfunding, neglect, and shrinking staff. In 2003, the office was rocked by allegations that a pathologist had sent the wrong set of eyeballs for testing to determine whether an infant had died from shaken baby syndrome. The office also faced allegations that it misidentified a fire victim's body, which was then cremated.

When he took over, Flomenbaum vowed that the office would perform more autopsies and hire more staff.

The office, which has about 65 employees, has increased the number of autopsies from 2,694 in 2005 to 3,552 last year, according to Marcia S. Izzi , his chief administrative officer.

The volume of autopsies has risen because the medical examiner's office, under Flomenbaum's orders, has been more aggressive in requiring that state pathologists review suspicious or unattended deaths. The office now has 11 pathologists, up from five when Flomenbaum took office.

But a former technician, Brian Gonsalves , said yesterday that the increased workload has strained the operation. He said he worked at the office about a year before leaving last October because of low pay and limited career opportunities, but acknowledged that on the day he gave notice he had a confrontation with a human resources official.

Gonsalves, 24, told the Globe that on several occasions the office ran out of basic supplies, including body bags and toe tags. The technicians, who assist the pathologists, were told to cut toe tags from manila envelopes and punch holes in them, he said.

He said that when the autopsies increased, waste tissue inadvertently overwhelmed the plumbing system. "The drain system backed up and for two days we had to perform autopsies in 2 inches of bloody water on the floor," he said.

He also said workers have been exposed more frequently to hazardous body fluid as a results of cuts from scalpels and other equipment during autopsies.

Izzi, in an e-mail message relayed by the Executive Office of Public Safety after inquiries from the Globe about Gonsalves's allegations, confirmed that "there does seem to be an increase in work-related injuries such as needle sticks," and pathologists as well as morgue technicians have been pricked.

Izzi also acknowledged that tissue from autopsies overwhelmed the plumbing system on one occasion.

In the e-mail, she also said that the office nearly ran out of body bags this week, but has placed a new order.

Senator Jarrett T. Barrios , a Cambridge Democrat, said he has been briefed several times on the problems at the medical examiner's office, and believes it needs more money.

"You have all these bodies coming to a facility that wasn't meant to handle the volume," he said, noting that several years ago there were four fully staffed offices across the state and there is now only one fully staffed office, in Boston.

Barrios said that the Romney administration refused requests to earmark additional money to fund shuttered medical examiner offices in Worcester and Springfield. Barrios said it was up to the Patrick administration and Beacon Hill lawmakers to act.

"If the funding needs aren't resolved, there's no way that these problems will be taken care of," said Barrios. "The backlog is because there aren't enough professional staff or adequate facilities."

Representative Edward M. Augustus Jr. , a Worcester Democrat, said he grew concerned about the medical examiner's office after hearing a constituent complain of a long delay in picking up his daughter's body.

The medical examiner's Worcester office closed several years ago, resulting in delays as crews traveled from Boston to get bodies in Central Massachusetts, said Augustus. He said the Worcester office is slated to reopen in a few weeks, but with only part-time staff because of a funding shortage. The only satellite office is in Holyoke.

He said a bond bill for $15 million for the medical examiner's office was drafted last year but never acted on. It will probably be taken up again this year and would go a long way to solve the office's issues, said Augustus.

"We're definitely not going to get the level of service we need," he said. "We've put a Band-Aid on the problem, but we haven't solved it. Ultimately, we need a new facility in Worcester."

Jonathan Saltzman can be reached at, and Raja Mishra at