Mass fatalities result in a surge of deaths above what is normally managed by normal medicolegal systems.  In the event of a major disaster within Los Angeles County, it may be several days before the Department of Coroner, County Morgue, or private mortuaries can respond, process and recover decedents. The following guidelines have been developed to aid hospitals and other healthcare entities in their response to an MFI.

How This Guide Can Help You

While this guidance is intended for use during a county-wide MFI, the principles can be applied anytime a hospital is experiencing a surge of deaths above what is normally managed by the hospital. These principles can also be used by any healthcare entity of any size to manage an MFI. The forms and checklists are designed to be personalized by your facility as needed.

This guidance includes information on preserving and safeguarding decedents, property, and evidence. It will also discuss the processes and issues for decedent identification, next of kin notification, death certificate processing, tracking, storage, and final disposition.

The Goal and Focus of These Guidelines

The goal of these guidelines is to enhance the ability of Los Angeles County and its healthcare partners to respond to andmass fatalities manage a surge in the number of decedents as a result of any disaster, including an influenza pandemic. While the importance of religious, cultural and mental health considerations is recognized, it is not addressed here. These guidelines focus on decedent processing for medical and legal reasons.

This guidance was developed in collaboration between the Los Angeles County Department of Coroner, Department of Health Services, Emergency Medical Services Agency (EMS), and Department of Public Health, Office of Health Assessment & Epidemiology, Data Collection & Analysis Unit.  This report aims to provide guidance to hospitals and other healthcare entities that are vulnerable to incidents of mass fatalities.  These entities, and the area that they support, will benefit from a strong understanding of mass fatality incident management.

Topics Covered

  • OVERVIEW
    • Purpose
    • Assumptions
    • County-Wide Coordination
    • Key Contacts
  • HOSPITAL MASS FATALITY INCIDENT (MFI) PLANNING
    • Planning Overview
    • 10 Questions to Get Started
    • Sample Table of Contents
    • Checklist: MFI Planning
  • HOSPITAL MASS FATALITY INCIDENT (MFI) RESPONSE
    • Hospital Mass Fatality Incident (MFI) Management Unit
    • Job Action Sheet: MFI Unit Leader
    • Checklist: MFI Management Unit Equipment and Supplies
    • Card: Decedent Information and Tracking
    • Form: Fatality Tracking
  • DEATH FLOW PROCESS
    • Decedent Processing: Potential Bottlenecks
    • Flow Chart: Death at A Hospital
    • Flow Chart: Pandemic Influenza Death at A Hospital
  • DEATH CERTIFICATES
    • Fact Sheet: About Death Certificates and Facts About Signing the Death Certificate
    • Flow Chart: Death Certificate Process
    • Sample: Form VS-11E Certificate of Death
    • Fact Sheet: California Electronic Death Registration System (CA-EDRS)
    • Fact Sheet: Information on the LAC Public Administrator
  • DECEDENT HANDLING AND STORAGE
    • Fact Sheet: Health Risk from Dead Bodies and Basic Infection Control for Staff Handling Dead Bodies 28
    • Fact Sheet: Human Remains Storage Myths and Truths
    • Fact Sheet: Decomposition
    • Fact Sheet: Recommended Methods of Storage for Hospitals
    • Checklist: Surge Morgue Equipment and Supplies
  • ADDITIONAL RESOURCES
    • Mass Fatality Pandemic Influenza Exercise Sample Pre and Post Test Questions
    • Web Resources