Medical examiners feel growing pains

Cramped state facility looks for larger space to help modernize, protect accreditation

September 26, 2005|By Tyrone Richardson | Tyrone Richardson,Sun reporter

The three-story building that houses Maryland's Office of the Chief Medical Examiner was considered modern when it was built in 1968 - with enough space to handle a growing state and technology to research causes of death.

Now the Penn Street building is showing its age, and officials with the Maryland Department of Health and Mental Hygiene want to move it to the University of Maryland BioPark, which is being built a few blocks away in West Baltimore.

The state legislature recently approved $1.5 million in funds for preliminary planning on a new office location.

Doctors and technicians examine about 4,000 bodies a year - nearly double what the building was designed for 37 years ago - and they don't have enough space to do autopsies and house equipment.

More than a dozen pathologists are squeezing into office space on the third floor, which was originally designed for classrooms to train police officers to investigate sudden deaths.

"Right now, the facility is just too small," said Dr. David R. Fowler, Maryland's chief medical examiner, who warned that his office could lose its accreditation without proper facilities. "I have four pathologists sharing one office, and I have a situation where I can't take on any more staff."

Fowler said the space shortage has not interfered with the requirement to examine and discharge a body to funeral directors within 24 hour.

There are six examination stations in the autopsy room. As a result, staff has to quickly clean from one examination to prepare for another, Fowler said.

Also, the shortage of space and lack of parking for portable refrigeration trucks limits the ability to "respond in the event of a mass fatality incident," according to a proposal document presented to the state legislature.

In the infectious disease room, white duct tape covers the seams in overhead ventilation ducts that are dotted with rust and remnants of condensation.

Fowler said that could cause health problems. "I would not dare do a smallpox examination in this building because it's such a dangerous disease," he said.

Fowler added that the infectious disease room lacks updated safety features such as seamless epoxy floors and enclosed lighting fixtures that lessen the chance of bacterial contamination.

Accreditation

According to the 2003 National Association of Medical Examiner's inspection document, the Baltimore's examiner's office has seen an increase of up to 40 autopsy cases each year. The office investigates all unattended and questionable deaths in Maryland, which includes murders.

In addition, the report had a cautionary notice citing "deficiencies in the areas of the size of the autopsy room ... the number of autopsy stations ... and the amount of general storage."

The national group is a volunteer organization of medical examiners around the country that standardizes research procedures and provides accreditation.

The group conducts inspections every five years, and Fowler said his accreditation could be in jeopardy if there is not enough space for autopsies. The next inspection is scheduled for 2008.

If the office loses its accreditation, Fowler said the staff could lose their credibility with the public and, more importantly, their integrity in criminal court when medical examiners are called to testify.

"The medical examiner testimony can rule out a heart attack or cancer as the cause of death," said University of Pennsylvania law professor David Rudovsky. "Their testimony can confirm that the cause of death was a blow to the head."

He added: "In some number of cases, the medical examiner is the critical piece to guilt or innocence ... and the defense lawyers would look at the integrity and the liability of the autopsy if there are problems in that office."

According to a capital proposal document sent to the state legislature, the new facility would have adequate space to handle more bodies, house paperwork and more staff, and have specialized areas for examinations of infectious diseases such as anthrax and smallpox.

The new building also would have enough space to handle a mass-casualty incident such as a terrorist attack or a natural disaster.

Proposed sites

The Department of Health and Mental Hygiene would prefer the new site to be at the University of Maryland BioPark instead of at an alternative site, a former auto junkyard on Potee Street in South Baltimore, according to a document sent to the state legislature last month.

The document said the Potee Street site would be a one-story, 72,000-square-foot facility on 8 acres of state-owned land. Total project costs would be more than $41 million.

According to the report, the Potee Street site would require decontamination and removal of high levels of methane gas and other hazardous waste.

The UM BioPark would be a six-story building with 120,000 square feet on a half-acre of state-owned property. Total costs would be more than $44 million.

University of Maryland, Baltimore officials are eager to welcome the medical examiner's office to their BioPark, a $300 million set of buildings in West Baltimore that is under construction.

Construction of the medical examiner's office could begin as soon as 2007.

"The [medical examiner's] office is currently located near our campus, and it's integrated with our medical school with teaching and researching partnerships and moving onto the BioPark would let those linkages continue," said James L. Hughes, university vice president of research and development.

"We've been trying to move it for a while, and I would support it on the Senate side and expect the same from the House," said Sen. Ulysses Currie, a Prince George's County Democrat and chairman of the Senate Budget and Taxation Committee.

tyrone.richardson@baltsun.com

Sun researcher Sarah Gehring contributed to this article.

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