DMORT. Post Mortem Exam Forms

Transcription

1 DMORT Post Mortem Exam Forms

2 Tracking Form PM Victim Status: Site Recovery # Date Received by Admitting: Morge Reference # Date Processed In Morgue: ME/C # Tracker: Name Presumptive ID: Last Name,, First Middle Suffix DOB Gender SSN Morgue Station: Admitting Tracking Form Comments Section Leader MUST mark below when processing completed. = Completed, = nothing was performed at that station. Start Time Station Leader s Name Radiology Pathology Personal Effects Fingerprints Odontology Anthropology DNA Embalming Admitting/Exit Triage From Site Recovery Description of Remains: Signiture Completed: Barcode Number: This Bag Also Produced Morgue Reference s: Place Barcode Sticker Here.

3 Site Recovery # Put N/A in all unused fields. Victim Site Recovery Form Morgue Reference. Recovery Date Time: MM/DD/YYYY 24 hour (00:00) Condition: select all that apply Autopsied Previously Burned-Partial Thickness Burned-Full Thickness Cremains Classification of Remains: Choices: Complete HR (C/HR), Fragmented HR (F/HR) or Common Tissue (CT/HR) Recovery Grid #: Place / Address of Recovery: Decomposed Embalmed Fragmented Fresh Mummified Saponified Scavenged Skin Slippage GPS of Recovery: Skeletonized-Partial Skeletonized-Full Wet-Environmental Description of Remains: Position Remains Found In: Estimated Age: Baby/Child Adolescent Young Adult Middle Aged Elderly Estimate Estimated Sex: Male Female Undetermined Estimated Race: Clothing on Remains: (brief description) Personal Effects on Remains: (brief description) Recovery Comments: Presumptive FIELD ID: Last First Middle ID Based On: DOB (MM/DD/YYYY) SSN ID# / Drivers license # / State Recovered By: Delivered to Transport Staging: Name and Agency (if applies) Phone # Name and Agency (if applies) Phone # Site Recovery Report Completed by: Name and Agency (if applies) Phone # Date Recovered Date Delivered Time Recovered Time Delivered Delivered to Morgue by: Agency Phone # Team Leader: Date Delivered Time Delivered

4 Examining Radiologist Scribe Radiology 1 Report Morgue Reference. Classification of Remains: This is Inital X-ray Exam: Number of Initial Radiographs: This includes a Secondary X-ray Exam: Number of Additional Radiographs: Radiology Technologist(s): Name (list all who worked on THIS case): Reason for Additional X-rays: Pacemaker Present: Implants Present: table Findings Per Technologist: Technologist notified the following person of notable findings : Name of Specialist Morgue Section Date tified

5 Examining Radiologist Scribe Radiology 2 Assessment for DVP Morgue Reference. Assessment Done By: List Names Type of Forensic Specialist: Radiologist Pathologist Anthropologist Dentist Estimated Gender: Male Female Undetermined Estimated Age: Radiology Specific Findings: 1 Location: Side: Type: Detailed Description: 2 Location: Side: Type: Detailed Description: 3 Location: Side: Type: Detailed Description: 4 Location: Side: Type: Detailed Description: 5 Location: Side: Type: Detailed Description: Comments:

6 Examining Pathologist Scribe Pathology 1 Page 1 of 3 Morgue Reference. Gender: Estimated Race: Male Female Caucasian Black Classification of Remains: Undetermined Asian American Indian Estimated Age: Condition of Remains: check all that apply Autopsied Previously Burned-Partial Thickness Burned-Full Thickness Cremains Decomposed Embalmed Fragmented Fresh Mummified Saponified Scavenged Skin Slippage Skeletonized-Partial Skeletonized-Full Wet-Environmental Hispanic Undetermined Build Other - specify Small/Gracile Medium/Intermediate Height inches: cm: Estimated Weight lbs: kg: Lividity: Fixed Unfixed Location of Lividity - required Rigor - check all that apply Absent Complete, all muscles Hands, Feet Fingers, Toes 71+ Large/Robust Undetermined Jaw/Face Only Large Extremities Resolving Hair Info Color: Auburn Black Blonde Brown Gray Red Salt & Pepper White Other - specify Length: Short Medium Long If measured: cm Shaved inches Bald Description: Curly Wavy Straight N/A Other - specify Male Pattern Baldness Undetermined Eyes Info Accessory: Extension Hair Piece Hair Transplant Wig N/A Other Facial Hair: Facial Hair Type: Facial Hair Color: Color: Condition: Aids: Clean Shaven Moustache Auburn Black Blue Brown Both Intact Missing-Left ne Contacts Blond Brown Green Grey Beard & Moustache Beard Gray Red Hazel Undetermined Missing-Right Glass-Left Glasses Salt & Pepper White Goatee Stubble Other - specify Glass-Right Cataract-Left Corneal Implant-Left Corneal Implant-Right Sideburns Lower Lip NA Other - Specify Cataract-Right Other - specify Other - specify Other - specify Dental Present: Dentures: Upper Engraved/Labeled Lower Engraved/Labeled Appliance: Type and location: Type and location:

7 Examining Pathologist Scribe Pathology 2 for DVP Morgue Reference. N a i l s Fingernails Length Toenails Evidence of Possible Surgery: As Indicated By Scars, Sutures, etc. Amputation Appendectomy Brain Caesarean Cardiac Scars, Amputation, Birth Marks, Deformities: Category Location Side Description Scars: Amputation: Birth Mark: Deformity: Category Location Side Description Scars: Amputation: Birth Mark: Deformity: Category Location Side Description Scars: Amputation: Birth Mark: Deformity: Category Location Side Description Scars: Amputation: Birth Mark: Deformity: Category Location Side Description Scars: Amputation: Birth Mark: Deformity: Type Natural Artificial t known Extra Long Long Medium Short Color External Genitalia (check all that apply) (check all that apply) Gall Bladder Laparotomy Mastectomy Reconstructive Tracheotomy Female Male Description Circumcised Uncircumcised Other - Specify Color Description Circumcision Undetermined Identifiable External Genitalia Specify Other Surgeries here:

8 Examining Pathologist Scribe Body Piercing and Tattoos Total # Path Photos Taken Pathology Narrative: Pathology 3 for DVP Page 3 of 3 Body Piercing(s) Tattoo(s) Image # s: Morgue Reference. Body Diagram Used Referred for Autopsy Tox Collected Category Tattoo Piercing Location Position Description Category Tattoo Piercing Category Tattoo Piercing Category Tattoo Piercing Category Tattoo Piercing Location Position Description Location Position Description Location Position Description Location Position Description Foreign Objects / Implants / Prosthetics / Orthopedics In Body Type: Type Other: Pacemaker Prosthetic Other - Specify Foreign Object Present: Position: Location: Description: Type: Type Other: Removed from Body: Position: Location: Pacemaker Prosthetic Other - Specify Description: Type: Type Other: Removed from Body: Position: Location: Pacemaker Prosthetic Other - Specify Description: Removed from Body:

9 PE Section Leader Photographer Clothing for DVP Page of Morgue Reference. CLOTHING INVENTORY: For additional items add pages. Clothing Item Color Description Size Unique Features Clothing Item Color Description Size Unique Features Clothing Item Color Description Size Unique Features Clothing Item Color Description Size Unique Features Clothing Item Color Description Size Unique Features Clothing Item Color Description Size Unique Features Anything Handwritten On Clothing Or Tags? (location and description) Associated Personal Effects (found on the body): Backpack Book Bag Other PE: Description of Item(s): Cellphone Coin Purse Fanny Pack ID Bracelet Jewelry Money Clip Wallet Purse Other-Specify in box below. Monetary Items: (cash, coin, travelers checks, foreign money) Identification Sources: (credit cards, checkbook, Id s, etc.) Unassociated Personal Effects (with but not on the body): Other Personal Effects:

10 PE Section Leader Photographer Jewelry for DVP Page of Jewelry Inventory Morgue Reference. Watch Type Make Band Material Face Color Description Inscription Photo taken: Photo taken: Jewelry Jewelry/Type Material Color Style Stone Color Size Description Inscription Photo taken: Photo taken: Jewelry/Type Material Color Style Stone Color Size Description Inscription Photo taken: Photo taken: Jewelry/Type Material Color Style Stone Color Size Description Inscription Photo taken: Photo taken: Jewelry/Type Material Color Style Stone Color Size Description Inscription Photo taken: Photo taken: Jewelry/Type Material Color Style Stone Color Size Description Inscription Photo taken: Photo taken: Use this Space for Additional Info Regarding Jewelry:

11 Examiner Date of Exam: Fingerprinting Morgue Reference. Classification of Remains: Condition of Hands: (burned, decomposed, skeletonized, scavenged, etc.) Condition of Right Hand: Condition of Left Hand: Fingers Printed Thumb Index Middle Fourth Little If not printed why? (Check all fingers printed below) Right Hand Describe Condition if Needed: Left Hand Thumb Index Middle Fourth Little Describe Condition if Needed: Right Palm Printed: Left Palm Printed: Footprints Taken: Right Foot Left Foot Condition of Feet: Fingerprint Exam tes:

12 Examining Anthropologist Scribe Anthropology 1. Page 1 of 2 Morgue Reference. Estimated Age Lower Age Range Upper Age Range Male Female Estimated Sex Male possible Female possible Unknown Classification of Remains: Condition of Remains: Autopsied Previously Burned-Partial Thickness Burned-Full Thickness Skeletal Race: Caucasian Black Asian American Indian Hispanic Undetermined Other - Specify Cremains Decomposed Embalmed Fragmented Fresh Mummified Skeletal Build: Saponified Scavenged Skin Slippage Small/Gracile Medium/Intermediate Large/Robust Undetermined Skeletonized-Partial Skeletonized-Full Wet-Environmental Estimated Stature (cm) (in) ne - Intact Body Cranium Partial Cranium Mandible Partial Mandible Torso Partial Torso R Upper Arm Partial R Upper Arm R Forearm Partial R Forearm R Hand Partial R Hand L Upper Arm Missing Parts Partial L Upper Arm L Forearm Partial L Forearm L Hand Partial L Hand R Upper Leg Partial R Upper Leg R Lower Leg Partial R Lower Leg R Foot Partial R Foot L Upper Leg Partial L Upper Leg L Lower Leg Partial L Lower Leg L Foot Partial L Foot Cranium Partial Cranium Mandible Partial Mandible Torso Partial Torso R Upper Arm Unique Skeletal Features (Pathology, Healed Trauma, Unique Identifiers, etc.) Partial R Upper Arm R Forearm Partial R Forearm R Hand Partial R Hand L Upper Arm Partial L Upper Arm L Forearm Partial L Forearm L Hand Partial L Hand R Upper Leg Partial R Upper Leg R Lower Leg Partial R Lower Leg R Foot Partial R Foot L Upper Leg Partial L Upper Leg L Lower Leg Partial L Lower Leg L Foot Partial L Foot Unique Skeletal Features: (include location, type and description) Skeletal Diagram Used:

13 Examining Anthropologist Scribe Anthropology 2. Page 2 of 2 Morgue Reference. Evidence of Ante Mortem Fractures (Old Fractures) Skeletal Trauma: (include location, type and description) Race / Ancestry Based On: Age Based On: Stature Based On: (include measurements) Anthropology Dental Comments: Anthropology Miscellaneous Comments:

14 Examiner DNA Morgue Reference. Classification of Remains: DNA Specimen Taken: If no DNA Specimen taken, why? Entire Remains Taken (If body bag contains less than complete body) Specimen Taken: Type: Side: Description: Size of Specimen: Bone1 Bone2 Muscle1 Muscle2 Organ1 Organ2 Tooth1 Tooth2 Buccal Swab FTA Card LAB ID # LAB or AFIP / AFDIL label: Place label here. DNA tes: