Abstract:case records of the massachusetts general hospitalT h e ne w e ngl a nd jou r na l o f m e dicine n engl j med 370;15 nejm.org april 10, 2014
Pr esentation of C a seDr. John T. Nagurney (Emergency Medicine): A 34-year-old man was brought to the emergency department at this hospital because of multiple traumatic injuries that he sustained when a bomb exploded while he was watching the 2013 Boston Marathon. At the scene, the patient reportedly lost consciousness, had a complete amputation of his right leg direc… Show more
“…Of note, only one person should handle each specimen, per chain of custody guidelines. 14 A dedicated team approach minimizes confusion, increases consistency, and provides structure to the process. It also provides law enforcement a point person for immediate and future communication.…”
pathology departments at hospitals across Boston, Massachusetts received numerous amputated limbs, as well as other surgical specimens from trauma surgeries. In the absence of clear guidelines, each department faced uncertainties in performing gross examination of these specimens.Objective.-To develop a protocol for processing surgical specimens with forensic evidence.Design.-We collaborated with representatives who knew the practices at 3 major Boston hospitals, the Office of the Chief Medical Examiner of Massachusetts, and a senior team leader for the evidence response team for the Boston, Massachusetts division of the US Federal Bureau of Investigation to construct a protocol for processing specimens with forensic evidence.Results.-A simple and robust protocol approved by experts in forensic evidence collection was developed. Important points in this protocol include (1) assigning the task of processing the specimens to one individual or one team of individuals, (2) photographing all specimens before and after washing, (3) obtaining a radiograph of each specimen, and (4) identifying a secure area to store forensic evidence.Conclusions.-When acts of terror occur, protocols provide order and clarification to the processing of surgical specimens. We propose a protocol that provides guidance for pathology departments across the country to handle trauma-related surgical specimens with forensic evidence in an efficient manner to allow optimal patient care and a secure way of gathering forensic evidence.
“…Of note, only one person should handle each specimen, per chain of custody guidelines. 14 A dedicated team approach minimizes confusion, increases consistency, and provides structure to the process. It also provides law enforcement a point person for immediate and future communication.…”
pathology departments at hospitals across Boston, Massachusetts received numerous amputated limbs, as well as other surgical specimens from trauma surgeries. In the absence of clear guidelines, each department faced uncertainties in performing gross examination of these specimens.Objective.-To develop a protocol for processing surgical specimens with forensic evidence.Design.-We collaborated with representatives who knew the practices at 3 major Boston hospitals, the Office of the Chief Medical Examiner of Massachusetts, and a senior team leader for the evidence response team for the Boston, Massachusetts division of the US Federal Bureau of Investigation to construct a protocol for processing specimens with forensic evidence.Results.-A simple and robust protocol approved by experts in forensic evidence collection was developed. Important points in this protocol include (1) assigning the task of processing the specimens to one individual or one team of individuals, (2) photographing all specimens before and after washing, (3) obtaining a radiograph of each specimen, and (4) identifying a secure area to store forensic evidence.Conclusions.-When acts of terror occur, protocols provide order and clarification to the processing of surgical specimens. We propose a protocol that provides guidance for pathology departments across the country to handle trauma-related surgical specimens with forensic evidence in an efficient manner to allow optimal patient care and a secure way of gathering forensic evidence.
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