How bad is the opioid crisis? Morgues are literally out of room

Published: Sep 26, 2017, 3:16 pm • Updated: Sep 26, 2017, 3:16 pm

By Rhonda Cook, The Atlanta Journal-Constitution

ATLANTA — One by one on a single day earlier this month, coroners from eight counties contacted the Georgia Bureau of Investigation’s crime lab. Each had just opened a death case that required an autopsy and each was told to call back the next day.

There were no “available tables,” they were told. It’s a response that isn’t unusual.

Several times on any given week, coroners have been told there’s no room at any of the state’s forensic labs until other bodies are released. The backlog has sometimes left local officials who rely on the state facilities scrambling to find ways to store bodies. Meanwhile, anxious family members must delay funerals, burials or cremations.

Officials hope the pressure on the lab will lessen when a new, much larger $6.68 million morgue, 17,511 square feet, opens in November. Expanded “intake” and body storage areas at that Decatur site opened last week.

But others caution the backlog could continue, fueled by a surge in opioid overdose deaths, a rising number of suicides and Georgia’s growing population.

“It’s tough,” Catoosa County Coroner Venita Hullinger said about the delays. “These families have given up someone. Their whole world is upside down. And they can’t even start their grieving.”

Hullinger said she has waited as long as five days before there was room at the morgue at the GBI’s Division of Forensic Sciences in Decatur, a 2 1/2-hour drive away. Recently, she alerted the state’s medical examiner there had been two deaths on the same day. The morgue could only take one body and the second one could be delivered the next day, she said.

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Fewer autopsies?

Autopsies are required in some cases — like in obvious homicides, when a child dies or if illicit or prescription drugs are suspected in a death. While Fulton, Cobb, DeKalb and Gwinnett counties have their own medical examiners and handle their own autopsies, the 155 remaining counties rely on the GBI’s 15 pathologists and three morgues. (Rockdale, Hall, Barrow and Henry Counties sometimes turn to DeKalb County for their autopsies.)

“Prior to the opening of the new cooler, there was often not enough space to accept bodies until others were released. Coroners would have to hold the body until notified when space became available.” said Dr. Jonathan Eisenstat, the state’s chief medical examiner.

Until there is an autopsy, there can be no funeral.

“It’s common for us to hold them,” Richmond County Coroner Mark Bowen said of bodies that have to be stored a day or for days because of the frequent lack of space at the any of the state’s three morgues.

In an effort to alleviate the problem, Eisenstat has issued new guidelines designed to reduce the number of bodies turning up at Georgia’s labs by lifting the cases where autopsies are required.

Not everyone likes that idea.

Hullinger called some of the changes “alarming,” arguing, for instance, that those over age 55 shouldn’t automatically be disqualified from autopsies as the new changes require.

The rise in overdose deaths has increased the workload for pathologists. They have been increasing steadily since 2013 to 776 last year, according to GBI statistics. So far in 2017, a quarter of all overdose deaths have been attributed to fentanyl, a powerful synthetic opioid.

“The whole process sucks”

According to the GBI, there are a total of 26 full-time forensic pathologists working for the state and in the four metro Atlanta counties that have their own medical examiners. That is well below what is recommended for a state of its size.

“As a general guideline, there should be one full-time forensic pathologist per 200,000 population,” the GBI wrote in a report to the governor asking for funds for more staff for the morgue. “Based on Georgia’s population of approximately 10 million, Georgia needs nearly twice the number of forensic pathologists as are currently working in the state.”

Last year, each of the state’s medical examiners performed 325 to 350 autopsies, a total of 3,609 autopsies. So far this year, the lab has performed 2,657 autopsies.

Meanwhile, the national standard is 250 autopsies a year per pathologist.

“They’re not funded so they can function the way the state deserves them to function,” said Hullinger, the Catoosa County coroner. “Maybe the families wouldn’t have to wait so long to get their results. From beginning to end the whole process sucks.”

Not enough people and not enough space is a long-running problem, said Whitfield County Coroner Greg Bates.

On Aug. 27, Bates called to request an autopsy. But there was not an autopsy table available until Aug. 29, which meant uncertainty in that family’s funeral planning.

“That was not bad. It has certainly gotten better since the first of the year,” said Bates, who stores bodies at the local hospital until the state crime lab has room.

This year, the state Legislature gave the GBI money to hire five additional part-time morgue staff as well as give pay raises to pathologists to make the crime lab more competitive with Georgia counties, other states and hospitals in hiring. The lab can now pay a starting board-certified pathologist $195,851 a year, which is more than the GBI director’s salary but less than other states; the chair of the Augusta University Pathology Department makes almost $429,000 and an associate there makes more than $218,000.

“I think our new morgue will hold us 10 years,” said GBI director Vernon Keenan. “What we’ll need is more doctors.”

Remains dating back to 1969

Contributing to the morgue backlog is one persistent problem: remains that either remain unidentified or are otherwise in limbo.

The number of identified bodies at the morgue changes day-by-day. On Sept. 13 there were 33, including the body of a 66-year-old woman that has been there since Nov. 27, 2015. Her relatives cannot agree on burial arrangements.

The body of a 60-year-old woman who died of natural causes in Clayton County has been stored at the morgue in Decatur since Nov. 27, 2015, because the GBI and local authorities cannot locate her relatives; a recently-located friend has offered to pay for a funeral.

At the same time, the morgue is storing 277 unidentified remains, at least one set of skeletal remains dates back to 1969.

“We’re working to have them buried but we have to have the authority to do it or get a court order,” Keenan said. “It’s time to bury the unidentified.”

Via AP Member Exchange

Topics: Atlanta, opioid epidemic, overdose