The Baltimore County funeral director worried more with each passing day. The morgue still hadn’t released the young woman’s body for cremation.
Her father wanted to see her, just to say goodbye. But nature was already at work. A body refrigerated below 40 degrees can show signs of decomposition after one week.
The funeral director called the morgue every two days. Always the same answer: “Not on today’s schedule.”
More than 200 bodies are awaiting autopsies by doctors at Maryland’s Office of the Chief Medical Examiner, the agency located in downtown Baltimore responsible for investigating deaths statewide. The unprecedented backlog is growing by the day and filling up the morgue refrigerators. Local funeral directors say it’s also worsening the anguish for grieving families, some of whom have been forced to postpone funerals and missed the chance to say goodbye to a loved one.
The backlog snowballed from 50 bodies awaiting autopsy in late December to 150 bodies in late January. State officials estimate the number will exceed 300 bodies this month. They blame office turnover and the coronavirus pandemic that’s kept employees sick at home. Staff shortages come amid increasing numbers of murders and drug overdoses, cases that require autopsies.
With space running out, officials turned to a makeshift field morgue in the parking garage of the old Social Security Administration building downtown. Tarps hang from the ceiling to hide their work from view.
“They’re storing bodies in a cooler in a parking garage. It’s a mess,” said Patrick Moran, president of the local chapter of the American Federation of State, County and Municipal Employees, whose members include autopsy assistants, lab techs and forensic investigators with the office.
The situation has so alarmed Dr. Victor Weedn, the chief medical examiner for Maryland, that he requested help from the federal mortuary disaster teams that responded to New York at the height of the pandemic and after the Sept. 11 attacks: the Disaster Mortuary Operational Response Teams or DMORT.
In an email to his staff obtained by The Baltimore Banner, Weedn wrote: “The entire OCME staff is struggling to cope. We are receiving endless calls from families, who have to wait without being given an answer to their questions when their loved one will be released. We have no good answers for them.”
Robert Smith said his father died of a presumed overdose Jan. 26 in Western Maryland and he continues to wait for the autopsy. Smith booked a flight to Ireland next month to scatter his father’s ashes, but he doesn’t know if he’ll be able to retrieve and cremate his father’s body in time.
“This is just kind of like playing games with people’s lives,” he said. “It’s keeping people from having closure.”
Industry standards recommend autopsies within 48 hours from the time the medical examiner receives a body, but some Baltimore area funeral directors say they’re waiting two weeks. The National Association of Medical Examiners, or NAME, begins to penalize local offices when the amount of autopsies performed within 48 hours dips below 90%.
Maryland’s office is required by law to maintain its accreditation with NAME, and it’s fully accredited through May 2023. A state health department spokesman, however, acknowledged the doctors are on pace to perform more than 250 autopsies per person per year, another violation of standards.
With the bodies held up, funeral homes are forced to cancel viewings and put off services. Worse yet, some bodies are released in no condition to be seen by a loved one. West Baltimore funeral director John Williams recalled picking up one man’s body after six days at the morgue.
“I don’t think he was in refrigeration at all. Honestly, he was hot to the touch,” Williams said. “When a person dies, especially if you want to have a funeral with a viewing, the clock is ticking. If that person is not refrigerated, if that person is not autopsied in a timely fashion, you start getting higher and higher levels of decomposition.”
Unlike states with local coroners, Maryland centralizes the work of investigating deaths to the Office of the Chief Medical Examiner, located in downtown Baltimore. Bodies from Hagerstown to Ocean City, thousands of bodies a year, come to the office. Doctors determine the cause and manner of death, for example, accident or suicide.
When a man, woman or child dies by accident, suicide, homicide, in suspicious circumstances, or not in the care of a physician, doctors perform an autopsy. According to the office’s annual reports, they perform more than 5,000 autopsies a year. It’s one of the busiest medical examiner’s offices in the U.S.
Even before the coronavirus pandemic, a rising number of murders and drug overdoses strained the staff. Between January 2019 and 2021, the number of full-time pathologists dropped from 20 to 13, according to the state health department.
Meanwhile, low wages are driving the techs and autopsy assistants to other jobs, said Moran, the union president.
“If the federal government is paying more, if cities and counties are paying more, that’s where people are going to go,” Moran said. We are having bodies piling up in the Office of the Chief Medical Examiner because they can’t bring anybody to work because the conditions are miserable, unsanitary and the pay is awful.”
The pay for assistant medical examiners in Maryland ranges from nearly $240,000 to as much as $370,000, according to NAME figures. That’s comparable, or slightly more, than salaries in other states.
A spokesman for Gov. Larry Hogan said the problem isn’t state salaries, but too few pathologists.
“There is a critical shortage of forensic pathologists – there’s only about 500 board-certified pathologists in the entire country, so this is not a challenge unique to Maryland,” said Michael Ricci, a spokesman for Hogan.
Pathologists may also earn higher salaries working for hospitals. Weedn told a state oversight board his office has struggled to retain employees.
“All the exit interviews say their pay is too low,” he said.
In his email to staff, Weedn wrote that he hopes to hire as many as 11 people, both full-time and as-needed employees, to perform autopsies. The candidates are going through the application and licensing process and none would begin before June, he wrote.
That’s left funeral directors – including the one in Baltimore County trying to retrieve the young woman’s body – bracing for even longer delays.
He spoke of his experience on the condition of anonymity to protect the young woman’s identity and out of fear his autopsies would be delayed even further.”
Two weeks passed before the funeral director could pick up the young woman’s body. He usually disinfects the body, combs hair, closes the eyes and mouth, just so they look clean and peaceful. But this time, he couldn’t mask the telltale signs of decomposition. Discoloration already showed in the young woman’s face.
Her father wanted to say goodbye, but the funeral director put the matter delicately.
“I said, look, you don’t want to see her like this. It creates a bad memory,” he said. “Remember your daughter for who she was.”