November 5, 2025 • 19 mins
Content Warning: This episode contains graphic descriptions of autopsies, workplace injuries, and bodily hazards. If you’re sensitive to these topics, this episode may not be for you.
They say the dead can't hurt you. Anyone who's worked in a morgue knows better. In this episode of Mayhem in the Morgue, Chief Medical Examiner Dr. Kendall Crowns begins Exposure, a two-part look at the hidden hazards of working among the dead. From bees buzzing out of body bags to bullets, snakes, and sparking pacemakers, these true stories prove that even in death, the threat of harm is still alive.
Highlights
- (0:00) Welcome to Mayhem in the Morgue with Dr. Kendall Crowns
- (0:45) The dead are still dangerous: hazards that arrive with the body
- (1:15) Bees, scorpions and other stinging surprises
- (3:15) A garter snake slithers out of a body bag
- (4:45) When lice from a deceased patient cause an office-wide infestation
- (7:40) The six main autopsy hazards: mechanical, sharp force, electrical, chemical, radiation, and infection
- (10:00) Back injuries and gurney accidents caused by the morbidly obese
- (12:15) Slippery floors, crush injuries, and repetitive strain
- (13:00) Sharp force dangers: knives, scalpels, broken glass, and needles
- (15:00) Decomposition fluid, broken bones, and close calls
- (17:15) Electrical hazards and sparking pacemakers
- (18:00) Radiation exposure and the early days of fluoroscopy
- (19:30) Closing reflections: the dead are always dangerous
About the Host: Dr. Kendall Crowns
Dr. Crowns is the Chief Medical Examiner for Travis County, Texas, and a nationally recognized forensic pathologist. He las led death investigations in Travis County, Fort Worth, Chicago, and Kansas. Over his career, he has performed thousands of autopsies and testified in court hundreds of times as an expert witness. A frequent contributor to Crime Stories with Nancy Grace, Dr. Crowns brings unparalleled insight into the strange, grisly, and sometimes absurd realities of forensic pathology.
About the Show
Mayhem in the Morgue takes listeners inside the bloody, bizarre, and often unbelievable world of forensic pathology. Hosted by Chief Medical Examiner Dr. Kendall Crowns, each episode delivers real-life cases from the morgue, the crime scene, and the courtroom. Expect gallows humor, hard truths, and unforgettable investigations.
Connect and Learn More
Learn more about Dr. Kendall Crowns on Linkedin. Catch him regularly on Crime Stories with Nancy Grace and follow Mayhem in the Morgue where you get your podcasts.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Today's episode includes information about the deaths of individuals and
environmental hazards. If this sort of thing upsets you, you
may want to consider reading a book. May I recommend
The Grapes of Wrath.
Speaker 2 (00:13):
Well, you may have an immorial with your host, Doctor
kinder Crown.
Speaker 1 (00:24):
Today's episode Exposure Part one, Cuts and Bruises. Today's episode
is the first episode of four in which I will
be talking about the hazards associated with autopsies. So let's
get started. After nearly forty years of working around dead
bodies as an autopsy technician and a medical examiner, there's
(00:45):
one important principle that I've learned, and that is the
dead are still dangerous. You never know what you will
find when you open up the body. Back before you
even get started with the autopsy, there are hazards and
those are the hazards that come in with the body,
and it depends on how and where the person died.
When people are found outside in the woods or someplace
(01:07):
like that, a myriad of poisonous insects might find their
way onto the body. Things like spiders or scorpions may
get into the body or body cavities and get onto
the clothing and you don't want them on you. Thankfully,
the cold temperatures are cooler slow them down, so when
you first open the body bag, you have a few
minutes to find them and dispose of them before they
(01:29):
wake up and start moving around. Many of the autopsy
technicians that I've worked with have a soft spot for
spiders and will catch them in specimen containers and release
them outside instead of squashing them. Other hazardous insects are bees, wasps,
or yellow jackets. Anytime they are involved, it can be
very hazardous because they're angry and they liked to sting.
(01:52):
For example, there was a case of a hobbyist beekeeper
who had a hard attack while tending his bees. He
collapsed into the beehive and they swarmed him. One of
the neighbors saw what had happened. They called nine to
one one and when the paramedics arrived and tried to
get to him, they were stung multiple times. Once they
got to him, they were able to determine that he
was dead and they contacted the Medical Examiner's office. The
(02:15):
death investigator arrived and while they were conducting their death investigation,
they were stung. They called body Transport Service and when
they arrived to try and retrieve the body, they were
also stung. They placed the body in the body bag
as quickly as they could and zipped it up, knowing
full well that the body still had multiple bees covering it,
and they at least let us know that there was
(02:37):
bees in the body bag, so we were prepared when
we opened it for what was going to happen. The
plan was made to take the body to an outside
covered porcherry where the public couldn't see it, and then
the body bag was unzipped. The bees, initially, being cold,
were a little sluggish, but as they warmed up, they
flew away and we gave them several minutes to clear
out by doing this. By the time the body was
(02:59):
brought back in, all the living bees were gone and
none of the autopsy technicians or doctors were stung. Usually
its insects, but sometimes it can be something else. An
example of this is another case that came in from
the woods. It wasn't my case, it was another doctor's,
but I worked across from him, so I had a
front row seat to the spectacle that occurred. There was
(03:20):
a case of a young person who had gone out
into the woods and shot himself in the head. When
his body was recovered, he was fully closed, placed in
a body bag, and brought into the morgue. He stayed
overnight before his autopsy was done, and he had been
in the cooler. Of course, next morning, when they took
the body out to do the autopsy, they opened the
body bag and began taking his clothes off, and when
they were pulling his pants off, a snake crawled out
(03:41):
of a pants leg. It was about twenty inches long,
and it caused quite a calamity. Several people panicked and
began running when they saw the snake crawling across the
autopsy table. The doctor in charge of the case kept
as cool and he quickly recognized that it was not
a poisonous snake, but just a garter snake based on
the markings. He grabbed it by the head and held
it up in the air and told one of the
(04:02):
autopsy technicians to bring over one of the trash cans,
and they put it into the trash can. The snake
was still moving a little sluggishly because it was cold,
and it was decided to put the snake in a
box and one of the autopsy technicians volunteered to take
the snake to a safe location. He took it to
one of the local parks and released it, so the
snake was not harmed. Of course, Maggot's beetles and flies
(04:24):
are common companions with the decomposed bodies, but they really
aren't hazardous, and we'll be talking about those in other episodes. Parasites,
on the other hand, sometimes come in with the bodies,
and the main ones are lice and bedbugs. They usually
come in with individuals who are homeless, and they so
heavily populate the bodies that you can see them even
(04:45):
though they are as small as a grain of sand,
moving about the hair and about the skin surface. The
problem with these parasites are their old host is now
dead and they're looking for a new one, and that
new one could be you. One of my colleagues had
an other unfortunate in the counter with lice. It occurred
when she was doing an autopsy on a homeless individual
who had a severe case of lice. You could see
(05:08):
the lice in his hair all across his body. It
was literally everywhere. He actually died from chronic alcoholism, but
an autopsy still had to be done, and when she
was doing the autopsy, the lice were falling off the
gurney onto the floor. Her PPE protected her for the
most part, but she had cuffed her pants, so her
pants were actually filling up with lice in the cuffs.
(05:31):
When she completed the autopsy, she removed her PPE and
then went to go change. But for whatever reason, she
used to always change in her office, so when she
changed out of her scrubs in her office, she threw
them in a pile in the corner. The lice were,
of course still there and still alive and looking for
a new host. When she got done for the day,
she gathered up her dirty scrubs and took him home
(05:53):
to be washed and threw them in her laundry basket
at home, with the lice still there looking for a
new host. I now got out in her office. They
got out in her home and began infesting these areas.
They eventually got on her and she developed a severe
case of head lice, but so did her husband, who
did not work at the medical examiner's office. They had
(06:15):
a severe lice outbreak at their home and they had
to call an exterminator to eradicate it. But she also
had a severe lice outbreak in her office that was
also beginning to infect the rest of the office, and
the county had to call out exterminators to eradicate this.
They determined the source of the lice was from her
and her cuffed pants, and she was told by the
(06:36):
chief medical Examiner to never cuff her pants again and
to change in the locker room. Now, of course, there
still would have been in a lice infestation no matter
where she changed, but they felt it would have been
easier to eradicate if she had been in the locker room.
Her husband also told her to not bring her clothes
home to be washed anymore, and to have them washed
at work. And he was incredibly upset by all of
(06:58):
this because he kept saying those came from dead people,
and now they're on me. Of course, she began changing
in her locker room instead of her office, and she
never got lice again, nor did I, so Lesson learned
on that one. Other hazards that can come in with
the bodies include guns, unexploded ordinance like fireworks or bombs,
(07:19):
and we usually spot these on X rays. And these
ones are easy because when you find them, they don't
go off. You just call the police. And they'll send
the bomb squad if necessary, and they'll take the ordinance
or weapon into evidence and handle it themselves. Now that
all of these surface hazards have been discussed, there are
six additional hazards associated with autopsies, and these are mechanical,
(07:44):
sharp force, electrical, chemical, radiation, and infection hazards. We combat
the majority of these issues by wearing personal protective equipment
or PPE, which includes a scrub cap or some other
head covering. The cover your hair because you don't want
your hair into the body cavity or stuff getting on
your hair, eye protection, a surgical mask, a surgical gown
(08:07):
which is usually plastic, and surgical gloves. I always wear
two pairs of gloves because I have found you can't
always trust the gloves you're given, and that's because counties
usually trying to save money. We'll get the medical examiners
old surplus stock from different areas, and those gloves can
often when you open them, be rotten and rip or
fall apart when you put them on, and then you're
(08:29):
wearing defective gloves and putting your hands in bodily fluids
or blood, and you don't want to get that on
your skin. And that's why I always wear two pairs,
because it increased the odds that you don't have two
pairs of defective gloves on. Although sometimes it does happen.
Occasionally offices try to order cheaper PPE or the wrong
things get ordered. There was one time I was given
a surgical gown that was actually water resistant and not
(08:52):
water repellent. And that's a problem because it's not water
that I'm worried about, it's the blood. And I spend
the whole day wearing the surgical games not thinking much
of it. And when I got done the blood it
actually soaked through the gown, through my pants and was
coating my legs the entire day for six hours. And
when I cleaned the blood off of my skin, I
(09:13):
actually had a rash from the blood, and that did
not make me happy. I made sure to complain about that,
and I never got those gowns again. PPE can help
prevent the majority of these hazards, but it does not
always completely stop them, and there are some of the
hazards that the PPE can't prevent at all. Out of
all these six potential hazards, I have experienced all of
(09:36):
them in some sort of form or fashion, and out
of all these incidences, I have only had two times
in which there were major consequences. Now, those two times
were associated with chemical and infectious hazards, and will discuss
those in the subsequent episode. Today, we'll take a tour
through some of my more memorable injuries that I or
my colleagues have experienced with the other hazards. Will start
(09:59):
with mechanical HAPs Usually mechanical hazards are associated with the
weight of the bodies themselves or the equipment we work with.
But the main injuries I've seen is from dealing with
the morbily obese. These bodies can be incredibly heavy and
difficult to lift, and we have to lift them onto
head blocks to do the autopsies. Usually lifting these cause
back injuries. I suffer from these back injries from all
(10:22):
the lifting of bodies that I have done over the years.
I know many of my colleagues have back injuries as well.
The other problem is is we have to look at
the back doing the autopsy, so the body has to
be rolled onto its side, and rolling a morbidly obese
person onto their side can be difficult because of the weight.
I was working with one autopsy technician once and we
(10:42):
were trying to lift a morbidly obese person onto their
side when I heard the sickening snap of her wrist.
As soon as I heard that sound, she screamed in
pain and let go of the body and it slammed
back onto the gurney. She had to be taken to
the emergency room. Her wrist was broken in multiple places
from just the sheer weight of trying to lift the
body up. This became a career ending injury for her
(11:03):
and she never returned back to work and subsequently found
another job in the county. Another problem with rolling the
morbidly obese on their side, it can actually destabilize the
gurney and cause the gurney to tip, and I've seen
people lose control of a body because the gurney tipping,
and then the gurney and the morbidly obese person falls
on the individual on the other side. And I've seen
(11:24):
injuries caused by that as well, but nothing so severe
the person couldn't come back to work. Gurney malfunctions as
another one that causes significant injuries. The worst one I
ever saw was when a wheel fell off one of
the gurneys. On an individual who is morbidly obese. The
technician that was moving that body at that time tried
to catch the gurney from falling, and when she did that,
(11:45):
it caused her to have a rupture of her lumbar spine.
She collapsed, the body fell off the gurney, and she
had to be taken to the emergency room. She was
found to have a ruptured disc in her lumbar spine
that was now causing her severe pain, and she ended
up having to have surgery and she also never returned
to work. You can also have crush injuries from gurnies
(12:06):
from people not paying attention when they're wheeling the gurney
and pinch their hand against a wall or pinch someone
else's hand against something, and that can cause fractures as well.
Another common cause of mechanical injury is slipping on the floor.
A lot of things during autopsies makes the floor slick.
It can be from water from cleaning the floor, but
(12:26):
it also can be from blood, crushed organs that were
dropped on the floor, and the worst one decompositional fluid.
When the body decomposes, the subcutaneous fat breaks down and
forms a slippery oil that then gets all over the
floor and makes things incredibly slippery. And if you're not
paying attention, you can slip on this and you can
get an ankle sprain or fall and get a back
(12:48):
injury or break your arm. And of course there's repetitive
strain injuries from the constant cutting, and the list goes
on and on. With mechanical injuries X we'll talk about
sharp forse injuries can be caused by a number of
different things. You can have knives that come in with
the bodies or found in coat pockets or pants pockets.
Scalpels or scalpel blades are left by the hospital, or
(13:09):
ems can be on the body or in the body bag.
Motor vehicle accidents can cause sharp pieces of metal or
parts of the car to come in that can be
very dangerous. And of course glass glass can come in
in big pieces, dice cubes, or a fine powdery dust.
In this glass powder, it looks like a white dust
on the body, but it's actually fine little glass shards
(13:32):
that can still go right through your glove and embed
into your skin. Needles are another hazard. They can be
left by ems or medical personnel, but they can also
be found with drug users. They can still be stuck
in the arm or stuck in pockets. Gotta be careful
searching those pockets. The problem with the needles that come
in with drug abusers is they can be attached to
a syringe that can still have a deadly drug in
(13:54):
it that you don't want poking you. Another problem with
needles is is we use needles to draw fluid from
the body, and when you're putting those into a specimen container,
you always have to be careful not to make a
mistake and poke yourself. I did this one time when
I drew bial from a case and was putting it
into the test tube, and I missed the test tube
and poked myself, accidentally injecting bile into my thumb. Now
(14:17):
I'll tell you this right now, bile really burns. But
fortunately the individual I got the bile from was an
older woman who was in a church bus going to
a retreat when they were struck by a semi truck. Thankfully,
she did not have any diseases, so I dodged a
bullet on that one. Bullets can also cause sharp force injuries,
in particular hollowpoint bullets. They're dangerous because When these type
(14:39):
of bullets hit tissue, they fan out and form pedals,
and these petals can be very sharp, depending on the
brand of the bullet, and when you're trying to dig
them out of muscle, bone, or tissue or whatever, these
petals can puncture or rip your glove and cut your
skin as well. Of course, you can always cut yourself
with a scalpel or be cut by the autopsy technician
working with you. I have a rule that I learned
(15:01):
long ago, and that is one set of hands in
the body at all times. This cuts down on the
slashes or being poked by the other person working with you.
I have, of course cut people, and I've been cut
by others not following this rule. And really the most
dangerous moment of the autopsy, if you're working together and
not paying attention, is when you're doing the y incision.
I've seen people be slash during that more often than not.
(15:24):
The worst, sharp, worse injury that I ever received was
when I was attempting to expose the skull in a
decomposed individual. I had just made the incision on the
scalp and was pulling the scalpskin forward to expose the
skull the decomposition fluid. It made my hands very slippery,
and my one hand slipped off, but I was holding
(15:45):
a scalpel in that hand, and when it slipped, my
hand went to the side and the scalpel stabbed my
other hand in the palm. The scalpel perforated my skin
and went deep into the muscle of my palm. The
stab wound hurt, of course, but what hurt worst was
the burning sensation created by the decompositional fluid. Problem with
this case was the individual who was murdered was actually
(16:07):
a sex worker, so who knows what she had on
board as far as infectious diseases. I quickly flushed out
the wound, washed my hands, evaluated it for stitches, which
I didn't need, put a band aid on it, and
put my gloves back on, and I went back to
work because I had more cases to get done that
day and I just couldn't stop. Luckily, the patient tests
(16:27):
the negative for all diseases, so once again I had
dodged another bullet. Broken bones are another hazard for sharp
force injuries, and the problem with them is they may
be hiding covered in blood or tissue or clothing and
you're not paying attention, and bones will rip right through
your ppe, puncture gloves, and puncture your skin. There was
one time I was working on a case that had
(16:48):
multiple rib fractures, and rib fractures are the worse because
there's so many ribs and so many different angles, and
they can be incredibly sharp. And the autopsy technician was
rolling the body so I could see something on the
back when one of these broken ribs hooked my leather apron,
tore right through it, right through my surgical gown and
my scrubs, and almost punctured my skin. I felt the
(17:09):
rib going through my PPE and clothing and jump backwards,
but I was still hooked to it. I had to
manually pull it off to get free from the rib.
It did leave a red mark on my skin, but
it didn't puncture me, so again a very close call.
The next hazard is electrical. It's not very common. Of course,
we're using electrical equipment with the autopsy saws, and we're
(17:31):
around water. I have never really had an instance of
someone being shocked or electrocuted from their autopsy saw. One
of the things is the autopsy station have GFI circuits,
so if that was to occur, it would trip. The
one thing I have seen with electrical is pacemakers. You
have to be very careful because even though the individual
has dyed, that pacemaker is still active and if you
(17:52):
cut the wires and they cross, it will begin sparking,
which I have seen. We're always very careful with pacemakers,
and we rub a magnet over them if we know
they're there, and this usually deactivates them and makes them safe.
Next is radiation. It's not very common. Occasionally an individual
has implanted radiation pellets for chemotherapy for prostate cancer, but
(18:13):
this is usually a low level radiation that really isn't
a problem for us. The one thing with radiation that
we have the most exposure from is all the X
rays we do. We do a lot of X rays.
These X rays are for looking for broken bones, bullets, needles,
all sorts of things that may be with the body
or may show evidence of injury, and we wear radiation
badges to make sure we're not getting exposed to too
(18:35):
much radiation. When I first started working, we had what
was called fluoroscopy, which is basically a real time X
ray where you can actually see movement. We would use
this for when we had difficult bullets to recover in
the body, and you would stand in there while they
were running the fluoroscopy. You could see the bones of
your hand on the monitor moving through the body cavity
(18:57):
trying to get to that bullet. If we couldn't reach
tave it at that time, we would place something in
there marking where the bullet was and take the body
back out and remove the bullet in the autopsy room.
But the thing was, you were standing in there for
several minutes just being x rayed the entire time. Phluoroscopy
wasn't all that safe. You could, of course, protect yourself
by wearing a lead line apron as well as a
(19:19):
lead line neckcuff to protect your thyroid, but people will
get a little lazy with that and not always wear them,
and that's kind of it for radiation. So we'll stop
there and discuss infectious hazards and chemical hazards in the
next episodes. And that brings us to the end of
the episode. I hope you learned something like the dead
(19:41):
are always dangerous, and I hope you were entertained until
the next time.
Today's episode includes information about the deaths of individuals and
environmental hazards. If this sort of thing upsets you, you
may want to consider reading a book. May I recommend
The Grapes of Wrath.
Speaker 2 (00:13):
Well, you may have an immorial with your host, Doctor
kinder Crown.
Speaker 1 (00:24):
Today's episode Exposure Part one, Cuts and Bruises. Today's episode
is the first episode of four in which I will
be talking about the hazards associated with autopsies. So let's
get started. After nearly forty years of working around dead
bodies as an autopsy technician and a medical examiner, there's
(00:45):
one important principle that I've learned, and that is the
dead are still dangerous. You never know what you will
find when you open up the body. Back before you
even get started with the autopsy, there are hazards and
those are the hazards that come in with the body,
and it depends on how and where the person died.
When people are found outside in the woods or someplace
(01:07):
like that, a myriad of poisonous insects might find their
way onto the body. Things like spiders or scorpions may
get into the body or body cavities and get onto
the clothing and you don't want them on you. Thankfully,
the cold temperatures are cooler slow them down, so when
you first open the body bag, you have a few
minutes to find them and dispose of them before they
(01:29):
wake up and start moving around. Many of the autopsy
technicians that I've worked with have a soft spot for
spiders and will catch them in specimen containers and release
them outside instead of squashing them. Other hazardous insects are bees, wasps,
or yellow jackets. Anytime they are involved, it can be
very hazardous because they're angry and they liked to sting.
(01:52):
For example, there was a case of a hobbyist beekeeper
who had a hard attack while tending his bees. He
collapsed into the beehive and they swarmed him. One of
the neighbors saw what had happened. They called nine to
one one and when the paramedics arrived and tried to
get to him, they were stung multiple times. Once they
got to him, they were able to determine that he
was dead and they contacted the Medical Examiner's office. The
(02:15):
death investigator arrived and while they were conducting their death investigation,
they were stung. They called body Transport Service and when
they arrived to try and retrieve the body, they were
also stung. They placed the body in the body bag
as quickly as they could and zipped it up, knowing
full well that the body still had multiple bees covering it,
and they at least let us know that there was
(02:37):
bees in the body bag, so we were prepared when
we opened it for what was going to happen. The
plan was made to take the body to an outside
covered porcherry where the public couldn't see it, and then
the body bag was unzipped. The bees, initially, being cold,
were a little sluggish, but as they warmed up, they
flew away and we gave them several minutes to clear
out by doing this. By the time the body was
(02:59):
brought back in, all the living bees were gone and
none of the autopsy technicians or doctors were stung. Usually
its insects, but sometimes it can be something else. An
example of this is another case that came in from
the woods. It wasn't my case, it was another doctor's,
but I worked across from him, so I had a
front row seat to the spectacle that occurred. There was
(03:20):
a case of a young person who had gone out
into the woods and shot himself in the head. When
his body was recovered, he was fully closed, placed in
a body bag, and brought into the morgue. He stayed
overnight before his autopsy was done, and he had been
in the cooler. Of course, next morning, when they took
the body out to do the autopsy, they opened the
body bag and began taking his clothes off, and when
they were pulling his pants off, a snake crawled out
(03:41):
of a pants leg. It was about twenty inches long,
and it caused quite a calamity. Several people panicked and
began running when they saw the snake crawling across the
autopsy table. The doctor in charge of the case kept
as cool and he quickly recognized that it was not
a poisonous snake, but just a garter snake based on
the markings. He grabbed it by the head and held
it up in the air and told one of the
(04:02):
autopsy technicians to bring over one of the trash cans,
and they put it into the trash can. The snake
was still moving a little sluggishly because it was cold,
and it was decided to put the snake in a
box and one of the autopsy technicians volunteered to take
the snake to a safe location. He took it to
one of the local parks and released it, so the
snake was not harmed. Of course, Maggot's beetles and flies
(04:24):
are common companions with the decomposed bodies, but they really
aren't hazardous, and we'll be talking about those in other episodes. Parasites,
on the other hand, sometimes come in with the bodies,
and the main ones are lice and bedbugs. They usually
come in with individuals who are homeless, and they so
heavily populate the bodies that you can see them even
(04:45):
though they are as small as a grain of sand,
moving about the hair and about the skin surface. The
problem with these parasites are their old host is now
dead and they're looking for a new one, and that
new one could be you. One of my colleagues had
an other unfortunate in the counter with lice. It occurred
when she was doing an autopsy on a homeless individual
who had a severe case of lice. You could see
(05:08):
the lice in his hair all across his body. It
was literally everywhere. He actually died from chronic alcoholism, but
an autopsy still had to be done, and when she
was doing the autopsy, the lice were falling off the
gurney onto the floor. Her PPE protected her for the
most part, but she had cuffed her pants, so her
pants were actually filling up with lice in the cuffs.
(05:31):
When she completed the autopsy, she removed her PPE and
then went to go change. But for whatever reason, she
used to always change in her office, so when she
changed out of her scrubs in her office, she threw
them in a pile in the corner. The lice were,
of course still there and still alive and looking for
a new host. When she got done for the day,
she gathered up her dirty scrubs and took him home
(05:53):
to be washed and threw them in her laundry basket
at home, with the lice still there looking for a
new host. I now got out in her office. They
got out in her home and began infesting these areas.
They eventually got on her and she developed a severe
case of head lice, but so did her husband, who
did not work at the medical examiner's office. They had
(06:15):
a severe lice outbreak at their home and they had
to call an exterminator to eradicate it. But she also
had a severe lice outbreak in her office that was
also beginning to infect the rest of the office, and
the county had to call out exterminators to eradicate this.
They determined the source of the lice was from her
and her cuffed pants, and she was told by the
(06:36):
chief medical Examiner to never cuff her pants again and
to change in the locker room. Now, of course, there
still would have been in a lice infestation no matter
where she changed, but they felt it would have been
easier to eradicate if she had been in the locker room.
Her husband also told her to not bring her clothes
home to be washed anymore, and to have them washed
at work. And he was incredibly upset by all of
(06:58):
this because he kept saying those came from dead people,
and now they're on me. Of course, she began changing
in her locker room instead of her office, and she
never got lice again, nor did I, so Lesson learned
on that one. Other hazards that can come in with
the bodies include guns, unexploded ordinance like fireworks or bombs,
(07:19):
and we usually spot these on X rays. And these
ones are easy because when you find them, they don't
go off. You just call the police. And they'll send
the bomb squad if necessary, and they'll take the ordinance
or weapon into evidence and handle it themselves. Now that
all of these surface hazards have been discussed, there are
six additional hazards associated with autopsies, and these are mechanical,
(07:44):
sharp force, electrical, chemical, radiation, and infection hazards. We combat
the majority of these issues by wearing personal protective equipment
or PPE, which includes a scrub cap or some other
head covering. The cover your hair because you don't want
your hair into the body cavity or stuff getting on
your hair, eye protection, a surgical mask, a surgical gown
(08:07):
which is usually plastic, and surgical gloves. I always wear
two pairs of gloves because I have found you can't
always trust the gloves you're given, and that's because counties
usually trying to save money. We'll get the medical examiners
old surplus stock from different areas, and those gloves can
often when you open them, be rotten and rip or
fall apart when you put them on, and then you're
(08:29):
wearing defective gloves and putting your hands in bodily fluids
or blood, and you don't want to get that on
your skin. And that's why I always wear two pairs,
because it increased the odds that you don't have two
pairs of defective gloves on. Although sometimes it does happen.
Occasionally offices try to order cheaper PPE or the wrong
things get ordered. There was one time I was given
a surgical gown that was actually water resistant and not
(08:52):
water repellent. And that's a problem because it's not water
that I'm worried about, it's the blood. And I spend
the whole day wearing the surgical games not thinking much
of it. And when I got done the blood it
actually soaked through the gown, through my pants and was
coating my legs the entire day for six hours. And
when I cleaned the blood off of my skin, I
(09:13):
actually had a rash from the blood, and that did
not make me happy. I made sure to complain about that,
and I never got those gowns again. PPE can help
prevent the majority of these hazards, but it does not
always completely stop them, and there are some of the
hazards that the PPE can't prevent at all. Out of
all these six potential hazards, I have experienced all of
(09:36):
them in some sort of form or fashion, and out
of all these incidences, I have only had two times
in which there were major consequences. Now, those two times
were associated with chemical and infectious hazards, and will discuss
those in the subsequent episode. Today, we'll take a tour
through some of my more memorable injuries that I or
my colleagues have experienced with the other hazards. Will start
(09:59):
with mechanical HAPs Usually mechanical hazards are associated with the
weight of the bodies themselves or the equipment we work with.
But the main injuries I've seen is from dealing with
the morbily obese. These bodies can be incredibly heavy and
difficult to lift, and we have to lift them onto
head blocks to do the autopsies. Usually lifting these cause
back injuries. I suffer from these back injries from all
(10:22):
the lifting of bodies that I have done over the years.
I know many of my colleagues have back injuries as well.
The other problem is is we have to look at
the back doing the autopsy, so the body has to
be rolled onto its side, and rolling a morbidly obese
person onto their side can be difficult because of the weight.
I was working with one autopsy technician once and we
(10:42):
were trying to lift a morbidly obese person onto their
side when I heard the sickening snap of her wrist.
As soon as I heard that sound, she screamed in
pain and let go of the body and it slammed
back onto the gurney. She had to be taken to
the emergency room. Her wrist was broken in multiple places
from just the sheer weight of trying to lift the
body up. This became a career ending injury for her
(11:03):
and she never returned back to work and subsequently found
another job in the county. Another problem with rolling the
morbidly obese on their side, it can actually destabilize the
gurney and cause the gurney to tip, and I've seen
people lose control of a body because the gurney tipping,
and then the gurney and the morbidly obese person falls
on the individual on the other side. And I've seen
(11:24):
injuries caused by that as well, but nothing so severe
the person couldn't come back to work. Gurney malfunctions as
another one that causes significant injuries. The worst one I
ever saw was when a wheel fell off one of
the gurneys. On an individual who is morbidly obese. The
technician that was moving that body at that time tried
to catch the gurney from falling, and when she did that,
(11:45):
it caused her to have a rupture of her lumbar spine.
She collapsed, the body fell off the gurney, and she
had to be taken to the emergency room. She was
found to have a ruptured disc in her lumbar spine
that was now causing her severe pain, and she ended
up having to have surgery and she also never returned
to work. You can also have crush injuries from gurnies
(12:06):
from people not paying attention when they're wheeling the gurney
and pinch their hand against a wall or pinch someone
else's hand against something, and that can cause fractures as well.
Another common cause of mechanical injury is slipping on the floor.
A lot of things during autopsies makes the floor slick.
It can be from water from cleaning the floor, but
(12:26):
it also can be from blood, crushed organs that were
dropped on the floor, and the worst one decompositional fluid.
When the body decomposes, the subcutaneous fat breaks down and
forms a slippery oil that then gets all over the
floor and makes things incredibly slippery. And if you're not
paying attention, you can slip on this and you can
get an ankle sprain or fall and get a back
(12:48):
injury or break your arm. And of course there's repetitive
strain injuries from the constant cutting, and the list goes
on and on. With mechanical injuries X we'll talk about
sharp forse injuries can be caused by a number of
different things. You can have knives that come in with
the bodies or found in coat pockets or pants pockets.
Scalpels or scalpel blades are left by the hospital, or
(13:09):
ems can be on the body or in the body bag.
Motor vehicle accidents can cause sharp pieces of metal or
parts of the car to come in that can be
very dangerous. And of course glass glass can come in
in big pieces, dice cubes, or a fine powdery dust.
In this glass powder, it looks like a white dust
on the body, but it's actually fine little glass shards
(13:32):
that can still go right through your glove and embed
into your skin. Needles are another hazard. They can be
left by ems or medical personnel, but they can also
be found with drug users. They can still be stuck
in the arm or stuck in pockets. Gotta be careful
searching those pockets. The problem with the needles that come
in with drug abusers is they can be attached to
a syringe that can still have a deadly drug in
(13:54):
it that you don't want poking you. Another problem with
needles is is we use needles to draw fluid from
the body, and when you're putting those into a specimen container,
you always have to be careful not to make a
mistake and poke yourself. I did this one time when
I drew bial from a case and was putting it
into the test tube, and I missed the test tube
and poked myself, accidentally injecting bile into my thumb. Now
(14:17):
I'll tell you this right now, bile really burns. But
fortunately the individual I got the bile from was an
older woman who was in a church bus going to
a retreat when they were struck by a semi truck. Thankfully,
she did not have any diseases, so I dodged a
bullet on that one. Bullets can also cause sharp force injuries,
in particular hollowpoint bullets. They're dangerous because When these type
(14:39):
of bullets hit tissue, they fan out and form pedals,
and these petals can be very sharp, depending on the
brand of the bullet, and when you're trying to dig
them out of muscle, bone, or tissue or whatever, these
petals can puncture or rip your glove and cut your
skin as well. Of course, you can always cut yourself
with a scalpel or be cut by the autopsy technician
working with you. I have a rule that I learned
(15:01):
long ago, and that is one set of hands in
the body at all times. This cuts down on the
slashes or being poked by the other person working with you.
I have, of course cut people, and I've been cut
by others not following this rule. And really the most
dangerous moment of the autopsy, if you're working together and
not paying attention, is when you're doing the y incision.
I've seen people be slash during that more often than not.
(15:24):
The worst, sharp, worse injury that I ever received was
when I was attempting to expose the skull in a
decomposed individual. I had just made the incision on the
scalp and was pulling the scalpskin forward to expose the
skull the decomposition fluid. It made my hands very slippery,
and my one hand slipped off, but I was holding
(15:45):
a scalpel in that hand, and when it slipped, my
hand went to the side and the scalpel stabbed my
other hand in the palm. The scalpel perforated my skin
and went deep into the muscle of my palm. The
stab wound hurt, of course, but what hurt worst was
the burning sensation created by the decompositional fluid. Problem with
this case was the individual who was murdered was actually
(16:07):
a sex worker, so who knows what she had on
board as far as infectious diseases. I quickly flushed out
the wound, washed my hands, evaluated it for stitches, which
I didn't need, put a band aid on it, and
put my gloves back on, and I went back to
work because I had more cases to get done that
day and I just couldn't stop. Luckily, the patient tests
(16:27):
the negative for all diseases, so once again I had
dodged another bullet. Broken bones are another hazard for sharp
force injuries, and the problem with them is they may
be hiding covered in blood or tissue or clothing and
you're not paying attention, and bones will rip right through
your ppe, puncture gloves, and puncture your skin. There was
one time I was working on a case that had
(16:48):
multiple rib fractures, and rib fractures are the worse because
there's so many ribs and so many different angles, and
they can be incredibly sharp. And the autopsy technician was
rolling the body so I could see something on the
back when one of these broken ribs hooked my leather apron,
tore right through it, right through my surgical gown and
my scrubs, and almost punctured my skin. I felt the
(17:09):
rib going through my PPE and clothing and jump backwards,
but I was still hooked to it. I had to
manually pull it off to get free from the rib.
It did leave a red mark on my skin, but
it didn't puncture me, so again a very close call.
The next hazard is electrical. It's not very common. Of course,
we're using electrical equipment with the autopsy saws, and we're
(17:31):
around water. I have never really had an instance of
someone being shocked or electrocuted from their autopsy saw. One
of the things is the autopsy station have GFI circuits,
so if that was to occur, it would trip. The
one thing I have seen with electrical is pacemakers. You
have to be very careful because even though the individual
has dyed, that pacemaker is still active and if you
(17:52):
cut the wires and they cross, it will begin sparking,
which I have seen. We're always very careful with pacemakers,
and we rub a magnet over them if we know
they're there, and this usually deactivates them and makes them safe.
Next is radiation. It's not very common. Occasionally an individual
has implanted radiation pellets for chemotherapy for prostate cancer, but
(18:13):
this is usually a low level radiation that really isn't
a problem for us. The one thing with radiation that
we have the most exposure from is all the X
rays we do. We do a lot of X rays.
These X rays are for looking for broken bones, bullets, needles,
all sorts of things that may be with the body
or may show evidence of injury, and we wear radiation
badges to make sure we're not getting exposed to too
(18:35):
much radiation. When I first started working, we had what
was called fluoroscopy, which is basically a real time X
ray where you can actually see movement. We would use
this for when we had difficult bullets to recover in
the body, and you would stand in there while they
were running the fluoroscopy. You could see the bones of
your hand on the monitor moving through the body cavity
(18:57):
trying to get to that bullet. If we couldn't reach
tave it at that time, we would place something in
there marking where the bullet was and take the body
back out and remove the bullet in the autopsy room.
But the thing was, you were standing in there for
several minutes just being x rayed the entire time. Phluoroscopy
wasn't all that safe. You could, of course, protect yourself
by wearing a lead line apron as well as a
(19:19):
lead line neckcuff to protect your thyroid, but people will
get a little lazy with that and not always wear them,
and that's kind of it for radiation. So we'll stop
there and discuss infectious hazards and chemical hazards in the
next episodes. And that brings us to the end of
the episode. I hope you learned something like the dead
(19:41):
are always dangerous, and I hope you were entertained until
the next time.
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