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Forensic Radiology: Response to the Pentagon Attack on September 11, 2001
Forensic Radiology: Response to the Pentagon Attack on September 11, 2001
The U.S. military has a time-honored commitment to its members and their families to recover those killed in service, identify their remains properly, and prepare them for appropriate honors and interment. The continued efforts to find those missing from the war in Vietnam and the recent identification of a serviceman from that conflict who was buried in the Tomb of the Unknowns at Arlington National Cemetery are evidence of this obligation (1). Following the September 11 attack on the Pentagon, as search and rescue efforts began, the process of recovery and identification of those who did not survive was also initiated. Forensic radiology was a key component in the system of casualty identification at the Port Mortuary, Dover Air Force Base, Del. Here, the Office of the Armed Forces Medical Examiner, augmented by a support group of more than 200 military and federal personnel representing all services and many agencies, undertook the identification of remains and forensic investigation of the deaths that occurred at the Pentagon. The military faced a situation unlike past experiences in war and peacetime accidents: a mass-casualty scenario, involvement of military and civilians, and the inclusion of terrorists among civilian casualties.
Radiographic analysis of the remains from this event was a crucial step in the identification of victims and the investigation of the crime scene. The Department of Radiologic Pathology at the Armed Forces Institute of Pathology, or AFIP, performed this step with support from the Diagnostic Imaging Department of the Dover Air Force Base Medical Clinic. Because of the extraordinary scope of the mass-casualty scenario created by the Pentagon attack, an additional radiologist and military technologists from two reserve components supported the mission. This staff operated up to 12 hours per day, 7 days per week, as required by the volume of recovered remains.
The mortuary has two radiographic rooms equipped with fixed overhead tubes. A daylight film-processing system arrived on the 2nd day of operation to replace a darkroom system. This system greatly reduced the time required to move specimens through the radiographic station. On review of the radiographs, the radiologist completed a report consisting of handwritten notations on a form that showed a schematic skeleton. The comments were brief and were designed to assist those performing other steps in the identification and investigation process, such as forensic dentistry, autopsy, and anthropologic assessment. The report and radiographs traveled with the specimen, and it was easy for professionals at other stations to compare their observations with the report and seek out the radiologist who completed the report for consultation and discussion.
Human remains that are recovered from a disaster site are highly variable in form and condition. Recovered bodies may have been subjected to extreme physical and thermal trauma. Casualties may result from crash impact, building collapse, or associated fire and smoke. The intense heat of burning fuel in aircraft accidents severely burns tissue, clothing, and furnishings. The process of recovery from beneath fallen rubble further alters tissues (2). Consequently, specimens ranging from relatively intact bodies to small body-part fragments were received from the Pentagon site. Whole-body radiography is one step in processing remains received at the military mortuary. In many cases, the whole-body radiograph established whether body parts, personal effects, or other materials were present in the specimen. The forensic radiologist reported all identifiable human structures and substantial objects recognized, along with comments on the condition of each. For example, we commented on the presence of fractures, the absence of anatomically contiguous body parts, and the presence of jewelry and/or personal effects. Also noted were distinguishing features that may aid in establishing the age of the victim (eg, the presence of skeletally immature bones or osteoarthritis in a knee) and identifying military personnel (eg, the presence of military insignia). The forensic dental team benefited from the discovery of teeth on a radiograph when they may not have been noted previously at gross inspection of the specimen. Since the event was known to be the result of a terrorist action, the radiologist also searched for any clues, such as weapons or aircraft parts, that might lead to a better understanding of the attack.
Published: October 14, 2007
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