RFP N 2016-094 A 1 C O (A -I S M E T C - Tarrant County

MEDICAL EXAMINER

RFP NUMBER 2016-094 APPENDIX 1 CURRENT OPERATIONS (AS-IS) LIMS SELECTION ? MEDICAL EXAMINER TARRANT COUNTY

Version 2.0 February 10, 2016

RFP 2016-094 LIMS Selection ? Medical Examiner - Appendix 1 As-Is Workflows Version 2.0

Table of Contents

1. INTRODUCTION........................................................................................................................................................ 8

2. GLOSSARY AND ACRONYMS .................................................................................................................................... 8

3. OVERVIEW ..............................................................................................................................................................11

4. CHAIN OF CUSTODY TRANSFERS .............................................................................................................................14

5. RECEIVE AND PROCESS ME CASES...........................................................................................................................16

5.1. CASE ASSIGNMENT..................................................................................................................................................... 16 5.1.1. Jurisdictional and Non-Jurisdictional Case Intake ........................................................................................ 16 5.1.2. Jurisdiction Terminated Case Intake............................................................................................................. 17

5.2. BODY, EVIDENCE AND PROPERTY HANDLING ................................................................................................................... 19 5.2.1. Body Intake .................................................................................................................................................. 20 5.2.2. Item Handling............................................................................................................................................... 21

5.3. REPORTS .................................................................................................................................................................. 21 5.3.1. Morning Mortality Report ............................................................................................................................ 22 5.3.2. Critical Case Review ..................................................................................................................................... 22

6. MORGUE OPERATIONS ...........................................................................................................................................23

6.1. CASE ASSIGNMENT..................................................................................................................................................... 24 6.2. AUTOPSY AND SPECIMEN COLLECTION ........................................................................................................................... 24 6.3. AUTOPSY EVIDENCE COLLECTION .................................................................................................................................. 25 6.4. COMPLETED EXAM..................................................................................................................................................... 26

7. HUMAN ID ..............................................................................................................................................................28

7.1. CASE ASSIGNMENTS ................................................................................................................................................... 29 7.2. FINGERPRINT IDENTIFICATION....................................................................................................................................... 29 7.3. FORENSIC ANTHROPOLOGY .......................................................................................................................................... 31

7.3.1. Examination of Skeletal Remains ................................................................................................................. 32 7.3.2. Examination of the Larynx............................................................................................................................ 37 7.3.3. Radiographic Comparisons........................................................................................................................... 37 7.3.4. Examination of Animal Bones ...................................................................................................................... 39 7.3.5. Field Recovery Work ..................................................................................................................................... 40 7.3.6. Statistical Reporting ..................................................................................................................................... 40 7.4. DNA ANALYSIS ......................................................................................................................................................... 40 7.5. FORENSIC ODONTOLOGY ............................................................................................................................................. 41 7.6. ID CERTIFICATES ........................................................................................................................................................ 43

8. HISTOLOGY .............................................................................................................................................................44

8.1. PRODUCTION OF SLIDES AND BLOCKS............................................................................................................................. 44 8.2. REQUESTS FROM THE DISTRICT ATTORNEY (DA) AND OTHERS ............................................................................................ 47

9. RECEIVE AND TRANSFER EVIDENCE.........................................................................................................................50

10. ANALYZE AND EXAMINE EVIDENCE.....................................................................................................................51

10.1. CRIME LABORATORY................................................................................................................................................... 51 10.1.1. Trace Evidence.............................................................................................................................................. 51 10.1.1.1. Evidence Receiving .................................................................................................................................................... 52 10.1.1.2. Trace Evidence Recovery........................................................................................................................................... 52 10.1.1.3. Gunshot Residue (GSR) Testing and Analysis ............................................................................................................ 54 10.1.1.4. Hair Examination ....................................................................................................................................................... 56

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RFP 2016-094 LIMS Selection ? Medical Examiner - Appendix 1

As-Is Workflows

Version 2.0

10.1.2. Forensic Biology ........................................................................................................................................... 58 10.1.2.1. Case Assignment ....................................................................................................................................................... 58 10.1.2.2. Serology..................................................................................................................................................................... 61 10.1.2.3. DNA Testing............................................................................................................................................................... 64 10.1.2.4. Reporting, Technical and Administrative Reviews .................................................................................................... 72 10.1.2.5. Blood Cards ............................................................................................................................................................... 73

10.1.3. Latent Fingerprints ....................................................................................................................................... 73

10.1.3.1. Case Assignments...................................................................................................................................................... 73 10.1.3.2. Latent Fingerprint Examinations ............................................................................................................................... 73

10.1.4. Firearms and Tool Marks.............................................................................................................................. 78

10.1.4.1. 10.1.4.2. 10.1.4.3. 10.1.4.4. 10.1.4.5.

Case Assignments...................................................................................................................................................... 78 Firearms Safety.......................................................................................................................................................... 79 Firearms and Tool Mark Examination ....................................................................................................................... 79 Verification and Reporting ........................................................................................................................................ 81 Reference Collections and Libraries .......................................................................................................................... 83

10.1.5. Forensic Photography................................................................................................................................... 83

10.1.5.1. Case Assignment ....................................................................................................................................................... 83 10.1.5.2. Photograph Retrieval ................................................................................................................................................ 83 10.1.5.3. Photographic Storage ................................................................................................................................................ 86 10.1.6. Crime Lab Reviews, Report Distribution and Billing ..................................................................................... 87

10.1.6.1. Technical and Administrative Reviews ...................................................................................................................... 88 10.1.6.2. Reporting and Billing ................................................................................................................................................. 90 10.2. DRUG CHEMISTRY AND TOXICOLOGY LABORATORY........................................................................................................... 92 10.2.1. Drug Chemistry............................................................................................................................................. 92

10.2.1.1. Evidence Transfers .................................................................................................................................................... 94 10.2.1.2. Testing ....................................................................................................................................................................... 95 10.2.1.3. Technical and Administrative Reviews .................................................................................................................... 101 10.2.1.4. Report Distribution.................................................................................................................................................. 103 10.2.2. Toxicology .................................................................................................................................................. 103

10.2.2.1. Receiving Evidence .................................................................................................................................................. 103 10.2.2.2. Testing ..................................................................................................................................................................... 108 10.2.2.3. Technical and Administrative Reviews .................................................................................................................... 117 10.2.2.4. Reporting and Billing ............................................................................................................................................... 119 10.2.2.5. Returning Evidence to the Evidence Custodian....................................................................................................... 120 10.3. QUALITY ASSURANCE (QA) AND QUALITY CONTROL (QC) ............................................................................................... 121 10.3.1.1. Reagents, Controls, Buffers and Calibrators............................................................................................................ 121 10.3.1.2. Instrument Maintenance and Environmental Controls........................................................................................... 121 10.3.1.3. Control Charting ...................................................................................................................................................... 122

11. DETERMINE AND REPORT CAUSE AND MANNER OF DEATH .............................................................................122

11.1. PREPARATION OF AUTOPSY REPORT ............................................................................................................................ 122 11.2. DEATH CERTIFICATES ................................................................................................................................................ 124

12. RELEASE BODY ..................................................................................................................................................126

13. BILLING CUSTOMERS ........................................................................................................................................128

13.1. 13.2. 13.3. 13.4.

AGENCY SERVICE REQUEST BILLING ............................................................................................................................. 129 NON-JURISDICTIONAL AUTOPSY BILLING ...................................................................................................................... 129 NON-JURISDICTIONAL TOXICOLOGY BILLING.................................................................................................................. 130 CHECK RECEIVING AND DEPOSITS................................................................................................................................ 131

14. RETURN EVIDENCE............................................................................................................................................132

15. ADMINISTRATION DEPARTMENT......................................................................................................................132

15.1. MEDICAL ADMINISTRATION ....................................................................................................................................... 132 15.1.1. Cremation Permits...................................................................................................................................... 133 15.1.2. Tarrant County Medical Examiner's Annual Report ................................................................................... 134

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RFP 2016-094 LIMS Selection ? Medical Examiner - Appendix 1 As-Is Workflows Version 2.0

15.1.3. Public Health Reportable Diseases or Conditions ....................................................................................... 135 15.2. RECORDS ADMINISTRATION ....................................................................................................................................... 135

15.2.1. Case File Creation ....................................................................................................................................... 135 15.2.2. Records Requests ....................................................................................................................................... 135 16. BUSINESS OFFICE ..............................................................................................................................................135 17. INTERACTIONS WITH TARRANT COUNTY DA'S OFFICE ......................................................................................136 17.1. REQUESTS FOR REPORTS ........................................................................................................................................... 136 17.2. REQUESTS FOR INFORMATION .................................................................................................................................... 137 18. REQUESTS FOR TISSUE PROCUREMENT ............................................................................................................138

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RFP 2016-094 LIMS Selection ? Medical Examiner - Appendix 1 As-Is Workflows Version 2.0

Table of Figures

Figure 1 TCME ? Overview of Operations ........................................................................................................................13 Figure 2 TCME ? Chain of Custody Transfer .....................................................................................................................15 Figure 3 Forensic Death Investigations ? Jurisdictional and Non-Jurisdictional Case Intake.............................................17 Figure 4 Forensic Death Investigations ? Jurisdiction Terminated Case Intake ................................................................18 Figure 5 Forensic Death Investigations ? Morgue Body Intake ........................................................................................20 Figure 6 Forensic Death Investigations ? Item Handling ..................................................................................................21 Figure 7 Forensic Death Investigations ? Daily Morning Mortality Report Generation ....................................................22 Figure 8 Forensic Death Investigations ? Critical Case Review Report Generation...........................................................23 Figure 9 Medical Examiner ? Autopsy Schedule Generation............................................................................................24 Figure 10 Medical Examiner ? Autopsy and Specimen Collection ....................................................................................25 Figure 11 Medical Examiner ? Autopsy Evidence Collection ............................................................................................26 Figure 12 Medical Examiner ? Completed Exam ..............................................................................................................27 Figure 13 Autopsy Technician ? Completed Exam............................................................................................................28 Figure 14 Human ID ? Fingerprint Collection and Records Search....................................................................................30 Figure 15 Human ID ? Fingerprint Analysis ......................................................................................................................31 Figure 16 Human ID ? Forensic Anthropology ? Skeletal Examination ? Retrieval ...........................................................32 Figure 17 Human ID ? Forensic Anthropology ? Skeletal Examination ? Examination......................................................34 Figure 18 Human ID ? Forensic Anthropology ? Skeletal Examination ? Example of Homunculus ...................................35 Figure 19 Human ID ? Forensic Anthropology ? Skeletal Examination ? Review and Reporting.......................................36 Figure 20 Human ID ? Forensic Anthropology ? Larynx....................................................................................................37 Figure 21 Human ID ? Forensic Anthropology ? Radiographic Comparisons ....................................................................38 Figure 22 Human ID ? Forensic Anthropology ? Animal Remains ....................................................................................39 Figure 23 Human ID ? DNA Send-Outs.............................................................................................................................41 Figure 24 Human ID ? Forensic Odontology.....................................................................................................................42 Figure 25 Human ID ? ID Certificates ...............................................................................................................................43 Figure 26 Histology ? Block and Slide Preparation...........................................................................................................45 Figure 27 Histology ? Send Outs ......................................................................................................................................46 Figure 28 Histology ? Requests from DA..........................................................................................................................48 Figure 29 Histology ? Requests from DA ? Prepare Slides................................................................................................49 Figure 30 Evidence Operations ? Evidence Intake............................................................................................................50 Figure 31 Trace Evidence ? Evidence Receiving ...............................................................................................................52 Figure 32 Trace Evidence ? Morgue Trace Evidence Recovery .........................................................................................53 Figure 33 Trace Evidence ? Vehicle Trace Evidence Recovery ..........................................................................................54

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