Sunday, August 05, 2007

Medical examiner office gets lambasted


Medical examiner office gets lambasted
Near 'collapse' reported due to mismanagement
By Peter Schworm, Globe Staff August 4, 2007

The state medical examiner's office, long considered one of the worst in the country and wracked by a series of high-profile missteps this year, is on the "verge of collapse" from extreme mismanagement, according to a scathing independent review released yesterday.

State public safety officials said yesterday that they strongly supported the report and would move quickly to reform the troubled office, which is currently "barely able to fulfill its basic legal responsibilities" and will get markedly worse without immediate action, a state-hired consultant found.

But the chief medical examiner, Mark A. Flomenbaum, will not be around to help oversee the fixes. Governor Deval Patrick confirmed yesterday that he has fired Flomenbaum after a three-month internal investigation that revealed "serious concerns" about his performance.

Patrick suspended Flomenbaum in May after the medical examiner's office misplaced the body of a Cape Cod man, which State Police found buried in another man's grave. Flomenbaum's departure followed the resignations of the state's top forensics official and the director of the state crime lab after several blunders there.

Kevin M. Burke, secretary of the Executive Office of Public Safety, which oversees the medical examiner, said Flomenbaum showed a "complete disregard for meeting his responsibility in tracking down that body" and in reducing a case backlog.

"The problems are so fundamental there could be no other explanation but failure to meet his responsibilities," he said. "He simply refused to take administrative responsibility."

Flomenbaum, who was hired in 2005 to overhaul the long-troubled office, was out of the country yesterday and not available for comment. His lawyer, Thomas Kiley, said it was too early to say whether Flomenbaum would contest his dismissal.

But Kiley said that his client had been unjustly blamed for the agency's troubles and that he was hired with the understanding that he would be given five years to fix the office's problems.

"Mark accomplished a great deal in a short time," he said. "He delivered what was asked for."

Michael O'Keefe, district attorney for the Cape and Islands, said, "Good scientists don't necessarily make good managers," and said he strongly backed the consultant's recommendation to hire a chief operating officer to oversee all nonmedical functions. The position would have independent authority from the chief medical examiner.

Without a well-run examiner's office, he said, "we are at a disadvantage with respect to other states in doing our job."

Flomenbaum was esteemed in the field for his work in identifying thousands of body parts in New York City after the Sept. 11 terrorist attack on the World Trade Center. But in a blunt 36-page report, Vance, a Virginia-based consulting firm, said the office "has been so thoroughly mismanaged that it current lacks the most basic infrastructure necessary to effectively support its core function."

The report said Flomenbaum, while a very capable forensic pathologist, lacked management skills, unwisely expanded the office's caseload, and developed ill-fated programs. It slammed the office for not having written policies for its core duties.

"It borders on the incredible that the intake and release of human remains [and personal effects] from a government agency is governed by a verbal understanding of the process," the report said.

It described the office's main receiving area for bodies as a "chaos of activity." With such shoddy protocol, Vance found, it is surprising the agency has "not lost more bodies."

The report also said that law enforcement officers at a death scene could not always contact the office after business hours, and that the office struggles to maintain basic supplies such as face shields and gloves.

Other findings included:

No written policies and procedures on body handling and evidence collection;

Little training of employees;

Little focus on the health and safety of employees and visitors;

Poor body handling procedures;

A creeping culture of indifference and a demoralized staff;

Little security of the South End headquarters;

No coordination between the Boston headquarters and Holyoke and Worcester offices.

But supporters of Flomenbaum criticized his dismissal and said he was being made a scapegoat for chronic problems that long preceded his arrival.

"I am quite sure that the office is in better shape than when he arrived," said Patricia O'Malley, director of pediatric emergency services at MassGeneral Hospital for Children. "I am very
disappointed in the outcome."

O'Malley, who worked with Flomenbaum on a child fatality review team, said Patrick's decision to fire him will make it harder to attract a qualified replacement.

"It is not going to inspire confidence," she said.

Joseph Prahlow, president of the National Association of Medical Examiners, said he did not believe Flomenbaum received the necessary political and financial backing to overhaul a shoestring operation.

"When you're trying to move bodies and your facilities are not sufficient to handle them, the last thing you're going to have time for is working on a written policy," he said.

Peter Stefan, who runs a Worcester funeral home, said that he considered Flomenbaum a "total victim" and that the office is woefully underfunded.

But the report said below-average funding "does not begin to explain the long-term and persistent problems of this agency. Unlimited funding of this agency would not fix it in its current state."

Peter Schworm can be reached at
schworm@globe.com.


No comments: