For many people, when the word “medical examiner” comes up in conversation, crime scene investigation television shows immediately come to mind. These experts spend a lot of time investigating fatalities, but when it comes to the Armed Forces Medical Examiner System, they do much more.
The Defense Department and the federal government only have access to AFMES, a comprehensive forensic investigation service. Its services include DNA testing to identify current and former service members, as well as forensic pathology and toxicology. By researching post-mortem injuries and preparing drug-sniffing military working dogs for training, AFMES ‘ work also includes a sizable counternarcotics program that enhances military readiness.
To handle all of this, AFMES has three divisions: the Division of Forensic Toxicology and DNA Operations, and the division of forensic pathology investigations. In this article, we’ll concentrate on the first two.  ,
Pathology: Identifying the Cause of Death, Manner &
Even when a service member is n’t on duty, AFMES looks into deaths related to combat as well as those caused by injuries, accidents, and illnesses. The Forensic Pathology Investigations division of AFMES, which enlists the assistance of various types of experts, is where the work begins.
First and foremost, there are forensic pathologists, also known as medical examiners, who perform autopsies to ascertain a person’s cause and manner of death. In addition to helping, medicolegal death investigators gather information to help pathologists determine whether the death was natural, accidental, a homicide, or suicide. Army soldiers with training in mortuary affairs also work in the division.  ,
Army Sgt. stated that” the medicolegal death investigators are accountable for being the eyes and ears of the forensic pathologist.” Earnie Williams, first class, is in charge of the morgue for the FPI division. To better inform that pathologist about what they discovered,” they will go to the scenes and obtain all the circumstances of the death.”
75 % of active-duty fatalities, including some that happen on military bases, are handled by medicolegal authorities outside of military jurisdiction, according to AFMES. Therefore, even though AFMES may not be in charge of those cases, they are still informed of them a day or two later. The decision is made by the MDIs regarding whether or not AFMES looks into it.
” Every investigation we carry out is based on jurisdiction at bases.” Williams explained that while some bases are entirely federal, others are covered by a [memorandum of agreement] with the local county.
Forensic anthropologists who examine bone and hard tissue, photographers who record the cases, and histotechnicians who process the tissue for the forensic pathologist to examine at the molecular level are additional members of the pathology division.
There are various pieces of evidence that investigators may look for during an autopsy to make a decision.
For instance, “pathologists would be looking for any fractures—anything in the neck or head that would indicate the result of how they died from the fall,” Williams said.” For example, if there was a slip and fall and someone passed away from that.” To find out why they fell in the first place, they would then examine the various organs that we had recovered.
In addition to Dover, AFMES has five other regional medical examiner labs in the United States, Germany, and South Korea.
Keeping an eye on injury trends
A section for mortality surveillance is part of the pathology division, and it uses autopsies and other forensics to examine injury trends in the military. To assist with readiness and force protection, AFMES can report these findings to military leaders.
Consider the operations in Iraq and Afghanistan. The AFMES director of DNA Operations, Dr. Tim McMahon, claims that combat armor was altered as a result of injuries that pathology division personnel discovered and reported at the time. He gave the redesign of blast plates on Humvees as one example.
The blast would travel straight up into the bottom of the car because there were plates underneath it. According to McMahon, that was resulting in some foot injuries and other problems. According to what I understand, experts were able to restructure the plates so that the blast energy or shockwave was focused away from the vehicle rather than coming straight up by looking at the wounds or the deaths.
The Military’s Crime Lab , toxicology
A group of toxicologists collaborates with AFMES pathologists as they look into deaths by testing autopsy samples to determine whether the deceased person may have had any drugs, alcohol, or other chemicals in their system that could have contributed to acute toxicity.
The Division of Forensic Toxicology at AFMES also functions as a sort of military crime lab. It aids the Air Force Office of Special Investigations, the Army’s Criminal Investigation Division, and the Navy Criminal Investigative Service. AFMES toxicologists are frequently asked to assist with cases of sexual assault and DUI, or, for instance, to determine whether someone accused of showing up to work while intoxicated had alcohol or drugs in their system.
In addition to Dover, AFMES supports five additional DOD-certified drug testing facilities in the United States that handle workplace drug tests for each military service. According to Dr. Jeff Walterscheid, the chief toxicologist for AFMES, those labs search for about 20 different drug types. However, samples are frequently sent directly to the DOD’s flagship lab in Dover to be examined in greater detail if a service member is suspected of abusing an opioid for which they do not have prescription, particularly when that drug falls outside the purview of the organization’S workplace drug testing program.
For instance, the spouse may occasionally have a prescription. The test subject does n’t take any medications, but he takes Ibuprofen or supplements, and it just so happens that it resembles one of those other pills, Walterscheid explained. ” Did a mistaken swap take place at home? Did the pharmacy fill out the prescription incorrectly? These are the issues that we must resolve and employ our investigative abilities to ask,” What are all the other possibilities?” without assuming that someone is secretly using drugs right away.
Immunoassays, quick, effective tests that use antibodies to look for different drug classes, are used by toxicologists to carry out their work. Time-of-flight mass spectrometry, which, in essence, measures the mass of various molecules and how quickly they travel to reveal what substances might be in a sample, is used for newer drugs that have n’t yet had antibody tests developed for them, according to Walterscheid.  ,
Walterscheid pointed to the device shown below and said,” We can also use something called tandem mass spectrometry.” Its magnetic chambers are capable of trapping an ion, shattering it, and producing fragments that can be used to identify the drug. Additionally, we can gauge how much.
AFMES toxicologists conduct tests on a diverse group of participants in accident and incident investigations. Walterscheid used a tragic plane accident as an illustration.
Because these decomposition products can enter the air during a fire and be attributable to toxicity, the pathology group will conduct an autopsy before collecting samples and searching for drugs, alcohol, and even carbon monoxide or cyanide. Additionally, there was the ground crew, or those responsible for preparing the aircraft for flight. Did they use drugs at all? Did they have alcoholism? We can provide the flight surgeons with this full-service investigation so they can finish it in time to resume the mission or if they need to put a hold on it and try to figure out what actually happened.
The centralized lab for Toxicology is primarily staffed by contractors, along with some service members and a few civilian government employees. A few military officers and a corps of enlisted service members who have received clinical training for work in hospital laboratories run it. For the majority of them, AFMES is a unique assignment.
A rotation through here gives service members this additional level of technical background, and when they are stationed at a new hospital lab, they will have much more experience, according to Walterscheid.
The toxicology team participates in conferences and other industry-related forums to learn about new drugs that are emerging across the nation and the world when it comes to keeping up with the most recent drug-use trends. In order to determine how drugs are being used, they also read public journals and reports and even use social media.  ,
Providing training materials for military working dogs
Military working dogs that the DOD uses to detect drugs are authorized to recognize cocaine, heroin, marijuana, and methamphetamine. If you’ve ever wondered where the kennels that train the dogs get the materials they use to teach them, you now know that the answer is in the Division of Forensic Toxicology of AFMES.
It’s actual street drugs. It perfectly captures what would happen in the real world, according to Walterscheid. As part of its counternarcotics mission to supply the training materials to 164 service kennels, the division buys its medications from the Drug Enforcement Administration’s Special Testing and Research Lab in Dulles, Virginia.
Each kennel has a predetermined number of training tools that it upkeeps. To prevent the degradation of the scent profile, they are returned to AFMES every two years for replacement.
The toxicology lab will carefully measure specific drug concentrations and place them in “bindles,” which are filter papers that release the odor, to prepare the training aids. They are then serialized and sealed in tins before being shipped safely. There are strict guidelines for receiving the aids properly, including steps to address any potential discrepancies. They can maintain tight control over what the DEA offers in this way, according to Walterscheid.
AFMES has a significant task to complete, whether it be supplying these training materials, ensuring that our service members are on the straight and narrow, or determining the cause of someone’s death. Thankfully, its devoted, knowledgeable staff takes on that extensive mission with pride.
It was a once-in-a-lifetime opportunity when this job opened up, according to Walterscheid.  ,” I’m so glad I took it.”