title: The Processing of Surgical Specimens With Forensic Evidence: Lessons Learned From the Boston Marathon Bombings.
abstract: BACKGROUND
  Following the Boston Marathon bombings in April 2013, pathology departments at hospitals across Boston, Massachusetts received numerous amputated limbs, as well as other surgical specimens from trauma surgeries. In the absence of clear guidelines, each department faced uncertainties in performing gross examination of these specimens.
  
  
  OBJECTIVE
  To develop a protocol for processing surgical specimens with forensic evidence.
  
  
  METHODS
  We collaborated with representatives who knew the practices at 3 major Boston hospitals, the Office of the Chief Medical Examiner of Massachusetts, and a senior team leader for the evidence response team for the Boston, Massachusetts division of the US Federal Bureau of Investigation to construct a protocol for processing specimens with forensic evidence.
  
  
  RESULTS
  A simple and robust protocol approved by experts in forensic evidence collection was developed. Important points in this protocol include (1) assigning the task of processing the specimens to one individual or one team of individuals, (2) photographing all specimens before and after washing, (3) obtaining a radiograph of each specimen, and (4) identifying a secure area to store forensic evidence.
  
  
  CONCLUSIONS
  When acts of terror occur, protocols provide order and clarification to the processing of surgical specimens. We propose a protocol that provides guidance for pathology departments across the country to handle trauma-related surgical specimens with forensic evidence in an efficient manner to allow optimal patient care and a secure way of gathering forensic evidence.
authors.forename: Cathryn J
authors.initials: CJ
authors.lastname: Byrne-Dugan
authors.forename: Terra A
authors.initials: TA
authors.lastname: Cederroth
authors.forename: Anita
authors.initials: A
authors.lastname: Deshpande
authors.affiliation: From the Department of Pathology, Boston University Medical Center, Boston, Massachusetts (Drs Byrne-Dugan, Deshpande, and Remick); and the Department of Pathology, Beth Israel Deaconess Medical Center, Boston (Dr Cederroth).
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Remick
mesh_terms: D001900:Boston; D049429:Forensic Pathology / Q000379:methods* / Q000592:standards*; D006801:Humans; D013048:Specimen Handling / Q000379:methods* / Q000592:standards*; D023481:Terrorism