Challenges, issues, and solutions of identification in mass disasters differ with the type and scope of the catastrophe.

At approximately 6:10 A.M. on Sunday, August 27, 2006, Comair Flight 5191 taxied into takeoff position at Blue Grass Airport in Lexington, Kentucky. Neither tower controllers nor the crew on the flight deck noticed the aircraft had turned on to unlit secondary Runway 26 — only half as long as intended 7000 ft. primary Runway 22.

Too soon after the Bombardier CRJ-100ER began its takeoff roll the 50 seat commuter aircraft ran out of concrete. With the crew fighting to get the doomed plane airborne, the plane’s landing gear clipped an 8 ft. perimeter fence at 158 mph with its tail dragging the ground. The plane failed to clear a nearby grove of trees; the tail separating from the fuselage. The aircraft then slammed into a hillside no more than 1000 ft. from the end of the runway and exploded.

A PLANE IS DOWN
Less than 90 minutes later, University of Louisville dentistry professor Mark Bernstein, DDS, and a diplomat of the American Board of Forensic Odontology, home asleep in nearby Borden, IN, is informed by Tracey Corey, MD, the Chief Medical Examiner (CME) of the Commonwealth of Kentucky, to assemble his odontology team. A plane is down at Bluegrass Airport, 50 onboard, one survivor.

“Although I lecture on mass disaster preparedness as a component of a University of Louisville Bioterrorism grant, and recently participated in a mock disaster exercise at the Greater Cincinnati Airport, the immediate reaction to such news is momentary confusion and inaction,” Bernstein said.

The shock is transient. Bernstein immediately passes the word to faculty colleague Ryan Noble, DDS. Within minutes the remaining members of Bernstein’s odontology team—Drs. James Woodward, William Lee, and Corky Deaton—are also notified, as is Virginia Woodward, the team’s dental hygienist. All are to report to the medical examiner’s facility in Frankfort, 18 miles from the crash site.

Bernstein and Noble first swing by the University School of Dentistry to gather supplies and equipment that have been stored for just such events. There is one snag. The mobile x-ray unit is not exactly portable—it weighs 500 pounds and must be dismantled, then somehow maneuvered into Bernstein’s SUV. Campus police help hoist the unit. Other gear in the emergency cache includes antemortem and postmortem dental charting forms, a computer, a Dexis digital x-ray probe and software package, miscellaneous containers, and a digital camera.