Victim Accounting: Best Practice Recommendations for Medicolegal Authorities 

in Mass Fatality Management

2021-N-0008

Victim Accounting: 

Best Practice 

Recommendations for 

Medicolegal Authorities in 

Mass Fatality Management

Disaster Victim Identification Task Group

Medicolegal Death Investigation Subcommittee

Medicine Scientific Area Committee

Organization of Scientific Area Committees (OSAC) for Forensic Science
Victim Accounting: Best Practice Recommendations for 

Medicolegal Authorities in Mass Fatality Management

DRAFT 2

Draft OSAC Proposed Standard

2021-N-0008 Victim Accounting: Best Practice 

Recommendations for Medicolegal Authorities in 

Mass Fatality Management

Prepared by 

Medicolegal Death Investigation Subcommittee

Medicine SAC

Version: 1.0

June 2021

Disclaimer:

This OSAC Proposed Standard was written by the Medicolegal Death Investigation 

Subcommittee of the Organization of Scientific Area Committees (OSAC) for Forensic Science 

following a process that includes an open comment period. This Proposed Standard will be 

submitted to a standards developing organization and is subject to change.

There may be references in an OSAC Proposed Standard to other publications under 

development by OSAC. The information in the Proposed Standard, and underlying concepts and 

methodologies, may be used by the forensic-science community before the completion of such 

companion publications.

Any identification of commercial equipment, instruments, or materials in the Proposed Standard 

is not a recommendation or endorsement by the U.S. Government and does not imply that the 

equipment, instruments, or materials are necessarily the best available for the purpose.
Victim Accounting: Best Practice Recommendations for Medicolegal Authorities 

in Mass Fatality Management

1 Foreword

2 The concept of accounting for the names of the dead is germane to the process of disaster victim 

3 identification. Another concept to be considered is the need to account for victims in the case of fragmented 

4 remains. These concepts are integrated into expectation by the public, media and public officials to 

5 accurately report the number of fatalities in a mass fatality incident. 

6 1.0 Scope

7 The purpose of this document is to provide guidance on the various aspects of victim accounting, accounting 

8 for fragmented remains, reconciling unaccounted for persons lists, and reporting numbers of fatalities 

9 including those who are identified, unidentified and unclaimed. The medicolegal authority should consider 

10 their role in the collection and dissemination of victim accounting information to the survivor families, 

11 media and partnering response agencies.

12 2.0 Normative References

13 There are no normative references. Informative references are included at the end of this document.

14 3.0 Definitions

15 For the purposes of this document, the following definitions and acronyms apply. 

16 3.1 

17 Closed Population Incident

18 An incident in which the number of victims and their names are known.

19 3.2

20 Group Remains 

21 Unidentified human remains that are not examined beyond the initial triage either due to the tissue lacking 

22 all potentially identifiable characteristics or yielding no information useful to death investigation and 

23 determination of incident causation.

24 3.2

25 Medicolegal Authority

26 The medical examiner, coroner or other office responsible for medicolegal death investigation in a given 

27 jurisdiction.

28 3.3

29 Mass Fatality Incident (MFI)

30 Any incident which produces fatalities of a sufficient number or complexity that special operations and 

31 organizations are required.

32 3.4

33 Minimum Number of Individuals (MNI)

34 The fewest number of individuals represented in a skeletal assemblage.

35 3.5

36 Open Population Incident

37 A disaster in which neither the number of victims nor their names are known.

38 3.6

39 Unaccounted for Person
Victim Accounting: Best Practice Recommendations for 

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40 Any individual believed to be involved in a mass fatality incident including living survivors and fatalities.

41 3.7

42 Victim Information Center 

43 The Victim Information Center (VIC) is the component of the Family Assistance Center. The VIC 

44 is a controlled area within the FAC where the acquisition of antemortem data occurs to enable the 

45 identification of victims of a mass fatality incident (MFI). Establishment of the VIC is the 

46 responsibility of the local medicolegal authority.

47

48 4.0 Recommendations 

49 4.1 The Difference between Victim Accounting and Accounting of Victims

50 The concept of victim accounting in its simplest form is reconciling the total number of unaccounted for 

51 persons with the number of fatalities. In a closed population incident, this will result in a 1:1 ratio where 

52 the total number of unaccounted for persons is equal to the number of fatalities. This is equally true for 

53 closed populations when there is no fragmentation of the remains. The number of remains collected from 

54 the incident site and processed in the morgue will equal the number of unaccounted for persons. This type 

55 of victim accounting can be performed using a whiteboard or computer matching database. 

56 In an open population incident, the number of unaccounted for persons reported may be significantly higher 

57 than the actual number of fatalities. This over reporting is due to a number of reasons, but should be 

58 expected. Historical data suggests that for every victim involved in a mass fatality incident, ten people will 

59 attempt to report them as unaccounted for. So, for every 100 victims, the medicolegal authority can 

60 reasonably expect 1000 unaccounted for persons phone calls. 

61 Open populations with fragmented remains exponentially increase the complexity of victim accounting. 

62 This is due to the need to process each identifiable fragment until the unaccounted for persons manifest is 

63 exhausted. 

64 Mass fatality incidents resulting in any degree of remains fragmentation may result in the opposite effect. 

65 In a closed population, the number of missing persons will be lower than the number of remains collected 

66 and processed in the morgue.

67 The concept of accounting of victims, and its complexity, is demonstrated by remains fragmentation. The 

68 medicolegal authority is faced with the challenge and decision to pursue identification processes until either 

69 the unaccounted for persons manifest is fully reconciled, including the survivors, or each individual victim 

70 is fully accounted for amongst the fragments recovered. This implies that every fragment will be associated 

71 with a victim name. This decision to continue with accounting of victims may be impacted by funding, 

72 resource capabilities, and desire of the families. In a closed population, it may be acceptable to account for 

73 each victim, and engage the families regarding disposition of the remaining grouped remains.

74 In an open population incident, reconciling the unaccounted for person manifest without complete 

75 identification of all recovered or fragmented remains, notwithstanding group remains, will only result in an 

76 estimated number of fatalities. This is because some victims may not have been reported as missing, or 

77 amongst the recovered victims or identified fragments and therefore will never be accounted for. This can 

78 also be true in incidents involving intense fire/explosion, or natural disasters (i.e. sinkholes, floods, 

79 hurricanes/tsunamis) where remains are never recovered. 

80 4.2 Unaccounted for Persons, Missing Persons, and Fatalities
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81 The medicolegal authority should work with partner agencies involved in the response to develop a list (or, 

82 manifest) of all individuals involved in the response, including healthcare agencies (e.g. hospitals), first 

83 responder agencies, shelter managers, the agency(ies) responsible for managing the missing persons call 

84 center, and other partners involved in the response. The medicolegal authority relies on these lists to cast a 

85 broad enough net to incorporate the total population of victims. The term victim is even misleading in the 

86 sense that a victim may be classified as suffering psychological trauma, physical injury or be deceased. The 

87 medicolegal authority is attempting to reach a singular conclusion; how many people died as a result of the 

88 incident and who are they.

89 Traditionally the term “missing person” has been favored by emergency management planners when 

90 discussing the concept of incident populations, living and dead. It is widely accepted that until an individual 

91 has been classified as either a survivor or fatality, they are simply missing. This narrow definition fails to 

92 consider the variety of victim classifications, and the legal implications of labelling someone as a missing 

93 person. For instance, law enforcement may be required to initiate an investigation into a missing person, or 

94 a court order may be needed to reduce the waiting time to declare the person dead in absentia. In some 

95 cases, missing persons are not missing at all. This could include survivors who disperse from an incident 

96 location, presently unidentified persons admitted to hospitals or walking wounded who are not yet reunified 

97 with family members. 

98 Therefore, it is recommended to classify persons believed to be involved in the incident as “unaccounted 

99 for persons”. This classification can further be defined through the process of reunification or identification, 

100 either as a survivor or confirmed fatality. This methodology will make the process of reconciling the 

101 incident population and fatalities less complex. It also supports the idea of centralized reporting with multi102 agency involvement.

103 4.4 Establishing an Unaccounted for Persons Manifest

104 In a mass fatality incident, the responsibilities of the medicolegal authority are focused on identification of 

105 deceased persons. This central focus suggests that reconciliation of unaccounted for persons lists is a 

106 priority. Commonly, law enforcement agencies will establish a missing persons list; hospitals will establish 

107 lists of injured victims and non-governmental organizations will collect information from the public on 

108 unaccounted for persons. It is only in the Victim Information Center (VIC) that medicolegal authorities 

109 gather names of individuals believed to be deceased. 

110 It is recommended that medicolegal authorities work with partner response agencies to establish a 

111 mechanism for collating various lists into a singular unaccounted for persons manifest. This list should be 

112 reconciled with the postmortem data to establish a list of confirmed fatalities.

113 4.4 Importance of Centralized Reporting of Unaccounted for Persons 

114 This disparate nature of gathering the names of unaccounted for persons highlights the inherent flaws in the 

115 system. The definitions applied to groups of individuals do not represent the totality of the affected 

116 population, and therefore may not incorporate all of the deceased persons depending on the characteristics 

117 of the mass fatality incident. 

118 Another limitation of compartmentalized reporting is the ability, or lack thereof, to share data. Once 

119 gathered and filed, data may be subject to various privacy laws which inhibit the sharing of information 

120 both internally through organizations, but also across agencies responding to the incident. 
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121 If data is able to be shared, it is typically done at defined times, such as in advance of a press conference or 

122 end of an operational period. These delays further inhibit the ability of the medicolegal authority to use 

123 critical data in the identification process.

124 It is recommended that medicolegal authorities work with their local response agencies to develop a 

125 centralized reporting mechanism for unaccounted for persons. There are a variety of options to consider, 

126 the most common being a dedicated call center. This has proven effective in recent years for mass shootings 

127 involving a large open population. The advantages of a dedicated call center include the simplicity by which 

128 the phone number can be disseminated to the media and general public, and ease of reporting through that 

129 number. The limitations include a need for space, set-up time, personnel to answer phones, a script for the 

130 operators, and a database to record entries. Agencies in small jurisdictions may not have the resources to 

131 stand up a centralized call center. 

132 The use of electronic reporting systems is beginning to emerge. NAMUS recently released their module for 

133 critical incidents which incorporates a web-based form that members of the public can use to submit 

134 information of unaccounted for persons. This NAMUS system also incorporates a feedback mechanism for 

135 survivors to enter their information to be reconciled against the database. Similar homegrown versions are 

136 being developed by medical examiners and other partner agencies to gather information on unaccounted 

137 for persons in a centralized database. The advantages of this model are the lack of relative overhead (space, 

138 equipment and personnel) needed to activate it in the aftermath of a mass fatality incident. By using 

139 electronic databasing, it also limits the number of touches on the data, thereby reducing the potential for 

140 human error due to transcription and typos. An electronic form is widely accessible via computer, tablet or 

141 mobile device from anywhere in the world. The ability to share databases, or give permissions to various 

142 agencies to access the information permits real-time accessibility to critical information. The limitations 

143 include having internet access to both distribute the form link and access the form for reporting. This type 

144 of form is not quickly modified, so consideration should be given to the content so that it is useful across a 

145 wide range of incident types.

146 4.4 Reporting Metrics (Identified, Unidentified and Unclaimed)

147 Medicolegal authorities rely on confirmatory methods of identification to accurately establish victim 

148 identities. In a mass fatality incident, this process may involve a multi-disciplinary analysis of the remains 

149 in a high throughput morgue.

150 In this type of setting, it is common that remains will be transported from the incident scene and stored until 

151 the process is complete. Re-examination may be necessary when additional information is needed to 

152 achieve an identification. Remains which have completed the examination process, but have not produced 

153 an identity remain Unidentified. 

154 As the fatality management operation progresses, the available data produces identifications. These victims 

155 are referred to as “Identified”.

156 As the operations end, there may be a subset of Identified fatalities for whom no family or next of kin is 

157 located, or the located family has declined to arrange for disposition for a variety of reasons. These fatalities 

158 are referred to as “Unclaimed”. 

159 This variation on victim accounting methodology and its limitations should be considered when reporting 

160 numbers of fatalities. It is not an accurate statement to suggest the sum total of unidentified and identified 

161 represent the total number of fatalities, unless all of the remains are intact. In other words, when 

162 fragmentation exists the unidentified may already be represented in the identified population. 
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163 However, these classifications may prove useful when interacting with the media, families, and elected 

164 officials. Medicolegal authorities can use these established metrics when reporting progress to the media 

165 and families without speculating on the number of deceased persons. They can also use the Unclaimed 

166 metric to garner media interest in hopes of locating family or seeking funding for a memorial. 

167 4.5 Numbers of Fatalities (Estimates vs Official vs Confirmed) 

168 In any mass fatality incident the media and elected officials will seek reporting on the number of fatalities 

169 almost immediately following the incident occurrence. In some instances, such as an all-fatal airline crash 

170 with a flight manifest, this may be a simple exercise. In other circumstances, such as natural disasters, the 

171 medicolegal authority may encounter difficulties establishing the number of fatalities accurately and the 

172 process may continue for days or weeks following the incident.

173 Estimates of the number of fatalities are often established by non-official sources soon after an incident 

174 occurs. These numbers may be proffered by the media, government officials, or first responders based on 

175 known parameters, such as the capacity of a building or aircraft. These estimates can vary widely and are 

176 usually inaccurate.

177 Medicolegal authorities should refrain from providing estimates to the media or government officials, even 

178 if pressed. Estimates established by the medicolegal authority should be based on a determination of the 

179 minimum number of individuals (MNI). Incident characteristics and fragmentation can produce estimations 

180 which vary by orders of magnitude. For this reason, estimations of the number of fatalities should only be 

181 used by the medicolegal authority for the purpose of evaluating response plans and resource needs.

182 In some catastrophic incidents involving open populations, estimates may be the only method of quantifying 

183 the number of fatalities. This occurs when medicolegal authorities are unable to reconcile lists of 

184 unaccounted for persons with confirmed fatalities and survivors. Incident examples include the Indian 

185 Ocean earthquake and tsunami of 2004 and 9/11 World Trade Center terrorist attack. 

186 The concept of official death tolls is referred to in historical context when examining an incident 

187 retrospectively. The medicolegal authority has the statutory responsibility to determine the manner and 

188 cause of death for individuals. The department of vital records has the responsibility for recording the death, 

189 and classifying it for statistical purposes. The CDC also records and reports on statistical information 

190 collected from death records. 

191 In some states, the death record now contains a field allowing the medicolegal authority to assign a death 

192 as being related to a specific incident. Despite academic efforts, there is no standard by which medicolegal 

193 authorities are required to assign a manner and cause of death as it relates to a specific incident. The result 

194 is that medicolegal authorities are free to apply whatever criteria they choose to certifying deaths from a 

195 mass fatality incident. The consequence of this is that official death tolls are often no more reliable than 

196 estimates in jurisdictions where the death record does not permit categorizing a death related to a specific 

197 incident. Even then, the medicolegal authority may exercise judgement and discretion when certifying the 

198 manner of death. The failure to properly classify deaths related to a mass fatality incident may have 

199 implications on emergency funding, disaster declarations, and personal life insurance policies.

200 The concept of confirmed fatalities seems straightforward and innocuous. An identification which is 

201 confirmed on remains recovered from the site of mass fatality incident would constitute a confirmed fatality. 

202 However, depending on the incident characteristics an unaccounted for person who is presumed to be 

203 deceased may never be identified, and therefore is not on the list of confirmed fatalities. They may be added 

204 to the official death toll through the process of having them legally declared dead by the courts. 
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205 The concepts of establishing estimates, official death tolls and numbers of confirmed fatalities are fraught 

206 with inconsistency and speculation, which is magnified by the scope of the incident. It is recommended that 

207 medicolegal authorities establish standardized, transparent processes for determining each metric.

208 4.6 Reporting of Fatality Numbers

209 The reporting of fatality numbers, regardless of the methodology is the responsibility of the medicolegal 

210 authority. The number of fatalities, and information related to victim accounting should be conveyed to the 

211 victim families prior to any media or government official. 

212 The medicolegal authority or designee should be present at press conferences to address questions regarding 

213 the fatality management operation, and specifically those pertaining to victim accounting. The medicolegal 

214 authority should prepare a message that is concise, accurate and transparent regarding the methodology 

215 being used to report any statistical data. 

216 This information is critical to ensure a consistent, accurate message is conveyed to the media and families. 

217 A medicolegal authority who fails to assert this responsibility or permits other response agencies to report 

218 on the number of fatalities or victim accounting may undermine their credibility if discrepancies exist. 

219 4.10.2 Victim Accounting and the Media

220 The concept of victim accounting during mass fatality incidents garners significant media attention. 

221 Criticism of the process may arise from a poor understanding of complex victim accounting methodologies 

222 resulting in a perceived lack of transparency by the responsible authorities. The medicolegal authority 

223 should utilize the media to accurately and definitively report this information. 
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224 Appendix A

225 (informative) 

226 Bibliography 

227 SWG MDI (2012), Guidelines for Media Relations: Dissemination of Public Information in Medicolegal 

228 Death Investigations

229 DMORT (2012), Victim Identification Center Team Procedure Manual

230 Twin Cities Operation Curtain Call AAR Workgroup (2014), Field Operations Guide for Reunification and 

231 Family Assistance

232 Reidenberg, J. R., Gellman, R., Debelak, J., Elewa, A., Liu, N. (2013) Privacy and Missing Persons after 

233 Natural Disasters. https://www.scribd.com/document/136520439/Privacy-and-Missing-Persons-after234 Natural-Disasters

235 Ohio State Coroners Association. (2017) State of Ohio Family Assistance Center Field Operations Guide. 

236 https://ema.ohio.gov/Documents/Plans/FACFOG.pdf