Guam's chief medical examiner has less than a month before his resignation takes effect, but before his departure he is calling for a better facility and more manpower to retain professionals at the Office of the Chief Medical Examiner (OCME).
Dr. Kenny Su stressed that "the OCME matters to all residents of Guam. It's a dignity to keep bodies and evidence and a place to find truths about our loved ones, therefore it's important. Comparing the importance of a hospital to that of an OCME misses the point, as both serve the needs of patients, decedents and their families."
In a June 11 email to Guam Memorial Hospital Authority interim administrator and CEO Dr. Joleen Aguon, Su shared his recommendations on the facility needs of the OCME.
"I performed an AI search, and the size range falls between 10,000 and 15,000 square feet based on an expected population of Guam. This would be about 1/20 of the area of Guam Regional Medical City (GRMC) (265,000 square feet), or 1/40 of the current Guam Memorial Hospital Authority (GMHA) (612,351 square feet)," he said.
Su said the "best example for Guam's office design" he found with the help of AI is the Johnson County Medical Examiner office in Olathe, Kansas.
Su broke down the structural needs of an OCME serving a population of 200,000 by zoning, staffing and budget — the closest scale to Guam's population of roughly 170,000.
Su told Guam News Network he performs roughly 600 autopsies a year in Guam. He noted that the standard baseline of one autopsy per 1,000 residents annually for a population of 200,000 would yield 150 to 200 accepted autopsy cases per year. He said the issue is not caseload but rather "quality," which he tied to facility and manpower needs.
For architectural layout and zoning, Su provided three recommendations to Aguon based on the Johnson County Medical Examiner model to prevent cross-contamination and ensure privacy.
The first is the Public and Administrative Zone, or "Clean Zone," which includes a secure lobby separating waiting areas for grieving families and visiting law enforcement, a bereavement and consultation room for family interviews and photo identification viewings, and desk space for administrative staff including investigator and pathologist offices, record storage and workstations for death investigators.
The second covers Clinical and Morgue Operations — decomposition and biohazard zones. Su recommended a Main Autopsy Suite with space for "two to three stainless steel autopsy stations with articulating lighting and downdraft ventilation," a Decomposition and Isolation Suite described as an "airborne infection isolation room" to "handle decomposition or infectious cases safely," and a walk-in Main Refrigerator Cooler built to "comfortably hold 15 to 20 decedents." Su told Guam News Network the current refrigerator is unreliable, at times forcing the OCME to rely on GMHA's refrigerator.
The third zoning recommendation covers the Secure Support and Evidence Zone, or Transitional Zone. Su recommended an enclosed sally port — a secure, drive-through garage bay where transport vehicles can load and unload decedents away from public view — along with a climate-controlled evidence storage room for personal property, toxicology samples and physical evidence. He also recommended a radiology or X-ray room housing a full-body imaging system such as a Lodox scanner, positioned adjacent to the autopsy suites.
Su estimated construction costs at $500 to $800 or more per square foot, "largely driven by complex mechanical, HVAC and negative-pressure air-exchange requirements." Equipment and IT costs were estimated at $1.5 million to $2.5 million for specialized stainless-steel casework, ventilation hoods and digital imaging equipment.
Guam News Network reached out to Guam Memorial Hospital for Aguon's response to Su's recommendations and plans for the OCME within the Medical Complex project. A response is pending.