“For we wrestle not against flesh and blood”
Ephesians 6:12
Take an unattended death, resulting in advanced human decomposition, add cross contamination from first responders and throw in cross bio-contamination from vectors creating fomites. Sprinkle in a dog, who has to eat, and just for good measure, throw in a family who is under duress and not happy with the two previous service providers. Serve “shaken, not stirred”, and gently pour into a glass clearly marked “global pandemic”, and you have the recipe for a perfect storm.
The following story is true. The names have been changed to protect the innocent, the unknowing, and the incompetent.
“Hi Jeff, it’s Ally, your favorite independent adjuster,” said the voice on the phone.
“Well, you may not be my favorite, but you are in the top two,” I replied. “Just kidding! How can I be of service to you?”
“Jeff, I have a claim that I really need your help on,” she said.
“I’ll do my best, Ally. Tell me what you know.”
“It’s an unattended death and the deceased was there for approximately two weeks. The gentleman passed away in the hall which is carpeted,” she said.
“Ally, would you happen to know if the sub-floor is concrete or wood?” I asked.
“It’s concrete,” she said.
“Were you out there?” I asked.
“No, I am going off what the family is telling me. It seems that after the body was removed, the family called a big crime scene cleaning company. They came out and removed some carpet and pad, some tile in the bathroom, and a little sheetrock in the hall,” she replied.
“So, the load reduction is done?” I asked.
“It is. And for that amount of work, they have submitted an invoice for $26,500.”
Silence. Crickets chirping.
“Hello Jeff, are you still there?” she asked.
“Yes ma’am, I am here,” I replied.
“Jeff, there was also a dog in the house,” she said.
Forensic Operators making a tactical entry for pre-disinfecting.
“You don’t have to go any further, I’ve seen this before. So, where are we now?” I asked.
“After dismissing the crime scene cleaning company, the family called a fire and water restoration company. They showed up but said they could not go in the house because they did not have any PPE,” she replied.
“Were they aware that this was an unattended death incident site before being dispatched?” I responded.
“The family told me the company was informed of the situation when the phone call was placed. The family said they looked in all the windows and then came back and informed the family that it was a total loss and everything including all of the sheetrock had to go, because of odor.”
The silence was deafening.
“Well, was there any looking through the window estimate on the project?” I asked.
“$100,000. Jeff, I’ve told you everything the family has told me. They called and asked if we knew someone, so here we are. We can’t tell them who to use, but if you would talk to them…” she said. “Of course, it would be an honor,” I replied. The next day, while parked in the driveway at the incident site, I found myself checking my watch, which informed me I was 15 minutes early for my meeting with Tom. “Fifteen minutes early is on time, and on time is late,” Dad always said. Tom showed up and introductions were made between myself, my wife, Lori, who is also a certified bio-forensic restoration specialist, and Tom. With that, Lori and I donned full PPE - two pairs of Nitrile medical grade gloves, protective booties, and PAPRs, and went to work.
Installing anti-microbial pre-filter rated to Capture and Inactivate 99.49% H1N1 Virus.
Site & Risk Assessment
It was clear from the beginning that this was not going to be an unattended death site that fit the profile. Most unattended death sites happen because someone died and had no one checking in on them, and therefore were not found for some time. If you, the reader of this article, didn’t show up for work or home, people would start looking for you, or in my case, celebrating.
Human decomposition begins approximately four minutes after death. In an average adult, there are between 1.2 and 1.5 gallons of blood. In an average 200-pound adult, there is more than 120 pounds of bodily fluids. They are going to go somewhere. Because of mental health and addiction issues often tied to unattended deaths, these incident sites are commonly unsanitary and more often than not, biologically hostile environments. While this incident site was devoid of visible gross contamination, it is what you could not see that could make people sick, or worse.
As Lori and I entered the residence, Lori stopped and took the first of many ATP scores, and I began to photograph the interior.
It takes five minutes for the human eye to adjust from bright sunlight to dimmer interior lighting, and now the canine fecal matter was becoming obvious. Small dog, I thought to myself, and began to notice that the older fecal matter was typical for the byproduct of commercial dog food. However, it was clear there had been a transition to looser stools and then just puddles of dried liquid matter. This happens when a dog’s diet is changed and goes higher in protein. I’ll spare you the gory details, but I am sure you can figure it out.
Wet washing of concrete subfloor in excess of 200°.
I made my way to the hall, where the person had passed, and there I found a 4x8-foot section of carpet and pad (1/2-inch re-bond) removed, along with two rows 1x1-foot tile going into the hall bath and a small section of sheetrock, 6x18 inches. I also noted that on the concrete subfloor, a white sealant was used.
Personally, I am not a big fan of using sealants; they make me wonder "what is someone hiding?” Clean it, verify cleanliness with an ATP, then apply an EPA-registered disinfectant.
Next on the list were the flies. Flies, especially blowflies, can show up minutes after death. It has been said that blowflies can smell death for miles. Flies begin to dine and lay eggs on the host’s eyes, nose, mouth, ears, open wounds, and any other orifice they can find. They then move about landing and turning contents and structures, especially windows, into fomites by transferring bacteria from the host wherever they land. Remember, whatever a living organism eats, that’s what it defecates whether fly or dog.
I noticed Lori kneeling down and examining an area just inside the master bedroom.
“Whatcha got?” I asked.
“Someone has tracked and transferred body fluids into here,” she replied. Lori is a certified crime scene track investigator as well as a search and rescue tracker. “Their right shoe was contaminated and it transferred to the carpet when they pivoted on the ball of their right foot, turning left to go to the master bathroom, probably a first responder.”
Disposable microfiber pad showing effectiveness of dry cleaning in reducing the soil and viral load.
ATP readings were recorded, pictures and measurements taken as well as all pertinent information needed to help establish a Forensic Restoration® solution based on the science of bio-risk management/infection control and utilize the techniques of Forensic Cleaning® and professional disinfecting.
After properly doffing our PPE at the door and bagging it, we went outside to visit with Tom to discuss our findings, his expectations, and the scope of work.
“Tom, the three major components of any forensic restoration project are structure, contents, and indoor air quality, not necessarily in that order,” I explained. From there, we discussed how each item would be addressed.
“And there won’t be any odor?” asked Tom. “And you don’t have to pull out all of the sheetrock?”
“No sir. Not only will it be odor-free, more importantly, it will be a healthy hygienic environment. I will be the first person in and the last one out, and I will not step off this project until I am comfortable with you opening a daycare center in that house the next day,” I replied.
“Sounds good Jeff, I’ll call my insurance company and go over it and I’ll be in touch,” Tom said.
Two days later, Tom did call back.
Wet cleaning of tile floors with an I-mop self-contained rotary extractor.
“Jeff, we dealt with two other companies before you,” Tom said. “Well, the family has discussed this and we firmly believe that God brought you and Lori into our lives.”
With that, Lori and I got to work. From the initial contact, we had been acquiring critical incident data: the who, what, when, where, and how, which begins to lay the foundation of knowledge that helps us as Forensic Operators® to prepare physically, mentally and even spiritually to perform at a top tier level.
From our incident site/risk assessment, we determined the scope of work to include ATP readings, photos, measurements, and developed a tactical approach to addressing structure, contents, and indoor air quality while never forgetting the prime directive of forensic restoration, which is safety – for us and all future occupants of the micro-environment.
Operations
After assembling a team of certified forensic operators, it was established that the operations zone would be the entire interior of the home, the transition zone would be the three-car garage, and the clear zone would be anything outside of the garage.
The introduction of a known infectious agent is known as a Tier 4, Risk Level 3 project. Life is full of possibilities and probabilities. Is it possible that in the middle of a global pandemic that the deceased had COVID-19? Yes. In the middle of a global pandemic, is it probable that the deceased had COVID-19? For safety reasons, we worked as if the answer were yes.
PPE included:
- MaxAir PAPRs
- Full microporous suits
- 2 pairs of Nitrile medical grade gloves
- Heaver mil exterior glove
- Protective booties.
Post forensic cleaning validation with an ATP showing a Certified Forensic Operator's favorite number, Zero.
The first phase of operations is to empty out and perform forensic cleaning of the three-car garage, including the use of disposable microfiber pads to dry clean the ceiling and the walls. Next, the above mentioned surfaces were wet-cleaned with an EPA-registered hospital grade tuberculocidal disinfectant/cleaner with a six-log kill, dispensed through a foaming delivery system so that dwell time could be achieved on vertical surfaces, and manipulated via mechanical action utilizing disposable micro fiber pads. The garage floor was swept and wet-washed utilizing a mobile cleaning plant at temperatures exceeding 200°, then rapidly dried to prepare the garage for the “transition zone.”
Pre-Disinfecting
Utilizing ULV delivery systems and working in pairs, two teams for forensic operators made a tactical entry and began the application of an EPA-registered, hospital-grade tuberculocidal disinfectant with a six-log kill, proven to kill both gram-negative and gram-positive bacteria and inactivate both enveloped and non-enveloped virus.
To the floor in front of them, the two teams then split off from each other working, their way to the HVAC returns, where they applied the EPA disinfectant while the fan was running for further dispensing of the disinfectant.
Then, both teams, while still working the floor in front of them, continued to apply disinfectant until they reached the furthest point of the home from the point of entry.
As they worked their way out of each microenvironment in the home including bedrooms, closets, and bathrooms, they treated the air space retracing their path back to the point of entry, thus completing pre-disinfecting operations for a pathogenic knock down creating a safer working environment.
After exceeding the manufacturer’s recommended dwell time, the home was burped with a fresh air exchange and the work of clearing out all the contents, including carpet and pad, began. Once all of the contents were removed, every bit of flooring was swept, vacuumed, and wet-washed utilizing a mobile cleaning plant at temperatures exceeding 200° to minimize tracking and transfer of both visible and invisible contaminants.
The next phase was the forensic cleaning of all vertical and horizontal surfaces. GBAC Forensic Cleaning is defined as the removal of biological contaminates, to prepare surfaces both vertical and horizontal for professional disinfecting. This actually ran in two phases.
First, all of the surfaces were dry cleaned with disposable micro fiber pads to reduce both the bio load and the soil load to prepare them for wet cleaning. Wet cleaning involved the application of an EPA-registered, hospital-grade disinfectant/cleaner dispensed through a foamer unit and manipulated via mechanical action using disposable micro fiber pads.
When all surfaces were deemed clean to the eye, it was time to put our efforts to the test. There are two reasons to clean anything: health and appearance. You can clean for appearance and still have a biologically hostile environment. If you clean for health, appearance will take care of itself.
An array of delivery systems to include foaming applicators and Electrostatic sprayers.
ATP readings were taken again. The scores? All zeros!
That, my friend, is a clean environment and what is accomplished through proper training and field experience. Next up, professional disinfecting using a disinfectant like I’ve been talking about through the entire article… with a six-log kill proven to kill both gram positive, gram negative bacteria, all known pathogens, and inactivate both enveloped and non-enveloped virus. The teams used both electrostatic delivery systems and BIT (Binary Ionization Technology) TOMI Steramist.
The final phase of this project involved the cleaning of the HVAC system using the source removal method, followed by the application of a disinfectant approved for that use and the replacement of new pleated media filters at the returns.
The next morning, I met Tom in the driveway, arriving 15 minutes early. I let Tom walk through the house on his own first.
“Wow, I don’t know how you did it, but I am impressed,” he said and handed me a check.
“Sir, it was an honor for my family to serve your family,” I responded as we parted ways.
Later, as I was driving home, I thought about something my father said, “Son, you can chase perfection and that’s a lofty goal you’ll never achieve, but if you work smart and run fast enough, you just might catch excellence.”
“Excellence is an art won by training and habitation. We are what we repeatedly do. Excellence then, is not an act, but a habit.” ~ Aristotle
Train Hard, Work Safe, Be Blessed