The Honolulu Medical Examiner’s office needs a lot of work. 

Refrigerators holding the corpses “frequently” warm up to levels that quicken decomposition, Acting Medical Examiner Masahiko Kobayashi said. 

After years of the city’s “band aid approach” to its leaky roof, an employee slipped on a puddle in October, injuring her head and wrist. She is still out on medical leave. 

The Hawaii Occupational Safety and Health Division said it’s investigating the office after another employee complained about mold.  

“The building is aging, so that creates all the challenges,” Kobayashi told Civil Beat earlier this month. 

Medical Examiner Medical Examiner Dr Kobayashi stands in morgue.
Masahiko Kobayashi, Honolulu’s acting medical examiner, said an organ scale once dropped from the ceiling while he was working. Cory Lum/Civil Beat/2020

The city has known for years that the office is in disrepair. Two years worth of maintenance records recently obtained by Civil Beat show a litany of problems: frequent leaks, falling ceiling tiles, termite and ant infestations, black mold. 

“Roof needs to be replaced,” a facilities maintenance official wrote in response to a September 2018 work order. “Former and past carpentry supervisors have been pointing this out for a while now. The repairs we have been making are only temporary at best.” 

In November, a grate on the morgue floor fell in. A year prior to that, an organ scale fell from the ceiling. Luckily there weren’t any body parts in it at the time, Kobayashi said with a laugh.  

The office is still experiencing many of the same issues it had the last time Civil Beat toured the office two years ago. Despite a budget allocation of $5 million approved in 2018, the only capital improvement project the medical examiner’s office has undergone since then is a $105,000 upgrade to the electrical system, according to the city.

But improvements are on the way.

A new refrigeration system, approved in last year’s budget process, is scheduled for installation starting in April, Kobayashi said. In May, re-roofing is supposed to start and a $4 million contract for interior renovations, including expanding body storage, will go out for bid. Interior work is slated to start this fall.

“It’s not like we approve the budget and all of a sudden, it starts to happen,” said Managing Director Roy Amemiya, adding that the city has two years after capital budget approvals to spend the money. “There’s planning and designing, and that happens before we go out to bid.” 

Still, other buildings have undergone improvements sooner including firehouses, which serve as secondary residences to firefighters, and Honolulu Hale, which got a new roof last year.

“There are priorities. There are roofs that we fix and roofs that have to wait,” he said, noting his own department leaks. “I don’t believe that people here suffered any more than others in the city.” 

‘Assist Us ASAP’

During a Civil Beat tour of the facility on a sunny Friday, the building didn’t seem to match the chaos reflected in the work orders. There was a drainage system on the ceiling of the autopsy room, and a few ceiling tiles were missing. But for the most part, the tiles were intact and mostly clean. The mold in the lobby was removed.

Medical Examiners 2nd floor fixed roof area. Before a large tarp covered and protected area from leaking roof.
The ceiling is patched up where there used to be a tarp catching rainwater. Cory Lum/Civil Beat/2020

An internal city email obtained by Civil Beat helps explain why. In the week between Civil Beat’s request for a tour and the visit itself, the city – with Amemiya’s help – scrambled to improve its appearance.

“Dr. Kobayashi, Charlotte, Charles, and I are all working with (the Department of Facility Maintenance) to repair the facility since the Civil Beat is possibly doing a follow up story,” a medical examiner’s office administrator wrote in a Jan. 13 email to staff. 

“This morning I met with the Assistant Chief of DFM, as well as from the divisions of Carpentry, Plumbing, Painting and Electrical.  Thankfully, we have the support of the (Managing Director), who has directed DFM to assist us asap.”

The office didn’t want to show off its mold problem, Kobayashi said. 

“So they fixed all the things so, kind of, quickly,” he said. 

The email lists a to-do list of 10 items to address including leaks, black mold, stabilizing grates and yard work. 

“When you called, we looked at some of the things that had not been completed and our facility maintenance people sent a crew down,” Amemiya told a reporter. “We wanted to put our best foot forward.” 

‘It Should Be OK’

The problems at the medical examiner’s office are a nuisance, but Kobayashi said they don’t threaten the integrity of evidence. That includes the bodies, he said. 

The refrigerators are supposed to be around 40 degrees, like a fridge in one’s home, Kobayashi said. But the morgue’s refrigerators sometimes increase into the 50s.

Medical Examiner morgue refrigeration area.
Honolulu needs body refrigerators that stay cold. The city says a new system will be installed this year. Cory Lum/Civil Beat/2020

His employees have to check on the system three times a day to make sure it’s working. If it’s not, maintenance workers respond to get it back on track. 

If the system breaks down completely, they have to remove the bodies and send them to a storage facility to the tune of $25 per body, per day, Kobayashi said. But that hasn’t happened in years, he said. 

As for how the warmth impacts the bodies, Kobayashi wasn’t concerned. If the body were left at a warmer temperature for half a day or longer, it could accelerate decay, according to Kobayashi, but he hasn’t heard of any issues. 

“Usually we can quickly find out, so it should be OK,” he said. 

Sally Aiken, president of the National Association of Medical Examiners, said rising temperatures can cause some problems if a body warms up before it’s been autopsied. DNA and evidence from a sexual assault, like semen, degrade with heat, she said.

Loss of evidence is unlikely, she said, but possible, especially if the bodies aren’t autopsied right away because of a holiday or backlog.

Medical Examiner damaged roof in morgue.
Ceiling tiles often need to be replaced at the medical examiner’s office. The facility needs a new roof. Cory Lum/Civil Beat/2020

“Probably Honolulu needs to invest some money because it sounds like a lot of work for the medical examiner to keep checking all the time and making sure it’s working,” she said.

Blood samples in vials and specimens of organs in glass jars are not exposed to leaks or mold, Kobayashi said. 

Aiken didn’t doubt that but said the crumbling ceiling is a problem.

“You could damage evidence with a tile striking the right place,” she said.

Is Evidence At Risk?

In the past, local criminal justice advocates have expressed concern about the state of the Honolulu medical examiner’s office. 

“The integrity of that particular workspace is important,” Jack Tonaki, a former public defender who is now a judge, told Civil Beat in 2018. 

Ken Lawson, co-director of the Hawaii Innocence Project, worried tainted blood or tissue samples could lead to wrongful convictions. 

“We’ve become accustomed to not trusting anything that comes out of those labs because we don’t believe that they’re reliable,” Lawson said at the time.

Representatives from the Hawaii Public Defender’s office and Honolulu Prosecuting Attorney’s office did not respond to requests for comment for this story. Neither did former Medical Examiner Christopher Happy, who resigned last year amid criticism from Amemiya that he wasn’t meeting the demands of his caseload.  

Beyond evidence, perhaps the bigger issue is preserving the bodies for the deceased’s family, Aiken said. Storage can be prolonged if the office has trouble locating next of kin or the family is taking some time to make arrangements.

“You preserve bodies because families may want to look at them,” she said. “It may not be what they desire if you’re having problems with your refrigerator every day and the temperature is increasing.”

While they wait for renovations, Kobayashi acknowledged that leaks in his office can create a hazard.

Medical Examiner Building Morgue.
Honolulu doesn’t think moving the medical examiner’s office out of its Iwilei Road facility is worth the trouble. Cory Lum/Civil Beat/2020

“I don’t want that to happen again,” he said of his employee’s slip and fall. 

The problems have gotten the attention of the Hawaii Government Employees Association which said its members have complained about “potentially unsafe working conditions” including the leaking roof and mold. 

“The Union takes health and safety issues very seriously,” HGEA Executive Director Randy Perreira said in an emailed statement. “We are currently conducting further investigations into the situation and are considering our options to try to force the City & County of Honolulu to make immediate repairs.” 

Despite the building’s issues, Amemiya said the city isn’t considering moving the morgue to a new location. The approvals needed to establish a new medical examiner’s office are a non-starter, he said. 

“Structurally, this building is still good,” he said. “It needs some tender loving care. With the roofing project, the refrigeration project and the $4 million renovation, we’ll get it up to the standard that is deserving of the department.”

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