HILO, Hawai‘i — The Hilo Benioff Medical Center morgue is severely overcapacity — with repercussions festering beyond the hospital’s campus, according to several sources.
HBMC spokeswoman Elena Cabatu said Friday the need for Hawai‘i County to build its own morgue is urgent, “due to the overcrowding in the morgue refrigerator at the hospital.”
“The mechanical cooling system is under constant strain, causing parts to often fail,” said Cabatu. “We are asking the county to store their bodies … starting in September to preserve our aged facility and alleviate crowding.”
According to state law, the chief of police in each county is the county coroner, and police officers are deputy coroners. Police, as coroners, have used the hospital’s morgue as a holding facility for bodies in coroner’s inquest cases and in criminal investigations.
Capt. Rio Amon-Wilkins, commander of the East Hawai‘i Criminal Investigation Division, acknowledged that HBMC “no longer wants the police department to store decedents at the morgue” if the the death occurred somewhere other than at the hospital.
“Anybody who died at home, anybody who died in a traffic fatality, drowning victims, homicide victims, suicide victims — they want the police to store the bodies elsewhere … pending the autopsy and pending the body being picked up by the mortuary,” Amon-Wilkins said.
According to Cabatu, HBMC’s morgue, which is in the basement of the main hospital building that was constructed in 1984, “was originally built to accommodate 16 bodies.”
“As of Monday, July 8, we had 24 bodies, four of which were HBMC’s and 19 of which could be transferred to the county,” she said. “Our occupancy rates average 175 percent to 230 percent capacity. We average around 20 to 25 bodies, and have gone to as high as 30 to 35 bodies. HPD consistently accounts for over 60 percent to 70 percent of the bodies held in the HBMC morgue.”
Cabatu said some bodies remain there for extended periods of time.
“The ‘oldest’ body currently in the morgue entered on Jan. 26, 2024,” she said. “In the past, we have stored bodies for well over seven months, and sometimes over a year, depending upon the HPD case.
“Another past situation involved us storing ‘bones from the Wailuku River’ in our morgue for well over two years.”
Cabatu said that ongoing problems with the morgue cooling system has HBMC looking to effect a “temporary intervention” by replacing “the overworked refrigeration coils.”
“This requires a couple of days and as such the morgue should be ideally emptied or census greatly reduced. HPD has capacity in their reefer in Kona (Community Hospital),” she said. “We are asking them to transfer the ‘County of Hawaii bodies’ to help make the repairs possible.”
Police have a contract with Clinical Labs of Hawaii to perform autopsies, and HBMC has a contract with Clinical Labs to manage and operate the morgue.
“There’s a forensic pathologist here in Hilo that does some of the autopsies,” Amon-Wilkins said. “And oftentimes, we’ll fly one in from Honolulu, if needed, dependent on the availability of the pathologist here. Then once the primary care physician signs off on the death report or the autopsy is completed, then the police, as deputy coroner, will sign off and release the body.
“And at that point, the mortuary of the family’s choice will … go to the morgue and make arrangements to pick up the decedent and take them to the mortuary.”
Mortuaries have their own smaller morgues, holding bodies prior to embalming, cremation or burial. An informal Tribune-Herald survey of obituaries the past two years indicates Dodo Mortuary handles arrangements for about 75 percent of the island’s decedents.
According to Mitchell Dodo, vice president and operations manager, his family’s Wainaku Street funeral home in Hilo has a current holding capacity of six unprocessed decedents.
“We currently have on order another three-body refrigeration unit which is being manufactured on the mainland. We anticipate receiving it in about a month,” Dodo said. “Based on an email I received from Clinical Labs personnel on Tuesday, we were made aware of six decedents which needed to be picked up from the morgue.
‘The decedents on that list passed away on varying dates, but no longer than a week prior to July 9.”
Dodo said his family’s facility has “the space and power capacity to accommodate a refrigerated shipping container on our premises.”
“In fact, we had a 20-foot refrigerated container on premises for the past three years, in a joint agreement with Hawai‘i County Civil Defense in anticipated preparation for deaths occurring due to the COVID-19 pandemic,” he said. “Fortunately, we didn’t have to use the container even once, and Civil Defense removed the container from our premises during the earlier part of this year.”
According to Dodo, “The current morgue facility at HBMC is in dire need of being expanded.”
He added it is “currently serving a three-fold purpose” — holding the bodies of patients who die at HBMC, acting as the unofficial “Medical Examiner/Coroner’s Office” for East Hawaii, and as a long-term storage facility for indigent decedents or those without families.
“A step in the right direction would be to establish a separate Medical Examiner/Coroner’s Office at an off-site location, such as is done on O‘ahu or the mainland,” he said.
“This would reduce overcrowding significantly, since ‘M.E. cases’ — a death due to other than natural causes — would be cared for outside of the HBMC. It would also increase the level of security and confidentiality for M.E. cases, because funeral homes picking-up decedents from HBMC would no longer need to go into the same area where all decedents are held together now.”
Puna Councilman Matt Kaneali‘i-Kleinfelder plans to introduce a bill seeking $1.5 million from the county’s capital improvement budget for the current fiscal year for land acquisition plus planning and design for a morgue.
A supporting document said there is a high urgency for the project. The document indicates an intent to request an additional $5 million for the project in the next fiscal year.
Kaneali‘i-Kleinfelder sent a letter dated June 28 to Mayor Mitch Roth requesting his “review and recommendation” for the councilman’s bill proposal to amend the budget to make the $1.5 million appropriation.
According to Kaneali‘i-Kleinfelder, the measure is scheduled for the July 23 meeting of the County Council’s Finance Committee at the West Hawai‘i Civic Center in Kailua-Kona.
“What worries me is that the county is going to have to find (refrigerated) containers and then put them in some parking lot” (to store bodoes), he said.
Kaneali‘i-Kleinfelder hinted a power outage to a storage container could exacerbate an already less-than-ideal situation.
“I mean, the logistics of that is just crazy,” he said.
The need for a separate morgue facility from the hospital’s is one that has all parties in apparent agreement.
“The county’s population has outgrown the morgue’s capacity,” said Cabatu. “We are working with the county to devise an interim solution that is not on the HBMC campus. HBMC is committed to providing morgue services for patients who pass in the hospital.
“We are glad that the county is working on a permanent solution for all other deceased and are appreciative of their efforts.”
