When most people think of diagnostic x-ray, the mental image that comes to mind is a live patient undergoing a scan. But at the Summit County Medical Examiner’s office, X-ray is used to gain additional information about patients who have already died. From autopsy planning to CSI-style identification based on dental records, the role played by FUJIFILM’s FCR Carbon X Digital X-ray system, implemented through a government grant in 2006, is anything but typical.

Gary Guenther began his work for the Medical Examiner’s office in 1988, as a photographer. Back then, he says, photographs and X-rays were developed by hand in chemical baths, a methodology that’s a far cry from how the facility operates today. Today, as a medical examiner investigator, Guenther is responsible for X-raying a wide array of bodies. “Anytime a person dies from a gunshot wound, stab wounds, all babies, burn victims, decomposed bodies, we use the Fuji’s FCR Carbon to process the images,” he says. “We also use it for making positive identifications. We take x-rays of the skull and do dental comparisons, or if a person has surgical hardware inside them, we can match that.”

Guenther estimates that between 25 and 50 bodies per year require identification. He explains that infants often have signs of internal trauma that x-ray alone can reveal; the technology is also used to locate bullets or the tips of knives to aid in autopsy planning, and can be used to detect trauma in fire victims or decomposed bodies. “X-rays can often tell us what an autopsy would,” he says.

In 1993, the office moved to a new location and began working with an X-ray system that had a film processor; thirteen years later, the office made the switch to Digital X-ray and chose FUJIFILM. Guenther says the benefits have been countless, particularly for staff members like him who perform X-rays. What’s nice with the Fuji machine is that if an image comes out too light or too dark, you can manipulate it without having to retake the x-ray. It’s so much quicker taking the images this way.”

The FCR Carbon X eliminates a multitude of hassles that came from working with film, Guenther explains. “When we had the processor, you’d take the x-ray and then you’d have to wait three or four minutes before the film even came out, and if it didn’t turn out right you’d have to do the whole process all over again,” he says. “Plus, in the long run, we’re saving all that money on film, we don’t have to deal with chemicals anymore, there’s no cleaning the processors— all in all, it’s a lot nicer.”

Digital X-ray also enables workflow benefits for the medical examiners themselves, as Lisa Kohler, MD, Chief Medical Examiner at Summit, attests. “We no longer have to wait for the film to get through the processor, which definitely helps speed things along,” she says. Images are transmitted directly to a tablet PC that Kohler can bring with her into the autopsy suite, helping guide the procedure and enabling easy comparison with medical images sent via CD-ROM from hospitals. “It’s very convenient,” she says. “I can even magnify certain areas on my tablet PC, so if I’m looking for a particular detail, I can just sit here and enlarge that portion on my screen. I don’t have to go hunting for a magnifying lens.”

Considering “the convenience factor, the speed, and the quality,” the shift to digital has her smiling—even in the most morbid of environments. “We’ve been really happy having the unit here,” she says. “The training was simple, most of the people are able to work with the unit during the day shift, and all three of the doctors here have been very happy with the equipment and the ability to utilize those images in the autopsy suite.”