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Home / Articles / News / News /  THE POLITICS OF DEATH:
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Thursday, May 15,2014

THE POLITICS OF DEATH:

NO ONE CARES WHO THE CORONER IS… UNTIL THEY DO

By Elizabeth Miller
Courtesy of Deron Dempsey and Emma Hall

The truth is, none of us really want to have to care about who becomes the next county coroner. If you care, it’s likely because you’ve been on the living side of a sudden and unexpected death, the kind of death the coroner’s office is called in to document and investigate — a car accident, a homicide, a suicide, the death of a child or any death that no one was around to see. But ask those unfortunate souls who have found themselves in the coroner’s office following the death of a loved one and they’ll tell you it matters greatly whom we elect as coroner every four years.

While the coroner’s office is responsible for determining cause of death, which requires investigating forensic details and performing autopsies based on state law and the coroner’s determination of need, it’s not the elected officer who performs those autopsies. Only a board-certified forensic pathologist — requiring medical school and a multi-year specialized residency — is qualified to perform an autopsy; the only educational requirement to become a county coroner is a high school diploma.

The coroner’s office is a hub that compiles and relays information gathered to families, law enforcement, mortuaries, hospitals, hospice centers and district attorneys. Much of the ground work is done by a team of medicolegal death investigators, who visit the scenes of a death not attended by a physician to interview the family, identify the deceased, obtain family and medical history, attend autopsies and compile the information that will determine what cause of death is ultimately listed on the death certificate. Their work is overseen by the county coroner — a job that could be best characterized as administrative and, particularly considering that it’s an elected position, a public service role.

On June 24, two candidates for coroner will face off in Boulder County, incumbent Emma Hall and her challenger Deron Dempsey, in the Democratic primary. No Republican or independent candidates are currently listed on the ballot, so the winner of the primary wins the election. The race has taken a surprisingly contentious turn as a few individuals who have worked with the coroner’s office under Hall’s administration have also come forward publicly to complain about the manner in which they were treated by Hall and her staff.

While Dempsey is quick to say this race isn’t personal, it is largely about personal philosophies, management styles and the method for handling cases that distinguishes the two candidates. One thing is clear: This time around, voters have two clearly distinct candidates from which to choose.

Ask each candidate about the moments that have confirmed why the work they do is important, and their answers illuminate their differences.

Hall talks about cases that presented a complex set of actions to unravel forensically. The domestic dispute that ended in a mother shooting her son, who then threw her down a staircase and stomped on her face, and required investigating the causes of her death and how he’d been able to come back from five bullet wounds to attack her (a case later dismissed as selfdefense). A 16-year-old killed in a hit-and-run on New Year’s Eve that, depending on whether he fell or was pushed, could have been ruled either a homicide or a suicide, but there was never enough forensic evidence to make that determination.

Dempsey talks about a blackjack dealer in Vegas who stopped handing out cards to tell him how important his job was, how her child had died while she was at work and the coroner had allowed her to hold him once more before they took his body for an autopsy. He mentions a case from his time working in the Boulder County Coroner’s office under Hall’s predecessor, Tom Faure, that had him calling a man in Chicago on a weekly basis. The calls went on for two months as they waited for DNA to confirm what circumstantial evidence suggested — that someone had finally found the man’s son who’d stopped calling home within a week of the paystub found with his remains. Half the time, Dempsey says, what they talked about wasn’t even the case.

The differences between the two candidates run as deep as the experiences and interests that led them each to careers in the coroner’s offices.

Hall grew up in Lyons and, as a 4-year-old, had her interest in death investigation first piqued when a woman was murdered near her family’s ranch — yes, that Hall Ranch.

“I had all these questions, but really what I was concerned about was that the family’s questions were answered,” Hall says.

Hall obtained a bachelor’s in chemistry from the formerly-named Metropolitan State College of Denver, interned with the Denver Police Department Crime Lab and worked for a year and a half as a death investigator in Adams County. She didn’t expect to run for county coroner as early as 2010, but when Tom Faure, her predecessor as county coroner, announced his retirement, she decided to go for it.

Immediately after being sworn in as the first female coroner for Boulder County in January 2011, she entered the county coroner’s office and found a project that would keep her up nights and working weekends for most of the first year she was in office. She found, and documented in photographs because, “It’s what I do, I document,” she says, evidence and decedent property loosely stored and boxes of case files stacked in various rooms around the office.

“It was just kind of like a scene from the Hoarders,” Hall says.

Medications were in various cabinets, unsorted, unlabeled and uncounted. A grocery bag on the floor held unlabeled ligatures. Decedent property that had never been returned to next of kin went back to the 1980s, Hall says, and among it was a set of baby clothes and a wedding ring. The refrigerator used to store tissue samples for toxicology was full to over flowing with evidence for cases long since solved.

A basement storage facility had the framework for shelves up, but no shelves in place. It held old tires from county vehicles, Hall says, and two tanks of helium that weren’t marked with any case information. Vehicles for the coroner’s office were similarly overcrowded and disorganized, she says.

“I was just mortified to think of a family seeing this vehicle show up at their house to transport their loved one,” Hall says. “You’d open the doors and things would fall out and it was just a disaster, and there just really wasn’t even adequate room in it for putting someone in there.”

High profile cases were loosely stacked on two shelves separate from the piles and boxes that crowded work spaces and edged out from under desks for medical investigators.

She compiled 40 boxes, holding some 300 case files, of cases for which final reports had never been completed. That report isn’t required, but it helps answer any questions that might later arise from law enforcement and family members about how the coroner’s staff arrived at the decision for cause of death, Hall says.

“There might be a few notes in the case file, but there’s nothing really that documents how they came to that conclusion,” Hall says. “To me, it shows a lack of documentation and lack of professionalism to have 40 boxes worth of that. It’s, to me, disgraceful.”

Was the state of the office a question of tight budgets and short staff?

“I would say it’s really more about philosophy, because that didn’t just happen overnight,” Hall says. “If you don’t have a philosophy and policies and procedures in place that keep you streamlined and organized, then over time, that’s what you’re going to end up with.”

The office is now the paragon of tidiness. Case files are stored in covered shelves, the counter tops and floors are clear and evidence lockers empty unless an investigator is actively sorting through evidence. The once over-stuffed fridge holds just a few carefully labeled samples. She’s also updated the communications equipment so the staff are on the same phones and pagers, instead of the array of various models from different providers that met her arrival. The computer system has been updated and a customized program for tracking case information, including chain of custody for decedent property has been added.

Staff have been issued uniform polo shirts embroidered with the logo of the county coroner’s office.

Draft reports are due within 24 hours of a death coming in and are reviewed by Hall or her chief deputy coroner. A white board in one of the offices for the medical investigators tracks the bodies currently in the Boulder Community Health morgue, the off-site facility the coroner uses for storage and autopsies.

Hall has successfully lobbied for a new facility, a 9,000-square-foot building that will house the coroner’s office and morgue in the same facility, along with autopsy suites and case file storage. (She went through 13 versions of the plans with county architects.)

Her office has handled an increasingly busy caseload coming from police departments in Longmont, Boulder and Lafayette. Police departments in Boulder had 70 cases in 2012 and 84 in 2013, Longmont had 79 cases in 2012 and 112 in 2013; and Lafayette had 21 in 2012 and 32 in 2013. Those are, respectively, 20 percent, 41.8 percent and 52.4 percent increases.

At campaign events, her opponent has pointed to a 34 percent increase in autopsies, an expensive medical procedure, since 2011, and Hall says that’s correlated to the increase in calls.

“The more scenes we have, the more autopsies we do,” she says.

Changes around the office don’t just include the organization, though. Hall has seen 100 percent of the staff she inherited leave those positions, and weathered an additional 43 percent turnover on top of that.

“When you’ve worked in a situation and an environment where there was really no accountability and there wasn’t any structure, I think it’s really a difficult change to suddenly have expectations and accountability and structure,” Hall says. “I was kind of methodically going through and making changes and not just making all of my changes all at once, but it was definitely hard for them.”

Two of her previous employees see it differently, though, and one of them is asking Boulder County’s voters to give him her job.

Dempsey worked in the Boulder County Coroner’s office as a medical investigator for half a decade before Hall was hired. He stayed five months after she started as his supervisor.

“There was a philosophical difference,” Dempsey explains. “This race isn’t personal by any means. I really think that this is about experience. And what I did see was a lack of experience. When the coroner took over in 2011, she only had 18 months of experience in the field prior to being elected and I think it’s very hard to develop an administrative policy in only 18 months.”

Dempsey’s arrival at the coroner’s office came by chance. The Ohio native, who studied criminal justice in college, was working with at-risk youth at Attention Homes and was on track to become a fire fighter, having earned an EMT certificate and started volunteering for the rural fire department, when the job opened up at the coroner’s office.

“I’ve always been passionate about public service and it was through an unexpected career in the coroner’s office I found that you could really provide a needful public service in a way I’d never expected,” says Dempsey, who now works in the Jefferson County coroner’s office as a medical investigator.

Hall says the impression she got from Dempsey was that “he really wanted to be in charge” and that she didn’t see a lot of “big picture thinking” from him and struggled to get him on task with projects like inventorying cases he might be behind on or helping to clean up the vehicles.

“A lot of people that don’t really know what they’re getting into when they get into this field think that all they’re going to do is scene work, so they don’t really have a good grasp or a real interest, or I don’t know if I want to use passion, but, for the paperwork,” she says. “For me, I don’t love paperwork, but yet I do.”

While Dempsey agrees that there were organizational changes needed at the coroner’s office and organization and infrastructure development are clear strengths for Hall, he says he thinks some of the changes Hall has described have been exaggerated. A staff he describes as competent, well-trained investigators who were good at engaging the public, collecting history and processing death evidence felt they had their skill set questioned from day one, perhaps because their organizational strategies didn’t align with Hall’s expectations.

“Some of the things that she’s said about the improvements she’s made is like comparing apples to oranges because they weren’t done the same way, and that’s OK, you can run the office however you want,” says Amber Grantham, who worked for the coroner’s office for three years with Faure and one year with Hall. “But I will say that the policies and procedures that she implemented, they decreased the morale of the staff.”

Grantham worked at the coroner’s office as part of an ongoing career in the medical field that began while she was a University of Colorado Boulder student working in ambulances.

She left that position a year after Hall began as county coroner over incidents she says she felt compromised her ethics to the point she took them to human resources — whose only reply was to say that Hall’s an elected official, and there wasn’t much they could do.

While all the new equipment is nice, Grantham says, at no point before it was purchased did she feel like she didn’t have what she needed to get her job done. She adds that the uniforms caused her to worry that the coroner’s staff, who are independent from law enforcement though they may collaborate and do interviews in tandem, would be confused as law enforcement agents.

“I can give you examples where I would go in and say, ‘Listen, I’m not a cop, anything that you tell me I do not have to share with them, it can be off the record, but we think that this person died of an overdose and it’s really important that you tell me what you were doing so that way we can do the right test,’” Grantham says. “And people would say to me, ‘OK, don’t tell them because I don’t want to get in trouble with the cops but...’” 

Bottom line, she says: “At three o’clock in the morning when I say, ‘I’m sorry, your dad is dead, but don’t worry, our office is organized’ — that’s meaningless. You want somebody who’s going to say, ‘I’m sorry, I want to give you some empathy, I want to give you some resources to get you through this time. It doesn’t matter that his file is alphabetically organized in a storage locker.”

Among the many changes Hall implemented was a fundamental shift in how cases were managed. When Faure managed the office, a single medical investigator handled a case from the time the call came in about a death until the death certificate was signed off. That investigator would have responded to and documented the scene, conducted any initial interviews to record medical, social and circumstantial history, worked with law enforcement, notified surviving family members, collected and summarized medical records, arranged and attended autopsies, followed up with families about preliminary findings and what tests would be required and provided updates and estimates for time frames throughout, right up to when the final results came in.

“That really did carry an ongoing dialogue and a good relationship with the family,” Dempsey says.

“I felt a stronger connection when I was able to work with the families all the way to the end,” agrees Grantham. “I think the families appreciated it more because when they called the office they had a point of contact to ask for.”

That system worked within an on-call/overtime system for staffing that Hall changed during her first year in office. Instead of investigators working a 40-hour work week along with a 24-hour on-call rotation, she split the day into shifts and investigators now staff the office around the clock.

“Only 30 percent of our cases come in during business hours, Monday through Friday 8 to 5, which is why we spend so much time in overtime because they’re working their 40 hours a week Monday through Friday,” Hall told the Boulder County Commissioners during the October 2011 budget hearing in which she proposed making the change. She’d conducted a nine-week pilot program on the 24-hour shift work rotation, and told commissioners that it improved response times at night and made workflow more fluid. The change would also reduce overtime expenses, which had been consistently over budget since 2006 and were, as of October 2011, more than double the budgeted amount for the year.

Total expenses for personnel in 2012 were still $87,430 more than in 2011, according to the coroner’s annual report. The 2013 numbers have not yet been released.

But that change has come at a cost to the families, her former employees argue.

Under the shift work model, cases pass from one investigator to the next as shifts change.

“When people would call the office after Emma took over, they would say, ‘My dad died, I need to talk to somebody. I don’t know who was there,’ and it was a crap shoot whether that person was in the office that day or not if they got somebody that was knowledgeable about their case,” Grantham says.

A single person can also hear the way a story changes as a family retells it, find nuances that might be different from one day to the next and troubleshoot those discrepancies.

“When you have one person who’s collecting all the information and knows the entire story, you’re able to put together a more comprehensive, collective picture,” she says.

There was also a forensic component to taking the time to listen, Dempsey says — sometimes people would mention a point they’d forgotten earlier but added relevant evidence to the case.

“Her management style is ‘everything is suspicious until proven otherwise,’ and her stats prove that that’s not the case, especially in this community,” Grantham says. “I mean, 98 percent of our case load is medical cases. You get those homicides in there — what has she had, like two in the last three years, three maybe. It’s not a big portion of the case load, so 98 percent of the time she should be treating the families with compassion because that’s who she’s serving.”

How they were handled on a personal level has been at the center of some of the complaints made publicly about Hall’s office.

Jacqueline Arnold rode with her 28-year-old daughter, Jodi ( Johanna), on the drive to the hospital from their north Boulder home after Jodi, became very ill to her stomach. She believes now that Jodi died on the drive, but was revived through, as she describes it, “horrific CPR” at the hospital and kept on life support for three days. Believing that her daughter, who had been diagnosed with cerebral palsy, would never breathe without the aid of a respirator and her quality of life, already challenged because of her existing health conditions, would be further deteriorated, she and her husband, Edward, made the impossible decision for parents: They took their daughter off life support on Nov. 9, 2012, just five days before her 29th birthday.

It was a hard enough situation, Arnold says, but made harder by the treatment that followed. Jodi died on a Friday and by Friday evening, they were getting calls from the county coroner’s office questioning their treatment of their daughter. The coroner’s staff had discovered a bruise on her stomach, and the line of questioning the Arnold family met was something she compares to a criminal interrogation. For three days, Arnold says, tearing up, Jodi’s body lay in the basement of the hospital where she died while her parents were questioned for any potential wrongdoing.

By Sunday evening, Arnold recounts, her husband finally started yelling at the coroner’s staff on the phone and demanded to speak to the county coroner herself. It was Arnold who spoke to Hall, and began by recounting her work as a librarian for the jail and a certified ombudsman in nursing homes.

“We’re both advocates for people with disabilities,” she told Hall, adding, “And I want you to know if any daughter was treated beautifully, it was our daughter.”

She also mentioned that Jodi had been taking fish oil. That news came as an apparent surprise to Hall. Fish oil is a blood thinner. It corroborated the suspicion Arnold had about the CPR Jodi had received as the cause of the bruise on her daughter’s stomach. Hall signed the death certificate and released Jodi’s body so her family could move forward with funeral arrangements.

At the end of the call, Hall offered her condolences.

“It just sounded kind of like a robot, and maybe when you do this work you have to be a robot, because it’s too much otherwise, day after day after day,” says Arnold, who now campaigns for Dempsey. “If she were the only one on the ballot in the primary I just wouldn’t vote for her until I knew she had turned this upside down and said, ‘You know, be very careful when you’re dealing with parents and loved ones.’ … She has organized everything — apparently things were in a big mess, I would not know because I’ve never been in the coroner’s office. But it’s like, what comes first, a clean desk or your interactions with people and making sure your staff kind of don’t go nuts with people?”

By the time Francie Sullivan came to wake her 9-year-old daughter, Nicole Haley’s body was already cold. Sullivan and her brother performed CPR on Nicole anyway while waiting for the ambulance to arrive. Standing in her pajamas in her living room, Sullivan had just one question for the law enforcement and medical professionals who soon filled her living room: Was there something else she could have done to save her daughter’s life?

An EMT told her no, Nicole had been gone so long by the time they got there that there was nothing anyone could have done.

Her introduction to the county coroner’s office was through a form letter that said the answer to what happened with Nicole — why a healthy 9-year-old who’d had a well visit to her pediatrician just three days before her death and been cleared for all activities had suddenly died — would be at least six weeks coming.

“I needed answers,” Sullivan says. “An unexpected, unexplained death in a child, it’s any person’s worst nightmare, but to be told, six weeks…”

Sullivan waited five weeks before she started calling the coroner’s office. She’d call, she says, be put on hold for a few minutes, and then someone would come back on the line and say the case was still pending. They had no answers for her. She started personally asking for Hall, and received, she says, one email response saying the case was ongoing.

“I think my frustration is, even if they were sending things off, if they could have just said, ‘We didn’t find anything to date and we really want to now send it to this expert in Denver, but it may take several more months,’ but I would never get anything like that, it was just, ‘We should know something in a week,’” Sullivan says. “I contacted the national organization, Sudden Unexplained Death in Children, and they assured me that coroner’s don’t act like this. This isn’t normal protocol. This isn’t the way grieving families should be treated.”

By the time the call did come, six months later, Sullivan had moved to Kansas City.

“Literally, they didn’t find anything,” Sullivan says. The doctor they’d consulted was speculating it was Sudden Unexplained Death in a Child based on epilepsy, she says, and she was asked to make the choice about what cause to list on the death certificate.

“It was almost, what are my choices, what’s the significance?” Sullivan says. “And I just felt like it was just one more jab as to this whole horrendous process.”

Cases that require a neuropathologist — like Nicole’s case — always take longer, Hall says.

“We’re trying to answer as many questions as you can for The family and that’s sometimes really hard for them to hear that, ‘Well, we’re trying to answer your questions but in the mean time we’re having to wait longer for this,’” Hall says. “This job is so physically and emotionally demanding that you need to be able to go to bed at night thinking you did the right thing and that you are here to serve the public and to help the families, and you have to know that in any job there’s always going to be someone that’s critical and not see thingS the way you do and not happy with what you did and who you are. And while that’s tough, because you want them to have a good experience with your office, but you also realize that they weren’t expecting this situation, they weren’t expecting your involvement in their life, and you just need to handle things the best that you can.”

Of course, positive experiences with the coroner’s office have also emerged in the debate over candidates. But often, those who say they’re happy with the interactions they had were extraordinary cases that Hall stepped in and handled herself — the fire at the Howe Mortuary, as one example. The flood in September as another.

Hall returned from her first vacation since taking office to be in Boulder during the September flood.

“I was expecting a mass fatality,” Hall says. “I was expecting the worst, so I got on a plane and came home.”

The first week after she got back she spent assisting the search crews in Lyons looking for Gerald Bohland, her fifth grade teacher. He had gotten separated from his wife during the 2:30 a.m. evacuation from their home and gone back looking for her. His truck was later found abandoned and then, eventually, his body.

“I would check in with his son every night and every morning to update him and he said, ‘I just don’t understand how you’re able to do this. There’s got to be someone else you can send,’ and I said, ‘I wouldn’t send anyone else. I’m in the position to be a part of this, that’s what I want to do, I want to be a part of this,’” Hall recounts. “If he would have just died at home in his sleep or something like that, I wouldn’t have wanted to go to the house and be a part of that. But because it was helping to bring closure to the family, just the mere fact of finding him, because we didn’t know if we were going to find him. I think I just wanted to make sure that everything was done that could be done to find him.”

The Bohlands have been vocal in their support for Hall’s reelection campaign. During the week he was missing his daughter Amy Hoh says they got a flurry of updates and would go right to Hall to confirm what they heard.

“We were just getting calls from people in town saying he’s alive, he’s here, or he’s on the last bus, it was all a chaotic rumor,” Hoh says. “In all this mess and all this horror that went on, the rock we had was Emma. … Whether we wanted to hear it or not, she gave us the truth and she was very timely, took very good care of us. … We had solid answers, we had honest answers, and I don’t know what we would have done without that. There were enough sleepless nights without answers as it was. And on the nights we needed answers, we got them.”

“She’s just a very compassionate and sweet person,” Hoh adds. “I don’t in any way think we got special treatment because Dad was her teacher. I fully believe that’s who she is.”

If there’s an increased emphasis on preserving forensic evidence and examining the details of every case in such a way as to make sure that the reasons the decedent is no longer with us are accurately reported, that’s because, Hall says, “That’s what you have to offer. You can’t change what happened but you can offer your professionalism in the situation.”

“Once you’ve processed that scene, you’ve removed the body, you can’t ever go back to that,” she adds. “You have that one opportunity to document everything as it is right then.”

Families are a priority, she says, but she tries to find a balance between the responsibilities and goals of her office, and the wants and wishes of the family.

“One of the things that we get probably the most often is when people just absolutely do not want an autopsy and usually what happens is we say, ‘OK, well this is the reason why we need to do this autopsy, which can be different depending on what the case is, but we understand you don’t want an autopsy and we’re willing to give you the time to contact a lawyer if you wish and try to stop us,’” Hall says. “We always give them the disclaimer that it’s never been done in Colorado, but if you want the time to do that we will allow it, and usually what happens is that they come back the next day and say, ‘We’re OK, go ahead and proceed — but now we want to know as soon as possible.’” 

Hall’s list of endorsements includes the district attorney’s office, State Rep. KC Becker, Boulder City Council member Tim Plass, the Louisville Chief of Police and the president of the Boulder Valley School District Board of Education. District Attorney Stan Garnett cites her work modernizing the office, her choice in forensic pathologist and her current staff as his reasons for endorsing her — a “hard-working, innovative and smart elected official” who should be given another term.

Dempsey’s own list of endorsements includes former sheriffs, the previous coroner and forensic pathologist for Boulder County, physicians, forensic pathologists and community activists, including victim advocates. Rocky Mountain Lions Eye Bank endorsed Dempsey on the basis that denial or restrictions of cornea donations have increased an average of 800 percent per year under Hall’s adminstration. He says a letter of support from a former hospice nurse, who would have worked with the coroner’s office to call in deaths that occurred in hospice care, is on the way.

“The perspective that I try to keep is that we are there to provide answers to the family. We have a particular role in that death and we have a responsibility to ask the important questions in an appropriate way,” Dempsey says. “We’re not grief counselors but we have to be aware of the grief and the grieving process and the way that we do our job can have very powerful impacts on the grieving process. … We can ask the appropriate questions and we can choose the right words that will stay with the family for a long time, and we can set them up for a healthy grieving process and they may never realize that we had a part in that process. And we can also respond and do our job poorly and not be sensitive about the words that we choose — we can be accurate, we can be thorough, but if we lack that sensitivity and we’re not cautious about the long-term impact of how we do our job, we can set a family up for a negative grieving process.”

That, he says, is part of why it’s important to have an experienced team of front-line investigators who know how to handle not just the evidence and the reports, but the people they meet with face-to-face and have to interview about the information that will assist in creating an accurate death certificate. They’ll also be responsible for making choices at the scene about how to handle forensic evidence — whether to ask a mother not to hold her dead child, for example, out of concerns she would compromise trace evidence from another caregiver, or a grieving widow should be allowed to kiss the forehead of her husband who appears to have died at home from natural causes.

The race may come down to a question of deciding between organization and empathy — or can both candidates do both?

Respond: letters@boulderweekly.com

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As the professional relations manager for the Rocky Mountain Lions Eye Bank, I think it is important to note that Emma Hall has refused to enter into a written protocol that is MANDATED by state law. We have had our attorneys working to get this state required protocol in place that outlines how coroner cases are handled when the decedent is an eye, organ or tissue donor for three years. Her failure to do that places her office outside what the legislature mandated and intended....to maximize the number of transplants that can occur when a donor is under the coroner's jurisdiction. The National Association of Medical Examiners advocates release for donation in ALL cases. Boulder County has moved in the opposite direction. Our organization feels she has not fulfilled her statuatory obligations under the Uniform Anatomical Gift Act. 

 

 
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