A growing number of dead bodies and not enough space to store them. Too few doctors to catch up on a backlog of cases numbering in the hundreds. A morgue so outdated the smell of what's inside drifts down the corridor and into public spaces.

The Volusia County Medical Examiner's Office has been so riddled with challenges that it lost its national accreditation in 2015, records show, and a quick fix seems unlikely even as the County Council voted last week to extend a contract to handle death investigations for Seminole County.

The county's medical examiner, Marie Herrmann, did not return a phone call or email seeking comment late last week. Deputy County Manager George Recktenwald said she and her 15 employees put in long hours to try and keep up. The county plans to begin designing a new facility in the coming year, at a time when medical examiners everywhere are understaffed and inundated with corpses.

"We are growing with more suicides, more (drug-related deaths), everything she investigates grows," Recktenwald said. "Sometimes we just can't meet those national standards (required for accreditation). Our work is still good, but we've had some issues."

While the doctors work hard to get bodies in and out of the morgue as quickly as possible, it takes longer to actually complete the report needed by law enforcement or family members to determine cause of death. The office is currently 374 reports behind, and the bodies don't stop coming.

Meanwhile, living ones have been harder to find. It took six months this year for the county to find a qualified forensic pathologist to fill one vacancy. Another position remains open.

Yet issues in medical examiners' offices are nothing out of the ordinary, said Brian Peterson, president of the National Association of Medical Examiners.

"Offices throughout the country are being overwhelmed by burgeoning case numbers, driven largely by the opiate tsunami." said Peterson, the medical examiner in Milwaukee. "At the same time, we face a critical shortage of forensic pathologists, also nationwide. There are fewer than 500 of us in practice, and given that many of us are over 50, it will only get worse."

'Substandard building'

Volusia County's 6,876-square-foot medical examiner facility on Indian Lake Road was built in 1997 and consists of two buildings: the administrative building and the morgue operations building. According to a 2014 annual report on the county's website — the most recent posted — the facility contains one walk-in cooler, measuring 646 square feet and capable of holding 20 bodies.

Today, the office sometimes holds as many as 25 bodies a day, but even when autopsies or toxicology reports are finalized and the cadavers released, it could be months before the official paperwork is done. The county has received 610 cases this year, as of June 30, and only 236 of those have been completed, according to county spokeswoman Joanne Magley.

Of the 374 on the backlog, it's unclear how long some of them have been there. What is clear is that operations inside aren't in line with standards. Magley said the office does not have sufficient space, equipment and facilities to support the volume of death investigations it receives. The morgue also can't contain the odors, Magley said.

The accrediting body, the National Association of Medical Examiners (NAME), downgraded the county's accreditation after a site visit in 2015 due to its "way substandard facility," said Peterson, the association president.

The loss of accreditation could hurt the office's standing when testifying in court, Peterson said. Other ramifications include adverse effects on staff retention and recruiting. "This is relatively new to NAME as well," Peterson said. "Mostly over the years, we have seen offices work to achieve accreditation, not lose it."

The time it takes Volusia County to process cases also falls below national standards. The county strives to complete cases within 90 days, Magley said. The national association issues Phase I violations to accredited agencies if too many cases linger beyond 60 days. Accreditation can be stripped away altogether if 90 percent of cases are still waiting past 90 days, a Phase II violation.

In the last year the county was accredited, 2014, it received five Phase II deficiencies and 11 Phase I violations, according to a letter NAME sent the county that year. With no accreditation, this merit system is no longer in place.

Medical examiners nationwide have struggled to overcome a shortage of workers and an increase of cases. When Connecticut's Office of the Chief Medical Examiner lost accreditation last year, David Fowler, former president of the national association told CNN what it means.

"Families will suffer," he said. "The law enforcement and judicial system will be compromised. Quality is going to be questionable. Imagine if you are waiting for a death certificate to get an insurance claim, and the person who is deceased was the sole breadwinner of the house, and now it could take months to get that result. Families need closure. Insurance companies need documents to close estates. Human beings do not cease to be human beings when they die."

Handling Seminole County

Despite the issues in Volusia County, the County Council moved without discussion to continue providing services to Seminole County, which is expected to bring in 400 more cases in the coming year.

Most medical examiners across the country handle multiple counties, even with the added pressure of rising caseloads. Small counties don't have enough work to support even just one forensic pathologist, so being a good neighbor and sharing those services "makes perfect sense," said Peterson with NAME.

Unable to fund its own facility or staff it, it's easier for Seminole County to pay Volusia County $880,000 for the work. The deal has been in place for more than 18 years and it's worked out well, said Valmarie H. Turner, director of Seminole County's Community Services Department.

"Volusia County Medical Examiner’s Office has been and continues to be a great partner with Seminole County," she said. "I am not aware of any significant delays and/or backups in the department."

Seminole County could be on the hook for more costs in the near future. A short-term county plan includes replacing the cramped medical examiner office with a new building — something that's required if the county hopes to get its accreditation back. Volusia County officials want Seminole County to help pay for it.

When that day comes, "we need to size it for the flow based on both counties," said County Manager Jim Dinneen. "In that case, we are willing to do it but only if they are willing to sign a long-term (funding) guarantee."

'Unsung heroes'

Six months. That's how long it took Volusia County to fill one of its two vacant assistant medical examiner positions. As cases backed up, county officials got desperate. They began calling colleges, asking if there were any qualified forensic pathologists in the house.

There aren't many. Roughly 70 new forensic pathologists complete training annually, and in general this number is insufficient to make up for retirement, death, people leaving the field, and so forth, said Peterson, with NAME.

The lack of available options plagued Volusia County's search for new hires. The same issues caused such backups in Palm Beach County that its agency ran the risk of losing its accreditation.

"There aren’t enough medical examiners in the country," said Michael Bell, Palm Beach County's medical examiner. "Because we don’t have enough, medical examiners, if they are willing to travel or move, they have their pick of (any) job they want (anywhere) in the country."

That's why it's important for agencies to pay its employees a competitive salary, Bell added. Volusia County's Herrmann was the second-highest earner on the county' payroll in 2016 at $245,255. Recktenwald spoke highly of the work her department does, despite the hardships.

"These folks are unsung heroes," he said. "They have to handle people who have been killed, and they do it with the utmost respect for the dead and for their families. They do a very careful job; it’s difficult work, and you have to be well-trained and be able to handle some ugly situations."