Medical examiner

25 years after the Waco massacre, a DO remembers the fire and the victims

KCU pathology professor identified victims and performed autopsies after the fire at David Koresh’s Branch Davidian compound in Texas.


Editor’s note: This story was originally published by Kansas City University of Medicine and Biosciences and has been edited for The DO.  It has been reposted here with permission. 

This April 19th will mark the 25th anniversary since a standoff between federal agents and the followers of David Koresh ended with fire consuming the Branch Davidian compound outside Waco, Texas. Inside, more than 70 men, women, and children would perish.

Stephen Putthoff, DO, a Kansas City University of Medicine and Biosciences (KCUMB) Pathology professor and a 1978 graduate from KCU-COM, was called on to help identify the Branch Davidian victims and perform autopsies.

“You have to be able to emotionally detach yourself,” Dr. Putthoff explained. “If you don’t, you’re no good to that child or body, or anybody else to acquire justice for them.”

Despite the passage of time, Dr. Putthoff remembers the days, weeks and months to follow. He often shares his experience with the medical students he teaches today.

First on the scene

Fire engulfed the compound on April 19, 1993. At that time, Dr. Putthoff chaired the Department of Pathology, Anatomy and DNA/Identity at Texas College of Osteopathic Medicine (TCOM). He also performed autopsies as a Deputy Medical Examiner with the Tarrant County Medical Examiners District (TCMD) just north of Waco. TCMD is a major forensic office which contracts with other counties like McClennen – where the Branch Davidian compound was located – to do forensic support and post-mortem examinations. Dr. Nizam Peerwani is the TCMD Chief Medical Examiner and a faculty member of TCOM’s Pathology Department.

“I’ve done a fair number of multiple fatality cases,” Dr. Putthoff said. “This was certainly beyond what most medical examiners have to deal with.”

Dr. Putthoff was one of the first officials to enter the scene with Dr. Peerwani following the fire. Dr. Putthoff has considerable experience with conducting autopsies. He joined the Army after high school as a Special Forces medic during Vietnam.

He describes the scene as, “a relatively big compound building that had been reduced to ash.”

The challenges inside the compound

Underneath the smoldering ash remained an arsenal of bullets, grenades, kerosene and propane gas stockpiled by the Branch Davidians. The heat would spark “occasional explosions.”

Authorities would spend a week attempting to locate remains of the victims, many of them women and children. Dr. Putthoff believes the intense heat from the fire made it impossible to locate everyone.

“The goal with something like that was to identify bodies and try to preserve them for information to determine cause, manner and mechanism of death,” Dr. Putthoff explained. “That is the task of the medical examiner.”

It would take months to identify victims and conduct autopsies. Dr. Putthoff said some remains were so severely burned and “commingled together in an agglutinated mass,” they were unable to be identified.

Another challenge was the fact that many of the Branch Davidians came from other countries. Dr. Putthoff said, “Dental X-rays or other forms of identification, including relatives for DNA studies, weren’t always accessible.”

David Koresh

At the center of this enormous investigation remained one pressing question; what happened to David Koresh?

In 1990, Koresh became the controversial leader of the Branch Davidians, building an “Army of God,” attracting followers from across the country and the world. They believed in the Apocalypse and stockpiled weapons on the 77-acre compound.

“We found Koresh’s body relatively intact,” Dr. Putthoff recalls.

Dental records were used to identify his remains. The cause of death – a single gunshot wound to the head.

But many wondered if the religious leader took his own life or was killed by someone else.

“We did not render an opinion. We said it was undetermined, either a murder or a suicide,” Dr. Putthoff said. When asked if he has an opinion, Dr. Putthoff added, “I think it’s more likely than not that he (Koresh) committed suicide.”

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