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. 2016 Jul:174:84-90.e1.
doi: 10.1016/j.jpeds.2016.03.057. Epub 2016 Apr 22.

Death Scene Investigation and Autopsy Practices in Sudden Unexpected Infant Deaths

Alexa B Erck Lambert  1 , Sharyn E Parks  2 , Lena Camperlengo  2 , Carri Cottengim  2 , Rebecca L Anderson  2 , Theresa M Covington  3 , Carrie K Shapiro-Mendoza  2
Affiliations

Death Scene Investigation and Autopsy Practices in Sudden Unexpected Infant Deaths

Alexa B Erck Lambert et al. J Pediatr. 2016 Jul.

Abstract

Objective: To describe and compare sudden unexpected infant death (SUID) investigations among states participating in the SUID Case Registry from 2010 through 2012.

Study design: We analyzed observational data from 770 SUID cases identified and entered into the National Child Death Review Case Reporting System. We examined data on autopsy and death scene investigation (DSI) components, including key information about the infant sleep environment. We calculated the percentage of components that were complete, incomplete, and missing/unknown.

Results: Most cases (98%) had a DSI. The DSI components most frequently reported as done were the narrative description of the circumstances (90%; range, 85%-99%), and witness interviews (88%, range, 85%-98%). Critical information about 10 infant sleep environment components was available for 85% of cases for all states combined. All 770 cases had an autopsy performed. The autopsy components most frequently reported as done were histology, microbiology, and other pathology (98%; range, 94%-100%) and toxicology (97%; range, 94%-100%).

Conclusions: This study serves as a baseline to understand the scope of infant death investigations in selected states. Standardized and comprehensive DSI and autopsy practices across jurisdictions and states may increase knowledge about SUID etiology and also lead to an improved understanding of the cause-specific SUID risk and protective factors. Additionally, these results demonstrate practices in the field showing what is feasible in these select states. We encourage pediatricians, forensic pathologists, and other medicolegal experts to use these findings to inform system changes and improvements in DSI and autopsy practices and SUID prevention efforts.

Keywords: autopsy; child death review; coroners; death scene investigation; forensic pathologists; infant mortality; medical examiners; sudden infant death syndrome; surveillance.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure
Figure
Description of the study population. *Cases that met the case definition were infant deaths (<365 days old) reported on the death certificate as cause unknown, undetermined, SIDS, SUID, unintentional sleep-related asphyxia/suffocation/strangulation, unspecified suffocation, cardiac or respiratory arrest without other well-defined causes, or ill-defined causes with potentially contributing unsafe sleep factors, except if manner of death was reported as homicide.
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