Unexplained Pediatric Deaths

This publication reviews medicolegal investigation of sudden, unexpected pediatric deaths, focusing on systems and procedures in the United States and those deaths which remain incompletely understood or entirely unexplained. It discusses the evolution of our understanding and practice in the area of sudden, unexpected pediatric death investigation, covering the changing philosophies and medical theories as to causation and changing investigative and certification strategies. Procedural guidance for investigation, autopsy and ancillary testing, certification and reporting, and key considerations for prevention, research and working with family members and other professional team members are provided.The path to production of this publication began in 2016 when the National Association of Medical Examiners received a scientific grant from the SUDC Foundation called "Sudden Death in Pediatrics: Consensus for Investigation, Certification, Research Direction and Family Needs" to convene, in collaboration with the American Academy of Pediatrics, an expert panel to identify and discuss the diverse issues and limitations surrounding these deaths and build a foundation for national consensus. The combined effort of a panel of medical examiners, pediatricians, and federal agency representatives, representing the diverse interests of death investigation, autopsy performance, certification, clinical subspecialties (pediatrics, neurology, cardiology, child abuse, injury prevention, infectious diseases, genetics, and metabolic diseases), family needs, prevention, and epidemiology, culminated in this publication.

This volume covers aspects of sudden infant and early childhood death, ranging from issues with parental grief, to the most recent theories of brainstem neurotransmitters. It also deals with the changes that have occurred over time with the definitions of SIDS (sudden infant death syndrome), SUDI (sudden unexpected death in infancy) and SUDIC (sudden unexpected death in childhood). The text will be indispensable for SIDS researchers, SIDS organisations, paediatric pathologists, forensic pathologists, paediatricians and families, in addition to residents in training programs that involve paediatrics. It will also be of use to other physicians, lawyers and law enforcement officials who deal with these cases, and should be a useful addition to all medical examiner/forensic, paediatric and pathology departments, hospital and university libraries on a global scale. Given the marked changes that have occurred in the epidemiology and understanding of SIDS and sudden death in the very young over the past decade, a text such as this is very timely and is also urgently needed.

A scientifically rigorous, multidisciplinary approach to Sudden Infant Death Syndrome, for practitioners, researchers and families alike.

The investigation of sudden or unexplained death of children represents a unique medical and forensic area of study. Children have unique anatomic and functional characteristics that must be recognized and understood by the medical investigator. Further complicating this process is the fact that the anatomic structure, composition and function of various organs and organ systems in the pediatric population change throughout the developmental stages of childhood. The disease processes, reactions to trauma and risk factors for accidental death and homicide change from infancy through adolescence. Forensic Pathology of Infancy and Childhood provides an authoritative, comprehensive reference text devoted to the medicolegal investigation of sudden unexpected death in children. With contributions from internationally renowned experts, individual chapters focus on specific unique causes and organ systems with detailed accounts of the changes in fatal diseases, risk factors of causes of sudden death, and responses to fatal trauma that occur as a child grows from neonatal stage through infancy, toddlerhood, childhood and adolescence. This text is an essential reference resource for forensic pathologists, medical examiner offices, pediatric pathologists, pediatric hospitals, anatomic pathologists and those in training as well as those in related legal professions.

Clearly presents the pathology of heart disease from fetus to adolescence, integrating histology and macroscopy with effects of treatment.

Child abuse and suspicious child deaths are very complicated matters for clinicians, pathologists, law enforcement officials and legal professionals to investigate. Meanwhile, the evidence base for forensic pathology, especially in paediatrics, is steadily growing. In Paediatric Forensic Medicine and Pathology, two internationally acclaimed editors have brought together a first class author team who provide an up-to-date, comprehensive, and thorough review of the contemporary problems encountered in practice today. Individual chapters explore the emerging role of imaging in the diagnosis of non-accidental injury and compare recent evidence contrasting sudden infant death and SIDS; the head and neck injury chapter carefully explores the 'shaken baby syndrome' and similar patterns of injury that have recently gained widespread media attention. Special emphasis is given to interview and assessment procedures, and useful clinical forms are included throughout the book. Whether in a clinical, laboratory, or legal setting, readers dealing with forensic inquiries or who are in preparation for court will find the comprehensive background and evidence base necessary to support their investigations. Paediatric Forensic Medicine and Pathology is an invaluable resource for forensic pathologists, paediatric pathologists, and paediatricians, as well as all practitioners in the judicial and legal, criminal investigation and social services systems that have to deal with such cases.

In this national bestseller, a work of vigorous reporting, deep compassion and unerring integrity, award-winning journalist and documentarian John Chipman investigates the lives left ruined in the wake of Dr. Charles Smith's ignominious career. In the mid-'90s, the Ontario Coroner's office decided that death investigation teams needed to "think dirty." They wanted coroners, pathologists and police to be more suspicious--to "assume that all deaths are homicides until satisfied that they are not." They were particularly concerned about pediatric deaths, which historically had been exceedingly difficult to investigate. There were usually no witnesses; no evidence to gather at the scene; no outward signs of trauma on the body. If the pathologist did not discover the truth of what had happened, child abuse could go uncovered. Among those charged to "think dirty" was Dr. Charles Smith, Ontario's top pediatric forensic pathologist at the time. But with virtually no training in forensics, Dr. Smith was ill prepared for his work. Instead of basing his judgments on forensic evidence found during autopsies, he allowed himself to be swayed by circumstantial evidence. The defendants were often single mothers--some on welfare, some struggling with substance abuse. And they made for easy targets. Dr. Smith made dangerous assumptions, and the results were catastrophic. Numerous individuals were pronounced guilty, and incarcerated, on his shaky evidence. This penetrating investigative work explores the wide ripples of destruction caused when the justice system fails, the burden felt by ethical individuals working within that system and the importance of its victims finally being heard.