What is Sudden Infant Death Syndrome? (SIDS)
The sudden death of an infant under one year of age which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and review of the clinical history.
Sudden Unexplained Infant Death Investigation "SUIDI"
5200 Sudden Unexpected Infant Deaths in the United States per year:
53% are SIDS or SUIDI
8% Unexplained (not SIDS)
Reporting Guidelines of
Sudden Unexplained Infant Death Investigation
involve the following:
Sharing sleep surfaces
Change in sleep conditions
Environmental hazards (CO, chemicals, etc)
Unsafe sleeping condition
Previous medical diagnosis
History of acute life threatening events
History of medical care without diagnosis
Recent fall or other injury
History of religious, cultural, or ethnic remedies
Cause of death due to natural causes other than SIDS
Prior sibling deaths
Previous encounters with police or social service agencies
Request for tissue or organ donation
bjection to autopsy
Pre-terminal resuscitative treatment
Death due to trauma (injury), poisoning, or intoxication
Other alerts for pathologist’s attention
Description of circumstances (what happened?)
Who speaks for the Child?
Emergency Medical Services
Children and Family Services
Emergency Room Staff
Deputy John Jones arrived at the scene and was met by Police Officers who escorted him to where the infant was found to be unresponsive by the mother. The child was supine in a wooden crib - the bedding was consistent - a mattress and at least one sheet of unknown fiber.
Examination of the body found the child to be clothed in a simple shirt, disposable diaper and a jumper with the decedent’s right arm out - extended upwards and away at a rough angle of 120 degrees. The infants face was observed to be blanched on the left forehead, cheek, mid and left mouth, chin, and noses. Light purple colored lividity was present on the right side of the face with sparing noted in the left peri-orbital cavity. The lividity appeared fixed, and potentially consistent with child spending some of the post-mortem interval in a supine position. The child was found face down by the mother. An EKG pad was seen on the right chest.
The 3-month old infant was last scene alive during a 2200 hours bottle feeding by the mother, who says she returned the infant to the crib, positio being on his back. Police dispatch say the child was discovered at 0730 hours, with our office contacted at 0745 hours.
Questions that would be asked by the Investigator:
- What was the child's past medical history, specific to gestational term, recent infection, or respiratory problems?
- Was anyone else home or could have seen the child between 10pm and 7:30am?
- Any recent colds or illness? Has the child been feeding?
- Does the child have siblings? Anyone else in the crib?
- Was there any other artifacts or items in the crib? Any pets?
- Was there any other blankets, sheets, or clothing present at the time of discover?
- Can you describe more specifically how the child was found? If I gave you a doll, could you replicate the position?
- Is there any chance the child could have fallen between the bedding and the crib?
- Did the child suffer any recent injuries or falls?
- Are there any medications or unused formula I could examine?
What items might be considered evidence?
- Collection of bedding, clothes, bottle, or any objects in the crib. Photograph entire scene and room.
- Collection of medications and last oral intake like the bottle.
- Run report of first in EMS unit describing actions and changes to the scene. Interview them if necessary
- Report of Law enforcement and initial contact report with child support services.
- Bring the crib if positional asphyxia is suspected or the crib is viewed in poor/unworking condition.
Why Do We Speak for the Child?
- Justic: Guilty are prosecuted and the innocent are exonerated
- Prevention: Educating the community
- Closure: For the family’s understanding and healing
How Will We Speak for the Child?
- Entry - Questions concerning the history of events that took place prior to the death, such as: Recent Contacts, Activities and Behaviors.
- Event - The last few days leading up to the death, such as: Scene Temperature/Heating and Cooling Systems, General Scene appearance, sleeping room and general area, sleeping surface, bedroom furnishings, and poweerd appliances in sleep area.
- Exit - Before leaving the scene of the event, explain to the family or next-of-kin what has been done in the investigation and why. Also, encourage family members to ask questions.
Placer - re-enact and photograph location and position in which infant was placed
Last Known Alive - re-enact and photograph location and position
Finder - re-enact and photograph location and position in which infant was found
The investigator would then photograph these positions in which the infant was found. Once the photographs have been taken and checked, the investigator must focus on verifying the sleep environment. Any pets and other animals that might have been present in the sleep environment should be documented as well.