Pathological findings in overlaying

A 2-month-old girl is reported who was found in cardiorespiratory arrest beneath her unconscious mother. Full autopsy examination failed to reveal any features which would give an indication of the nature of the terminal event. This case confirms the non-specificity of autopsy findings in an infant who suffocated underneath an adult--a situation mimicking classical 'overlaying'. Given that there may be no specific histopathological findings when an infant suffocates underneath an adult, a diagnosis should not be formulated if a full death scene description is not available and no specific lesions or diseases are found. The manner of death should be designated as 'undetermined'.