Death Scene Investigation and Autopsy Practices in Sudden Unexpected Infant Deaths

Area of Science:

• Forensic Pathology
• Pediatric Medicine
• Public Health Surveillance

Background:

• Sudden unexpected infant death (SUID) investigations are crucial for determining causes of infant mortality.
• Variations in investigation protocols can impact the completeness and accuracy of data collected.
• Understanding current investigation practices is essential for identifying areas for improvement.

Purpose of the Study:

• To describe and compare sudden unexpected infant death (SUID) investigations across participating states.
• To assess the completeness of death scene investigation (DSI) and autopsy components.
• To establish a baseline for SUID investigation practices.

Main Methods:

• Analysis of observational data from 770 SUID cases using the National Child Death Review Case Reporting System.
• Examination of autopsy and DSI components, focusing on infant sleep environment information.
• Calculation of completeness, incompleteness, and missing/unknown percentages for investigation components.

Main Results:

• Most SUID cases (98%) included a death scene investigation (DSI).
• Key DSI components like narrative description (90%) and witness interviews (88%) were frequently reported.
• Autopsies were performed in all cases, with high reporting rates for histology (98%) and toxicology (97%).
• Critical infant sleep environment data was available for 85% of cases.

Conclusions:

• The study provides a baseline understanding of SUID investigation scope in selected states.
• Standardized DSI and autopsy practices may enhance knowledge of SUID etiology and risk factors.
• Findings demonstrate feasible investigation practices and encourage improvements in SUID prevention efforts.