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Published on: September 19, 2019
When a Child Dies Unexpectedly: No Truth Be Told
Deborah L Callanan, William D McClain1
1Bexar County Medical Examiner's Office, San Antonio, TX.
Insights
Sudden childhood death is rare. Autopsy revealed aortic rupture and spinal fractures, despite an asthma attack report, underscoring the medical examiner's role in unexplained child fatalities.
Area of Science:
- Forensic Pathology
- Pediatric Medicine
- Cardiology
Background:
- Sudden death in children beyond infancy is uncommon.
- A case presented with cardiac arrest (asystole) following a reported asthma attack.
Observation:
- The child received emergency care and resuscitation attempts were unsuccessful.
- An autopsy was conducted by the medical examiner.
- Minor bruising was noted, with no definitive signs of abuse.
Findings:
- The autopsy revealed significant internal injuries: aortic rupture and spinal fractures.
- These findings were unexpected given the initial presentation and external examination.
Implications:
- This case emphasizes the critical importance of thorough medical examiner evaluation in sudden, unexplained childhood deaths.
- It highlights the need to consider severe internal trauma even when external signs are minimal or an underlying condition is suspected.
Abstract:
Sudden death of a child beyond infancy is a rare event. We report a child who presented to the emergency care system with asystole and the caregiver's report of an asthma attack as the preceding event. After unsuccessful attempts at resuscitation, an autopsy was performed by the medical examiner. Despite only scattered bruises with no clear-cut signs of abuse, aortic rupture and spinal fractures were found. This case highlights the crucial role of the medical examiner in evaluating sudden childhood death, even in the setting of underlying illness.
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