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National Association of Medical Examiners Position Paper: Postmortem Assessment of Suspected Head Trauma in Infant
James Gill1, Elizabeth Bundock2, Kristinza Giese3
1Connecticut Office of the Chief Medical Examiner, Farmington, CT.
Insights
This position paper guides forensic pathologists in investigating infant deaths from suspected inflicted head trauma. It details crucial procedures, tests, and documentation for accurate cause and manner of death certification.
Area of Science:
- Forensic Pathology
- Pediatric Autopsy
- Child Abuse Investigation
Background:
- Infant deaths due to suspected inflicted head trauma require meticulous investigation.
- Accurate determination of cause and manner of death is critical.
- Existing guidelines may not fully address the complexities of these cases.
Purpose of the Study:
- To provide a comprehensive guide for forensic pathologists investigating pediatric deaths from suspected inflicted head trauma.
- To outline essential procedures, ancillary tests, and documentation methods.
- To ensure a reviewable, objective data set for legal and public inquiries.
Main Methods:
- A panel convened by the National Association of Medical Examiners (NAME) developed this position paper.
- The paper reviews existing literature and expert consensus on investigating inflicted head trauma in children.
- It details specific examination techniques, laboratory analyses, and documentation standards.
Main Results:
- The paper details specific postmortem examination procedures for infants and toddlers.
- It lists relevant ancillary laboratory tests to aid in the investigation.
- It emphasizes comprehensive documentation to support findings.
Conclusions:
- Standardized investigation protocols are essential for evaluating suspected inflicted head trauma in pediatric deaths.
- Forensic pathologists must integrate scene, autopsy, and ancillary data for accurate death certification.
- This paper serves as a critical resource for consistent and thorough investigations.
Abstract:
The National Association of Medical Examiners (NAME) convened a panel to create a position paper for the investigation of pediatric deaths due to suspected inflicted head trauma. The certification of both the cause and manner of death is dependent upon an evaluation of all available data including information derived from the investigation, scene, postmortem examination, and ancillary studies. This paper provides the forensic pathologist with a comprehensive review for the postmortem examination of infants and toddlers who have died or have apparently died of inflicted head trauma. Specifically, this paper describes (1) procedures, (2) ancillary laboratory tests, and (3) forms of documentation that may be important in the investigation of these deaths. Some of these techniques are highly specialized and are performed at the discretion of the prosector. The evaluation and documentation of such fatalities involves the production of a reviewable, objective data set to support the multitude of inquiries that may follow from the public and the criminal justice system.
