Investigating Infant Deaths PDF

Preface

Sensational true crimes abound in the media as the lay public has become fascinated with forensic science. The more spectacular, bizarre, and remarkable the case, the more likely it will be featured in newspaper headlines, reenacted during investigative news segments or be fictionalized on a prime time television show. This media attention has glamorized the criminal justice profession and those individuals who investigate deaths. This publicity has resulted in an increased number of individuals who want to pursue this profession and have dreams and aspirations of investigating spectacular newsworthy cases.

What the lay public does not realize is that often the most complicated and challenging cases to investigate are those in which the individual's death was sudden, unexpected, and unexplained. Very few deaths occur in which the decedent has no significant medical history, no trauma, no significant autopsy findings, and very little social history to investigate. The majority of infant deaths, however, fit this category. When I entered the forensic field, I too had "delusions of grandeur." Although some of those sensational cases have come my way, I have come to realize that the most complicated and challenging deaths to investigate are those of infants.

Infants have vulnerabilities that place them at greater risk of falling victim to health or medical problems, environmental hazards, as well as lifestyle and child care decisions made by the individuals responsible for their care and safety. As a result of their vulnerabilities and inabilities to fend for themselves, they are at risk of injury or death due to unintentional accidents, neglect, and intentional acts of violence.

This book was conceived years ago when I was fortunate to be mentored by professionals who recognized the complicated nature of infant death investigations, sought to make system and investigational changes, and then shared their insight, expertise, and wisdom with me. As an investigative team, we continued to seek ways to improve our skills and educate other professionals about infant and child death investigation. We also developed and implemented prevention and education programs for the residents of our community to attempt to save lives and decrease the number of infant deaths that needed investigating. Discussions in this office often centered on the idea of putting our thoughts and ideas regarding infant death investigation into a book; however, it was something we would get to "one day."

Our office organized and implemented an extensive Back-to-Sleep campaign to educate professionals and the lay public regarding risks associated with unsafe sleep positions and environments. Educational programs were directed toward hospitals, pediatricians, child care providers, public health representatives, retail establishments that sold baby supplies, and the media. After implementing this extensive and successful prevention and educational campaign, I was honored to be asked to join the board of directors for the SIDS Alliance of the Carolinas. The experience was extremely rewarding; however, it was during that time that it became apparent that to prevent infant death, we must first ensure that each infant death is thoroughly and completely investigated.

After learning of our unique approach to infant death investigation, I was honored again to be asked by Dr. Kay Tomashek and her peers at the Centers for Disease Control and Prevention (CDC) to be a part of the Sudden Unexpected Infant Death Investigation National Training and Dissemination Core Team, a group of infant death investigation experts, brought together to assist in the development of the Sudden Unexplained Infant Death Investigation training text. It was a great experience being able to share experiences and investigational ideas with other professionals and use our collective expertise to develop a guide that will be widely disseminated.

The goal of this project, which in no way takes the place of the comprehensive training guide that was developed with the CDC team, is to provide information about additional techniques and approaches that may be used to thoroughly investigate infant deaths, in particular those infant deaths that occur in an emergency room setting. All of the techniques presented are used during all infant death investigations in Charleston County, South Carolina. Our approach to infant death investigation may seem to some to be "ideal" but not "practical." It is, however, a workable approach that may require investigators and agencies to evaluate their investigational approach and determine what changes may be made to improve the effectiveness of infant death investigation. It is only through continued improvement that we will be able to ensure that all infant deaths are investigated thoroughly and completely. Information obtained from those investigations may then be used to prevent future premature infant deaths from occurring.