Infant deaths are tragic, but must be investigated

Infant deaths are tragic,
but must be investigated

Nothing is more difficult on a family than dealing with the death of an infant. And so it is understandable that medical practitioners, police and coroner’s investigators would tread gently when dealing with the tragedy of an unexplained death of a baby.

But a recent nationwide investigation of death records by a team of Scripps Howard reporters indicates that in some cases, local and state authorities may be too deferential.
And the result is that some children are accidentally killed or even murdered — with no homicide ruling ever made and no adult held to account.

This is necessarily a very sensitive subject. Most unexplained deaths of children — many of them officially ruled due to Sudden Infant Death Syndrome — are exactly that: tragic deaths for which there is no explanation. There is no foul play involved, there is nothing any parent or caregiver could have done to prevent the deaths.

Geographic disparities

But as the Scripps Howard report showed, while there is no reason to believe that children are any more inclined to die suddenly in one area, state or county than another, there are quite dramatic differences in the percentage of unexplained deaths that are recorded.

The inescapable conclusion is that some jurisdictions do a better job of investigating infant deaths than others. As a result, places where there are established protocols for investigating infant deaths in ways that are both sensitive and thorough determine that a higher percentage of infant deaths are homicides. Conversely, in areas that do not conduct multi-level investigations into infant deaths, some people are, quite literally, getting away with murder.

The American Academy of Pediatrics recommends that unexplained deaths be subject to a multidisciplinary death review committee that includes a child welfare or protective services social worker, a law enforcement officer, a public health officer, the medical examiner/coroner, a pediatrician with expertise in child maltreatment, a forensic pathologist, a pediatric pathologist and the local prosecutor.

That’s a pretty sophisticated panel for some jurisdictions to muster. But a thorough review of every unexplained death is necessary not only in the interest of justice, but in the interest of protecting other children. It is from such reviews that various environmental factors have been identified as contributing factors in infant deaths; that knowledge allows parents everywhere to better protect their children.

Percentages easily skewed

Looking at the statistics for any one county can be deceptive. The number of infants who die unexpectedly are so low, that the difference between one case or two identified as a homicide can skew the percentages.

For instance, the rate of infant homicides is 7 percent for all jurisdictions that have no children death review procures. That increases to 7.5 percent in areas with state review only, 8.0 percent in areas with local review only and 9 percent in areas with state and local review.

Locally, over the last five years, Columbiana County has had a 14.3 percent rate of infant homicides, but that is based on a total of seven cases, one of which was homicide. Mahoning County had a percentage of 10.5, based on two cases out of 19. But during the same period, Trumbulll County had 20 sudden infant deaths, none of which was found to be homicide.

Both Ohio and Pennsylvania are among the 22 states that have only local review of infant deaths. Establishing a state component would increase the likelihood of identifying more homicide and accidental death cases and would tend to even out disparities among local subdivisions.