title: Death of a 6-year-old boy with mental retardation: accident versus child abuse.
abstract: This case study involved death of a 6-year-old child with a history of mental retardation secondary to meningitis at 11 months, spastic quadriplegia, seizure disorder, and hydrocephaly with a remote ventriculoperitoneal shunt placement and gastric tube feedings. Reportedly, the child was co-sleeping with his mother when she awoke and discovered him lying prone and not breathing on the carpeted floor next to the bed. He was transported to the hospital and died in the emergency room of unknown causes. The medical examiner assumed jurisdiction of the body. The external examination revealed petechial hemorrhages on the neck and face, with patterned linear pressure abrasions on the chest, arms, and face. X-rays revealed leg fractures of different ages. This case emphasizes the importance of coordination of death scene investigation, medical history review, and autopsy results through a forensic team approach to determine the accurate cause and manner of death.
authors.affiliation: Jackson County Medical Examiner's Office, Kansas City, MO 64108, USA. mdudley@jacksongov.org
authors.forename: Mary
authors.initials: M
authors.lastname: Dudley
authors.forename: BreAnna M
authors.initials: BM
authors.lastname: Chapman
mesh_terms: D000058:Accidental Falls; D000061:Accidents, Home; D001237:Asphyxia / Q000209:etiology*; D001851:Bone Diseases, Metabolic / Q000000981:diagnostic imaging; D002114:Calcinosis / Q000000981:diagnostic imaging; D002547:Cerebral Palsy / Q000150:complications; D002648:Child; D002649:Child Abuse / Q000175:diagnosis; D003937:Diagnosis, Differential; D005264:Femoral Fractures / Q000000981:diagnostic imaging; D005360:Fibula / Q000000981:diagnostic imaging / Q000293:injuries; D049429:Forensic Pathology; D050723:Fractures, Bone / Q000000981:diagnostic imaging; D006801:Humans; D008607:Intellectual Disability / Q000150:complications*; D008297:Male; D011312:Pressure; D016684:Prone Position; D011693:Purpura / Q000473:pathology; D011782:Quadriplegia / Q000150:complications*; D011859:Radiography; D012867:Skin / Q000293:injuries / Q000473:pathology; D013978:Tibial Fractures / Q000000981:diagnostic imaging