Death Scene Investigation and Autopsy Practices in Sudden Unexpected Infant Deaths.
OBJECTIVE
To describe and compare sudden unexpected infant death (SUID) investigations among states participating in the SUID Case Registry from 2010 through 2012.


METHODS
We analyzed observational data from 770 SUID cases identified and entered into the National Child Death Review Case Reporting System. We examined data on autopsy and death scene investigation (DSI) components, including key information about the infant sleep environment. We calculated the percentage of components that were complete, incomplete, and missing/unknown.


RESULTS
Most cases (98%) had a DSI. The DSI components most frequently reported as done were the narrative description of the circumstances (90%; range, 85%-99%), and witness interviews (88%, range, 85%-98%). Critical information about 10 infant sleep environment components was available for 85% of cases for all states combined. All 770 cases had an autopsy performed. The autopsy components most frequently reported as done were histology, microbiology, and other pathology (98%; range, 94%-100%) and toxicology (97%; range, 94%-100%).


CONCLUSIONS
This study serves as a baseline to understand the scope of infant death investigations in selected states. Standardized and comprehensive DSI and autopsy practices across jurisdictions and states may increase knowledge about SUID etiology and also lead to an improved understanding of the cause-specific SUID risk and protective factors. Additionally, these results demonstrate practices in the field showing what is feasible in these select states. We encourage pediatricians, forensic pathologists, and other medicolegal experts to use these findings to inform system changes and improvements in DSI and autopsy practices and SUID prevention efforts.
DB Consulting Group, Inc, Silver Spring, MD. Electronic address: xwp5@cdc.gov.
Alexa B
AB
Erck Lambert
Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA.
Sharyn E
SE
Parks
Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA.
Lena
L
Camperlengo
Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA.
Carri
C
Cottengim
Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA.
Rebecca L
RL
Anderson
National Center for the Review and Prevention of Child Death, Michigan Public Health Institute, Okemos, MI.
Theresa M
TM
Covington
Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA.
Carrie K
CK
Shapiro-Mendoza
D001344:Autopsy; D002423:Cause of Death; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D012042:Registries; D012189:Retrospective Studies; D012890:Sleep; D013398:Sudden Infant Death / Q000175:diagnosis* / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology
autopsy; child death review; coroners; death scene investigation; forensic pathologists; infant mortality; medical examiners; sudden infant death syndrome; surveillance