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This publication reviews medicolegal investigation of sudden, unexpected pediatric deaths, focusing on systems and procedures in the United States and those deaths which remain incompletely understood or entirely unexplained. It discusses the evolution of our understanding and practice in the area of sudden, unexpected pediatric death investigation, covering the changing philosophies and medical theories as to causation and changing investigative and certification strategies. Procedural guidance for investigation, autopsy and ancillary testing, certification and reporting, and key considerations for prevention, research and working with family members and other professional team members are provided.The path to production of this publication began in 2016 when the National Association of Medical Examiners received a scientific grant from the SUDC Foundation called "Sudden Death in Pediatrics: Consensus for Investigation, Certification, Research Direction and Family Needs" to convene, in collaboration with the American Academy of Pediatrics, an expert panel to identify and discuss the diverse issues and limitations surrounding these deaths and build a foundation for national consensus. The combined effort of a panel of medical examiners, pediatricians, and federal agency representatives, representing the diverse interests of death investigation, autopsy performance, certification, clinical subspecialties (pediatrics, neurology, cardiology, child abuse, injury prevention, infectious diseases, genetics, and metabolic diseases), family needs, prevention, and epidemiology, culminated in this publication.
This volume covers aspects of sudden infant and early childhood death, ranging from issues with parental grief, to the most recent theories of brainstem neurotransmitters. It also deals with the changes that have occurred over time with the definitions of SIDS (sudden infant death syndrome), SUDI (sudden unexpected death in infancy) and SUDIC (sudden unexpected death in childhood). The text will be indispensable for SIDS researchers, SIDS organisations, paediatric pathologists, forensic pathologists, paediatricians and families, in addition to residents in training programs that involve paediatrics. It will also be of use to other physicians, lawyers and law enforcement officials who deal with these cases, and should be a useful addition to all medical examiner/forensic, paediatric and pathology departments, hospital and university libraries on a global scale. Given the marked changes that have occurred in the epidemiology and understanding of SIDS and sudden death in the very young over the past decade, a text such as this is very timely and is also urgently needed.
A scientifically rigorous, multidisciplinary approach to Sudden Infant Death Syndrome, for practitioners, researchers and families alike.
The investigation of sudden or unexplained death of children represents a unique medical and forensic area of study. Children have unique anatomic and functional characteristics that must be recognized and understood by the medical investigator. Further complicating this process is the fact that the anatomic structure, composition and function of various organs and organ systems in the pediatric population change throughout the developmental stages of childhood. The disease processes, reactions to trauma and risk factors for accidental death and homicide change from infancy through adolescence. Forensic Pathology of Infancy and Childhood provides an authoritative, comprehensive reference text devoted to the medicolegal investigation of sudden unexpected death in children. With contributions from internationally renowned experts, individual chapters focus on specific unique causes and organ systems with detailed accounts of the changes in fatal diseases, risk factors of causes of sudden death, and responses to fatal trauma that occur as a child grows from neonatal stage through infancy, toddlerhood, childhood and adolescence. This text is an essential reference resource for forensic pathologists, medical examiner offices, pediatric pathologists, pediatric hospitals, anatomic pathologists and those in training as well as those in related legal professions.
Clearly presents the pathology of heart disease from fetus to adolescence, integrating histology and macroscopy with effects of treatment.
The death of a child is a special sorrow. No matter the circumstances, a child's death is a life-altering experience. Except for the child who dies suddenly and without forewarning, physicians, nurses, and other medical personnel usually play a central role in the lives of children who die and their families. At best, these professionals will exemplify "medicine with a heart." At worst, families' encounters with the health care system will leave them with enduring painful memories, anger, and regrets. When Children Die examines what we know about the needs of these children and their families, the extent to which such needs areâ€"and are notâ€"being met, and what can be done to provide more competent, compassionate, and consistent care. The book offers recommendations for involving child patients in treatment decisions, communicating with parents, strengthening the organization and delivery of services, developing support programs for bereaved families, improving public and private insurance, training health professionals, and more. It argues that taking these steps will improve the care of children who survive as well as those who do notâ€"and will likewise help all families who suffer with their seriously ill or injured child. Featuring illustrative case histories, the book discusses patterns of childhood death and explores the basic elements of physical, emotional, spiritual, and practical care for children and families experiencing a child's life-threatening illness or injury.
Forensic professionals, particularly medical examiners—often working through heavy caseloads—require quick and easy access to reliable sources of information to help interpret toxicology results. While several in-depth resources are available, they are often large, cumbersome, and contain more information than is often needed. The Handbook of Forensic Toxicology for Medical Examiners is a concise handbook referencing the most common toxic substances and their reported non-toxic, toxic, and lethal concentrations, making it an ideal text for quick reference in the lab or autopsy room. Features of the Second Edition: Explains the principles of postmortem toxicology and the factors which must be considered Provides tables of toxicologic data for over 200 commonly encountered substances, including drugs of abuse, poisons, prescription drugs, and over-the-counter medications Includes discussion and description of the novel psychoactive drugs—including synthetic opioids, cannabinoids, stimulants and hallucinogens Supplemental appendices provide additional information regarding specimen types and selection, testing methodologies, normal laboratory values, and conversion charts The busy forensic professional needs a concise handbook that provides critical information quickly and accurately. This heavily referenced text offers an easy-to-use format allowing for rapid access for both routine daily use and preparation for courtroom testimony.
With current recommendations calling for infants to receive multiple doses of vaccines during their first year of life and with sudden infant death syndrome (SIDS) the most frequent cause of death during the postneonatal period, it is important to respond to concerns that vaccination might play a role in sudden unexpected infant death. The committee reviewed epidemiologic evidence focusing on three outcomes: SIDS, all SUDI (sudden unexpected death in infancy), and neonatal death (infant death, whether sudden or not, during the first 4 weeks of life). Based on this review, the committee concluded that the evidence favors rejection of a causal relationship between some vaccines and SIDS; and that the evidence is inadequate to accept or reject a causal relationship between other vaccines and SIDS, SUDI, or neonatal death. The evidence regarding biological mechanisms is essentially theoretical, reflecting in large measure the lack of knowledge concerning the pathogenesis of SIDS.
Unraveling a twenty-five-year tale of multiple murder and medical deception, The Death of Innocents is a work of first-rate journalism told with the compelling narrative drive of a mystery novel. More than just a true-crime story, it is the stunning expose of spurious science that sent medical researchers in the wrong direction--and nearly allowed a murderer to go unpunished. On July 28, 1971, a two-and-a-half-month-old baby named Noah Hoyt died in his trailer home in a rural hamlet of upstate New York. He was the fifth child of Waneta and Tim Hoyt to die suddenly in the space of seven years. People certainly talked, but Waneta spoke vaguely of "crib death," and over time the talk faded. Nearly two decades later a district attorney in Syracuse, New York, was alerted to a landmark paper in the literature on Sudden Infant Death Syndrome--SIDS--that had been published in a prestigious medical journal back in 1972. Written by a prominent researcher at a Syracuse medical center, the article described a family in which five children had died suddenly without explanation. The D.A. was convinced that something about this account was very wrong. An intensive quest by a team of investigators came to a climax in the spring of 1995, in a dramatic multiple-murder trial that made headlines nationwide. But this book is not only a vivid account of infanticide revealed; it is also a riveting medical detective story. That journal article had legitimized the deaths of the last two babies by theorizing a cause for the mystery of SIDS, suggesting it could be predicted and prevented, and fostering the presumption that SIDS runs in families. More than two decades of multimillion-dollar studies have failed to confirm any of these widely accepted premises. How all this happened--could have happened--is a compelling story of high-stakes medical research in action. And the enigma of familial SIDS has given rise to a special and terrible irony. There is today a maxim in forensic pathology: One unexplained infant death in a family is SIDS. Two is very suspicious. Three is homicide.
Medicolegal investigation of death is the most crucial and significant function of the medical examiner within the criminal justice system. The medical examiner is primarily concerned with violent, sudden, unexpected, and suspicious deaths and is responsible for determining the cause and manner of death, identifying the deceased, determining the ap