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Procedural guidance and key considerations developed by the National Association of Medical Examiners' Panel on Sudden Unexpected Death in Pediatrics.
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.
Topics include:
- The evolution of our understanding and practice in the area of sudden, unexpected pediatric death investigation
- 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
- Key considerations for prevention, research, and working with family members and other professional team members
This manual represents the combined efforts of a panel of medical examiners, pediatricians, and federal agency representatives, representing the diverse interests of death investigation, autopsy performance, certification, clinical subspecialities (pediatrics, neurology, cardology, child abuse, injury prevention, infectious diseases, genetics, and metabolic diseases), family needs, prevention, and epidemiology.
Contents
- AUTHORED BY THE NATIONAL ASSOCIATION OF MEDICAL EXAMINERS’ PANEL ON SUDDEN UNEXPECTED DEATH IN PEDIATRICS
- ACKNOWLEDGEMENTS
- The Motivation
- Section 1. Introduction
- 1. OverviewLaura Gould Crandall and Cynthia M. Schmidt.
- 2. Historical PerspectivesWendy M. Gunther, Tracey S. Corey, Laura Gould Crandall, Stacy A. Drake, Brandi McCleskey, and Vincent J. Palusci.
- ANCIENT, MEDIEVAL, AND RENAISSANCE TIMES
- THE 19TH CENTURY: SHIFT TO SCIENCE
- THE RISING TIDE OF NATURAL EXPLANATIONS
- THE 1960s AND 1970s: SIDS AS A NATURAL DISEASE
- THE TIDE TURNS, 1980s–1990s: DISCOVERY OF SCENE INVESTIGATION AND THE DISAPPEARANCE OF SIDS
- UNEXPLAINED INFANT DEATHS AND ITS COMPANION PROBLEM, UNEXPLAINED CHILD DEATHS
- RECOGNITION AND REFINEMENT, FROM 2000 ON
- REFERENCES
- 3. Risk FactorsRachel Y. Moon, Stacy A. Drake, Amanda J. Kay, Jane W. Turner, and Mary Ann Sens.
- 1. Overview
- Section 2. Medicolegal Death Investigation, Certification and Reporting
- 4. Scene InvestigationKathryn Pinneri, Stacy A. Drake, and Kelly C. Lear.
- 5. AutopsyLaura D. Knight, Thomas A. Andrew, Eric A. Eason, Kristen Landi, Kelly C. Lear, Brandi McCleskey, and Kathryn Pinneri.
- DIAGNOSTIC YIELD
- ORGAN WEIGHTS
- NEUROPATHOLOGY
- RADIOLOGICAL IMAGING
- HISTOLOGY
- MICROBIOLOGY
- TOXICOLOGY
- VITREOUS ELECTROLYTES
- METABOLIC SCREENING
- GENETIC TESTING
- OTHER LABORATORY EVALUATIONS
- NON-DIAGNOSTIC POSITIVE FINDINGS
- AUTOPSY PERFORMANCE
- ANCILLARY TESTING
- COMMUNICATIONS AROUND THE AUTOPSY
- SUPPORT SYSTEMS FOR MEDICAL EXAMINER/CORONER OFFICES
- REFERENCES
- 6. Evaluation of Infectious DiseasesJane W. Turner, Rudolph J. Castellani, Laura Gould Crandall, Wendy M. Gunther, Adele Lewis, and Rachel Y. Moon.
- EPIDEMIOLOGY OF INFECTIOUS ETIOLOGIES OF SUDDEN UNEXPECTED DEATHS IN INFANTS AND CHILDREN
- CHALLENGES IN INTERPRETING POSTMORTEM CULTURES
- CURRENT TRENDS IN MICROBIOLOGY
- VACCINES AND SUDDEN UNEXPECTED INFANT DEATH
- THE ROLE OF MICROBIOMES IN SUDDEN UNEXPLAINED DEATHS IN INFANCY
- SAMPLE COLLECTION AT AUTOPSY
- REFERENCES
- 7. Evaluation for Cardiac DiseasesSteven M. White, Michael J. Ackerman, Kristin M. Burns, and Evan W. Matshes.
- 8. Evaluation for Central Nervous System DisordersElizabeth A. Bundock, Derek A. Bruce, Rudolph J. Castellani, and Orrin Devinsky.
- 9. Evaluation for Genetic and Metabolic DisordersElizabeth A. Bundock, Michael J. Ackerman, Susan A. Berry, Kristin Landi, Evan W. Matshes, and Nori Williams.
- 10. Death Certification and SurveillanceElizabeth A. Bundock, Eric A. Eason, Thomas A. Andrew, Laura D. Knight, Kelly C. Lear, Mary Ann Sens, Carrie K. Shapiro-Mendoza, and Margaret Warner.
- DEATH CERTIFICATION
- CODING AND CLASSIFICATION
- DIAGNOSTIC SHIFT IN CERTIFICATION OF SUDDEN UNEXPLAINED PEDIATRIC DEATHS
- CHALLENGES AND CONTROVERSIES IN CERTIFICATION
- THE EFFECT OF LITERAL TEXT ON CODING
- CERTIFICATION OF UNEXPECTED DEATHS THAT BECOME EXPLAINED BY INVESTIGATION AND AUTOPSY
- CERTIFICATION AND RECOMMENDED CODING OF UNEXPECTED DEATHS THAT REMAIN UNEXPLAINED
- SUMMARY
- REFERENCES
- 11. Synoptic Reporting of Unexplained Sudden Deaths in Infants and ChildrenEvan W. Matshes, Elizabeth A. Bundock, and Mary Ann Sens.
- 4. Scene Investigation
- Section 3. Family and Professional Interactions
- 12. Family Needs and Follow-up Care After the Sudden, Unexpected Death of a ChildVincent J. Palusci, Orrin Devinsky, Stacy A. Drake, Amanda J. Kay, Kristen Landi, Erin Bowen, and Laura Gould Crandall.
- GRIEF, TRAUMA, AND THE SUDDEN, UNEXPECTED DEATH OF AN INFANT OR CHILD
- EFFECTS ON PARENTS, SIBLINGS, AND LATER CHILDREN
- FAMILY COMMUNICATION
- WHEN CHILD ABUSE IS SUSPECTED
- GUIDELINES FOR FAMILY COMMUNICATION THROUGHOUT THE MEDICOLEGAL DEATH INVESTIGATION AND BEYOND
- COMMUNICATING WITH FAMILIES WHEN THE DEATH INVESTIGATION IS FINALIZED
- MENTAL HEALTH ADVOCACY AFTER SUDDEN UNEXPECTED DEATH
- MEDICAL NEEDS AND REFERRALS
- RECOMMENDATIONS, RESEARCH NEEDS, AND ADDRESSING BARRIERS TO IMPLEMENTING GUIDELINES
- CONCLUSION
- REFERENCES
- 13. Professional RelationsJane W. Turner, Isabel Barata, Susan A. Berry, Derek A. Bruce, Laura Gould Crandall, Wendy M. Gunther, Amanda J. Kay, and Kristen Landi.
- 12. Family Needs and Follow-up Care After the Sudden, Unexpected Death of a Child
- Section 4. Moving Forward
- 14. Prevention and ResponseRachel Y. Moon, Stacy A. Drake, Amanda J. Kay, Jane W. Turner, and Mary Ann Sens.
- 15. Research NeedsOrrin Devinsky, Vincent J. Palusci, Carrie K. Shapiro-Mendoza, Michael J. Ackerman, Laura Gould Crandall, Steven M. White, and Kristin M. Burns.
- 14. Prevention and Response
- Appendices
- APPENDIX 1. PubMed Search Strategy
- APPENDIX 2. Procedural Guidance and Key Considerations
- APPENDIX 3. Process Flow in Medicolegal Death Investigations of Infants and Children
- APPENDIX 4. Infant Death Reporting Form
- APPENDIX 5. Child Death Reporting Form
- APPENDIX 6. Autopsy Specimens and Ancillary Studies for Sudden Unexpected Pediatric Deaths
- APPENDIX 7. Case Examples With Recommended Certifications and Synoptic Reporting
- APPENDIX 8. American Medical Association guidelines for communication between hospitals, medical examiners, and next of kin following unexplained or unexpected deaths in the hospital
- APPENDIX 9. Abbreviated Listing of Advocacy/Family Support Programs
- APPENDIX 10. Medical and Bereavement Information to Help Clinicians When Caring For Families
- APPENDIX 11. Sample Family Information Letter Provided to Family Members/Caregivers
- APPENDIX 12. SUDC Foundation “Help for Families” Sample Brochure
- APPENDIX 13. Tips for Talking With and Helping Children and Youth Cope After a Disaster or Traumatic Event: A GUIDE FOR PARENTS, CAREGIVERS, AND TEACHERS
- APPENDIX 14. Guidelines for Interacting with Families: (highlighted areas indicate professionals involved)
- APPENDIX 15. Synoptic Report for Sudden Unexpected Pediatric Death
The Publisher (Academic Forensic Pathology International [AFPi]), the Editors (Dr. Elizabeth A. Bundock and Dr. Tracey S. Corey), and the Authors (National Association of Medical Examiners’ Panel on Sudden Unexpected Death in Pediatrics) are committed to the publication of high quality legal and scholarly forensic pathology materials, and make reasonable efforts to ensure that the information published is precise and accurate.
However, errors and/or omissions can occur and readers must carefully evaluate the literature and decide how to best integrate it into their own practice. The work, opinions, and assertions contained herein are those of the Authors and do not necessarily reflect those of their employers. The Authors, Editors, and Publisher shall not be liable or responsible for the validity of all materials, the consequences of their use and any direct or indirect losses or damages of any kind whatsoever, whether based in contract, tort, strict liability, or otherwise, arising out of or in any way connected with any information herein. There is no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of this publication. The Authors, Editors, and the Publisher do not assume any responsibility for any injury and/or damage to persons or property related to any use of the content contained herein. Readers are advised to check the most recent information published on all related subjects.
Neither this book, nor any part may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, microfilming, and recording, or by any information storage or retrieval system, without prior permission in writing from The SUDC Foundation.
The consent of The SUDC Foundation does not extend to copying for general distribution, for promotion, for creating new works, or for resale. Specific permission must be obtained in writing from The SUDC Foundation for such copying.
- NLM CatalogRelated NLM Catalog Entries
- Evaluation of Concordance Between Original Death Certifications and an Expert Panel Process in the Determination of Sudden Unexplained Death in Childhood.[JAMA Netw Open. 2020]Evaluation of Concordance Between Original Death Certifications and an Expert Panel Process in the Determination of Sudden Unexplained Death in Childhood.Crandall LG, Lee JH, Friedman D, Lear K, Maloney K, Pinckard JK, Lin P, Andrew T, Roman K, Landi K, et al. JAMA Netw Open. 2020 Oct 1; 3(10):e2023262. Epub 2020 Oct 1.
- Review National Association of Medical Examiners position paper: Recommendations for the investigation and certification of deaths in people with epilepsy.[Epilepsia. 2018]Review National Association of Medical Examiners position paper: Recommendations for the investigation and certification of deaths in people with epilepsy.Middleton O, Atherton D, Bundock E, Donner E, Friedman D, Hesdorffer D, Jarrell H, McCrillis A, Mena OJ, Morey M, et al. Epilepsia. 2018 Mar; 59(3):530-543. Epub 2018 Mar 1.
- Review National Association of Medical Examiners Position Paper: Recommendations for the Investigation and Certification of Deaths in People with Epilepsy.[Acad Forensic Pathol. 2018]Review National Association of Medical Examiners Position Paper: Recommendations for the Investigation and Certification of Deaths in People with Epilepsy.Middleton OL, Atherton DS, Bundock EA, Donner E, Friedman D, Hesdorffer DC, Jarrell HS, McCrillis AM, Mena OJ, Morey M, et al. Acad Forensic Pathol. 2018 Mar; 8(1):119-135. Epub 2018 Mar 7.
- Review Natural Diseases Causing Sudden Death in Infancy and Early Childhood.[SIDS Sudden Infant and Early C...]Review Natural Diseases Causing Sudden Death in Infancy and Early Childhood.Bryant VA, Sebire NJ. SIDS Sudden Infant and Early Childhood Death: The Past, the Present and the Future. 2018 May
- Statewide systematic evaluation of sudden, unexpected infant death classification: results from a national pilot project.[Matern Child Health J. 2010]Statewide systematic evaluation of sudden, unexpected infant death classification: results from a national pilot project.Walsh SL, Kryscio R, Holsinger JW, Krous HF. Matern Child Health J. 2010 Nov; 14(6):950-7.
- Unexplained Pediatric DeathsUnexplained Pediatric Deaths
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