Forensic pediatrics

• Infanticide

  • Elements that must be proven

    • Baby was born alive

      • Air in lungs (float test unreliable due to gas of decomposition)

      • Air in middle ear

      • Air in stomach

      • Food in stomach (only conclusive proof of live birth)

    • Death from violence or willful act of omission

    • Act or failure to act was done with intent to harm

  • Most commonly from suffocation

• SIDS

  • Most common cause of death if <>

  • Def: death of an infant, < 1 YOA, in apparent good health who dies suddenly and unexpectedly, and in whose case a complete post mortem investigation does not reveal a commonly accepted cause of death (diagnosis of exclusion)

  • Must do complete investigation, which includes

    • Visit to scene of death

    • Interview of caretaker

    • Total body x-rays

    • Complete autopsy, including cultures, genetic and metabolic screen, and toxicology exam

  • SIDS more common with

    • Congested urban areas

    • Poverty

    • Illegitimacy

    • Poor maternal prenatal care

    • Male to female ratio = 3:2

  • Autopsy findings

    • May have petechiae on pleura, epicardium, and thymus

    • Organ congestion

    • Autopsy can’t tell difference between SIDS, overlay, and smothering

• Child abuse

  • Most cases occur before 6 YOA (after that the kid’s in school)

  • When looking at bones, look for avulsion of the metastasis, multiple rib fractures, posterior rib fractures, long bone fractures, and skull fractures

  • Shaken baby syndrome: generally see subdural hemorrhage (from tearing of the bridging veins…hemorrhage over hemispheres), subarachnoid hemorrhage, and retinal hemorrhage

  • Ocular injuries will show retinal detachment, retinal hemorrhage, and/or permanent visual defects

  • It is a class B misdemeanor not to report suspected child abuse

Category: Forensic Medicine Notes , Medical Subject Notes