Investigating Infant Deaths: 1st Edition (Hardback) book cover

Investigating Infant Deaths

1st Edition

By Bobbi Jo O'Neal

CRC Press

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Hardback: 9780849382048
pub: 2007-05-07
eBook (VitalSource) : 9780429245343
pub: 2007-05-07
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It stands to reason that the most difficult cases to investigate are those in which the individual’s death was sudden, unexpected, and unexplained. Very few deaths occur where the deceased has no significant medical history, no trauma, no significant autopsy findings, and very little social history in which to investigate. Infant deaths almost always fit this category, making them consistently the most complicated and challenging deaths to investigate.

Investigating Infant Deaths draws on the expertise of a forensic nurse and member of the CDC core team for the Sudden Unexpected Infant Death Investigation Reporting Form to provide medicolegal death investigators and law enforcement personnel with investigative techniques applicable to sudden unexpected infant deaths. Beginning with a general state-of-the-field, the author defines the role of the investigator and explains the benefits of “double-teaming” an investigation. The book emphasizes the importance of timing and gives crucial tips for examining the incident scene and performing an initial post-mortem external exam. Specific instruction regarding the “art” of interviewing the grieving parents and how to follow up with families gives investigators an important edge when autopsy findings are slim. Additional chapters cover how to use a doll re-enactment and how to review medical records, social service records, and criminal histories. It also illustrates how to set up task forces including State Child Fatality Teams and an Investigative Child Death Review at the local level.  Case studies are used throughout the book to give investigators real-life examples of the techniques at work.

Presenting a workable approach that may facilitate a re-evaluation of current protocols, Investigating Infant Deaths provides the tools for continued improvement that will ensure all infant deaths are investigated thoroughly and thereby help prevent future premature infant deaths from occurring.


“In this book, B. O’Neal, a registered nurse and board certified medicolegal death investigator with the American Board of Medicolegal Death Investigators, gives an extensive overview on the investigation of infant deaths including epidemiological background, the significance of the emergency helpers, the initial post-mortem external assessment, the death scene investigation, the parental interview, the forensic autopsy, the analysis of the medical history, the case conference and the family or caregiver follow-up.

“The book shows that the author has an extended knowledge in this field and, moreover, a long-standing experience in doing such investigations. The book integrates different resources, refers the situation in the US, and reflects the relevant literature in this field. It is an excellent guideline for performing death investigations in infants. Besides the general overview, a number of special problems/tasks are discussed in great detail and always from a practical point of view. However, good experiences from outside the US, for example from projects in Australia or Norway, are not referred.

“In summary, the book gives an excellent overview on all the relevant questions and problems in relation to the investigation of infant deaths and can be used as guideline for practical casework. It can be recommended without any limitation for specialists in legal medicine and specialists from other fields involved in the investigation of these deaths. “

— T. Bajanowski, Institute of Legal Medicine, University of Duisburg-Essen, in the International Journal of Legal Medicine (2008) 122:267

"Anyone who participates in the investigation of infant death, or who may find themselves involved in infant medical resuscitation attempts, will find conceptual and practical guidance for what is often a daunting task."

—Jennifer R. Schindell, Deputy Medical Examiner / Forensic Nurse, Linn and Benton Counties, Corvallis, Oregon, writing in Journal of the International Association of Forensic Nurses

Table of Contents

Investigating Infant Deaths: Why Is It Important?

The Process

The Impact

Why Are They Difficult to Investigate?

What Is Being Done about It?

Current Statistics

Goal and Text Organization

Maternal and Infant Health: What Investigators Should Know

Maternal Health

Infant Health

Infant Growth and Development

The Investigation Begins: Timing Is Everything

A Common Beginning

Think outside the Box

Advanced Notification

Following Death Notification

Double-Team Approach

First Responders: Their Observations Are Important

9-1-1 Emergency Calls

First Responders

Initial Postmortem External Assessment



Performing the External Assessment

Equipment Needed

Assessing the Infant’s General Appearance

Skin Assessment

Body Diagram

Physical Evidence

Transporting the Body

Infant Death Scene Investigation: It Tells a Story

Death Scene Investigation: When Does It Begin?

Macro vs. Micro: What Is the Difference?

Documenting the Macroenvironment

Documenting the Microenvironment

Evidence or Chain of Custody

Day-Care Centers

The Art of Interviewing

Interview Basics

Types of Interviews

Initial Interview

Clarification Interview

Follow-Up Interview


Doll Reenactment with Scene Walk-Through

The Opposition

Benefits of Doll Reenactments

Preplanning: Doll Reenactment and Scene Walk-Through


Preplanning the Doll Reenactment: What to Consider

Explain Procedure to Law Enforcement

Explain Procedure to Witnesses

Initiating the Scene Walk-Through and Doll Reenactment

Investigative Concerns

The Forensic Autopsy: The Investigator’s Role

Why Should MDIs Be Informed?

Autopsy Basics


The Infant Forensic Autopsy: Before, During, and After

Records Review: Let the Records Speak


Infant’s Medical Record Review

Pharmacy Records

State Health and Home Health Agencies

Family Medical Records Review

Social Service Records Review

Birth Certificates

School Records

Criminal Records Review

Previous Infant Deaths

Child Death Review: It Brings It All Together


Types of CDRs


Retrospective CDRs

Family or Caregiver Follow-Up and Referral

Family Follow-Up

Family Referrals

Where Do We Go from Here?

Death Investigation Guidelines

Agency Policies and Protocols

Professional Certification

Death Certificate Completion

Proactive Prevention Initiatives


Subject Categories

BISAC Subject Codes/Headings:
LAW / Forensic Science
LAW / Medical Law & Legislation