Florida calls for better infant death investigations

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Florida authorities have issued a wide-ranging call for improved standards of infant death investigation and review in the state, citing some of the deficiencies brought to light by recent Scripps Howard reports.The state's Child Abuse Death Review Committee, in its annual report to state leaders released late last month, suggested a number of steps be taken to increase consistency of investigations, including the adoption of standardized protocols by all 24 of the state's district medical examiners and local police investigators.The panel expressed particular concern that an inconsistent approach to reviewing infant deaths statewide has resulted in an incomplete picture of the risk posed to infants placed in unsafe sleep settings, with many accidental suffocation deaths still mistakenly attributed to Sudden Infant Death Syndrome.Scripps' review of infant deaths found that while medical examiners in Florida overall are about 50 percent more likely than investigators nationwide to determine that a baby died from suffocation (about 22 percent compared to 14 percent nationally), there are still many jurisdictions where up to 80 percent of infant deaths are either unexplained or labeled SIDS."The Scripps Howard report showed there are areas where it is too differential in how these deaths are investigated, thus the need for training and/or education for parents, hospitals, medical examiners, pediatricians and law enforcement investigating these types of deaths are essential,'' the committee wrote.The review panel attributed 22 of the 170 child deaths it reviewed from 2006 to unsafe sleeping environments, including couches, sofas, chairs, adult beds, sleeping in a crib with excessive bedding or toys, or sharing a bed with other persons, particularly someone overly tired, obese or under the influence of drugs or alcohol."This has been a high priority for us for several years, and our members are convinced that opportunities to prevent future deaths are being lost because we're not getting complete information on how many babies are dying in these circumstances,'' said Maj. Connie Shingledecker, commander of the criminal investigations division of the Manatee County Sheriff's Office and chairperson of the review committee.In Florida, state and local child death review teams are authorized to consider only child deaths in which a report of child abuse or neglect was verified by state welfare officials or local sheriff's office investigators."Only in those cases are all the agencies, like school districts and mental health agencies, statutorily permitted to share information,'' Shingledecker said. But the local review committee in Manatee County has done a rare, but limited investigation of infant deaths using publicly available medical examiner and police reports and found that 26 babies died there in unsafe sleep conditions between 2000 and 2006.Most of the babies were 2 months of age or younger. Most of their deaths had already been classified as either due to suffocation or unexplained by the medical examiner."We're using the demographics of these cases to work with pediatricians and hospital maternity nurses to target messages about putting infants in safe places to sleep --- and to spell out what not to do."We've seen a number of cases where the family had a proper crib or bassinette, but either they didn't use it or changed it so that it was unsafe. One mom felt the firm crib mattress was too hard, so she put an adult pillow on it -- and laid her baby on it face down on that pillow,'' Shingledecker said."We have to call these deaths what they are. Calling it SIDS for the comfort of a parent will not prevent the next child from being suffocated."The committee also urged state lawmakers to expand the panel's mandate to review all child deaths in the state, noting that with current inconsistencies in how child deaths are reported and recorded across the state, "the larger picture of why children die is lost."On the Net: http://www.flcadr.org(Distributed by Scripps Howard News Service, http://www.scrippsnews.net)