Sudden and unexpected deaths in infants/ children (SUDI/C) Flashcards
SUDI/C
Rare – several hundred a year
1 in 10 Child deaths may be as a result of neglect or murder
Traumatic
Difficult to investigate
Most due to natural causes, illness or accident
Other causes:
Violence
Maltreatment
Neglect
Physical abuse
Drugs
Joint working
Police
Social services
Healthcare services
Child services
Why do we investigate all SUDI/C?
Every child death deserves to be fully investigated
To understand the causes
To prevent further deaths
To prosecute offenders
3 categories of SUDI/C
Category 1 – Unsuspicious (but sudden
and unexpected)
Category 2 – Suspicious (certain factors raise chance of criminal act having taken place)
Category 3 - Homicide
Initial actions
Initial actions are the same for all 3 categories
Full history
Examination of the body –
Post Mortem
Examination of place of death
Multi- agency background checks
If category 2/3
Classification becomes homicide
Crime Scene
Consider arrests
Significant witnesses
HOLMES
H2H
Witnesses
Why is it difficult to decide on category initially?
Injuries may not be apparent
Distress of parents
Concealment of evidence
Difficulty in obtaining information
Victim at hospital and not scene
Key questions
Why did the child die?
What was the cause of death and the circumstances that lead to it?
Were any criminal offences committed?
If so, Who was responsible?
Were there any suspicious marks or injuries?
What are the parents explanations?
Who was present?
Neglect?
Factors that would lead to suspicion
History of violence to children
Inconsistent accounts
Mental health issues
Previous unusual illness or hospital admissions
Child is older than 12 months
Family members know to social care
Parent/ carer has a criminal record
Child has been dead longer that stated
Evidence indicates smothering/physical abuse
Unusual bruising/petechiae
Foreign bodies in airway
Previous child death
History of drug/alcohol/domestic abuse in family
Delay in seeking help
Position or condition of body
Parents reaction/demeanour
Neglect issues
Investigative process
1st response
Death confirmed
Initial briefing
Home visit
Post mortem
Investigation
Case discussion
Coroners Inquest
Child Death overview Panel
First response
Low key
Unobtrusive
Initial assessment
Explain reason for police involvement
Recover evidence
Obtain information and historical info
Scene examination
Recover and document:
Food
Bedding
Clothing
Check heating
Look for:
Staging and alteration
Rubbish
Laundry
Soiling or vomiting
Important investigative considerations
Sympathetic and sensitive
Avoid harm
Open minded
Co-ordinated response
Clear communication
Meticulous investigation
Proportionate response
Preservation of evidence
Serious case review
Protection of other siblings
Learn Lessons
Recommendations made
Prevent future harm
Sally Clark case
2 sons died at 8 weeks and 10 weeks of age – 1 year apart
Signs of trauma on both children
Both parents arrested
Advised by solicitor to give no comment interviews
Sally Clark was alone at time of both deaths
At trial results of medical tests withheld
Professor Roy Meadows - Paediatrician
- Chance of two children from an affluent family suffering cot death was 1 in 73
million
Sally Clark found guilty of both murders
1st appeal turned down
2nd appeal
Statistical analysis flawed
Pathologist withheld information about
colonisation of staphylococcus aureus
bacteria – natural causes
Criminal Cases Review Commission
referred case to Court of Appeal
Released after 3 years in prison
