2 Matching Annotations
  1. Jul 2018
    1. On 2017 Jul 19, David Mage commented:

      The authors have done a thorough survey of the sudden unexpected infant death (SUID) investigations in several U.S. states. They report on the autopsy and death scene investigations (DSI) of the case infants performed to determine which if any of the three conditions considered to form SUID may be involved: [ICD-10 sudden infant death syndrome (SIDS R95); unknown causes (UNK R99); accidental suffocation and strangulation in bed (ASSB W75)]. However, it is well known that the DSI have an inherent problem if the infant under review has been moved upon discovery by the parents or other caregiver: “cases of sudden death are associated with so much shock to the family that an accurate history is impossible to obtain” (Farber S. NEJM 211 (4):157;1934); “The suddenness of death so stuns the family that attempts to obtain a reliable history on the first visit to the scene are frequently unsuccessful” (Werne J, Garrow I. AJPH 37(June):678;1947); When a possible SIDS infant is immediately picked up on discovery the final resting position is reconstructed from subjective recall, which complicates the DSI (Willinger M, James LS, Catz C., Pediatric Pathology 11: 677-684, 1991). The writer notes that to calculate accurately the reduction of oxygen and the increase in carbon dioxide from possible rebreathing exhalations at the infant’s nares, the distance between the nares and the possible obstruction must be known to the millimeter, that is lost when the infant is picked up on discovery (Mage DT. Forensic Sci Med Pathol 9:2013; 283.) The reader should note that when a SUID infant is picked up on discovery and the DSI is compromised, the ICD-10 code chosen (R95 or R99 or W75) may be incorrect but the totals for SUID remain unchanged.


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  2. Feb 2018
    1. On 2017 Jul 19, David Mage commented:

      The authors have done a thorough survey of the sudden unexpected infant death (SUID) investigations in several U.S. states. They report on the autopsy and death scene investigations (DSI) of the case infants performed to determine which if any of the three conditions considered to form SUID may be involved: [ICD-10 sudden infant death syndrome (SIDS R95); unknown causes (UNK R99); accidental suffocation and strangulation in bed (ASSB W75)]. However, it is well known that the DSI have an inherent problem if the infant under review has been moved upon discovery by the parents or other caregiver: “cases of sudden death are associated with so much shock to the family that an accurate history is impossible to obtain” (Farber S. NEJM 211 (4):157;1934); “The suddenness of death so stuns the family that attempts to obtain a reliable history on the first visit to the scene are frequently unsuccessful” (Werne J, Garrow I. AJPH 37(June):678;1947); When a possible SIDS infant is immediately picked up on discovery the final resting position is reconstructed from subjective recall, which complicates the DSI (Willinger M, James LS, Catz C., Pediatric Pathology 11: 677-684, 1991). The writer notes that to calculate accurately the reduction of oxygen and the increase in carbon dioxide from possible rebreathing exhalations at the infant’s nares, the distance between the nares and the possible obstruction must be known to the millimeter, that is lost when the infant is picked up on discovery (Mage DT. Forensic Sci Med Pathol 9:2013; 283.) The reader should note that when a SUID infant is picked up on discovery and the DSI is compromised, the ICD-10 code chosen (R95 or R99 or W75) may be incorrect but the totals for SUID remain unchanged.


      This comment, imported by Hypothesis from PubMed Commons, is licensed under CC BY.