Investigating sudden unexpected deaths in infancy and childhood and caring for bereaved families: an integrated multiagency approach

doi:10.1136/bmj.328.7435.331

BMJ 2004;328:331-334 (7 February), doi:10.1136/bmj.328.7435.331

Clinical review

Investigating sudden unexpected deaths in infancy and childhood and caring for bereaved families: an integrated multiagency approach

Peter J Fleming, professor of infant health and developmental physiology¹, Peter S Blair, edical statistician¹, Peter D Sidebotham, consultant paediatrician², Tracy Hayler, detective superintendent³

¹ University of Bristol, Institute of Child Health, United Bristol Healthcare NHS Trust Education Centre, Bristol BS2 8AE, ² Community Child Health, Designated Child Protection Doctor, Department of Community Paediatrics, Bristol BS2 8EF, ³ Avon and Somerset Constabulary, Criminal Investigation Department, Portishead, Bristol BS20 8QJ

Correspondence to: P J Fleming peter.fleming@bris.ac.uk

The first 150 words of the full text of this article appear below.

Introduction

The sudden unexpected death of an infant or child is one ofthe worst events to happen to any family. Bereaved parents expectand should receive appropriate, thorough, and sensitive investigationsto identify the medical causes of such deaths. As a result,several parallel needs must be fulfilled. Firstly, the needsof the family must be recognised—including the need forinformation and support. Further, there is the need to identifyany underlying medical causes of death that may have geneticor public health implications; the need for a thorough forensicinvestigation to exclude unnatural causes of death; and theneed to protect siblings and subsequent children.^1-5 Alongsidethis, families need to be protected from false or inappropriateaccusations. Limitations in the present coronial system haveled to delays or failures to detect deaths caused by relatives,carers, or health professionals.⁶ ^{w1 w2 w3} Several recent, highlypublicised trials have highlighted the possibilities of . . . [Full text of this article]

Methods

Professional responses to sudden unexpected deaths

Balance between care and investigation

What investigations are needed?

Interpretation of findings at the scene of death

Medical or forensic investigation of sudden deaths in infancy

Avon's multiagency approach

Summary

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