Postmortem Skeletal Survey Practice in Pediatric Forensic Autopsies: A National Survey

• NCJ Number: 225905
• Journal: Journal of Forensic Sciences Volume: 54 Issue: 1 Dated: January 2009 Pages: 189-191
• Author(s): Antoinette L. Laskey M.D., M.P.H.; Kelly L. Haberkorn M.P.H.; Kimberly E. Applegate M.D., M.S.; Michele J. Catellier M.D.
• Date Published: January 2009
• Length: 3 pages
• Publication Format: Article
• Publication Type: Survey
• Language: English
• Country: United States of America

Annotation

This study assessed procedures used in forensic autopsies in cases of unexplained death in children 36 months old or younger, with attention to the factors that influenced the use or nonuse of a postmortem skeletal survey (PMSS), which is recommended by the American Academy of Pediatrics and the Society for Pediatric Radiology.

Abstract

Nearly all of the respondents (99.6 percent) indicated they performed PMSS at least some of the time; however, the study found that although a “babygram” is universally considered inadequate to visualize the areas of interest, namely the metaphyses, nearly a third of the pathologists surveyed performed only “babygrams” in the types of cases considered in this study. An additional 30 percent typically obtained three to five films, which approximates the minimal standards developed by the National Association of Medical Examiners and the Society for Pediatric Radiology. Classic metaphyseal injuries are commonly not visible at autopsy and are best visualized through dedicated films of the limbs. These lesions in an infant could affect the determination of cause and manner of death. Although the number of pathologists who indicated that they did not perform imaging studies in cases of suspected sudden infant death syndrome (SIDS) was small (9 percent), it is important to be aware of the diagnostic criteria related to SIDS. Given that SIDS is a diagnosis of exclusion, made only after a complete autopsy that includes radiological examination--as well as a complete death-scene investigation; internal examination; and appropriate histological, microbiological, and toxicological studies--cases without the appropriate radiological studies could be incorrectly labeled as SIDS. Data were obtained through a national mail survey of pathologist members of the American Academy of Forensic Sciences who had conducted forensic autopsies of children 36 months old or younger (n=259). 1 table, 1 figure, and 13 references