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Child fatalit ynotes

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  • 1. CHILD FATALITY Lt. Kenneth Landwehr Wichita Police Department Homicide Section
  • 2. Multidisciplinary Team
    • Homicide Unit
    • EMCU
    • SRS
    • District Attorneys Office
  • 3. Child Fatalities
    • Natural Deaths
    • Accidents
    • Suicides
    • Homicides
    • Undetermined
  • 4. Causes of Fatalities Distinguishing between accidental and inflicted injuries
  • 5. Definitions
    • An accident is an event that occurs incidentally, casually or by chance
    • An abusive inflicted injury is one that occurs voluntarily and under conscious control
    • Inflicted injuries may be intentiona l or unintentional
  • 6. Accidental or NOT
    • Motor Vehicle
    • Drowning
    • Poisoning
    • Fire
    • Firearms
    • Exposure
    • Falls
    • Choking
    • Suffocation
    • Strangulation
  • 7. Abusive Inflicted Injury
    • Intentional
    • Reckless
    • Negligent/Neglectful
    • Acute or Chronic
  • 8. Law Enforcement Protocol
    • Homicide Unit responds to all child deaths with victims under the age of 6
    • Homicide also responds to victims with serious/ life threatening injuries
    • Traffic cases excluded
    • All cases reported to State Child Death Review Board
  • 9. Law Enforcement Response
    • To a hospital
    • To the scene
    • Separate Witnesses
    • Notification of Detectives
    • Neighborhood
    • Special problems due to dynamics
  • 10. Detective Response
    • Identify and Secure potential scenes (could be multiple)
    • Physical exam of baby
    • Processing of scene(s)/Consent or Search Warrant
    • Interviews with medical staff/EMS
  • 11. Detective Response
    • Obtain Family and medical history of child- Releases or Subpoenas
    • Obtain DNA samples /Consent or Search Warrant
    • Interviews with parents/caregivers
    • Interview witnesses
    • Interview siblings / family
  • 12. Detective Response
    • Attend Autopsy
    • Suspect Interrogation
    • Review Investigation with District Attorney Felony Review Team
    • Follow up Investigation
  • 13. CSI Response
    • Boundaries of Scene
    • Preservation of Scene and Evidence
    • Documentation of Scene and Body
    • Photographs, Measurements, Diagrams
    • Collection of Evidence
    • Chain of Custody
  • 14. Evidence
    • Last Meal dishes bottles
    • Meds,drugs poison
    • Bedding
    • Clothing/diaper
    • Blood,saliva,vomit, urine,feces
    • Hair, fiber
    • 911 tape
    • Latents
    • Pattern Instruments
    • Weapons
    • Documents
    • Photos or videos of child
    • School records
    • Phone records
  • 15. Knowledge about Child Development Essential in Distinguishing Accidental from Inflicted injuries
  • 16. Developmental Milestones
    • Sitting up alone
    • Rolls over
    • Crawling/Up
    • Walking alone
    • Runs
    • Toilet training
    • 4-10 words
    • 5-7 months
    • 6-7 months
    • 7-9 months
    • 8-13 months
    • 12-15 months
    • 22-36 months
    • 15-18 months
  • 17. Fatal Falls
    • You don’t CRUISE -You don’t BRUISE
    • No significant injury-Fall < than 3 feet
    • Fatal Outcome-Fall > than 2-3 stories
    • Stairways do not usually result in life threatening injuries
  • 18. Separating Accidental from Inflicted
    • Age of victim?
    • Is the history plausible?
    • Does history change with changing information given to caretaker?
    • Does history change when related in subsequent accounts by other family members?
  • 19. More Questions
    • Are there non-familial witnesses to the event?
    • Is the caretaker defensive, belligerent, hostile, passive or unconcerned?
    • Is the social situation in which the event occurred a high-risk environment?
    • Most importantly, what else could have caused the observed injuries?
  • 20. Histories Suspicious for Abuse
    • Delay in seeking medical attention
    • Discrepant history
    • Fractures in varying stages of healing
    • Extremity plus skull fracture
    • Intracranial injuries plus skull fracture
  • 21. Head Injury
    • Impulsive loading without impact whiplash
    • Struck by moving object causing head acceleration
    • Moving head strikes object
    • Head compression vise
    • Penetrating
  • 22. SYMPTOMS
    • Decreased responsiveness
    • Irritability
    • Lethargy
    • Limpness
    • Convulsions
    • Vomiting
    • Low body temperature
    • Low heart rate
    • Increased breathing rate
    • Coma with fixed and dilated pupils
    • Death
  • 23. Shaken Baby Syndrome Shaken Impact Syndrome
    • Commonest cause of mortality and long term disability due to physical abuse
    • Age range-newborn to 4 years
    • Most occur before babies first birthday
    • Average age: 3-8 months of age
  • 24. SBS/ SIS
    • Inconsolable crying is usual trigger mechanism
    • Perpetrator grabs infant by the thorax, upper arms or neck, and violently shakes the baby
    • Time of shaking-- 5-20 seconds
  • 25. Shaken Baby Intracranial Injury
    • Bridging veins from the brain to the dura tear open and bleed, creating subdural hemotoma and subarachnoid hemorrhages
    • Brain strikes the inner skull, causing direct trauma to the brain and swelling
  • 26. Other Injuries of SBS
    • Most significant are the retinal and petechial hemorrhages
    • Skull fractures with sufficient impact
    • Posterior rib fractures reflect chest compression during shaking
    • Bruising of the head, face, chest, and other areas or other fractures
  • 27. Head Trauma History
    • Symptoms will begin immediately
    • LUCID INTERVAL –A period of unconsciousness followed by a period of apparent recovery (0nly in adults and adolescents, Never documented in a child)
  • 28. Abdominal Injuries
    • Organs most Frequently injured Small Intestine, Liver, Pancreas
    • May not produce dramatic signs or symptoms Quickly
    • Liver damage most likely Blunt Uppercut
  • 29. Thoracic Injuries
    • Rib cage
    • Internal Organs-heart,lungs, blood vessels,nerves,esophagus, trachea, diaphragm
    • Types of Force: Direct impact Penetration,Compressions
  • 30. Likely Inflicted Thoracic Injury
    • Posterior Rib Fracture
    • Perforation of the posterior pharynx or upper esophagus
    • Chylothorax-Allows Milky Chyle to leak into thoracic cavity
  • 31. Skeletal Injury
    • Humeral – common in abuse
    • Femoral-if accidental either motor vehicle crash or major blunt trauma
    • Clavicular –uncommon under 3yrs,can result from shaking
    • Vertebral-due to compression of vertebral bodies during shaking
  • 32. Suspicious Fractures
    • Metaphyseal in children under 2yrs(disc like or bucket handle)
    • Posterior rib
    • Medial or lateral clavicular
    • Scapular
    • Sternum
    • Skull
    • Multiple
    • Bilateral(longbones on both sides)
    • Repetitive(in same child)
    • Fractures in hands or feet
  • 33. Suffocation
    • Hypoxia-lack of oxygen
    • Minimal or no external or internal trauma Petechial hemorrhages may or may not be present
    • Overlaying
    • Wedging
  • 34. Poisonings
    • Administration of Toxic agents
    • Salt Poisoning
    • Most Toxic screens miss
  • 35. Strangulation
    • Manual may have some external marks, fingerpad bruises,crescent abrasions
    • Ligature may see marks,abrasions, or bruises from instrument
    • Broken Hyoid, Thyroid,Crioids bone and cartilage
    • Internal bleeding
    • Petechial hemorrhages
  • 36. BURNS
    • IMMERSION BURNS
    • DRY CONTACT BURNS
    • CHEMICAL BURNS
  • 37. IMMERSION BURNS
    • Uniformity of the burn
    • Sparing of skin surface by skin folds
    • Sharply demarcated margins of the burn
    • Most often involve the upper and lower extremities and the buttocks
  • 38. DRY CONTACT BURNS
    • Uniform in degree
    • Often involve exposed surfaces of the body (arms, legs, hands, and feet)
    • Associated with discrepant histories
  • 39. CHEMICAL BURNS
    • Associated with acid or alkali substances
    • May involve the skin or the internal organs, particularly the mouth, throat, esophagus.
  • 40. Pattern Burns
    • Conforms to heating elements (Irons, grills, curling irons, cigarette lighters, or stove heating elements)
    • May be accidental or inflicted
    • Factors: age of child, location of burn, history
  • 41. Neglect Failure to meet child’s needs food, shelter,clothing, medical care,safekeeping
  • 42. Prosecution
    • Negligent Supervision
    • Medical Neglect
    • Reckless Acts
    • Intentional Acts
  • 43. Criminal Charges
    • 1 ST Pre-meditated or Felony Murder
    • 2 ND Intentional or Reckless
    • Voluntary Manslaughter
    • Involuntary Manslaughter- reckless or commission of Misdemeanor
    • Abuse of Child, Endangering a Child Abandonment or other persons crimes
  • 44. Prosecution Problems
    • Parent as Killer
    • Invisible Trauma
    • Establishing Mens Rea (State of Mind)
    • Multiple Killers
    • Time of Injury
    • Mechanism of Injury
    • Poor Investigation
    • Public Perception
  • 45. Successful Investigation and Prosecution
    • Timely Response
    • Coordinated Response
    • Careful and Complete Documentation
    • Well trained investigators and prosecutors
  • 46. Toshua A Pool 3mo 5-17-2004 Multiple closed head wounds
  • 47. Anthony Melton 18 WM Boyfriend of Mom not the father Plead to 2nd Intentional and two Aggravated batteries
  • 48. Left Skate South at 8:00 PM on June 9, 2006 Chelsea Brooks 14
  • 49.  
  • 50. Everett Gentry 17 Gentry will Plead Guilty to first degree murder
  • 51. Theodore Burnett 49 Burnett will be found guilty of Capital Murder sentenced to 50 years
  • 52. Elgin Ray Robinson 20 Robinson found guilty of Capital Murder sentenced to 50 years