Child deaths in Virginia, 1996: a review of investigations of sudden, unexpected, or unnatural deaths of children less than age 13

This study examines the consistency of investigative procedures used by the Office of the Chief Medical Examiner, law enforcement, and child protective services, when investigating the violent, sudden, unexpected, or unnatural deaths of children. The study also assessed the status of communication and cooperation among the investigating agencies, to determine whether improvements in the level of cooperation and communication among the systems recommended by prior legislative studies had been achieved. The subjects of this study were children from birth through age 12 who died a sudden, unexpected, or unnatural death in Virginia in 1996. The findings from this research provide both justification to celebrate the progress that has been made and the stimulus to improve the investigation into the sudden, unexpected, or unnatural deaths of children in Virginia. Data suggested that the level of cooperation and communication among child protective services workers, medical examiners, and law enforcement personnel in Virginia had increased between 1986 and 1996. The results demonstrated that some investigative procedures were consistent, especially within regional boundaries. However, the results also showed that inconsistencies exist in the way some deaths are investigated, and that room for improvement exists.     

Fatal traffic injuries among pedestrians, bicyclists and motor vehicle occupants

The objective of this study was to investigate characteristic injuries of pedestrians and bicyclists (unprotected) compared to motor vehicle occupants' (protected) in fatal traffic accidents. Cases of 664 fatal traffic accidents (371 pedestrians, 45 bicyclists, and 248 motor vehicle occupants) were collected from 1999 to 2001 using the database of the Forensic Institute in Budapest. Autopsy reports were analyzed. Location of injuries, blood alcohol levels, seasonal distribution and natural diseases influencing accident outcome were evaluated. For statistical analysis, odds ratio (OR) with 95% confidence interval (CI) was used by a conditional logistic regression. There were substantial differences in distribution of injuries suffered by pedestrians, bicyclists and motor vehicle occupants. Among pedestrians and bicyclists there was a higher rate of head injuries, such as skull fractures, epidural haemorrhage, subdural haemorrhage, brain contusion, and injuries of the lower extremities. Thoracic damages, such as traumatic aortic rupture, hemothorax, and abdominal damages, like liver rupture were dominant in motor vehicle occupants. Considering existing natural diseases, coronary artery disease was the only one with higher occurrence among motor vehicle occupants 24 (9.7%) compared with pedestrians and bicyclist 36 (8.6%). These results underline the importance of preventive strategies in transportation, pointing out that different methods are necessary to reduce fatal injuries of various traffic participants.