Onondaga County Child Fatality Review Team
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Annual Report 2008


Onondaga County Child Fatality Review Team          back to annual reports

Annual Report 2008 (PDF)

Introduction
The Onondaga County Child Fatality Team (CFRT) reviews cases of children/adolescents 18 years of age and younger who have died in Onondaga and surrounding counties and have been referred to the Medical Examiner's office. In 2008, there were 48 cases referred to the Onondaga County Medical Examiner's office of which 42 were reviewed by the CFRT (six homicides cases were pending litigation). Sixteen were infants, six were between the ages of 1-4 years, five between 5-9 years of age, four between 10-14 years of age and seventeen between15-18 years of age. Thirty two were males and sixteen were females. The manners of death include accidental, natural, homicide, suicide, and undetermined. The causes of death were varied and are noted in Table 3. The majority of these cases were from Onondaga County but other counties included Cayuga, Jefferson, Madison, Oswego, Tompkins, Broome, Oneida, Ontario, Steuben, Cortland and Herkimer. These cases may have been referred to the Medical Examiner's office or the child/adolescent may have been transported to Onondaga County for medical care and subsequently died in Onondaga County.

With the deaths during 2008, eleven were reported to the State Central Registry, five reports were made and open to Child Protective Services for petition, two were open Preventive Service cases, and one was in the care and custody of DSS in another county. The CFRT did not review or write any independent reports during 2008.

The CFRT which is chaired by the Medical Examiner held 10 meetings during 2008. Team members include representatives from:

  • Child Protective Services
  • Office of Children and Family Services
  • County Health Department
  • County Mental Health
  • Medical Examiner
  • District Attorney
  • County Attorney
  • Local/State Law Enforcement
  • Emergency Medical Services
  • Pediatrician
  • Local Hospitals
  • Center for Maternal Child Health
  • NYS SID Center
  • McMahon Ryan Child Advocacy Site

At each meeting there is a review of new cases, discussion of old and new business and an update on upcoming trainings.

Team Members

Christine Larkin Child Protective Services
Sonoma Pelton Office of Children and Family Services
Susan Serrao, Kathleen Coughlin and Adah Vaughn County Department of Health
Sue Ellen Harris County Mental Health
Dr. Robert Stoppacher Medical Examiner
Kristina Knoll District Attorney Office
Joanna Gozzi County Attorney Office
Richard Walsh, Philip Rougeux Local/State Law Enforcement
Anthony DiGregorio Emergency Medical Services
Dr. Ann Botash and Dr. Alicia Pekarsky Pediatricians
Janet Press, Elizabeth Kinsey and Sally Sutphen Local Hospitals
Dr. Richard Aubry, Heather Shannon, Kristen Luke-Housemann and Mary Jensen Center for Maternal Child Health
Clemencia Molina NYS SID Center
Julie Cecile McMahon Ryan Child Advocacy Site
Maureen O’Hara CFRT Coordinator

The Chief Medical Examiner was previously Dr. Mary Jumbelic. She retired in February 2009 and Dr. Stoppacher became the Chief Medical Examiner and a member of the CFRT.

Manner and Cause of Child/Adolescent Deaths in Onondaga County

  • Natural Causes
    A total of 11 children/adolescents between the ages of 0-18 years were ruled natural deaths. This is 23% of the total cases for 2008. Of these deaths, causes were acute myocarditis, bacterial sepsis d/t neisseria meningitides, sudden death associated with seizure disorder d/t undetermined etiology, streptococcal meningitis, congenital heart disease, SIDS, seizure disorder d/t remote meningitis cc. clostridium difficile bacteremia and Turner and Wolff-Hirschorn syndrome, acute lobar pneumonia, fulminant meningitis, sepsis d/t Group B strep infection, cc.premature birth and diabetic ketoacidosis.

    Seven of the natural deaths were under the age of 1 year, zero 1-4 years, one 5-9 years, one 10-14 years and two 15-18 years. Seven were males and four were females. Eight were Caucasian and three African-American. Three were from Onondaga County, two from Oswego County, one from Oneida County, one from Cayuga County, one from Broome County, one from Ontario County, one from Steuben County and one from Jefferson County.

  • Accidental Deaths
    Accidental deaths were the most frequent cause of child fatalities reviewed by the CFRT. A total of 17 children/adolescents between the ages of 0-18years were ruled accidental deaths. This is 35% of the total cases for 2008. Of these deaths three were caused by motor vehicle accidents, two positional asphyxia (both overlaying, co-sleeping), four house fire (carbon monoxide intoxication, thermal burns), other causes included fetanyl toxicity, mixed drug toxicity, multiple injuries d/t bicyclist being struck by truck, blunt head trauma d/t pedestrian being struck by motor vehicle, drowning, aspiration pneumonia d/t tramadol toxicity and complications of acute methadone intoxication.

    Two of the accidental deaths were under the age of 1 year, two 1-4 years, four 5-9 years, two 10-14 years and seven 15-18 years. Ten were males and seven were females. Twelve were Caucasian and five were African-American. Eleven were from Onondaga County, one from Oswego County, three from Madison County, one from Herkimer County and one from Cortland County.

  • Homicide Deaths
    A total of 9 deaths were ruled homicides. This is 19% of the total cases for 2008. Of these homicides, two were due to blunt trauma to the head, two due to gunshot wounds to chest/abdomen, two due to stab wound to neck, one due to asphyxia, one multiple blunt force and one due to multiple injuries.

    No homicide death was under the age of 1 year, four were between 1-4 years, one 10-14 years and four 15-18 years. Six were males and three were females. Five of the homicides were of Caucasian ethnicity and four African-American. Five were from Onondaga County, one from Madison county, one from Tompkins County and two from Oswego County.

  • Suicide Deaths
    A total of 4 deaths were ruled suicides. This is 8% of all the cases reported in 2008. Of these suicides, two were by asphyxia, one by a gunshot wound and one due to mixed drug toxicity.

    Three were males between the ages of 15-18 years and one was a female between 15-18 years of age. All were Caucasian and one was from Jefferson County, one from Oneida County and two from Onondaga County.

  • Undetermined Deaths
    A total of 7 deaths were ruled undetermined. This is 14% of all the cases reported in 2008. All of these were infants and the cause of death in each was determined to be sudden unexpected death in infancy (SUDI). The deaths were related to co-sleeping (5) or unsafe sleeping environment (2).

    All of these deaths were infants under the age of 1 year. Six were Caucasian and one was African-American. Five were male and two were females. Six were from Onondaga County and one was from Madison County.

  • Infant deaths
    A total of 16 infants under the age of one year were reported to the CFRT in 2008. This is 33% of the total cases reviewed by the CFRT. Eleven of these infants were male and five were female. Five of these infant deaths were considered to be the result of co-sleeping, two unsafe sleeping environments, and one asphyxia due to overlaying. This is 50% of the infant deaths. The other causes of infant deaths were two due to meningitis, one lobar pneumonia, one SIDS, one sudden death associated with seizure disorder, one congenital heart disease, one complication of maternal blunt force to abdomen, and one due to late onset group B strep. These causes account for 50% of the infant deaths.

Team Activities
In 2008, the Onondaga County Child Fatality Review Team:

  1. Established Mission statement, Goals and Interagency Guidelines for the CFRT.

  2. Identified need for education and public awareness in regards to accidental causes of death, i.e. drownings, fires, MVA, carbon monoxide poisonings as noted by members of the CFRT. The Medical Examiner put together a listing of topics to be covered in "News You Can Use" put out by the Onondaga County Health Department.

  3. Participation in trainings by team members or staff within team agencies to include:
    • Web cast, April 30, 2008 titled "Is it Injury or Neglect? Bridging our Understanding of Child Fatalities Caused from Unintentional Injury and/or Neglect."
    • Workshop, May 29, 2008 on Children and Adolescents titled "Sexual Behavioral Issues: Dynamics and Interventions."
    • Video conference, July 10, 2008 titled "Munchausen Syndrome by Proxy" which was coordinated by the Midwest Regional CAC.
    • Course, July 14-18, 2008 for District attorneys titled "Investigation and Prosecution of Child Fatalities and Physical Abuse"
    • Workshop, September 16, 2008 titled "Shaken Baby. Abusive Head Trauma: Diagnosis and Investigation."

  4. Identified need for public education and awareness for safe sleeping environment for infants-started working with appropriate agencies in community at end of year.

  5. Identified need for community awareness of common triggers for physical abuse. Some members from CFRT or their agencies involved In "Keeping Kids Safe" campaign being headed by United Way at the end of 2008.

  6. Team member initiated discussion regarding unsafe roadway in neighboring county which has been a frequent site of accidents with a child fatality this year.

  7. Improved case outcomes resulting from CFRT sharing of information.

Recommendations
The CFRT’s recommendations for 2009 is a safe sleeping campaign to be initiated by community agencies to try to decrease the number of infant deaths due to unsafe sleeping environments.

Establish a web site which will be informational to agencies within the community and to the general public.

Continued involvement in "Keeping Kids Safe" campaign with the United Way in order to help community identify abuse and have resources of where to go when identified.

September 2009

 
   


Copyright 2010-2017 Onondaga County Child Fatality Review Team
601 E. Genesee St., Syracuse, New York 13202   phone 315-701-2985
www.OnondagaChildFatalityReview.com


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