The Role of Environmental Factors in the Causation of Sudden Death in Infants: Two Cases of Sudden Unexpected Death in Two Unrelated Infants Who Were Cared for by the Same Babysitter
Article first published online: 15 SEP 2007
Journal of Forensic Sciences
Volume 52, Issue 6, pages 1355–1358, November 2007
How to Cite
Omalu, B. I., Lindner, J. L., Janssen, J. K., Nnebe-Agumadu, U. and Weedn, V. (2007), The Role of Environmental Factors in the Causation of Sudden Death in Infants: Two Cases of Sudden Unexpected Death in Two Unrelated Infants Who Were Cared for by the Same Babysitter. Journal of Forensic Sciences, 52: 1355–1358. doi: 10.1111/j.1556-4029.2007.00547.x
- Issue published online: 15 SEP 2007
- Article first published online: 15 SEP 2007
- Received 30 Dec. 2006; and in revised form 4 Mar. 2007; accepted 18 Mar. 2007; published 21 Dec. 2007.
- forensic science;
- carbon monoxide;
- sudden unexpected death
Abstract: We report two cases of sudden unexpected death in two unrelated African American female infants, 2 months and 4 months old. Both infants were attended to by the same babysitter in the same apartment and died 39 days apart in the same bed and in the same bedroom. The autopsy of the first infant revealed sudden unexplained death in an infant. Toxicologic analysis for carbon monoxide (CO) was not performed because it was not suspected. When the second infant died, investigation into the ambient air quality within the apartment revealed high levels of CO emanating from a poorly ventilated and defective hot water heater, which was located across a hallway from the bedroom where the two babies died. CO saturation levels in the postmortem blood samples of the two babies were elevated and were similar (13% and 14%). Nicotine and cotinine were not detected in the blood sample of the two infants. Cherry-red livor mortis was absent. Acute CO intoxication was determined to be the underlying cause of these two unexpected deaths. These two cases underscore the need to integrate ambient air analysis and postmortem CO analysis as routine components of the comprehensive death investigation of infants who die suddenly and unexpectedly.