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Death of a 6-Year-Old Boy with Mental Retardation: Accident Versus Child Abuse

Authors

  • Mary Dudley M.D., M.S., R.N.,

    1. Jackson County Medical Examiner’s Office, 660 East 24th Street, Kansas City, MO 64108.
    2. Department of Clinical Pathology, University of Missouri-Kansas City, 2411 Holmes Street, Kansas City, MO 64108.
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  • BreAnna M. Chapman B.S.

    1. Jackson County Medical Examiner’s Office, 660 East 24th Street, Kansas City, MO 64108.
    2. Department of Biochemistry, Indiana Wesleyan University, 4201 South Washington Street, Marion, IN 46953.
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    • Present address: 15678 South Blackfeather Street, Olathe, KS, 66062.


  • Presented at the 36th Annual Meeting of the National Association of Medical Examiners, September 25–October 3, 2002, in Shreveport, LA.

Additional information and reprint requests:
Mary Dudley, M.D., M.S., R.N.
Chief Medical Examiner
Jackson County Medical Examiner’s Office
660 East 24th Street
Kansas City, MO 64108
E-mail: mdudley@jacksongov.org

Abstract

Abstract:  This case study involved death of a 6-year-old child with a history of mental retardation secondary to meningitis at 11 months, spastic quadriplegia, seizure disorder, and hydrocephaly with a remote ventriculoperitoneal shunt placement and gastric tube feedings. Reportedly, the child was co-sleeping with his mother when she awoke and discovered him lying prone and not breathing on the carpeted floor next to the bed. He was transported to the hospital and died in the emergency room of unknown causes. The medical examiner assumed jurisdiction of the body. The external examination revealed petechial hemorrhages on the neck and face, with patterned linear pressure abrasions on the chest, arms, and face. X-rays revealed leg fractures of different ages. This case emphasizes the importance of coordination of death scene investigation, medical history review, and autopsy results through a forensic team approach to determine the accurate cause and manner of death.

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