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

:  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 re...

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Bibliographic Details
Published in:Journal of forensic sciences 2007-11, Vol.52 (6), p.1355-1358
Main Authors: Omalu, Bennet I., Lindner, Jennifer L., Janssen, Jennifer K., Nnebe‐Agumadu, Uche, Weedn, Victor
Format: Article
Language:English
Subjects:
African Americans
Air - analysis
Babies
Carbon monoxide
Carbon Monoxide - analysis
Carbon Monoxide Poisoning - diagnosis
Caregivers
Death & dying
Environmental Exposure - adverse effects
Equipment Failure Analysis
Female
Forensic Medicine
forensic science
Forensic sciences
Heating - adverse effects
Humans
Infant
Postmortem Changes
Safety
Sudden Infant Death - etiology
sudden unexpected death
Toxicology
Ventilation
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Summary::  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.
ISSN:0022-1198
1556-4029
DOI:10.1111/j.1556-4029.2007.00547.x