Frequently Asked Questions - Teams
Reviewing cases of infant death due to natural causes is difficult. How can we get further information?
Infant deaths due to natural causes make up a large percentage of the child deaths in Michigan every year. Information gained from these reviews is extremely valuable in identifying gaps in our systems. Birth records (or certificates) are a good source of information and can be accessed by the health officer of your local health department. Birth weight, gestational age, substance abuse and many other factors are listed. In order to obtain these records, the county health officer must make a formal request on health department letterhead to: Glenn Copeland, Manager, Vital Record & Development Section, Division for Vital Records & Health Statistics, Michigan Department of Community Health, N Complex, Baker-Olin South, First Floor, 3423 N Martin Luther King Jr Blvd, Lansing MI 48906. This letter must state that the records will be used for the CDR process and will be kept strictly confidential. The director of the division has approved the use of these certificates for this purpose. Upon approval, the health officer should then begin to receive birth records on residents of their county automatically, without having to make repeated requests. If your local health department is already receiving all resident birth certificates for another public health purpose, the health officer should still submit a letter to the above, requesting that the Child Death Review process be added to the purposes for which the records will be used. It is also important to check for a history of contact on the parents of the infant with the Department of Human Services (formerly known as the Family Independence Agency.)
How do I utilize the electronic version of the Child Death Review Case Report form?
Only team coordinators are given access to this secure website. Each coordinator is assigned a user name and password with which to enter the site. Case reports can be entered on this system or teams can choose to continue mailing the paper version of the form to the program office, which will then be entered by CDR staff.
Our county medical examiner is hesitant to perform or order autopsies on sudden and unexpected infant deaths if he/she thinks it may be determined to be natural. What can we do?
There is a state program that provides up to $800 for the reimbursement of autopsy costs on deaths to infants between the ages of one month and one year, as long as the death was sudden and unexpected. Final ruling on cause and manner do not affect this reimbursement. If the county ME sends in the autopsy report alone, $500 will be paid. If the autopsy report is accompanied by the death scene investigation forms, the full $800 will be paid.
A doctor at a hospital in our county signed out a death certificate as SIDS before an autopsy was performed. Isn’t this the call of the medical examiner?
Yes. Statutory responsibilities of county medical examiners state, "Any physician…or any person who shall have first knowledge of the death of any person who shall have died suddenly and unexpectedly…shall notify the county medical examiner or his deputy immediately of the death," (from MCL 52.203). Deaths of infants are referred to specifically: "When a child under the age of two (2) dies within this state under circumstances of sudden death, cause unknown, or found dead, cause unknown, that death shall be immediately reported to the county medical examiner of the county wherein the body lies," (from MCL 52.205a). It further states that "County medical examiners…shall make investigations as to the cause and manner of death in all cases of persons…whose death was unexpected," (from MCL 52.202), and "The medical examiner…may order and conduct the autopsy with or without the consent of the next of kin," [from MCL 52.205, (5)].
A teenager who was a resident of our county was killed in a car crash in another county. Who reviews the case?
Most teams review all of their resident deaths. However, teams may wish to review non-resident deaths in order to get at issues involved in the case that are under their jurisdiction. In the case of a motor vehicle crash, the county where the death occurred should also review the case, to discuss issues of response, investigation and service delivery, or the safety issues regarding the location of the crash (visibility, construction of road, etc.). As another example, counties that border on one of the Great Lakes or have large inland lakes may wish to review drowning deaths of non-residents, in order to assess water safety in their communities. Reviewing other types of non-resident deaths may also reveal important information for the county of death.
Knowing when a child resident of your county dies in another county can be a challenge. If you find out about a non-resident child who died in your county, please consider using the form provided today (Resident County Notification of Child Death) as a means of notifying other CDR team coordinators about their resident child deaths. Otherwise, a quick email or phone call could assist the county of residence in their review of the death. Public Act 167 of 1997 also allows for Child Death Review Teams to share their case report with another CDR team. In doing this, information can be shared that will assist both teams in the review process.
Our last county clerk was very good about sending me death certificates of children filed in our county. The new one is not. What can I do?
Attachment D in the back of the yellow CDR team protocol book gives a sample of a letter that can be sent to county clerks requesting assistance in death certificate procurement for the purposes of the review process. Also, team members with who have a strong standing in the community (prosecutors, chief law enforcement officers, etc.) may assist by contacting the clerk to make the request. If these attempts do not work, know that you should be receiving all deaths to residents of your county 0-18 years of age within a reasonable amount of time from the CDR program staff. The year 2001 was the first full year in which the program office received microfilmed copies of all child death certificates as filed with the State, usually within 1-3 months of the death. Paper copies are then forwarded to the coordinator(s) of the CDR team of the county of residence of the child.
My team members often bring in obituaries from the paper if they see it was a child. Sometimes I am never able to locate a death certificate based on an obituary. Why is this?
There are a number of reasons why this might occur. Often, family members will put obituary notices in their local paper, whether or not they themselves are residents of the same county as the deceased child. If the deceased was an infant, it may be because the baby was actually stillborn. If the hospital determines that the delivery of an unresponsive fetus is not a live birth, no birth certificate, and therefore no death certificate, will be issued. This does not prevent family members from posting obituaries for the baby in the paper.
During our reviews, there is confusion regarding whether or not a death is preventable. How do we answer that question?
A child’s death is considered to be preventable if the team believes that an individual or the community could reasonably have done something that would have changed the circumstances that led to the death. For example, a teenager is killed in a car crash due to speeding. This case would be definitely preventable because the teen could have controlled the speed of the vehicle.