Suspicion of sudden infant death syndrome & injuries to infants: The effects of type of death certifier, training, and economics

This paper examines the level of suspicion by death certifiers when ruling infant deaths as accidents. Data were gathered on economic factors, amount of training in death investigation received, and personal characteristics for 1995 from 776 medical examiners or coroners. Findings indicate that personal and social factors such as age, education, and population have negligible or no effects on the level of suspicion held by death certifiers in manner of death rulings for infants. The findings from this study do suggest there is potential for inaccurate rulings of infant death due to lack of training, education, and economic resources depending on the events surrounding an infant's death and whether the death certifier is a coroner or medical examiner. This study suggests the variables studied have low overall predictive power of level of suspicion of fatal infant injuries. This is noteworthy since the variables examined are frequently discussed as important factors in death certification. The results of this study suggest other factors have greater importance in explaining decisions by death certifiers or that the factors surrounding rulings of infant death are significantly different from those related to adult death.