Determining the cause and manner of death when an infant or young child dies suddenly and unexpectedly requires a thorough investigation. Examination of the scene where the infant/child died, performance of a complete autopsy, and a review of the child’s and family’s medical history are the three critical elements that will give the medical investigation team valuable knowledge to assist in determining how and why the child died.

Due to the rarity of these types of tragedies after one year of age, even in populated areas, we offer the below information to assist you in focusing your autopsy where our research project has found the most helpful findings thus far.

The SUDC Research project has already evaluated the medical records and histological slides of over 100 children who died suddenly where the cause of death was not clear to the attending pathologist. The items listed below have been guided by our completed reviews of these children- as they have proven to be valuable pieces of information when attempting to determine the specific cause and manner of their deaths.

I. Microscopic sections (in addition to routine sections of heart, lung, etc.)
      a. Representative sections of brain including
               1. Bilateral Hippocampus
               2. Midbrain
               3. Pons
               4. Rostral Medulla
               5. Cerebellum including Dentate
               6. Basal Ganglia
               7. Watershed Cortex
       b. Thymus
       c. Gastro-esophageal junction for signs of GER

II. Retain as much brain tissue as possible in formalin

III. Specimens for ancillary testing 
       a. Blood & bile spots for metabolic testing 
       b. Urine and/or blood for toxicology
       c. Vitreous electrolytes, VUN, creatinine
       d. Microbiology specimens for culture/PCR when indicated
       e. Fresh frozen tissue for further metabolic studies or genetic studies (including channelopathies)

IV. Radiographs, preferably a detailed skeletal series and photographs as indicate