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Child Death Investigations Jim Holler, Jr. Holler Training Chief of Police, Liberty Township Police Department (Retired) (717)752-4219 Email: [email protected] www.hollertraining.com Gentle Homicides Course Outline Homicide Risk Among Infants ✓ Infants are at greatest risk for homicide during the first week of infancy and the first day of life. ✓ Among homicides during the first week of life, 82.6% occurred on the day of birth. ✓ The second highest peak in risk for infant homicide occurs during the eighth week of life ✓ Among homicides during the first week of life, 89% of perpetrators are female, usually the mother. ✓ If an infant is killed after the first 24 hours, the mother is no longer the primary suspect ✓ Prime suspects: husband, father, or boyfriend, perhaps working together with the mother to accomplish the end. ✓ Younger children, especially under the age of five. ✓ Parents or caregivers who are under the age of 30. ✓ Low income, single-parent families experiencing major stresses. ✓ Children with emotional and health problems. ✓ Lack of suitable childcare. ✓ Substance abuse among caregivers. ✓ Parents and caregivers with unrealistic expectations of child development and behavior. ✓ Children left with male caregivers who lack emotional attachment to the child Neonaticide The deliberate killing of a child within 24 hours of its birth and almost always committed by the mother. ✓ Because most perpetrators claim that the child was stillborn, forensic experts must determine whether or not the child was alive at birth. ✓ The presence of milk or food in the stomach obviously indicates that the child had been alive for some period of time. ✓ The hydrostatic test is traditionally used to determine if a child has breathed. ✓ The hydrostatic test is traditionally used to determine if a child has breathed. ✓ During the autopsy, the pathologist removes the lungs from the body of the infant and places them in water. ✓ If the lungs float, the child is presumed to have breathed. If they sink, the child is presumed to have been stillborn. Re-Breathing ✓ The inhalation of expired CO2 and other gases recovered from porous sleeping surfaces. ✓ Covering or other object caused a buildup of carbon dioxide around their head ✓ The inspired CO2 inhibits CO2 receptors in the brainstem. ✓ It truly appears that they either peacefully fall asleep or continue peacefully sleeping through this life-threatening event. Suffocation ✓ The impedance of oxygen supply by obstruction of nose or mouth. ✓ Difficult diagnosis ✓ Requires investigation and corroboration by witness/perpetrator statements ✓ Minimal or no external or internal trauma ✓ Petechiae may or may not be present ✓ If petechiae are present, they are suggestive but not diagnostic of suffocation or smothering Strangulation - Suicidal, Homicidal or Accidental Hanging is the most common type of committing suicide ✓ Ligature mark around the neck ✓ Presence of abrasion, ecchymoses (bruising) and redness around the ligature mark ✓ Trickling of saliva from the mouth ✓ When found in a case of suspect hanging, the presence of petechial hemorrhages strongly suggests the victim was hung when still alive. This helps distinguish hangings staged to make a murder look like a suicidal act. Petechiae ✓ Tiny broken capillary broken blood vessels ✓ Everyone has them ✓ A hard bout of coughing or vomiting can cause facial petechiae, especially around the eyes ✓ Petechiae may or may not be present ✓ If petechiae are present, they are suggestive but not diagnostic of suffocation or smothering Post-mortem Hanging ✓ A person may be murdered, and the body suspended to simulate suicide ✓ Look for signs of dragging to the place of suspension ✓ When a dead body is suspended, the rope is usually tied first around the neck and then around the beam, branch of a tree etc. Homicidal Strangulation ✓ Most common form of murder ✓ Many victims are adult women and is often associated with sexual interference ✓ Strangulation by ligature ✓ Manual strangulation, or throttling ✓ In ligature strangulation, in contrast to hangings, the ligature mark usually encircles the neck ✓ Abrasions are usually seen due to movement of the ligature across the neck. ✓ Fingernail marks may be seen either from the victim attempting to remove the ligature of the from the assailant tying to secure the ligature ✓ The victims clothing may sometimes be caught in the ligature during a struggle and produce marks ✓ The mark may completely encircle the neck or may be seen only at the front, when the ligature is pulled tightly from behind Suicidal “Throttling” ✓ Suicide by throttling is not possible, because the compression of the windpipe produces rapid unconsciousness and the fingers relax Homicidal Strangulation ✓ Sudden and violent compression of the windpipe causes almost IMMEDIATE unconsciousness insensibility and death ✓ If the windpipe is partially closed, buzzing in the ears, congestion, vertigo, tingling, muscle weakness, bleeding from the mouth, nose and ears, clinching of the hands and convulsions occurs before death ✓ Evidences of a struggle is usually found but if the victim is taken unawares, and the ligature is suddenly placed around the neck and pulled tightly, the person loses consciousness quickly and is unable to offer much resistance. ✓ Signs of strangulation include bruises, marks on the neck, bleeding in the throat, and fracture of the hyoid bone, a U-shaped bone at the base of the tongue ✓ Signs of strangulation include bruises, marks on the neck, bleeding in the throat, and fracture of the hyoid bone, a U-shaped bone at the base of the tongue Post-mortem Appearances ✓ Composition of ligature: the pattern and texture is produced in the skin ✓ Width of ligature: when the ligature is narrow a deep grove is made because much more force is being used Accidental Strangulation ✓ Children may get entangled in ropes during play, or the neck may get caught in widow cords. ✓ Belts, ropes or parts of clothing may get caught in rollers of machinery and causes accidental strangulation Positional Asphyxia ✓ Positional asphyxia happens when a person can't get enough air to breathe due to the positioning of his/her body. ✓ This happens most often in infants, when an infant dies and is found in a position where his/her mouth and nose is blocked, or where his/her chest may be unable to fully expand. ✓ There may be markings of congestion, cyanosis, and petechiae ✓ Examples include an infant found wedged between a mattress and the wall, an infant sleeping on a couch with an adult who is found with his face pushed against the cushions of the couch. “Gentle” Homicides Smothering – Probably the most commonly missed method of homicide in infants ✓ Victims tend to be very young, very old, debilitated, or incapacitated by restraints ✓ When a pillow is used, it is placed over the face and pushed down ✓ This causes the obstruction to the nose and mouth, asphyxia, and death ✓ There are usually NO MARKS on the face ✓ The face is not congested and there is no petechiae indicated ✓ Why would anyone suffocate their child? ✓ Suffocatory abuse, usually there is no history is provided to explain the child’s life-threatening symptoms. ✓ Most parents who repeatedly intentionally suffocate their infants do not necessarily intend to kill them. ✓ Suffocation may represent an unhealthy response to an infant’s crying. ✓ Infants suffocated as part of Munchausen Syndrome by Proxy may suffer at the hands of their abuser for several months before the correct diagnosis becomes apparent Clues of Suffocatory Abuse ✓ High number of recurrent, poorly explained events ✓ Infant older that six months of age ✓ Events that decrease or cease with admission to hospital ✓ Family history of sudden infant syndrome/ALTEs ✓ Presence of facial bleeding after event “Gentle” Homicides – Suffocation Homicide by Pillow ✓ This causes the obstruction to the nose and mouth, asphyxia, and death ✓ There are usually NO MARKS on the face ✓ The face is not congested and there is no petechiae indicated ✓ In infants smothering is easily accomplished ✓ One closes off the child’s nose with two fingers, at the same time pushing up on the lower jaw with the palm to occlude the airway ✓ The amount of force necessary to produce smothering is so minor in this age group and there is virtually never evidence of trauma Mechanical - External pressure on the body preventing chest movement Environmental - Oxygen is displaced from the atmosphere Traumatic Asphyxia ✓ Traumatic asphyxia appears to be relatively rare in children ✓ The ages of children is typically older than the infants who die in an unsafe sleep environment Drowning Homicides Drowning is: "suffocation due to immersion of the nostrils and mouth in a liquid". Immersion of the nostrils and mouth is the minimal requirement ✓ Typically the entire body is submerged in the liquid. ✓ The liquid is most commonly water but drowning can occur in any liquid e.g. beer, wine, gasoline, bitumen, dye, paint or some other chemical solution. Phases of Drowning ✓ Submersion is followed by struggle which subsides with exhaustion and drowning begins. ✓ Breath holding lasts until carbon dioxide accumulation stimulates respiration resulting in inhalation of water ✓ Gulping of water coughing and vomiting is rapidly followed by loss of consciousness. ✓ Death occurs within 2 to 3 minutes ✓ ALL drowning's should be considered HOMICIDE ✓ Children are typically drowned face down ✓ Pressure is exerted by the murderer’s fingers and hands to the back of the head and upper torso. ✓ Because of the ensuing cardiac arrest, not enough blood is not pumped through the broken blood vessels for the bruise to be visible. ✓ Asks the medical examiner to specifically look for possible subcutaneous bruising at the back of the head and upper torso ✓ Holding a child’s head underwater in a tub takes relatively little effort. ✓ The only signs of struggle may be a little water splashed from the tub, if the child is large enough to resist, which can easily be wiped away with a towel.
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