Data Dictionary National Fatality Review Case Reporting System Version 5.1 Data entry website: https://data.ncfrp.org 1-800-656-2434 [email protected] www.ncfrp.org SAVING LIVES TOGETHER 0 Contents Case Number .................................................................................................................................... 3 Section A. Child Information ............................................................................................................ 5 A1. Child Information (Complete for all ages) ............................................................................. 5 A2. Complete for Children Over One Year Old ............................................................................ 8 A3. Complete for All Infants Under One Year ............................................................................ 13 A4. Expanded Infant/Maternal Questions ................................................................................. 22 A5. Maternal Interview .............................................................................................................. 36 Section B. Biological Parent Information ................................................................................... 40 Section C. Primary Caregiver(s) Information ................................................................................. 44 Section D. Supervisor Information ................................................................................................. 49 Section E. Incident Information ..................................................................................................... 53 Section F. Investigation Information .............................................................................................. 56 Section G. Official Manner and Primary Cause of Death ............................................................... 59 Section H. Detailed Information by Cause of Death ...................................................................... 61 H1. Motor Vehicle and other Transport .................................................................................... 61 H2. Fire, Burn, or Electrocution ................................................................................................. 63 H3. Drowning ............................................................................................................................. 65 H4. Unintentional Asphyxia ....................................................................................................... 68 H5. Assault, Weapon, or Person’s Body Part ............................................................................. 69 H6. Fall or Crush ......................................................................................................................... 71 H7. Poisoning, Overdose, or Acute Intoxication ........................................................................ 72 H8. Medical Condition ............................................................................................................... 73 H9. Other Known Injury Cause ................................................................................................... 74 Section I. Other Circumstances of Incident ................................................................................... 76 I1: Sudden and Unexpected Death in the Young (SDY) ............................................................. 76 I2. Death Related to Sleeping or the Sleeping Environment ..................................................... 86 I3. Was Death a Consequence of a Problem with a Consumer Product .................................... 90 I4. Did Death Occur During Commission of Another Crime ....................................................... 91 I5. Child Abuse, Neglect, Poor Supervision, and Exposure to Hazards ...................................... 92 I6. Suicide ................................................................................................................................... 97 1 I7. Life Stressors ....................................................................................................................... 101 I8. COVID-19 Related deaths .................................................................................................... 105 Section J. Person Responsible (Other than Decedent) ................................................................ 107 Section K. Services to Family and Community as a Result of the Death...................................... 112 Section L. Findings Identified During the Review ........................................................................ 113 Section M. The Review Meeting Process ..................................................................................... 116 Section N. SUID and SDY Case Registry ........................................................................................ 118 Section O. Narrative ..................................................................................................................... 121 O1. Narrative ........................................................................................................................... 121 O2. Issues Summary (present and contributing factors) ......................................................... 121 1. Pre-, Inter-, and Post-conception Care ............................................................................ 121 2. Medical: Mother .............................................................................................................. 122 3. Family Planning ............................................................................................................... 124 4. Substance Use .................................................................................................................. 124 5. Prenatal Care/Delivery ................................................................................................... 125 6. Medical: Fetal/Infant ..................................................................................................... 125 7. Pediatric Care ................................................................................................................... 126 8. Environment .................................................................................................................... 126 9. Injuries ............................................................................................................................. 127 10. Social Support .............................................................................................................. 128 11. Partner/FOB/Caregivers ................................................................................................ 128 12. Family Transition ........................................................................................................... 128 13. Mental Health/Stress ................................................................................................... 129 14. Family Violence/Neglect .............................................................................................. 130 15. Culture ........................................................................................................................... 131 16. Payment for Care ......................................................................................................... 131 17. Services Provided .......................................................................................................... 132 18. Transportation .............................................................................................................. 132 19. Documentation ............................................................................................................. 132 20. Other ............................................................................................................................. 133 Section P: Form Completed By .................................................................................................... 133 1 Description of Integrated CDR/FIMR Case Reporting System The National Fatality Review Case Reporting System (NFR-CRS), Version 5.0 integrated Child Death Review (CDR) reporting and Fetal and Infant Mortality Review (FIMR) reporting into one data system. Depending on the age of the child or the cause of the death being reviewed, some sections of the database and data dictionary will be relevant to the case you are reviewing and some will not. The table below outlines which sections are CDR-specific, which ones are FIMR- specific, and which sections are shared by both fatality review forms. Overview of the CDR and FIMR Case Reporting System Section Description CDR FIMR A1 Child information (age, race, etc.) √ √ A2 Children over 1 year old √ A3 Infants √ √ A4 Expanded infant/maternal questions (expanded medical √ complications, education topics, referrals, etc.) A5 Maternal interview √ B Biological parents √ √ C Caregiver √ √ D Supervisor √ √ E Incident √ √ F Investigation √ √ G Cause of Death √ √ H Detailed causes (motor vehicle, fall/crush, drowning, etc.) √ √ I1 Sudden Death in the Young (SDY) √ I2 Sleep-related environment √ √ I3 Problem with a consumer product √ √ I4 Commission of a crime √ √ I5 Child abuse, neglect, poor supervision, exposure to hazards √ √ I6 Suicide √ I7 Life stressors √ √ J Person(s) responsible √ √ K Services provided √ √ L Findings √ √ M Review meeting √ √ N SUID/SDY categorization √ O1 Narrative