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The Oklahoma Child Death Review Board 2010 Annual Report Containing information on cases reviewed and closed during the 2010 calendar year A statutorily established Board contracted through the Oklahoma Commission on Children and Youth Think. Prevent. Live. Keep Our Children Safe The mission of the Oklahoma Child Death Review Board is to reduce the number of preventable deaths through a multidisciplinary approach to case review. Through case review, the Child Death Review Board collects statistical data and system failure information to develop recommendations to improve policies, procedures, and practices within and between the agencies that protect and serve the children of Oklahoma. Acknowledgements The Oklahoma Child Death Review Board would like to thank the following agencies for their assistance in gathering information for this report: The Police Departments and County Sheriffs’ Offices of Oklahoma Department of Public Safety Office of the Chief Medical Examiner Oklahoma Commission on Children and Youth Oklahoma Department of Human Services Oklahoma State Bureau of Investigation Oklahoma State Department of Health - Vital Statistics Contact information: Oklahoma Child Death Review Board Phone: (405) 606-4900 1111 N. Lee Ave. Fax: (405) 524-0417 Oklahoma City, OK 73103 http://okkids.org Table of Contents Introduction Recommendations of the Board 1 Board Actions and Activities 8 Cases Closed in 2010 9 Government Involvement 10 Cases by Manner of Death Accident 11 Homicide 12 Natural 13 Suicide 14 Unknown 15 Selected Causes of Death Traffic Deaths 16 Drowning Deaths 17 Sleep Related Deaths 18 Firearm Deaths 19 Fire Deaths 20 Abuse/Neglect Deaths 21 Table of Contents Near Deaths 22 Age of Decedent in Graph Form By Manner 23 By Select Causes 25 Resources 27 Recommendations The following are the 2011 annual recommendations of the Oklahoma Child Death Review Board as submitted to the Oklahoma Commission on Children and Youth. The majority of the recommendations are based on the deaths reviewed and closed in 2010 that were due to motor vehicles, drowning, unsafe sleep practices, fires, and child abuse/neglect. Motor Vehicle Related Recommendations Legislative recommendations: Mandatory sobriety testing of drivers in motor vehicle accidents resulting in a child fatality and/or a critical or serious injury to a child. Year first recommended: 2002 Total number of deaths since first recommended: 831 Number of additional deaths since last recommended: 81 Legislation that bans the use of wireless hand-held telephone or electronic com-munication device by motor vehicle operators. Year first recommended: 2008 Total number of deaths since first recommended: 226 Number of additional deaths since last recommended: 81 Strengthening of the booster seat legislation to include use up to age 8. Year first recommended: 2005 Total number of deaths since first recommended: 45 Number of additional deaths since last recommended: 3 (Specific to children between six and eight years of age.) Passage of All-Terrain Vehicle (ATV) legislation that contains elements prohibiting passengers, prohibiting drivers aged 12 and under, and requiring ATV safety train-ing. Requirements should be statewide, including on private land. Year first recommended: 2006 Total number of deaths since first recommended: 23 Number of additional deaths since last recommended: 5 Administrative recommendations: Enforcement of child passenger safety restraint laws, which include fines for driv-ers transporting unrestrained children. Year first recommended: 2000 Total number of deaths since first recommended: 502 Oklahoma Child Death Review Board 2010 Annual Report Page 1 Recommendations Number of additional deaths since last recommended: 50 (Specific to unrestrained occupants.) Develop and disseminate a campaign that will promote the best practices related to booster seat usage. Year first recommended: 2006 Total number of deaths since first recommended: 34 Number of additional deaths since last recommended: 3 (Specific to children between six and eight years of age.) Provide, at no cost, driver education classes for all high school and career tech students. Year first recommended: 2001 Total number of deaths since first recommended: 277 Number of additional deaths since last recommended: 27 (Specific to decedent as driver.) Increase accessibility and usage of drug courts and drug treatment programs. Year first recommended: 2000 Total number of deaths since first recommended: 1039 Number of additional deaths since last recommended: 81 Sleep Related Recommendations The Office of the Chief Medical Examiner and law enforcement agencies should adopt the Centers for Disease Control’s model policy for investigation and clas-sification of Sudden Unexpected Infant Deaths (SUID) and Sudden Infant Death Syndrome (SIDS), including the use of scene recreation and digital photography. The methods currently utilized do not adequately provide the opportunity to distinguish accidental overlay (smothering) from other causes. Year first recommended: 2007 Total number of deaths since first recommended: 334 Number of additional deaths since last recommended: 79 Affordable childbirth classes should be available to all expectant mothers and ad-dress safe sleep issues prior to birth. Scholarships should also be available to those who cannot afford classes. Year first recommended: 2006 Total number of deaths since first recommended: 411 Oklahoma Child Death Review Board 2010 Annual Report Page 2 Recommendations Number of additional deaths since last recommended: 79 Education on safe sleep environments should be provided to families after deliv-ery but prior to discharge. Year first recommended: 2006 Total number of deaths since first recommended: 411 Number of additional deaths since last recommended: 79 Education on safe sleep environments should be provided to families at the first well-child visit. Year first recommended: 2007 Total number of deaths since first recommended: 334 Number of additional deaths since last recommended: 79 Distribute cribs to low-income families. Year first recommended: 2007 Total number of deaths since first recommended: 334 Number of additional deaths since last recommended: 79 All hospitals in Oklahoma should adopt a policy regarding in-house safe sleep issues. Year first recommended: 2008 Total number of deaths since first recommended: 221 Number of additional deaths since last recommended: 79 *An unsafe sleep environment is defined as the child not in his/her own personal sleep area (i.e. crib, bassinette, play pen), with pillows or other items, including peo-ple, and/or placed face down to sleep. Drowning Recommendations Legislative recommendations: All pool/hot tub retailers in Oklahoma should be bound by law to distribute in-formation on pool/hot tub safety to new pool/hot tub owners at the time of sale or installation of any new pool/hot tub. Year first recommended: 2005 Total number of deaths since first recommended: 47 Number of additional deaths since last recommended: 9 (Specific to private pools only.) Oklahoma Child Death Review Board 2010 Annual Report Page 3 Recommendations Oklahoma Child Death Review Board 2010 Annual Report Page 4 Administrative recommendations: Increase access to swimming lessons for all children. Year first recommended: 2008 Total number of deaths since first recommended: 55 Number of additional deaths since last recommended: 25 Fund and distribute “Water Watcher” badges that promote appropriate and re-sponsible adult supervision of children around water. Year first recommended: 2008 Total number of deaths since first recommended: 55 Number of additional deaths since last recommended: 25 Work with Oklahoma Parks and Recreation to provide “Water Watcher” badges at Oklahoma lakes. Year first recommended: 2009 Total number of deaths since first recommended: 8 Number of additional deaths since last recommended: 0 (There were no lake deaths reviewed and closed in 2010.) EMS/National Weather Service include a warning regarding the dangers of flash floods in weather alerts. Year first recommended: 2010 Total number of deaths since first recommended: 49 Number of additional deaths since last recommended: 9 (Specific to open water and a drainage ditch.) Fire Recommendations Smoke alarm give-away programs should include carbon monoxide detectors. Year first recommended: 2008 Total number of deaths since first recommended: 19 Number of additional deaths since last recommended: 5 Increased penalties for homeowners who do not provide smoke alarms for rental houses. Year first recommended: 2008 Total number of deaths since first recommended: 10 Number of additional deaths since last recommended: 2 (There were two cases where the smoke alarm information was unknown.) Recommendations Child Abuse/Neglect Recommendations Increased funding of primary and secondary prevention programs of the Okla-homa Department of Human Services, Oklahoma State Health Department, De-partment of Education, and the Oklahoma Department of Mental Health and Substance Abuse Services. Year first recommended: 2003 Total number of deaths since first recommended: 337 Number of additional deaths since last recommended: 54 Provide the Oklahoma Department of Human Services with funding to hire ad-ditional child welfare staff to be in compliance with the recommended national standard issued by the Child Welfare League of America and with a salary com-petitive with positions in other states. Year first recommended: 2000 Total number of deaths since first recommended: 439 Number of additional deaths since last recommended: 54 Make court records pertaining to custody and guardianship available for public inspection after a child death. Year first recommended: 2007 Total number of deaths since first recommended: 168 Number of additional deaths since last recommended: 54 Create and support through funding, a medical team to review the medical re-cords in child abuse/neglect cases and submit an opinion if requested by the court. Year first recommended: 2007 Total number of deaths since first recommended: 168 Number of additional deaths since last recommended: 54 Recommend the legislature ensure funding for the Period of Purple Crying dis-tribution project of the Preparing for a Lifetime; It’s Everyone’s Responsibility in-fant mortality reduction initiative. Year first recommended: 2011 Total number of deaths since first recommended: N/A Number of additional deaths since last recommended: N/A Recommend the legislature support the findings of the Shaken Baby Prevention Education Initiative created by H.B. 2920 of the 2010 Legislative Session. Oklahoma Child Death Review Board 2010 Annual Report Page 5 Year first recommended: 2011 Total number of deaths since first recommended: N/A Number of additional deaths since last recommended: N/A Agency Specific Recommendations Oklahoma Safe Kids Coalition Promotion and establishment of funding for the Safe Kids Oklahoma Child Pas-senger Safety Program. This program includes: providing car seats for low-income families; providing training and car seats for every child care center in the state starting July 2006; providing, through a loaner program, car seats for special needs children; piloting a program for providing car beds for babies born prematurely; and the “Please Be Seated” program which allows citizens the op-portunity to send a card to Safe Kids with license plate information when a citi-zen has observed a child to be transported unrestrained. Safe Kids then con-tacts the family through a letter reminding them of the law and offering assis-tance for obtaining a car seat. Promotion and establishment of funding for the Safe Kids Oklahoma “Walk This Way” program which is aimed at reducing the number of child pedestrian inju-ries and fatalities. Promotion and establishment of funding for the Safe Kids Oklahoma bicycle safety program, which includes conducting bicycle safety rodeos and providing free helmets to groups who conduct bike safety education events utilizing Safe Kids curriculum. Promotion and establishment of funding for Safe Kids Oklahoma burn preven-tion programs, which include the “Save-A-Life” smoke detector giveaway/ installment programs, and a fireworks safety campaign. Promotion and establishment of funding for the Safe Kids Oklahoma water safety programs, which include the “Wee Water Wahoo” and “Wacky Water Wa-hoo” water safety training events and the Brittany Project, which provides loaner life jackets at Oklahoma Corps of Engineer lakes. Year first recommended: 2004 Total number of deaths since first recommended: 1083 Number of additional deaths since last recommended: 127 Oklahoma Child Death Review Board Promotion and establishment of funding for the Oklahoma Child Death Review Board’s Think. Prevent. Live. public service campaign addressing deaths due to drowning, fires, wheeled activities, unsafe sleep practices, and child abuse/neglect. Recommendations Oklahoma Child Death Review Board 2010 Annual Report Page 6 Year first recommended: 2008 Total number of deaths since first recommended: 645 Number of additional deaths since last recommended: 238 New Recommendations: Creation of a drug death review board to look at the drug deaths (all ages) oc-curring in Oklahoma. Creation of substance abuse programs for pregnant women who have a positive drug screen prior to delivery. Legislation requiring first responders (law enforcement, EMS, medico-legal inves-tigators) to undergo mandatory specialized training in child death scene investi-gation. Women’s health providers to include domestic violence screenings at health ap-pointments. Continued financial support for the Child Protection Committee of The Chil-dren’s Hospital of Oklahoma. Recommendations Oklahoma Child Death Review Board 2010 Annual Report Page 7 Board Actions and Activities Oklahoma Child Death Review Board 2010 Annual Report Page 8 Include but are not limited to: Continued collaborations with the Oklahoma Domestic Violence Fatality Review Board, including case review. Continued collaborations with the Oklahoma Violent Death Reporting and Sur-veillance System, Injury Prevention Services, Oklahoma State Department of Health. Continued participation with Central Oklahoma Fetal Infant Mortality Review Community Action Team. Began partnership with Preparing for a Lifetime, a statewide program aimed at reducing infant mortality. Followed up with the Oklahoma Department of Human Services (OKDHS) on 14 cases, including but not limited to: requesting that OKDHS request the Okla-homa State Bureau of Investigation investigate a case that had minimal law en-forcement involvement; requesting clarification on the priority level a referral was assigned; expressing the CDRB’s concern for the placement of a near death victim; requesting OKDHS conduct an internal review of a child death; making a formal referral; requesting the final disposition of a referral; and commending an exceptional investigation. Correspondence to an attending physician educating on when the diagnosis of Sudden Infant Death Syndrome can be utilized. Correspondence to an attending physician recommending the cause of death be amended to reflect the true cause of death and not the underlying condition. Referred a physician to the Oklahoma Board of Medical Licensure. Followed up with the Oklahoma Chief Medical Examiner’s Office (OCME) on eight cases, including but not limited to: recommending the cause and/or manner of death be amended; referring cases to the OCME for review (cases that had not been referred to that office); requesting clarification of content in reports; and requesting clarification of policies and procedures. Followed up with the involved law enforcement agency, including but not limited to: recommending the agency adopt the Center for Disease Control’s Sudden Unexpected Infant Death Investigation protocols; recommending the agency contact OKDHS when a child dies; requesting clarification on why a caregiver was not interviewed; recommending a case be reopened; recommending an agency follow statute and comply with CDRB requests for records; and request-ing an agency request an out-of-state law enforcement agency make contact with a caregiver. Followed up with District Attorney’s involved in four cases, including inquiring about charges and expressing concern for the sentence of a perpetrator. Cases Closed 2010 The Oklahoma Child Death Review Board is comprised of five review teams. The total number of deaths reviewed and closed in 2010 by all five teams is 282. The year of death for these cases ranged from 2005 to 2010. Oklahoma Child Death Review Board 2010 Annual Report Page 9 2010 Deaths Reviewed Manner Number Percent Accident 127 45.0% Unknown 64 22.7% Natural 43 15.3% Homicide 26 9.2% Suicide 22 7.8% Gender Number Percent Males 186 66.0% Females 96 34.0% African American 40 14.2% American Indian 37 13.1% Asian 1 0.4% Multi-race 16 5.7% White 188 75.4% Race Ethnicity Number Percent Hispanic (any race) 36 12.8% Non-Hispanic 246 87.2% Number of Deaths Reviewed by County The map to the right shows the number of deaths that were reviewed and closed for each county. The death is assigned to the county in which the injury or illness occurred. Government Involvement The chart below indicates a child’s involvement in government sponsored programs, either at the time of death or previous to the time of death. The Child Welfare cases are those children who had an abuse and/or neglect referral prior to the death incident. It does not reflect those child deaths that were investigated by the Oklahoma Department of Human Services. In addition to the information in the chart below, there were five foster care deaths re-viewed and closed in 2010. Five were ruled accidental deaths, two were ruled natural deaths and one had an unknown manner of death. One was confirmed by the OKDHS/ CW as to the abuse/neglect allegations. Oklahoma Child Death Review Board 2010 Annual Report Page 10 Number of Cases with Previous Involvement in Selected State Programs Agency Number Percent Of All Deaths OKDHS - TANF 219 77.7% Oklahoma Health Care Au-thority (Medicaid) 172 61.0% OSDH - Children First 10 3.5% OKDHS - Foster Care 5 1.8% OKDHS - Emergency Assistance 3 1.1% OKDHS - Child Care Assistance 17 6.0% OKDHS - Child Welfare 52 18.4% OKDHS - Child Support Enforcement 136 48.2% Office of Juvenile Affairs 20 7.1% OKDHS - Food Stamps 51 18.1% OKDHS - Disability 20 7.1% OSDH - Office of Child Abuse Prevention 3 1.1% Accidents The Board reviewed and closed 127 deaths in 2010 whose manner of death was ruled Ac-cident. Nine (81.8%) of the 11 asphyxia deaths were infants. Both of the accidental overdoses were due to a combination of prescription medications. The crushing death was due to a forklift. Oklahoma Child Death Review Board 2010 Annual Report Page 11 Type Number Percent Vehicular 81 62.2% Drowning 25 19.7% Asphyxia/ Suffocation 11 8.7% Fire 5 4.7% Poisoning/ Overdose 2 1.6% Firearm 1 0.8% Crush 1 0.8% Medical Misadventure 1 0.8% Mechanism of Death Gender Number Percent Males 80 63.0% Females 47 37.0% Race African American 9 7.0% American Indian 19 15.0% Multi-race 5 4.0% White 94 74.0% Ethnicity Number Percent Hispanic (any race) 19 15.0% Non-Hispanic 108 85.0% Accidental Deaths by County Homicides The Board reviewed and closed 26 deaths in 2010 whose manner of death was ruled Homicide. Thirteen (50%) of these were due to physical abuse, with nine (34.6%) specific to abusive head trauma. Oklahoma Child Death Review Board 2010 Annual Report Page 12 Mechanism of Death Method Number Percent Firearm 11 42.4% Struck/ Shaken/Beat 11 42.4% Drowning 1 3.8% Overdose 1 3.8% Stabbed 1 3.8% Suffocation 1 3.8% Gender Number Percent Males 16 61.5% Females 10 38.5% Race African American 12 46.2% American Indian 1 3.8% Multi-race 3 11.5% White 10 38.5% Ethnicity Number Percent Hispanic (any race) 2 7.7% Non-Hispanic 24 92.3% Homicide Deaths by County Naturals The Board reviewed and closed 43 deaths in 2010 whose manner of death was ruled Natural. Oklahoma Child Death Review Board 2010 Annual Report Page 13 Mechanism of Death Gender Number Percent Males 30 69.8% Females 13 30.2% Race African American 8 18.6% American Indian 4 9.3% Multi-race 1 2.3% White 30 69.8% Ethnicity Number Percent Hispanic (any race) 8 18.6% Non-Hispanic 35 81.4% Illness/Disease Number Percent SIDS 18 41.9% Infectious Disease 11 25.6% Seizure Disorder 3 7.0% Cardiovascular 2 4.7% Other Conditions 4 9.3% Congenital Anomaly 1 2.3% Malnutrition 1 2.3% Prematurity 1 2.3% Undetermined 1 2.3% Unknown 1 2.3% Natural Deaths by County Suicides The Board reviewed and closed 22 deaths in 2010 whose manner of death was ruled Suicide. Oklahoma Child Death Review Board 2010 Annual Report Page 14 Gender Number Percent Males 19 86.4% Females 3 13.6% Race African American 1 4.5% American Indian 2 9.1% White 19 86.4% Ethnicity Number Percent Hispanic (any race) 0 0% Non-Hispanic 22 100% Mechanism of Death Method Number Percent Firearm 14 63.7% Asphyxia 7 31.8% Motor Vehicle 1 4.5% Suicide Deaths by County Unknown The Board reviewed and closed 64 deaths in 2010 ruled Unknown. Fifty-nine (92.2%) were 2 years or younger. Fifty-four (84.4%) were less than 1 year of age. Fifty-one (79.7%) involved questionable safe sleeping environments. Seven (10.9%) were suspicious for trauma. Two (3.1%) were premature infants with maternal drug exposure in utero. Two (3.1%) had questionable safe sleep environments as well as upper respiratory ill-nesses. One (1.6%) died of hyperthermia and the pathologist was unable to determine an exact manner of death. Oklahoma Child Death Review Board 2010 Annual Report Page 15 Race African American 10 15.6% American Indian 11 17.2% Asian 1 1.6% Multi-Race 7 10.9% White 35 54.7% Gender Number Percent Males 41 64.1% Females 23 35.9% Ethnicity Number Percent Hispanic (any race) 6 9.4% Non-Hispanic 58 90.6% Unknown Deaths by County The Board reviewed and closed 81 accidental deaths in 2010 related to traffic. For the ATV deaths, all were operators and only two were wearing a helmet. The child in the motorcycle death was wearing a helmet; the children on the bicycles/ tricycle were not wearing helmets. *Other includes the fender of a tractor, a child in utero, a child riding the sideboards, and a child exiting a vehicle with the car stopped in traffic (game) Traffic Related Deaths Oklahoma Child Death Review Board 2010 Annual Report Page 16 Vehicle of Decedent Vehicle Number Percent Car 24 29.6% Pick-Up 18 22.2% SUV 18 22.2% Pedestrian 8 9.9% ATV 5 6.3% Bicycle 3 3.7% Van 2 2.5% Motorcycle 1 1.2% Tricycle 1 1.2% Tractor 1 1.2% Use of Safety Restraints Seatbelt/Car seat Use Number Percent Properly Restrained 18 22.2% Not Properly Restrained 50 61.7% Not Applicable 13 16.1% Activity of Decedent Position Number Percent Operator 27 33.3% Rear Passenger 25 31.0% Front Passenger 15 18.5% Other* 4 4.9% Unknown Passenger Placement 1 1.2% Truck Bed 1 1.2% N/A 8 9.9% Gender Number Percent Males 52 64.2% Females 29 35.8% Race African American 2 2.5% American Indian 16 19.8% Multi-race 3 3.7% White 60 74.1% Ethnicity Number Percent Hispanic (any race) 11 13.6% Non-Hispanic 70 86.4% The Board reviewed and closed 25 accidental deaths in 2010 due to drowning. Drowning Deaths Oklahoma Child Death Review Board 2010 Annual Report Page 17 Location of Drowning Location Number Percent Private, Residential Pool 9 36.0% Open Body of Water (i.e. creek, river, pond, lake) 8 32.0% Bathtub 6 24.0% Drainage Ditch 1 4.0% Bucket 1 4.0% Type of Residential Pool Type of Pool Number Percent Above Ground 5 55.6% In Ground 4 44.4% Gender Number Percent Males 15 60.0% Females 10 40.0% Race African American 2 8.0% American Indian 1 4.0% White 21 84.0% Multi-Race 1 4.0% Ethnicity Number Percent Hispanic (any race) 4 16.0% Non-Hispanic 21 84.0% Type of Open Body of Water Open Body Number Percent Pond 6 75.0% River 2 25.0% The Board reviewed and closed 79 deaths that were related to sleep environments. These included accidental asphyxiations, SIDS, and Undetermined manners of death where the pathologist noted the sleep environment was a possible contributor to the death. Oklahoma Child Death Review Board 2010 Annual Report Page 18 Manner Number Percent Accidental 10 12.6% Natural (SIDS) 18 22.8% Undetermined 51 64.6% Sleep Related Deaths Manner of Death for Sleep Related Deaths Position of Infant When Placed to Sleep Position Number Percent On Back 22 27.8% On Side 9 11.4% On Stomach 11 13.9% Unknown* 37 46.9% Sleeping Arrangement of Infant Sleeping Arrangement Number Percent Alone 45 57.0% With Adult and/or Other Child 34 43.0% Sleeping Location of Infant Location Number Percent Adult Bed 40 50.6% Couch 11 13.9% Crib 9 11.4% Playpen 4 5.1% Bassinette 2 2.5% Chair 1 1.3% Floor 1 1.3% Other 9 11.4% Unknown* 2 2.5% Gender Number Percent Males 51 63.1% Females 28 36.9% Race Ethnicity Number Percent Hispanic (any race) 10 12.7% Non-Hispanic 69 87.3% Position of Infant When Found Position Number Percent On Back 13 16.5% On Side 10 12.7% On Stomach 26 32.9% Unknown* 30 37.9% *This information is unknown due to the lack of information collected by scene investigators African American 14 17.7% American Indian 14 17.7% Asian 1 1.3% Multi-race 8 10.1% White 42 53.2% The Board reviewed and closed 26 deaths in 2010 due to firearms. Oklahoma Child Death Review Board 2010 Annual Report Page 19 Manner Number Percentage Accident 1 3.9% Homicide 11 42.3% Suicide 14 53.8% Type of Firearm Number Percent Handgun 14 53.9% Hunting Rifle 5 19.2% Shot gun 2 7.7% Assault Rifle 2 7.7% Unknown 3 11.5% Firearm Deaths Type of Firearm Used Manner of Death for Firearm Victims Gender Number Percent Males 21 80.8% Females 5 19.2% Race African American 10 38.4% American Indian 1 3.9% White 15 57.7% Ethnicity Number Percent Hispanic (any race) 1 3.9% Non-Hispanic 25 96.1% The Board reviewed and closed five deaths in 2010 due to fires. Four fires resulted in five deaths. Four died of smoke inhalation, one died of thermal injuries. Oklahoma Child Death Review Board 2010 Annual Report Page 20 Fire Deaths Working Smoke Detector Present Detector Number Percent Yes 1 20.0% No 2 40.0% Unknown 2 40.0% Fire Ignition Source Source Number Percent Appliance 2 40.0% Matches 1 20.0% Space Heater 1 20.0% Wall Heater 1 20.0% Gender Number Percent Males 3 60.0% Females 2 40.0% Race African American 2 40.0% White 3 60.0% Ethnicity Number Percent Hispanic (any race) 0 0 Non-Hispanic 5 100% The Board reviewed and closed 42 cases where it was determined that abuse or neglect caused or contributed to the death. Thirteen (31.0%) cases were ruled abuse, 28 (66.7%) cases were ruled neglect, and one (2.3%) was ruled both. Oklahoma Child Death Review Board 2010 Annual Report Page 21 Abuse/Neglect Deaths Manner of Death for Abuse/Neglect Cases Manner Number Percent Accident 21 50.0% Homicide 14 33.3% Natural 2 4.8% Suicide 3 7.1% Undetermined 2 4.8% Gender Number Percent Males 24 57.1% Females 18 42.9% Race Asian 1 2.4% African American 7 16.6% American Indian 2 4.8% Multi-race 4 9.5% White 28 66.7% Ethnicity Number Percent Hispanic (any race) 6 14.3% Non-Hispanic 36 85.7% The Board reviewed and closed 49 near death cases in 2010. A case is deemed near death if the child was admitted to the hospital diagnosed in serious or critical condition by the treating physician as a result of suspected abuse or neglect. Forty-one (83.7%) were substantiated by OKDHS as to having been abuse and/or neglect. Thirteen (26.5%) had a previous referral that was investigated by OKDHS. Oklahoma Child Death Review Board 2010 Annual Report Page 22 Near Deaths Injuries in Near Death Cases Injury Number Percent Physical Abuse 24 49.0% Poison/Overdose 13 26.6% Fire 2 4.1% Firearm 2 4.1% Medical Condition 2 4.1% Non-Organic Failure to Thrive 2 4.1% Asphyxia 1 2.0% Fall 1 2.0% Drowning 1 2.0% Stabbing 1 2.0% Gender Number Percent Males 33 67.3% Females 16 32.7% Race Asian 1 2.0% African American 11 22.4% American Indian 9 18.4% Multi-race 2 4.1% White 26 53.1% Ethnicity Number Percent Hispanic (any race) 4 8.2% Non-Hispanic 45 91.8% Oklahoma Child Death Review Board 2010 Annual Report Page 23 Age of Decedents by Manner 0 20 40 60 80 100 120 <1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Number of Deaths Age All Deaths by Age 0 2 4 6 8 10 12 14 16 18 20 <1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Number of Deaths Age Accidental Deaths by Age 0 5 10 15 20 25 30 35 <1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Number of Deaths Age Natural Deaths by Age Oklahoma Child Death Review Board 2010 Annual Report Page 24 Age of Decedents by Manner 0 1 2 3 4 5 6 <1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Number of Deaths Age Homicide Deaths by Age 0 1 2 3 4 5 6 7 8 <1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Number of Deaths Age Suicide Deaths by Age 0 10 20 30 40 50 60 <1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Number of Deaths Age Unknown Deaths by Age Oklahoma Child Death Review Board 2010 Annual Report Page 25 Age of Decedents by Select Causes 0 2 4 6 8 10 12 14 16 <1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Number of Deaths Age Traffic Related Deaths by Age 0 1 2 3 4 5 6 <1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Number of Deaths Age Drowning Deaths by Age 0 2 4 6 8 10 <1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Number of Deaths Age Firearm Deaths by Age Oklahoma Child Death Review Board 2010 Annual Report Page 26 Age of Decedents by Select Causes 0 5 10 15 20 25 <1 1 2 3 4 5 6 7 8 9 10 11 12 Number of Deaths Age (in months) Sleep Related Deaths by Age 0 0.5 1 1.5 2 2.5 3 3.5 <1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Number of Deaths Age Fire Deaths by Age 0 2 4 6 8 10 12 <1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Number of Deaths Age Abuse/Neglect Deaths by Age Oklahoma Child Death Review Board 2010 Annual Report Page 27 Resources Child Abuse Reporting Hotline Heartline Crisis Helpline Office of the Chief Medical Examiner Oklahoma Coalition Against Domestic Violence and Sexual Assault Oklahoma Commission on Children and Youth Oklahoma Health Care Authority Oklahoma Mental Health and Substance Abuse Services Oklahoma Office of Juvenile Affairs SAFE KIDS Oklahoma Oklahoma State Department of Education Oklahoma State Department of Health Acute Disease Service Adolescent Health Program Child Abuse Prevention Children First Program Dental Health Services Injury Prevention Service SoonerStart Sudden Infant Death (SIDS) Program Vital Records WIC Oklahoma State House of Representatives Oklahoma State Senate Oklahoma Department of Human Services SAFELINE TEENLINE 1-800-522-3511 1-800-784-2433 (405) 239-7141 (405) 524-0700 1-866-335-9288 or (405) 606-4900 (405) 522-7300 (405) 522-3908 (405) 530-2800 (405) 271-5695 (405) 521-3301 (405) 271-5600 (405) 271-4060 (405) 271-4480 (405) 271-7611 (405) 271-7612 (405) 271-5502 (405) 271-3430 (405) 271-6617 (405) 271-4471 (405) 271-4040 1-888-655-2942 (405) 521-2711 (405) 524-0126 (405) 521-3646 1-800-522-7233 1-800-522-TEEN Oklahoma 211 Collaborative www.211Oklahoma.com Joint Oklahoma Information Network www.join.ok.gov Suicide Prevention Resource Center www.sprc.org This publication, printed in June 2011 by the University of Oklahoma Health Sciences Center printing office, is issued by the Oklahoma Child Death Review Board. [150] copies were pro-duced at a cost of [$1530.00]. Copies have been deposited with the Publications Clearinghouse of the Oklahoma Department of Libraries. Proud partner of Preparing for a Lifetime to ensure a safe and healthy start for Oklahoma babies For more information please visit: http://www.iio.health.ok.gov
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Title | Child Death Review Board annual report 2010 |
OkDocs Class# | C1650.3 D283 2010 |
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ODL electronic copy | Downloaded from agency website: http://www.okkids.org/CDRB/documents/2010%20Report.pdf |
Rights and Permissions | This Oklahoma government publication is provided for educational purposes under U.S. copyright law. Other usage requires permission of copyrightholders. |
Language | English |
Full text | The Oklahoma Child Death Review Board 2010 Annual Report Containing information on cases reviewed and closed during the 2010 calendar year A statutorily established Board contracted through the Oklahoma Commission on Children and Youth Think. Prevent. Live. Keep Our Children Safe The mission of the Oklahoma Child Death Review Board is to reduce the number of preventable deaths through a multidisciplinary approach to case review. Through case review, the Child Death Review Board collects statistical data and system failure information to develop recommendations to improve policies, procedures, and practices within and between the agencies that protect and serve the children of Oklahoma. Acknowledgements The Oklahoma Child Death Review Board would like to thank the following agencies for their assistance in gathering information for this report: The Police Departments and County Sheriffs’ Offices of Oklahoma Department of Public Safety Office of the Chief Medical Examiner Oklahoma Commission on Children and Youth Oklahoma Department of Human Services Oklahoma State Bureau of Investigation Oklahoma State Department of Health - Vital Statistics Contact information: Oklahoma Child Death Review Board Phone: (405) 606-4900 1111 N. Lee Ave. Fax: (405) 524-0417 Oklahoma City, OK 73103 http://okkids.org Table of Contents Introduction Recommendations of the Board 1 Board Actions and Activities 8 Cases Closed in 2010 9 Government Involvement 10 Cases by Manner of Death Accident 11 Homicide 12 Natural 13 Suicide 14 Unknown 15 Selected Causes of Death Traffic Deaths 16 Drowning Deaths 17 Sleep Related Deaths 18 Firearm Deaths 19 Fire Deaths 20 Abuse/Neglect Deaths 21 Table of Contents Near Deaths 22 Age of Decedent in Graph Form By Manner 23 By Select Causes 25 Resources 27 Recommendations The following are the 2011 annual recommendations of the Oklahoma Child Death Review Board as submitted to the Oklahoma Commission on Children and Youth. The majority of the recommendations are based on the deaths reviewed and closed in 2010 that were due to motor vehicles, drowning, unsafe sleep practices, fires, and child abuse/neglect. Motor Vehicle Related Recommendations Legislative recommendations: Mandatory sobriety testing of drivers in motor vehicle accidents resulting in a child fatality and/or a critical or serious injury to a child. Year first recommended: 2002 Total number of deaths since first recommended: 831 Number of additional deaths since last recommended: 81 Legislation that bans the use of wireless hand-held telephone or electronic com-munication device by motor vehicle operators. Year first recommended: 2008 Total number of deaths since first recommended: 226 Number of additional deaths since last recommended: 81 Strengthening of the booster seat legislation to include use up to age 8. Year first recommended: 2005 Total number of deaths since first recommended: 45 Number of additional deaths since last recommended: 3 (Specific to children between six and eight years of age.) Passage of All-Terrain Vehicle (ATV) legislation that contains elements prohibiting passengers, prohibiting drivers aged 12 and under, and requiring ATV safety train-ing. Requirements should be statewide, including on private land. Year first recommended: 2006 Total number of deaths since first recommended: 23 Number of additional deaths since last recommended: 5 Administrative recommendations: Enforcement of child passenger safety restraint laws, which include fines for driv-ers transporting unrestrained children. Year first recommended: 2000 Total number of deaths since first recommended: 502 Oklahoma Child Death Review Board 2010 Annual Report Page 1 Recommendations Number of additional deaths since last recommended: 50 (Specific to unrestrained occupants.) Develop and disseminate a campaign that will promote the best practices related to booster seat usage. Year first recommended: 2006 Total number of deaths since first recommended: 34 Number of additional deaths since last recommended: 3 (Specific to children between six and eight years of age.) Provide, at no cost, driver education classes for all high school and career tech students. Year first recommended: 2001 Total number of deaths since first recommended: 277 Number of additional deaths since last recommended: 27 (Specific to decedent as driver.) Increase accessibility and usage of drug courts and drug treatment programs. Year first recommended: 2000 Total number of deaths since first recommended: 1039 Number of additional deaths since last recommended: 81 Sleep Related Recommendations The Office of the Chief Medical Examiner and law enforcement agencies should adopt the Centers for Disease Control’s model policy for investigation and clas-sification of Sudden Unexpected Infant Deaths (SUID) and Sudden Infant Death Syndrome (SIDS), including the use of scene recreation and digital photography. The methods currently utilized do not adequately provide the opportunity to distinguish accidental overlay (smothering) from other causes. Year first recommended: 2007 Total number of deaths since first recommended: 334 Number of additional deaths since last recommended: 79 Affordable childbirth classes should be available to all expectant mothers and ad-dress safe sleep issues prior to birth. Scholarships should also be available to those who cannot afford classes. Year first recommended: 2006 Total number of deaths since first recommended: 411 Oklahoma Child Death Review Board 2010 Annual Report Page 2 Recommendations Number of additional deaths since last recommended: 79 Education on safe sleep environments should be provided to families after deliv-ery but prior to discharge. Year first recommended: 2006 Total number of deaths since first recommended: 411 Number of additional deaths since last recommended: 79 Education on safe sleep environments should be provided to families at the first well-child visit. Year first recommended: 2007 Total number of deaths since first recommended: 334 Number of additional deaths since last recommended: 79 Distribute cribs to low-income families. Year first recommended: 2007 Total number of deaths since first recommended: 334 Number of additional deaths since last recommended: 79 All hospitals in Oklahoma should adopt a policy regarding in-house safe sleep issues. Year first recommended: 2008 Total number of deaths since first recommended: 221 Number of additional deaths since last recommended: 79 *An unsafe sleep environment is defined as the child not in his/her own personal sleep area (i.e. crib, bassinette, play pen), with pillows or other items, including peo-ple, and/or placed face down to sleep. Drowning Recommendations Legislative recommendations: All pool/hot tub retailers in Oklahoma should be bound by law to distribute in-formation on pool/hot tub safety to new pool/hot tub owners at the time of sale or installation of any new pool/hot tub. Year first recommended: 2005 Total number of deaths since first recommended: 47 Number of additional deaths since last recommended: 9 (Specific to private pools only.) Oklahoma Child Death Review Board 2010 Annual Report Page 3 Recommendations Oklahoma Child Death Review Board 2010 Annual Report Page 4 Administrative recommendations: Increase access to swimming lessons for all children. Year first recommended: 2008 Total number of deaths since first recommended: 55 Number of additional deaths since last recommended: 25 Fund and distribute “Water Watcher” badges that promote appropriate and re-sponsible adult supervision of children around water. Year first recommended: 2008 Total number of deaths since first recommended: 55 Number of additional deaths since last recommended: 25 Work with Oklahoma Parks and Recreation to provide “Water Watcher” badges at Oklahoma lakes. Year first recommended: 2009 Total number of deaths since first recommended: 8 Number of additional deaths since last recommended: 0 (There were no lake deaths reviewed and closed in 2010.) EMS/National Weather Service include a warning regarding the dangers of flash floods in weather alerts. Year first recommended: 2010 Total number of deaths since first recommended: 49 Number of additional deaths since last recommended: 9 (Specific to open water and a drainage ditch.) Fire Recommendations Smoke alarm give-away programs should include carbon monoxide detectors. Year first recommended: 2008 Total number of deaths since first recommended: 19 Number of additional deaths since last recommended: 5 Increased penalties for homeowners who do not provide smoke alarms for rental houses. Year first recommended: 2008 Total number of deaths since first recommended: 10 Number of additional deaths since last recommended: 2 (There were two cases where the smoke alarm information was unknown.) Recommendations Child Abuse/Neglect Recommendations Increased funding of primary and secondary prevention programs of the Okla-homa Department of Human Services, Oklahoma State Health Department, De-partment of Education, and the Oklahoma Department of Mental Health and Substance Abuse Services. Year first recommended: 2003 Total number of deaths since first recommended: 337 Number of additional deaths since last recommended: 54 Provide the Oklahoma Department of Human Services with funding to hire ad-ditional child welfare staff to be in compliance with the recommended national standard issued by the Child Welfare League of America and with a salary com-petitive with positions in other states. Year first recommended: 2000 Total number of deaths since first recommended: 439 Number of additional deaths since last recommended: 54 Make court records pertaining to custody and guardianship available for public inspection after a child death. Year first recommended: 2007 Total number of deaths since first recommended: 168 Number of additional deaths since last recommended: 54 Create and support through funding, a medical team to review the medical re-cords in child abuse/neglect cases and submit an opinion if requested by the court. Year first recommended: 2007 Total number of deaths since first recommended: 168 Number of additional deaths since last recommended: 54 Recommend the legislature ensure funding for the Period of Purple Crying dis-tribution project of the Preparing for a Lifetime; It’s Everyone’s Responsibility in-fant mortality reduction initiative. Year first recommended: 2011 Total number of deaths since first recommended: N/A Number of additional deaths since last recommended: N/A Recommend the legislature support the findings of the Shaken Baby Prevention Education Initiative created by H.B. 2920 of the 2010 Legislative Session. Oklahoma Child Death Review Board 2010 Annual Report Page 5 Year first recommended: 2011 Total number of deaths since first recommended: N/A Number of additional deaths since last recommended: N/A Agency Specific Recommendations Oklahoma Safe Kids Coalition Promotion and establishment of funding for the Safe Kids Oklahoma Child Pas-senger Safety Program. This program includes: providing car seats for low-income families; providing training and car seats for every child care center in the state starting July 2006; providing, through a loaner program, car seats for special needs children; piloting a program for providing car beds for babies born prematurely; and the “Please Be Seated” program which allows citizens the op-portunity to send a card to Safe Kids with license plate information when a citi-zen has observed a child to be transported unrestrained. Safe Kids then con-tacts the family through a letter reminding them of the law and offering assis-tance for obtaining a car seat. Promotion and establishment of funding for the Safe Kids Oklahoma “Walk This Way” program which is aimed at reducing the number of child pedestrian inju-ries and fatalities. Promotion and establishment of funding for the Safe Kids Oklahoma bicycle safety program, which includes conducting bicycle safety rodeos and providing free helmets to groups who conduct bike safety education events utilizing Safe Kids curriculum. Promotion and establishment of funding for Safe Kids Oklahoma burn preven-tion programs, which include the “Save-A-Life” smoke detector giveaway/ installment programs, and a fireworks safety campaign. Promotion and establishment of funding for the Safe Kids Oklahoma water safety programs, which include the “Wee Water Wahoo” and “Wacky Water Wa-hoo” water safety training events and the Brittany Project, which provides loaner life jackets at Oklahoma Corps of Engineer lakes. Year first recommended: 2004 Total number of deaths since first recommended: 1083 Number of additional deaths since last recommended: 127 Oklahoma Child Death Review Board Promotion and establishment of funding for the Oklahoma Child Death Review Board’s Think. Prevent. Live. public service campaign addressing deaths due to drowning, fires, wheeled activities, unsafe sleep practices, and child abuse/neglect. Recommendations Oklahoma Child Death Review Board 2010 Annual Report Page 6 Year first recommended: 2008 Total number of deaths since first recommended: 645 Number of additional deaths since last recommended: 238 New Recommendations: Creation of a drug death review board to look at the drug deaths (all ages) oc-curring in Oklahoma. Creation of substance abuse programs for pregnant women who have a positive drug screen prior to delivery. Legislation requiring first responders (law enforcement, EMS, medico-legal inves-tigators) to undergo mandatory specialized training in child death scene investi-gation. Women’s health providers to include domestic violence screenings at health ap-pointments. Continued financial support for the Child Protection Committee of The Chil-dren’s Hospital of Oklahoma. Recommendations Oklahoma Child Death Review Board 2010 Annual Report Page 7 Board Actions and Activities Oklahoma Child Death Review Board 2010 Annual Report Page 8 Include but are not limited to: Continued collaborations with the Oklahoma Domestic Violence Fatality Review Board, including case review. Continued collaborations with the Oklahoma Violent Death Reporting and Sur-veillance System, Injury Prevention Services, Oklahoma State Department of Health. Continued participation with Central Oklahoma Fetal Infant Mortality Review Community Action Team. Began partnership with Preparing for a Lifetime, a statewide program aimed at reducing infant mortality. Followed up with the Oklahoma Department of Human Services (OKDHS) on 14 cases, including but not limited to: requesting that OKDHS request the Okla-homa State Bureau of Investigation investigate a case that had minimal law en-forcement involvement; requesting clarification on the priority level a referral was assigned; expressing the CDRB’s concern for the placement of a near death victim; requesting OKDHS conduct an internal review of a child death; making a formal referral; requesting the final disposition of a referral; and commending an exceptional investigation. Correspondence to an attending physician educating on when the diagnosis of Sudden Infant Death Syndrome can be utilized. Correspondence to an attending physician recommending the cause of death be amended to reflect the true cause of death and not the underlying condition. Referred a physician to the Oklahoma Board of Medical Licensure. Followed up with the Oklahoma Chief Medical Examiner’s Office (OCME) on eight cases, including but not limited to: recommending the cause and/or manner of death be amended; referring cases to the OCME for review (cases that had not been referred to that office); requesting clarification of content in reports; and requesting clarification of policies and procedures. Followed up with the involved law enforcement agency, including but not limited to: recommending the agency adopt the Center for Disease Control’s Sudden Unexpected Infant Death Investigation protocols; recommending the agency contact OKDHS when a child dies; requesting clarification on why a caregiver was not interviewed; recommending a case be reopened; recommending an agency follow statute and comply with CDRB requests for records; and request-ing an agency request an out-of-state law enforcement agency make contact with a caregiver. Followed up with District Attorney’s involved in four cases, including inquiring about charges and expressing concern for the sentence of a perpetrator. Cases Closed 2010 The Oklahoma Child Death Review Board is comprised of five review teams. The total number of deaths reviewed and closed in 2010 by all five teams is 282. The year of death for these cases ranged from 2005 to 2010. Oklahoma Child Death Review Board 2010 Annual Report Page 9 2010 Deaths Reviewed Manner Number Percent Accident 127 45.0% Unknown 64 22.7% Natural 43 15.3% Homicide 26 9.2% Suicide 22 7.8% Gender Number Percent Males 186 66.0% Females 96 34.0% African American 40 14.2% American Indian 37 13.1% Asian 1 0.4% Multi-race 16 5.7% White 188 75.4% Race Ethnicity Number Percent Hispanic (any race) 36 12.8% Non-Hispanic 246 87.2% Number of Deaths Reviewed by County The map to the right shows the number of deaths that were reviewed and closed for each county. The death is assigned to the county in which the injury or illness occurred. Government Involvement The chart below indicates a child’s involvement in government sponsored programs, either at the time of death or previous to the time of death. The Child Welfare cases are those children who had an abuse and/or neglect referral prior to the death incident. It does not reflect those child deaths that were investigated by the Oklahoma Department of Human Services. In addition to the information in the chart below, there were five foster care deaths re-viewed and closed in 2010. Five were ruled accidental deaths, two were ruled natural deaths and one had an unknown manner of death. One was confirmed by the OKDHS/ CW as to the abuse/neglect allegations. Oklahoma Child Death Review Board 2010 Annual Report Page 10 Number of Cases with Previous Involvement in Selected State Programs Agency Number Percent Of All Deaths OKDHS - TANF 219 77.7% Oklahoma Health Care Au-thority (Medicaid) 172 61.0% OSDH - Children First 10 3.5% OKDHS - Foster Care 5 1.8% OKDHS - Emergency Assistance 3 1.1% OKDHS - Child Care Assistance 17 6.0% OKDHS - Child Welfare 52 18.4% OKDHS - Child Support Enforcement 136 48.2% Office of Juvenile Affairs 20 7.1% OKDHS - Food Stamps 51 18.1% OKDHS - Disability 20 7.1% OSDH - Office of Child Abuse Prevention 3 1.1% Accidents The Board reviewed and closed 127 deaths in 2010 whose manner of death was ruled Ac-cident. Nine (81.8%) of the 11 asphyxia deaths were infants. Both of the accidental overdoses were due to a combination of prescription medications. The crushing death was due to a forklift. Oklahoma Child Death Review Board 2010 Annual Report Page 11 Type Number Percent Vehicular 81 62.2% Drowning 25 19.7% Asphyxia/ Suffocation 11 8.7% Fire 5 4.7% Poisoning/ Overdose 2 1.6% Firearm 1 0.8% Crush 1 0.8% Medical Misadventure 1 0.8% Mechanism of Death Gender Number Percent Males 80 63.0% Females 47 37.0% Race African American 9 7.0% American Indian 19 15.0% Multi-race 5 4.0% White 94 74.0% Ethnicity Number Percent Hispanic (any race) 19 15.0% Non-Hispanic 108 85.0% Accidental Deaths by County Homicides The Board reviewed and closed 26 deaths in 2010 whose manner of death was ruled Homicide. Thirteen (50%) of these were due to physical abuse, with nine (34.6%) specific to abusive head trauma. Oklahoma Child Death Review Board 2010 Annual Report Page 12 Mechanism of Death Method Number Percent Firearm 11 42.4% Struck/ Shaken/Beat 11 42.4% Drowning 1 3.8% Overdose 1 3.8% Stabbed 1 3.8% Suffocation 1 3.8% Gender Number Percent Males 16 61.5% Females 10 38.5% Race African American 12 46.2% American Indian 1 3.8% Multi-race 3 11.5% White 10 38.5% Ethnicity Number Percent Hispanic (any race) 2 7.7% Non-Hispanic 24 92.3% Homicide Deaths by County Naturals The Board reviewed and closed 43 deaths in 2010 whose manner of death was ruled Natural. Oklahoma Child Death Review Board 2010 Annual Report Page 13 Mechanism of Death Gender Number Percent Males 30 69.8% Females 13 30.2% Race African American 8 18.6% American Indian 4 9.3% Multi-race 1 2.3% White 30 69.8% Ethnicity Number Percent Hispanic (any race) 8 18.6% Non-Hispanic 35 81.4% Illness/Disease Number Percent SIDS 18 41.9% Infectious Disease 11 25.6% Seizure Disorder 3 7.0% Cardiovascular 2 4.7% Other Conditions 4 9.3% Congenital Anomaly 1 2.3% Malnutrition 1 2.3% Prematurity 1 2.3% Undetermined 1 2.3% Unknown 1 2.3% Natural Deaths by County Suicides The Board reviewed and closed 22 deaths in 2010 whose manner of death was ruled Suicide. Oklahoma Child Death Review Board 2010 Annual Report Page 14 Gender Number Percent Males 19 86.4% Females 3 13.6% Race African American 1 4.5% American Indian 2 9.1% White 19 86.4% Ethnicity Number Percent Hispanic (any race) 0 0% Non-Hispanic 22 100% Mechanism of Death Method Number Percent Firearm 14 63.7% Asphyxia 7 31.8% Motor Vehicle 1 4.5% Suicide Deaths by County Unknown The Board reviewed and closed 64 deaths in 2010 ruled Unknown. Fifty-nine (92.2%) were 2 years or younger. Fifty-four (84.4%) were less than 1 year of age. Fifty-one (79.7%) involved questionable safe sleeping environments. Seven (10.9%) were suspicious for trauma. Two (3.1%) were premature infants with maternal drug exposure in utero. Two (3.1%) had questionable safe sleep environments as well as upper respiratory ill-nesses. One (1.6%) died of hyperthermia and the pathologist was unable to determine an exact manner of death. Oklahoma Child Death Review Board 2010 Annual Report Page 15 Race African American 10 15.6% American Indian 11 17.2% Asian 1 1.6% Multi-Race 7 10.9% White 35 54.7% Gender Number Percent Males 41 64.1% Females 23 35.9% Ethnicity Number Percent Hispanic (any race) 6 9.4% Non-Hispanic 58 90.6% Unknown Deaths by County The Board reviewed and closed 81 accidental deaths in 2010 related to traffic. For the ATV deaths, all were operators and only two were wearing a helmet. The child in the motorcycle death was wearing a helmet; the children on the bicycles/ tricycle were not wearing helmets. *Other includes the fender of a tractor, a child in utero, a child riding the sideboards, and a child exiting a vehicle with the car stopped in traffic (game) Traffic Related Deaths Oklahoma Child Death Review Board 2010 Annual Report Page 16 Vehicle of Decedent Vehicle Number Percent Car 24 29.6% Pick-Up 18 22.2% SUV 18 22.2% Pedestrian 8 9.9% ATV 5 6.3% Bicycle 3 3.7% Van 2 2.5% Motorcycle 1 1.2% Tricycle 1 1.2% Tractor 1 1.2% Use of Safety Restraints Seatbelt/Car seat Use Number Percent Properly Restrained 18 22.2% Not Properly Restrained 50 61.7% Not Applicable 13 16.1% Activity of Decedent Position Number Percent Operator 27 33.3% Rear Passenger 25 31.0% Front Passenger 15 18.5% Other* 4 4.9% Unknown Passenger Placement 1 1.2% Truck Bed 1 1.2% N/A 8 9.9% Gender Number Percent Males 52 64.2% Females 29 35.8% Race African American 2 2.5% American Indian 16 19.8% Multi-race 3 3.7% White 60 74.1% Ethnicity Number Percent Hispanic (any race) 11 13.6% Non-Hispanic 70 86.4% The Board reviewed and closed 25 accidental deaths in 2010 due to drowning. Drowning Deaths Oklahoma Child Death Review Board 2010 Annual Report Page 17 Location of Drowning Location Number Percent Private, Residential Pool 9 36.0% Open Body of Water (i.e. creek, river, pond, lake) 8 32.0% Bathtub 6 24.0% Drainage Ditch 1 4.0% Bucket 1 4.0% Type of Residential Pool Type of Pool Number Percent Above Ground 5 55.6% In Ground 4 44.4% Gender Number Percent Males 15 60.0% Females 10 40.0% Race African American 2 8.0% American Indian 1 4.0% White 21 84.0% Multi-Race 1 4.0% Ethnicity Number Percent Hispanic (any race) 4 16.0% Non-Hispanic 21 84.0% Type of Open Body of Water Open Body Number Percent Pond 6 75.0% River 2 25.0% The Board reviewed and closed 79 deaths that were related to sleep environments. These included accidental asphyxiations, SIDS, and Undetermined manners of death where the pathologist noted the sleep environment was a possible contributor to the death. Oklahoma Child Death Review Board 2010 Annual Report Page 18 Manner Number Percent Accidental 10 12.6% Natural (SIDS) 18 22.8% Undetermined 51 64.6% Sleep Related Deaths Manner of Death for Sleep Related Deaths Position of Infant When Placed to Sleep Position Number Percent On Back 22 27.8% On Side 9 11.4% On Stomach 11 13.9% Unknown* 37 46.9% Sleeping Arrangement of Infant Sleeping Arrangement Number Percent Alone 45 57.0% With Adult and/or Other Child 34 43.0% Sleeping Location of Infant Location Number Percent Adult Bed 40 50.6% Couch 11 13.9% Crib 9 11.4% Playpen 4 5.1% Bassinette 2 2.5% Chair 1 1.3% Floor 1 1.3% Other 9 11.4% Unknown* 2 2.5% Gender Number Percent Males 51 63.1% Females 28 36.9% Race Ethnicity Number Percent Hispanic (any race) 10 12.7% Non-Hispanic 69 87.3% Position of Infant When Found Position Number Percent On Back 13 16.5% On Side 10 12.7% On Stomach 26 32.9% Unknown* 30 37.9% *This information is unknown due to the lack of information collected by scene investigators African American 14 17.7% American Indian 14 17.7% Asian 1 1.3% Multi-race 8 10.1% White 42 53.2% The Board reviewed and closed 26 deaths in 2010 due to firearms. Oklahoma Child Death Review Board 2010 Annual Report Page 19 Manner Number Percentage Accident 1 3.9% Homicide 11 42.3% Suicide 14 53.8% Type of Firearm Number Percent Handgun 14 53.9% Hunting Rifle 5 19.2% Shot gun 2 7.7% Assault Rifle 2 7.7% Unknown 3 11.5% Firearm Deaths Type of Firearm Used Manner of Death for Firearm Victims Gender Number Percent Males 21 80.8% Females 5 19.2% Race African American 10 38.4% American Indian 1 3.9% White 15 57.7% Ethnicity Number Percent Hispanic (any race) 1 3.9% Non-Hispanic 25 96.1% The Board reviewed and closed five deaths in 2010 due to fires. Four fires resulted in five deaths. Four died of smoke inhalation, one died of thermal injuries. Oklahoma Child Death Review Board 2010 Annual Report Page 20 Fire Deaths Working Smoke Detector Present Detector Number Percent Yes 1 20.0% No 2 40.0% Unknown 2 40.0% Fire Ignition Source Source Number Percent Appliance 2 40.0% Matches 1 20.0% Space Heater 1 20.0% Wall Heater 1 20.0% Gender Number Percent Males 3 60.0% Females 2 40.0% Race African American 2 40.0% White 3 60.0% Ethnicity Number Percent Hispanic (any race) 0 0 Non-Hispanic 5 100% The Board reviewed and closed 42 cases where it was determined that abuse or neglect caused or contributed to the death. Thirteen (31.0%) cases were ruled abuse, 28 (66.7%) cases were ruled neglect, and one (2.3%) was ruled both. Oklahoma Child Death Review Board 2010 Annual Report Page 21 Abuse/Neglect Deaths Manner of Death for Abuse/Neglect Cases Manner Number Percent Accident 21 50.0% Homicide 14 33.3% Natural 2 4.8% Suicide 3 7.1% Undetermined 2 4.8% Gender Number Percent Males 24 57.1% Females 18 42.9% Race Asian 1 2.4% African American 7 16.6% American Indian 2 4.8% Multi-race 4 9.5% White 28 66.7% Ethnicity Number Percent Hispanic (any race) 6 14.3% Non-Hispanic 36 85.7% The Board reviewed and closed 49 near death cases in 2010. A case is deemed near death if the child was admitted to the hospital diagnosed in serious or critical condition by the treating physician as a result of suspected abuse or neglect. Forty-one (83.7%) were substantiated by OKDHS as to having been abuse and/or neglect. Thirteen (26.5%) had a previous referral that was investigated by OKDHS. Oklahoma Child Death Review Board 2010 Annual Report Page 22 Near Deaths Injuries in Near Death Cases Injury Number Percent Physical Abuse 24 49.0% Poison/Overdose 13 26.6% Fire 2 4.1% Firearm 2 4.1% Medical Condition 2 4.1% Non-Organic Failure to Thrive 2 4.1% Asphyxia 1 2.0% Fall 1 2.0% Drowning 1 2.0% Stabbing 1 2.0% Gender Number Percent Males 33 67.3% Females 16 32.7% Race Asian 1 2.0% African American 11 22.4% American Indian 9 18.4% Multi-race 2 4.1% White 26 53.1% Ethnicity Number Percent Hispanic (any race) 4 8.2% Non-Hispanic 45 91.8% Oklahoma Child Death Review Board 2010 Annual Report Page 23 Age of Decedents by Manner 0 20 40 60 80 100 120 <1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Number of Deaths Age All Deaths by Age 0 2 4 6 8 10 12 14 16 18 20 <1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Number of Deaths Age Accidental Deaths by Age 0 5 10 15 20 25 30 35 <1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Number of Deaths Age Natural Deaths by Age Oklahoma Child Death Review Board 2010 Annual Report Page 24 Age of Decedents by Manner 0 1 2 3 4 5 6 <1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Number of Deaths Age Homicide Deaths by Age 0 1 2 3 4 5 6 7 8 <1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Number of Deaths Age Suicide Deaths by Age 0 10 20 30 40 50 60 <1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Number of Deaths Age Unknown Deaths by Age Oklahoma Child Death Review Board 2010 Annual Report Page 25 Age of Decedents by Select Causes 0 2 4 6 8 10 12 14 16 <1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Number of Deaths Age Traffic Related Deaths by Age 0 1 2 3 4 5 6 <1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Number of Deaths Age Drowning Deaths by Age 0 2 4 6 8 10 <1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Number of Deaths Age Firearm Deaths by Age Oklahoma Child Death Review Board 2010 Annual Report Page 26 Age of Decedents by Select Causes 0 5 10 15 20 25 <1 1 2 3 4 5 6 7 8 9 10 11 12 Number of Deaths Age (in months) Sleep Related Deaths by Age 0 0.5 1 1.5 2 2.5 3 3.5 <1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Number of Deaths Age Fire Deaths by Age 0 2 4 6 8 10 12 <1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 Number of Deaths Age Abuse/Neglect Deaths by Age Oklahoma Child Death Review Board 2010 Annual Report Page 27 Resources Child Abuse Reporting Hotline Heartline Crisis Helpline Office of the Chief Medical Examiner Oklahoma Coalition Against Domestic Violence and Sexual Assault Oklahoma Commission on Children and Youth Oklahoma Health Care Authority Oklahoma Mental Health and Substance Abuse Services Oklahoma Office of Juvenile Affairs SAFE KIDS Oklahoma Oklahoma State Department of Education Oklahoma State Department of Health Acute Disease Service Adolescent Health Program Child Abuse Prevention Children First Program Dental Health Services Injury Prevention Service SoonerStart Sudden Infant Death (SIDS) Program Vital Records WIC Oklahoma State House of Representatives Oklahoma State Senate Oklahoma Department of Human Services SAFELINE TEENLINE 1-800-522-3511 1-800-784-2433 (405) 239-7141 (405) 524-0700 1-866-335-9288 or (405) 606-4900 (405) 522-7300 (405) 522-3908 (405) 530-2800 (405) 271-5695 (405) 521-3301 (405) 271-5600 (405) 271-4060 (405) 271-4480 (405) 271-7611 (405) 271-7612 (405) 271-5502 (405) 271-3430 (405) 271-6617 (405) 271-4471 (405) 271-4040 1-888-655-2942 (405) 521-2711 (405) 524-0126 (405) 521-3646 1-800-522-7233 1-800-522-TEEN Oklahoma 211 Collaborative www.211Oklahoma.com Joint Oklahoma Information Network www.join.ok.gov Suicide Prevention Resource Center www.sprc.org This publication, printed in June 2011 by the University of Oklahoma Health Sciences Center printing office, is issued by the Oklahoma Child Death Review Board. [150] copies were pro-duced at a cost of [$1530.00]. Copies have been deposited with the Publications Clearinghouse of the Oklahoma Department of Libraries. Proud partner of Preparing for a Lifetime to ensure a safe and healthy start for Oklahoma babies For more information please visit: http://www.iio.health.ok.gov |
Date created | 2012-01-30 |
Date modified | 2012-02-09 |
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