Non-Accidental Injury Involving a Neonate

Abstract

Non-accidental injury (NAI) was brought forward by the investigation and research that was conducted by Ambroise Tardieu, John Caffey and Henry Kempe. Whiplash-shaken infant syndrome and battered child syndrome are the other alternative terms used. NAI is defined as repetitive physical abuse. Marks of injuries such as multiple bruises or abrasions of differing ages and patterns, bite marks, burns and radiological evidence of old bony fractures are valuable indicators in distinguishing nonaccidental from accidental injuries. In addition, birth trauma, bleeding disorders, sepsis, vasculopathy, congenital anomalies, metabolic abnormalities and true accidental injuries must be ruled out beforehand with a meticulous approach when dealing with such deaths. Here, we report a case of a 28-day-old female neonate who was brought in unresponsive by her parents and was pronounced dead at the accident and emergency department. The external examination did not reveal any gross abnormality whereas, the internal examination revealed subgaleal haematoma, subdural and subarachnoid haemorrhage. The microscopic examination revealed retinal haemorrhage. The cause of death was attributed to blunt force trauma to the head. This case is a reminder to all forensic and clinical pathologists that an extremely uncommon manifestation can occur, therefore, a meticulous approach should always be undertaken, before corroborating a cause of death. In conclusion, the findings of the forensic autopsy and histopathology facilitated the investigation and established the cause of death.