Fatality Review Teams Research Articles

Social Work Expertise and Domestic Violence Fatality Review Teams

Social Work Expertise and Domestic Violence Fatality Review Teams

Fatalities involving acetaminophen combination products reported to United States poison centers

Context. Deaths from overdose of acetaminophen (APAP) combination medications are reported, yet the individual ingredients are not well examined as individual putative causes of death. Objective. To examine the individual contribution of APAP or other ingredient(s) to fatalities resulting from ingestion of APAP combination products reported to poison centers. Materials and methods. A search in the United States (US) National Poison Data System between 1 January 2000 and 31 December 2009 (10 years) was conducted. Only fatal cases determined by American Association of Poison Control Centers Fatality Review team to be caused by ingestion of one or more APAP combination products were included. The fatality abstract narrative for each case was obtained. Each narrative abstract was rated independently by four reviewers and putative cause of death was determined to be APAP, ‘other ingredient’ or ‘unable to determine’. Fleiss’ Kappa test was utilized to assess interrater agreement. Results. Three hundred and thirty-seven deaths met inclusion criteria: 204 were due to suicides, 96 were the result of nonmedical use, 3 were from a therapeutic error, 1 resulted from an unsupervised pediatric ingestion, and 33 were due to unknown reason for exposure. The overall putative cause of death was APAP in 60.8%, other ingredients in 29.7%, and unable to determine in 9.5% of fatalities. APAP was responsible for the fatality in 79.2% of deaths resulting from nonmedical use of APAP combination products. Fleiss Kappa was 0.74, indicating substantial interrater agreement. Discussion and conclusion. The most common putative cause of death in fatal overdoses involving APAP combination products reported to US poison centers is the APAP component.

Domestic Violence Fatality Reviews and the African American Community

Cultural competence is important to the domestic violence fatality review process. This article reviews current knowledge about cultural competence for Black women abused by men in the United States, with suggested implications for domestic violence fatality review teams (DVFRTs). Help-seeking behaviors, coping strategies, historical context, and cultural values within the African American community are explored. These areas are further examined using a framework inclusive of the structure, goals, processes, outcomes, and barriers of DVFRTs. The implications for how DVFRTs can utilize this information are discussed.

Ethical Conundrums in Fatality Review Planning, Data Collection, and Reporting

The multidisciplinary, interprofessional practice of fatality review is quickly becoming more methodologically sophisticated. However, the discussion of ethical issues related to fatality review has been limited to the topics of confidentiality and the ethical guidelines of participant professions. We propose that the work of fatality review teams is similar to the research practice of evaluation. Using the Guiding Principles of Evaluation recommended by the American Evaluation Association (AEA), this paper begins an exploration of potential ethical conundrums faced by domestic violence fatality review teams and identifies suggestions for ensuring that the teams have the necessary tools for ethical practice.

The Domestic Violence Fatality Review: Can It Mobilize Community-Level Change?

Domestic Violence Fatality Review (DVFR) teams are a means of identifying systems' gaps in the coordinated response to domestic violence. While the number of homicide reviews has grown, little is known about whether DVFRs facilitate change in the community-level response to domestic violence. This research evaluated whether the recommendations made by one state-level DVFR had an effect on community and organizational priorities and practices. The results indicate that the recommendations influence countywide priorities, but less was done to implement the recommendations. DVFRs have the capacity to influence community-level change agendas; however, organizations need support moving from issue prioritization to implementation.

Child Fatality Review

This Policy Statement was revised. See https://doi.org/10.1542/peds.2023-065481. Injury remains the leading cause of pediatric mortality and requires public health approaches to reduce preventable deaths. Child fatality review teams, first established to review suspicious child deaths involving abuse or neglect, have expanded toward a public health model of prevention of child fatality through systematic review of child deaths from birth through adolescence. Approximately half of all states report reviewing child deaths from all causes, and the process of fatality review has identified effective local and state prevention strategies for reducing child deaths. This expanded approach can be a powerful tool in understanding the epidemiology and preventability of child death locally, regionally, and nationally; improving accuracy of vital statistics data; and identifying public health and legislative strategies for reducing preventable child fatalities. The American Academy of Pediatrics supports the development of federal and state legislation to enhance the child fatality review process and recommends that pediatricians become involved in local and state child death reviews.

International Legal Note: Child fatality review teams and the role of social workers

We are living in dangerous and violent times, and our most precious resources, our children, are sometimes its victims. Disease, inadequate health care, violence, a faulty smoke alarm, an unlocked seat belt, a loaded gun, poison or medicine within easy reach, an unprotected electric outlet, a pack of matches: in rich countries and poor countries, all of these things can and have killed children (UNICEF, 2003). When these result in the death of a child, in a growing number of countries and jurisdictions the death is reviewed by a child fatality review team. The purpose is to perform a comprehensive review of child deaths in order to gain a better understanding of these deaths, and to use that knowledge to take preventative actions in similar situations.

Recommendations from child fatality review teams: results of a US nationwide exploratory study concerning maltreatment fatalities and social service delivery

AbstractMultidisciplinary child fatality review teams (CFRT) have existed in the United States (US) for almost 30 years; the products of the review process, however, remain unexamined. This study reviewed reports from CFRT throughout the US to compile and evaluate the identification of problems and recommendations by professionals concerning child maltreatment fatalities. Team‐ and state‐level data were also used for analysis to better understand the context in which recommendations are made. Over 300 recommendations for change from CFRT were grouped into 11 macro categories. The frequency of each type of recommendation and examples from each category are provided. The authors provide recommendations of their own for improvements in CFRT outputs. Copyright © 2008 John Wiley & Sons, Ltd.

Child Abuse Recognition and Reporting: Supports and Resources for Changing the Paradigm

As shown previously in the Child Abuse Recognition Experience Study (CARES), primary care providers reported that they decided not to report a substantial proportion of injuries that they suspected might have resulted from abuse. The most serious cases result in death. This article provides detailed reports of 2 illustrative cases from the author's experience as a member of a multidisciplinary child fatality review team and discusses several alternative legal mechanisms for improving mandated reporting. Regional centers of excellence in child protection may be an effective way of improving child protection; current proposals to establish such centers are reviewed.

Domestic violence fatality review teams: An interprofessional model to reduce deaths

In an effort to reduce injuries and prevent deaths from violence, interprofessional domestic violence fatality review teams (DVFRT) have developed across the United States and globally to study factors that contribute to intimate partner injury and deaths. Drawing upon knowledge from the disciplines of health, education, criminal justice, social services, and policy, these teams review and analyze domestic violence homicide cases to uncover basic knowledge about causes, factors that increase or decrease the risk for death and injury, and specific ways to prevent further injury and death. Through interprofessional collective recommendations and cooperative actions, these teams are developing promising practices and systems' changes that offer better services, learning, and interventions to reduce injury and death from domestic violence.

R & B

The conversation that unfolds takes place at a restaurant between an imaginary researcher, R, and an imaginary battered woman, B. The researcher embodies some of the traits of researchers in general and particularly those who stray into the arena of domestic violence fatality review. The battered woman lives with her three teenage children, works as a secretary at a university, and has just completed her master’s degree in Women’s Studies. R and B met 13 years ago at a shelter, where R interviewed B about B’s life and the domestic violence she had endured. Now, 13 years later, the two meet on the street, lock eyes, and agree to talk over dinner. By way of background, fatality review refers to the deliberative process whereby communities and their various domestic violence agencies identify homicides and suicides traceable to domestic violence and suggest preventive interventions. The past decade has witnessed the phenomenal growth of domestic violence fatality review teams. 1 In 1990, only a handful of states evidenced such review activity. At the close of 2004, approximately 32 states have adopted fatality reviews. Of these, at least half have passed enabling legislation to guide the process and protect the confidentiality of the deliberations and findings. A number of issues permeate the debate about the desirability and worth of

A National Look at Elder Abuse Multidisciplinary Teams

SUMMARY Elder abuse multidisciplinary teams (MDTs) include professionals from diverse disciplines who work together to review cases of elder abuse and address systemic problems. Using an e-mail survey format, the authors received information from 31 MDT coordinators across the country representing fatality review teams, financial abuse specialist teams, medically oriented teams, and “traditional” teams. The coordinators provided information on the functions their teams perform, the importance of specific functions, cases reviewed, composition of teams, policies and procedures, administration, funding, and challenges to effective functioning. Teams expressed only mild concern for breaches in confidentiality. MDTs stressed the importance of input by professionals from the legal community for successful team functioning.

Child fatality review: recommendations for state coordination and cooperation.

Preventable childhood injuries and deaths are a major public health problem in the United States. In 2000, the most recent year for which mortality data are available, over 10,000 children from birth to age 18 died from unintentional injuries in the United States and nearly 3,000 from the same age group died from homicide or suicide. According to theChildhood Injury Fact Sheetproduced by the Centers for Disease Control and Prevention (CDC), “unintentional injuries are the leading cause of death for children one to 21 years of age.”Preventing child fatalities requires further understanding of the causes and circumstances surrounding child deaths. One mechanism for doing this is multidisciplinary child fatality review teams. These teams exist at the state and local level and perform the functions of identifying, reviewing, and recommending preventive measures to reduce the number of preventable child deaths and life-threatening injuries.

Child Abuse Underestimated by Death Certificates

Child Abuse Underestimated by Death Certificates

Underascertainment of Child Maltreatment Fatalities by Death Certificates, 1990–1998

Child fatality review teams have emerged across the United States in the past decade to address the concern that systems of child protection, law enforcement, criminal justice, and medicine do not adequately assess the circumstances surrounding child fatality as a result of maltreatment. We compared data collected by a multidisciplinary child fatality review team with vital records for all children who were aged birth to 16 years and died in Colorado between January 1, 1990, and December 1, 1998. Odds ratios and 95% confidence intervals for ascertainment by the death certificate were estimated using logistic regression. Only half of the children who died as a result of maltreatment had death certificates that were coded consistently with maltreatment. Black race and female gender were associated with higher ascertainment, whereas death in a rural county was associated with lower ascertainment. Deaths resulting from violent causes (eg, shaking, blunt force trauma, striking) were more likely to be ascertained than those that involved acts of omission (eg, neglect and abandonment, drowning, fire). The most common perpetrators of maltreatment were parents. However, maltreatment by an unrelated perpetrator was 8.71 times (95% confidence interval: 3.52-21.55) more likely to be ascertained than maltreatment by a parent. The degree of underascertainment found in this study is of concern because most national estimates of child maltreatment fatality in the United States are derived from coding on death certificates. In addition, the patterns recognized in this study raise concern about systematic underascertainment that may affect children of specific sociodemographic groups.

Child fatality review: an international movement

Objective: This article discusses the multidisciplinary Child Fatality Review process in the US, Canada, and Australia, including common patterns, unique programs, changes over time, impact on multiagency systems, and future directions. Method: An open-ended survey was shared with teams listed in the directories of the Los Angeles County Inter-Agency Council on Child Abuse and Neglect National Center on Child Fatality Review (ICAN-NCFR). Responses were received from 58 state and local Child Fatality Review teams. Results: Teams exist in all 50 states, Washington, DC, most Canadian provinces, and New South Wales, Australia. Team structure varies but generally includes a similar core membership, and most teams select cases from coroner/medical examiner or vital statistics records through established protocols. While most case review is conducted by local teams, state teams may review cases because of small size or sparse population or choose to review specific types of cases (e.g., Child Protective Services). State teams often support local review through training, resources, policy development, and political assistance. An increasing number of teams collect data and issue reports, often published on the internet, allowing teams to share resources. Conclusions: Teams have matured with time, often broadening their intake spectrum, membership and data collection, and developing and following through with case management or systems change recommendations. Teams continue to improve multiagency interaction and are committed to the prevention of child injury and death. The number of teams, as well as their scope and expertise, continues to increase, developing into a national/international system.

Child death reviews: a gold mine for injury prevention and control

Objectives—The purpose of this study was to demonstrate how child death review teams can be used to prevent future deaths through retrospective, multiagency case analysis and recommendations for educational programs...

The Role of Photo Documentation of Genital Findings in Medical Evaluations of Suspected Child Sexual Abuse

Results of a national survey of 104 nurse practitioners (NPs), registered nurses (RNs), and Physician Assistants (PAs) who conducted physical assessments in cases of suspected child physical abuse, neglect, and sexual abuse revealed that evaluation for suspected CSA was the type of evaluation conducted most often (92.5%), followed by physical abuse (70%), and neglect (54%). Most participants (76.9%) conducting CSA evaluations used a colposcope and interpreted colposcopic findings (70.2%). The mean number of years of speciality practice in CM reported by participants was 6, with a range of one to 20 years. While the majority (68%) of respondents were members of interdisciplinary child protection teams, only 10.7% were members of child fatality review teams. Although the vast majority (78.4%) of participants had testified in court on CM cases, most reported experiencing barriers to testifying in cases of CM. The barrier to testifying cited most often was a lack of credibility with the judicial system (60%), with 32% of respondents citing not being a physician (31%) as a major barrier in being accepted as an expert in CM. Implications for practice, policy, and future research are discussed.

SIDS prevention.

The mortality attributed to sudden infant death syndrome ahs decreased significantly in Northern Europe and Australia in conjunction with the majority of infants being placed to sleep on their back or side instead of on their stomach. Since the AAP recommendation in 1992 to place healthy infants on their back or side to sleep, the fraction of infants sleeping prone in the United States has decreased to approximately 43%. It is hoped that the national "Back to Sleep" education campaign will accelerate the acceptance of back or side sleeping for healthy infants so that only a small fraction of infants will be sleeping on their stomach within the next few years. Health-care providers should promote the recommendation in the newborn nursery and at well-baby visits. They should encourage dialogue with caregivers regarding this and other early infant care practices. It is still too soon to know how predominantly nonprone sleeping will affect the rate of SIDS in the United States. It is important that providers continue to stress access to prenatal and well-baby care, and cessation of smoking and substance abuse, as these risk factors may play a larger role in the high-risk communities in the United States. Pediatric medical personnel should advocate for proper death certification for infants and children, to include state legislation that supports autopsies for sudden unexpected deaths in children, and the establishment of state child fatality investigation and review teams. They also should participate in the training of death scene investigators or be part of the death scene investigative team.(ABSTRACT TRUNCATED AT 250 WORDS)

Maltreatment‐Related Fatalities: Issues of Policy and Prevention*

Maltreatment‐related child fatalities, despite their relatively infrequent occurrence, constitute a serious social problem. Based on a review of national and unpublished state and local child fatality review team reports, we ascertained some risk factors that set parameters for prevention programs. Children under age four, and in particular those under age two, are at highest risk for maltreatment‐related fatalities. Neglect‐related deaths occur almost as often as abuse‐related ones. Unrelieved crying and toilet training problems are “triggers” for assaults on young children. Males are frequently involved in abuse‐related fatalities. People in their mid‐twenties, rather than teenage parents are the most frequent perpetrators. About a third of maltreatment‐related fatalities were known to child protective services. Implications of these findings, as well as the problem of predicting infrequently occurring events, are discussed in relation to programs of prevention.