Georgia Child Fatality Review Panel annual report calendar year 2000

GEORGIA CHILD FATALITY REVIEW PANEL
(Formerly "Statewide Child Abuse Prevention Panel")
Annual Report Calendar Year 2000
Office of Child Fatality Review 506 Roswell Street, Suite 230
Marietta, Georgia 30060 Phone: (770) 528-3988 Fax: (770) 528-3989
Website: www.gacfr.org

GEORGIA CHILD FATALITY REVIEW PANEL
MISSION
To serve Georgia's children by promoting more accurate identification and reporting of child fatalities, evaluating the prevalence and circumstances of both child abuse cases and child fatality investigations, and monitoring the implementation and impact of the statewide child abuse prevention plan in order to prevent and reduce incidents of child abuse and fatalities in the State.
Acknowledgements The Georgia Child Fatality Review Panel wishes to acknowledge those whose enormous commitment,
dedication, and unwavering support to child fatality review have made this report possible. These include:
Dr. John T. Carter, Ph.D. , Jill Andrews, and associates of the Epidemiology Department of Emory University, Rollins School of Public Health
All the members of county child abuse protocol and child fatality review committees All the public/private agencies that have so willingly collaborated with this office and provided
support 2

GEORGIA CHILD FATALITY REVIEW PANEL
MEMBERS
Chairperson Mr. J. Tom Morgan District Attorney, Stone Mountain Judicial Circuit

DeAlvah Simms Child Advocate3

Dr. Todd Jarrell, M.D. Chair, Board of Human Resources3

Honorable Cynthia Wright Judge, Fulton County Judicial Circuit

Mr. Milton "Buddy" Nix, Jr., Director Georgia Bureau of Investigation3

Ms. Jane B. Garrison, Safe Kids Coalition/County Health Dept.

Honorable Georganna T. Sinkfield State Representative2

Kathleen Toomey, M.D. Director, Division of Public Health3

Ms. Juanita Blount-Clark, Director Division of Family & Children Services3

Ms. Vanita Hullander Coroner, Catoosa County

Honorable Sallie W. Paist Judge, Cobb County Juvenile Court

Mr. Richard A. Malone Chair, Criminal Justice Coordinating Council3

Randall Alexander, M.D. Center for Child Abuse

Detective Charles Spann Cobb County Department of Public Safety

Honorable Nadine Thomas State Senator1

Vacant Medical Examiner3

STAFF

Eva Y. Pattillo Executive Director

Ann Mintz

Annette Rainer

Program Manager

Program Manager

________________________________________

Karen Robinson Administrative Assistant

The Georgia Child Fatality Review Panel is an appointed body of 16 representatives that oversees the county child fatality review process, reports to the governor annually on the incidence of child deaths, and recommends prevention measures based on the data. Two year appointments are made by the governor except as otherwise noted.

1 Appointed by the Lieutenant Governor 2 Appointed by the Speaker of the House of Representatives
3 Ex-Officio
3

MESSAGE FROM THE CHAIR
The year 2000 marked a decade of the child fatality review system in the State of Georgia. We have shown promise in some areas. During the decade: The average number of fire-related child deaths for the past four years (18.5) is less than half the average
number for the preceding seven years (41) The death rate among African American males due to firearms is at its lowest point
Yet, we remain challenged in others: Deaths to children less than 5 years of age make up more than 70% of all deaths related to child abuse
and neglect Motor vehicle crashes remain the leading cause of death for 15 to 17 year olds
The question is often posed, "What can we do"? The answer to this question is very complex and multifaceted. One promising initiative for ensuring the protection of abused and neglected children was the creation of the Office of the Child Advocate. Since it's inception, this office, under direction of DeAlvah Simms (Child Advocate), has aggressively advocated to bring about positive change for children. However, there are other simple, yet powerful proposals that would assist in our efforts to promote safe and healthy environments for our children. These include:
Passage of a Child Endangerment Statute to ensure that parents/caretakers who knowingly create and/or allow children to be placed in dangerous situations and circumstances are held accountable
Further expansion of Child Death Investigation Teams to ensure that death scene investigations of child deaths are conducted by trained, skilled professional teams. We must identify and hold accountable those who perpetrate crimes against children
Appropriate additional resources for protective services workers to adequately protect children Appropriate resources to support child fatality review committees who act as sentinels in the protection
of children Employ proven prevention strategies to reduce the risk of children being harmed
We are living in difficult economic times. However, our economic challenges must not be met at the expense of the children in this state. Just as those difficult times challenge you and I, how much more so children living in "at risk" situations? These are children whom we may not know personally or may never see. Yet, as children of this state and our communities, they are our children. We are responsible for the welfare of all Georgia's citizens. Children must grow up in safe, secure, and nurturing environments.
We have embarked on both a new millennium and a new decade that offers us yet another opportunity to demonstrate our commitment to the children of Georgia. Together, we can meet the challenge.
J. Tom Morgan, Chairperson Georgia Child Fatality Review Panel
4

TABLE OF CONTENTS
Mission ..........................................................................................................................................................2 Members ..........................................................................................................................................................3 Message from the Chair ....................................................................................................................................4 List of Figures....................................................................................................................................................6 Executive Summary ..........................................................................................................................................7 Recommendations ............................................................................................................................................9 Child Deaths in Georgia ..................................................................................................................................10
Summary of All Child Deaths ..........................................................................................................10 All 2000 Reviewed Deaths ................................................................................................................13 Child Abuse and Neglect ..................................................................................................................14 Prior Agency Involvement ................................................................................................................16 Sudden Infant Death Syndrome........................................................................................................17 Unintentional Injury-Related Deaths ................................................................................................19
Motor Vehicle-Related ......................................................................................................................19 Drowning..........................................................................................................................................21 Fire-Related ......................................................................................................................................23 Intentional Injury Deaths..................................................................................................................24 Homicides ........................................................................................................................................25 Suicides ............................................................................................................................................26 Firearm Deaths ................................................................................................................................27 Race, Ethnicity and Disproportionate Deaths ..................................................................................................29 History of Child Fatality Review in Georgia ....................................................................................................30 Appendices......................................................................................................................................................31
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LIST OF FIGURES AND TABLES

Figure 1. Figure 2. Figure 3. Figure 4. Figure 5. Figure 6. Figure 7. Figure 8. Figure 9. Figure 10. Figure 11. Figure 12. Figure 13. Figure 14. Figure 15. Figure 16. Figure 17. Figure 18. Figure 19. Figure 20. Figure 21. Figure 22. Figure 23. Figure 24. Figure 25. Figure 26. Figure 27. Figure 28. Figure 29. Figure 30. Figure 31. Figure 32. Figure 33. Figure 34. Figure 35. Figure 36. Figure 37. Figure 38. Figure 39. Figure 40. Figure 41. Figure 42.

Deaths to Children Under 18 in Georgia, All Causes All Child Deaths by Race and Gender All Causes of Death, Age <1 All Causes of Death, Age 1-4 All Causes of Death, Age 5-14 All Causes of Death, Age 15-17 Number of Reviewed Child Deaths by Cause of Death Circumstances of Death for Reviewed Deaths with Abuse/Neglect Findings Relationship of Perpetrators to Decedent in Reviewed Cases with Abuse and Neglect Findings Age Distribution for Reviewed Deaths with Abuse or Neglect Findings Reviewed Deaths with Abuse or Neglect Findings by Race and Gender Agency Involvement: Reviewed Deaths with No Child Abuse/Neglect Findings Agency Involvement: Reviewed Deaths With Child Abuse/Neglect Findings Reviewed SIDS Deaths by Age Reviewed SIDS Deaths by Race and Gender Sleeping Positions At the Time of Death for Infants Who Died of SIDS SIDS Death Rates per 1,000: Age <1, 1990-2000 Reviewed Unintentional Injury-Related Deaths by Cause Reviewed Motor Vehicle-Related Deaths by Age Reviewed Motor Vehicle-Related Deaths by Race and Gender Motor Vehicle Fatality Rates per 100,000: Ages 15-17, 1990-2000 Reviewed Deaths Due to Drowning by Age Reviewed Drowning Deaths by Race and Gender Place of Drowning Drowning Fatality Rates per 100,000: Ages <18, 1990-2000 Reviewed Deaths Due to Fire by Age Reviewed Deaths Due to Fire by Race and Gender Fire-Related Fatality Rates per 100,000: Ages <18, 1990-2000 Reviewed Homicides by Circumstances of Death Reviewed Homicide Deaths by Age Reviewed Homicide Deaths by Race and Gender Death Rates for Teen Homicides per 100,000: Ages 15-17, 1990-2000 Reviewed Suicide Deaths by Age Reviewed Suicide Deaths by Race and Gender Suicide Death Rates per 100,000: Ages 15-17, 1990-2000 Reviewed Firearm Deaths by Manner of Death Reviewed Firearm Deaths by Age Reviewed Firearm Deaths by Race and Gender Reviewed Firearm Deaths by Type of Firearm Firearm Death Rates per 100,000: Ages 15-17, 1990-2000 Deaths to Children <1 and Percent of Population in Georgia by Race and Gender Deaths to Children 1-17 and Percent of Population in Georgia, By Race and Gender

APPENDICES

Appendix A Criteria for Child Death Reviews

Appendix B Child Fatality Review Timeframes and Responsibilities

Appendix C.1 2000 Total Child Fatalities by Age, Race, Gender, and Cause of Death

Appendix C.2 2000 Reviewed Deaths by Age, Race, Gender, and Cause of Death

Appendix C.3 2000 Reviewed Deaths with Abuse Findings by Age, Race, Gender, and Cause of Death

Appendix C.4 Prevention Potential by Cause of Death, by Abuse Classification

Appendix D County Compliance with Reviewing Eligible Deaths (Map)

Appendix E 2000 Child Fatality Reviews by County, by Age Group

6

Appendix F Definitions of Terms and Abbreviations Used in this Report

EXECUTIVE SUMMARY

Terrorism is intended to provoke intense fear and anxiety, using violence as a means of coercion. On September 11, 2001, our country experienced acts of terrorism to a degree never experienced before. Many Americans sat helpless as they watched their world--family, job, and sense of security-- come tumbling down right before their eyes. Our nation's response to these horrific acts was a declaration of war against terrorism, and a pledge that this war would not end until terrorism is eradicated. We all joined in united efforts to ensure that the families who lost loved ones would be cared for.

involved children under the age of 5. Perpetrators were identified in 44 of the child abuse related deaths and 64% of those perpetrators were parents.
Natural
Death certificate data indicated a total of 1,306 children under the age of 18 died of natural causes (including SIDS). Infants accounted for the vast majority (1,060) of those deaths. The leading causes of infant deaths were congenital anomalies, low birth weight, and prematurity. There were 117 SIDS deaths.

Terror, however, continues as a way of life for many children living in this country, including our great state of Georgia. Everyday, children die preventable and often horrific deaths, frequently at the hands of their parents/caretakers. Is it because these children's deaths are not typically en masse or the focus of unrelenting media scrutiny that we continue to ignore them? When will we declare war on the terror of child abuse, or the societal elements that cause children to die preventable deaths everyday? Just as our nation has committed resources to end terrorism, let Georgia commit needed resources to end child suffering and death.
In year 2000, 1,761 of Georgia's children died according to Vital Records' preliminary file. The Georgia Child Fatality Review Panel (Panel) publishes an annual report which contains detailed information, compiled from reports submitted by local county child fatality review committees, regarding those deaths which are sudden, unexpected, and/or unexplained.

Child fatality review committees reviewed 169 deaths from natural causes. Ninety-one (91) of those deaths were SIDS. Committees are required to review all SIDS deaths, and medical deaths that are unexpected or unattended by a physician.
Unintentional Injuries
Death certificate data indicated that 61% of deaths (390) in children ages 1 17 resulted from injuries. Seventy-seven percent (77%) of all injuries in this age group resulting in death were unintentional. Leading causes of unintentional injury related deaths included motor vehicle crashes (195), drowning (47), and suffocation (39). The most marked increase in deaths from 1999 was fire related deaths (160%), and the most marked decrease was poisoning (50%).
Child fatality review committees reviewed 235 deaths determined to have resulted from unintentional injuries.

The Panel is charged with not only tracking the numbers and causes of child death, but also identi-

Intentional Injuries

fying and recommending prevention strategies that

could reduce the number of children who are

Death certificate data reported 106 children died

deprived of their childhood.

from injuries intentionally inflicted by themselves or

another (suicide and homicide). In 2000, there

Key Findings

were 76 homicides and 30 suicides. Homicides among whites represented a 65% increase from the

Fatal Child Abuse/Neglect
Child fatality review committees determined that 92 child deaths were suspected or confirmed abuse

previous year due to the increase among white males (8 in 1999 to 23 in 2000). Suicides represent a 15% increase overall.

and/or neglect. Thirty (30) of those abuse related

Child fatality review committees reviewed 80 deaths

deaths were ruled homicides. Seventy percent (70%) of those homicides resulting from abuse

that were intentional 58 homicides and 22 suicides.

7

Firearm Deaths
Death certificate data indicated firearms were used in 45 child deaths. Twenty-three (23) of those deaths were ruled homicides, sixteen (16) suicides, and three (3) unintentional shootings. The circumstances of 3 firearm deaths were undetermined.
Child fatality review committees reviewed 44 firearm related deaths. Ninety-one percent were intentional. The type of firearm was identified in 41 of the 44 firearm related deaths. Handguns were most frequently used (29 of the 44 reviewed firearm deaths.)
Preventability
A primary function of the child fatality review process is to identify those deaths believed to be preventable. The issue of preventability was

addressed in 470 of the 484 child deaths reviewed. Child fatality review committees determined that 354 (75%) of the 470 child deaths were definitely or possibly preventable.
Agency Involvement/Intervention
Child fatality review committees reported that in 66% (61) child abuse/neglect related deaths, the child and/or family had prior involvement with at least one state or local agency. Committees identified 15 instances in which agency intervention could have prevented a number of these child abuse/neglect related deaths.

8

RECOMMENDATIONS OF THE GEORGIA FATALITY REVIEW PANEL

Children can be better safeguarded if the valuable information in this report is used by readers to encourage implementation of the Panel's proposed recommendations. A summary of those recommendations to the Governor, General Assembly, and the public is listed below:

Legislative Recommendations:
1. Fully implement recommendations of the Child Protective Service Task Force to improve the state's ability to protect children from child abuse and neglect
2. Fund expansion of home-based family support models that promote and enable appropriate parenting skills for prevention of child abuse and neglect
3. Require fences and gates in public and private swimming pools statewide
4. Require an autopsy, including toxicology studies, for every death of a child under the age of seven with the exception of children who are known to have died of a disease process while attended by a physician. Further, complete skeletal x-rays (following established pediatric and radiological protocol), of the bodies of children who died before their second birthday, along with immediate drug screens of people in the area of a child death, should be required
5. Pass a "Child Endangerment Law" to hold adults accountable who knowingly create or allow children to be placed in dangerous situations
6. Provide sufficient funding to the Georgia Child Fatality Review Panel and the local committees to fulfill their statutory requirements
7. Expand funding for mental health services for children, especially those identified as "at risk"
Agency Recommendations:
1. DFCS: The Panel recommends that all cases of newborns whose mothers have a positive drug screen be referred to juvenile court
2. DFCS: The Panel recommends that when a child dies due to a parent's or a caretaker's neglect or aggression, that ongoing efforts be made to visit the surviving children in that home to assess the safety and well-being of these children and enable voluntary referrals to appropriate services

3. GBI, and Medical Examiner's Office: The Panel recommends that a death scene investigation be conducted for any child death suspected of being accidental, a homicide, or of unknown causes. No case should be classified as SIDS unless a death scene investigation and investigation of the clinical circumstances are done
Recommendations for the Public:
1. Properly secure children in appropriate child passenger safety seats or seat belts at all times
2. Always supervise small children while playing in or near water (tub, pool, beach, etc.) even if they know how to swim
3. Place babies on their backs while asleep and remove all soft bedding or other soft materials
4. Place babies alone in a crib to sleep. Co-sleeping places a child at risk for suffocation. This risk is further magnified if the caretaker has been drinking or using drugs
5. Keep toxic substances out of reach of children 6. Ensure that there are a sufficient number of prop-
erly functioning smoke detectors in the home 7. Keep children away from guns and guns away
from children. All guns should be stored in a locked, secured place that is inaccessible to children and ammunition be securely stored separately. Also, parents should ask if there is a gun in the home where their child will be playing

9

CHILD DEATHS IN GEORGIA
Each year in Georgia hundreds of children die before they reach the age of 18. The majority of these children die before their first birthdays. In 2000, 1,761 children died, which was equivalent to almost five children dying every day. Unfortunately, these deaths represent only a small percentage of serious injuries to children. Many children suffer preventable non-fatal injuries that result in disabling conditions. These non-fatal injuries impose tremendous emotional, social and economic costs for families, communities and the state. The purpose of the child fatality review process is to analyze the circumstances of child deaths. This process is critical in identifying prevention strategies that can help reduce these needless costs and improve the health and well being of Georgia's future generations.
Information Sources
Child fatality review reports are the primary source of data for this report. Child fatality review reports are submitted on deaths that are identified by the county coroner, medical examiner, or child fatality review committee. In addition to the SIDS and unintentional/intentional deaths, the committee may identify other deaths as appropriate for review. Child fatality review reports provide details of the cause and circumstance of death, supervision at time of death, prior history of abuse or neglect, perpetrator(s) in child abuse-related deaths, and prior agency involvement. Reports also contain information regarding whether a death might have been prevented and what measures might be taken to lessen the likelihood of a similar death occurring in the future.

A preliminary 2000 death certificate file was used to describe all child deaths; therefore, the numbers for infant and child deaths in Figure1 may vary slightly from the final Georgia 2000 vital statistics data. The death certificate file was also used to identify the subset of deaths that met the criteria for review. The child fatality review file was linked with the death certificate file. The death certificate provides demographic information and states the official cause of death. These two data sources do not always agree on the cause or manner of death. In 18 deaths, child fatality review committees determined the cause or manner of death for a child to be different from the reported cause or manner on the death certificate based on additional information made available to the committees.
Of the 1,761 child death certificates filed in 2000, 572 met the criteria requiring review. Child fatality review committees reviewed 381 (67%) of these eligible deaths, 16 deaths for which no death certificate was issued, 7 deaths of out-of-state residents, and additional deaths related to medical causes. A total of 484 deaths was reviewed and are included in Appendix C.2 of this report.
Except as noted, information and figures from child fatality review reports are designated by the term "Reviewed Deaths", and include a total of 406 child deaths (injury-related and SIDS). All information on "Trends" is based on death certificate data.

SUMMARY OF ALL DEATHS

Figure 1. Deaths to Children Under 18 in Georgia

Figure 1 shows the causes of all 1,761 child

All Causes based on Death Certificate

deaths in Georgia in 2000. Natural causes were

responsible for 74% (1,306) of all deaths, with 81% (1060) of these deaths occurring before age one.

Medical (Not to Scale) Motor Vehicle SIDS Homicide

1189 195 117 76

The term "medical" when used in this report as a cause of death for infants does not include SIDS.

Drowning Suffocation
Other Suicide

47 39 35 30

Fire

26

Poisoning 7

10

0

50 100 150 200 250 300

Deaths

Findings The total number of infant/child deaths (1,761) is higher than the totals for the preceding 3 years (an
average of 1,701 for 1997 through 1999). The increase is a result of infant deaths due to medical causes (up to 943 in 2000 from an average of 872 for the preceding 3 years) The number of motor vehicle related deaths (195) was the lowest since 1994 Homicide deaths increased to 76 after remaining below 70 for the past 3 years

Figure 2. Race and Gender of All Child Deaths

20 Other 25 Other 342 A-A Female Male
Female

512 White Male

503 A-A Male

357 White Female

Findings
Though African American children make up only 34% of the child population, their deaths make up 48% of all child deaths
Although not shown in the figure, there was an increase in deaths among all children identified as Hispanic (from 63 in 1999 to 85 in 2000)

Figure 3. All Causes of Death, Age < 1

M edical (Not to Scale)
S ID S

943 117

S u ffo c a t i o n

24

H omicide

14

M otor Vehicle

14

O ther U n in te n tio n a l

13

0

50

100

150

Deaths

Findings Only 65 (6%) of infant deaths resulted from unintentional or intentional injuries. However, this is an increase
from 48 in 1999 Of defined causes, suffocation (24) was the largest single injury related category

11

Figure 4. All Causes of Death, Age 1-4

M edical M otor Vehicle
H om icide Drowning
Fire S u ffo c a t i o n Other Unintentional

26 16 13 11 8 7

0

20

40

60

Deaths

93 Findings
Deaths among this age group increased slightly in 2000 (from 161 in 1999 to 174)
32% of injury related deaths were a result of motor vehicle crashes
Deaths due to fire increased to 11 after an average of 5 for the past 3 years

80

100

Figure 5. All Causes of Death, Age 5-14

Medical Motor Vehicle
Homicide Drowning
Other Fire
Suffocation Suicide

20 16 14 9 6 6

102 64

0

20

40

60

80

100

120

Findings

Deaths

57% of deaths in this age group were caused by injuries 47% of those injuries were motor vehicle related, representing a decrease from 1999 (84)

The total number of deaths dropped 15% (279 in 1999 to 237)

Figure 6. All Causes of Death, Age 15-17

Findings
Deaths to older teens showed very little change in total or cause distribution from 1999
77% of all deaths were due to unintentional and intentional injuries
53% of injury related deaths are due to motor vehicle crashes

Motor Vehicle Medical
Homicide Suicide
Other Unintentional Drowning

12

0

51

26

24

17

16

20

40

60

Deaths

91 80

ALL 2000 REVIEWED DEATHS

In 2000, 572 of the total 1,761 child deaths met the criteria requiring review according to death certificate data. Committees filed reports for 67% (381) of these deaths within the reporting period, representing a decline of 9% since calendar 1999. (The Panel attributes the decrease to a lack of resources available to local child fatality review committees for training and technical assistance during calendar year 2000.) Committees reviewed an additional 103 child deaths for a total of 484 deaths reviewed.

While 188 of these deaths were reviewed (74%), three of the 11 counties reviewed only 2 of their combined 36 reviewable deaths The remaining 318 reviewable child fatalities were to children residing within 113 counties, and 193 of these deaths (61%) were reviewed. Thirtyseven of the 113 counties (33%) reviewed none of their reviewable deaths Eight counties had no child fatalities in 2000, and 27 had no child fatalities that met the review criteria

The distribution of child deaths in Georgia is generally proportional to the county population. Two hundred fifty-four (44%) of the reviewable
child fatalities in 2000 occurred in 11 counties accounting for almost half of the population.

Four hundred six deaths, (injuries and SIDS), are discussed in the "Reviewed Deaths" sections of this report. Medical deaths are not included unless noted.

Figure7. Number of Reviewed Child Deaths by Cause

Medical

131

SIDS

91

Homicide

58

Suffocation

30

Drowning

28

Other Accident

23

Fire

22

Suicide

22

Unknown 1

0

50

100

15 0

Number of Deaths

Finding

Injuries due to motor vehicle incidents continued as a leading cause of death among children

Preventability

Each child fatality review report asks the team to determine whether the death could have been

The extent to which a death is judged preventable by a committee depends on the cause of death and

prevented. Only 14 (3%) of the 484 reports (all

the age of the child (see Appendix C.4).

reviewed deaths) submitted in 2000 omitted this

Committees concluded that 63% (30/48) of the

information. Of the remaining 470 (97%) reports

child deaths with confirmed child abuse were defi-

addressing preventability, teams reported the

nitely preventable. In contrast, the proportion of

following:

definitely preventable deaths among those with no

findings of abuse was less than half (30%).

Definitely Preventable 34%

Possibly Preventable 41%

Not Preventable

25%

13

CHILD ABUSE AND NEGLECT

Local Child Fatality Review Committees either suspected or confirmed child abuse or neglect in 92 (19%) of the 484 reviewed deaths. For 49 of those deaths (53%), abuse or neglect was confirmed. Data on maltreatment by age, gender and cause of death are included in Appendix C.3 of this report. The local Child Fatality Review Committees did not always agree with the cause of death stated on the death certificate, resulting in small differences in the numbers of abuse-related deaths in some categories. In this section, deaths are discussed using the committee's determination of cause of death.

Committees addressed the issue of whether there was a history of domestic violence in the home in 88 of the 92 child abuse/neglect related deaths. Nineteen percent (17) of those deaths indicated a history of domestic violence. Domestic violence was addressed in 378 reviewed deaths with no reported abuse or neglect, and 3% of those deaths indicated a domestic violence history.

Figure 8. Circumstances of Reviewed Deaths with Abuse/Neglect Findings

Homicide

SIDS

Motor Vehicle

9

Medical

9

Drowning

8

Suffocation

8

Fire

5

Suicide

2

Other

2

Poison 1

Gun 1

Unknown 1

0

5

10

16

15

20

25

Number of Deaths

Findings

30

33% of reviewed deaths with child

abuse or neglect findings were homi-

cides

Of the 30 homicides, 5 were confirmed

as the result of Shaken Baby/Sudden

Impact Syndrome, and another 6 were

by firearms

Local Child Fatality Review Committees

suspected or confirmed abuse/neglect in

16 of the 91 SIDS deaths (17 percent).

30 35 Seven of the 8 suffocation deaths with child abuse or neglect findings were

to infants

Perpetrators

Figure 9. Relationship of Perpetrator to Decedent in Reviewed Cases with Abuse and Neglect

Missing Parent Other Non-relative 4 Paramour of Parent 4 Friend/Acquaintance 3 Other Relative 2 Grandmother 1 Sibling 1 Child Care Worker 1

Findings

52

Local Child Fatality Review Committees

28

identified perpetrators in 40 of the 92

deaths (44%)

Among the identified 44 perpetrators,

64% (28) were the child's natural parent

0

10

20

*Total = 44, reflecting 4 cases with 2 perpetrators identified.

30

40

5

Number of Deaths

14

Figure 10. Age Distribution for Reviewed Deaths with Abuse or Neglect Findings

50 42
40

30

25

Findings 73% were under the age of 5 46% were under the age of 1

20

18

Number of Deaths

10

7

0 < 1

1 - 4

5 - 14

Age Range (years)

15 - 17

Figure 11. Reviewed Deaths with Abuse or Neglect Findings by Race and Gender

1 Other 3 Other 18 A-A Male Female
Female

25 White Male

28 A-A Male

17 White Female

Findings 50% (46) of deaths were to African American children 59% (54) of deaths were to males and 30% were to African American males
Opportunities for Prevention Promote prevention of child maltreatment as a community endeavor requiring the scrupulous adherence to
proven prevention practices within all sectors of the community Expand home-based family support and visitation programs to prevent abuse and neglect Adopt a Child Endangerment law that penalizes adults who knowingly place children in
dangerous situations and circumstances Authorize DFACS to access registry, law enforcement and court records regarding domestic
violence in order to better assess the safety of children referred to their care Encourage Child Abuse Protocol Committees and Child Fatality Review Committees to take a proactive role in
informing communities about prevention needs and successful prevention strategies
15

Sixty percent (289) of all 484 child fatality review reports received for 2000 indicated that one or more community agencies had prior interaction with the deceased child or his or her family. A designated list of agencies is provided on the reporting form, but child fatality review committees may add others as necessary. Agencies were not necessarily actively

PRIOR AGENCY INVOLVEMENT
involved with children or families at the time of the deaths. The following figures list the agencies and the number of deaths in which they were identified. A child or family was often involved with more than one agency; therefore, the number of agencies exceeds the number of deaths.

Figure 12. Agency Involvement: Reviewed Deaths with No Child Abuse/Neglect Findings

No Agency Indicated

164

Health Department

126

DFCS/CPS

76

Law Enforcement

47

OtherAgency Court
DFCS/Public Assistance DJJ

45 34 26 16

DFCS: Department of Family and Children Services
DJJ: Department of Juvenile Justice
CPS: Child Protective Services

0

50

100

150

Number of Deaths
*Total reflects more than one agency per child in some cases

Findings 58% of deaths (228) had prior agency
involvement Families had involvement with an average
1.6 agencies 45% of families had involvement with the
Department Family & Children Services 55% of families had involvement with
Public Health
200

Figure 13. Agency Involvement: Reviewed Deaths With Child Abuse/Neglect

Findings

66% of deaths (61) had prior agency involvement
Families had involvement with an average 2.1

Health Department DFCS/CPS

agencies 69% of families had involvement with the
Department of Family & Children Services 57% of families had involvement with Public

None Law Envorcement
Other Agency

Health

Court

For the 33 children/families known to Child

Protective Services, four reports did not indi- DFCS/Public Assistance

cate the nature of the involvement. For the

DJJ

remaining 29 children/families, involvement

0

was as follows:

35

33

31

21

15

11

DFCS: Department of Family and Children Services

9 3

DJJ: Department of Juvenile Justice CPS: Child Protective Services

10

20

30

40

Number of Deaths

*Total reflects more than one agency per child in some cases

Decedent

7

Both decedent and another child in the family 10

Another child in the family, not the decedent 10

Decedent, another child in family, and caretaker 1

Caretaker

1

16

SUDDEN INFANT DEATH SYNDROME

Sudden Infant Death Syndrome (SIDS) is the sudden death of an infant under one year of age that remains unexplained after performance of an autopsy, a thorough investigation of the death scene, and a review of the clinical history. SIDS is the most common cause of infant death among normal birthweight infants between one month and one year of age. It is estimated that at least 4,000 infants within the U.S. die as a result of SIDS each year.

component in accurately determining the cause of an infant's death, and differentiating other medical conditions and injuries from SIDS. Of the 91 deaths determined to be SIDS by child fatality review committees, autopsies were known to be completed for 86. Equally important are death scene investigation findings which provide critical guidance for autopsies. Ninety (90) death scene investigations were completed for the 91 reviewed SIDS deaths.

SIDS continued to be a leading cause of infant deaths in Georgia. In 2000, death certificates listed 117 infant deaths as SIDS. Child fatality review committees reviewed 91 deaths that were determined to be SIDS.
Georgia law requires that an autopsy be completed for every SIDS death. Autopsies are a very critical

Child fatality review committees reviewed several infant deaths that related to "bed-sharing". Bed-sharing is a term used to describe an infant sleeping in the same bed with one or more individuals. Committees identified bed-sharing as an increased risk for suffocation of infants that could be mistaken for SIDS.

Figure 14. Reviewed SIDS Death by Age

Number of Deaths

35

30

29

25

23

20 15 10 7 5 0

14 11

3

2

1

1

0 1 2 3 4 5 6 8 12 Age (months)

Finding 77% (70) of SIDS deaths occurred among infants 0 to 3 months of age.

FIGURE 15. Reviewed SIDS Death by Race and Gender

2 Other 2 Other Male Female

18 A-A Female

18 White Male

Findings 57% (52) of SIDS victims were
African-American 59% (54) of SIDS victims were
male

17 White Female
17 34 A-A Male

FIGURE 16. Sleeping Position of Infants Who Died of SIDS

16 Unknown 12 On Side

32 On Stomach

Findings
Committees responded to the question regarding sleep position for 84 SIDS deaths. Sleep position was known in 81% (68) of those deaths
47% of the victims were reported to be sleeping on their stomachs, and 35% were reported to be sleeping on their backs

24 On Back

* 7 cases did not include any information on sleeping position

SIDS TRENDS

Figure 17. SIDS Deaths Rates Per 1,000, Age <1, 1990-2000

4.5

4

Death Rate (per 1,000 Births)

3.5

3

White M ales

2.5

White Females

2

Black M ales

1.5

Black Females

1

0.5

Findings

0 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

The total number of SIDS deaths was essentially unchanged from 1999 to 2000 (an increase from 116 to 117). There have been an average of 117 SIDS per year for the past five years. There were an average of 165 SIDS deaths per year for the preceding five years. A portion of this decline is likely due to the "Back to Sleep" campaign, but the decrease has not continued
The Georgia SIDS data show consistent race and gender effects. Rates remain higher among African American infants (of both sexes) than among white infants, and African American male infants are almost four times more likely than a white male infant to be a victim of SIDS. The number of African American, male SIDS deaths has increased from 27 in 1998 to 47 in 2000

Opportunities for Prevention Educate the public (targeting African American communities) about risk reduction including back sleeping,
breastfeeding, prenatal smoking cessation, smoke free environment and use of firm bedding materials Incorporate risk reduction information in prenatal education for expectant parents Promote a statewide public education program on the risks of overlay when bed-sharing 18

UNINTENTIONAL INJURY RELATED DEATHS

According to death certificate data, injuries were responsible for 455 child deaths. Three hundred forty-nine (349) of those deaths were unintentional. Child fatality review committees reviewed

235 injury related deaths determined to be unintentional. Figure 18 shows the distribution of those deaths by type of injury. Committees could not determine the manner of death in 3 instances.

Figure 18. Reviewed Unintentional Injury-Related Deaths by Cause

Motor Vehicle (not to scale) Suff/Strang Drowning Fire
Other Accident Poisoning Gun Other Fall Unknown

10 6 4 2 1 1

30 28
22

0

20

*Does not include homicide, suicide, medical, SIDS

40

60

Number of Deaths

131 Findings 56% of deaths resulted from motor vehicle-related incidents 34% (80) of injury-related deaths occurred among children under the age of 5 Although there were fewer reviewed cases in 2000 than 1999, fire deaths increased 120% from 1999 (10)

MOTOR VEHICLERELATED DEATHS

It is estimated that children 0-17 are more likely to die from a motor vehicle-related injury than any other injury. Motor vehicle incidents continue to be the leading cause of death among teens 15-17 and the second leading cause of death to children between ages 1-15 in Georgia. Death certificate data indicated that 195 child deaths resulted from motor vehicle incidents. Child fatality review committees reviewed 131 child deaths that were related to motor vehicle incidents.
Of the 131 reviewed motor vehicle-related deaths, 84 (64%) involved children who were passengers, and 32 (24%) were operators of cars, trucks, RVs, or vans. Information on the presence of restraints was provided for 128 of the reviewed deaths. It was determined that restraints were not used in 30 (41%) incidents in which a vehicle was known to be equipped with a restraint (74). The remaining 12% of the 131 reviewed motor vehicle-related deaths involved bicycles (4), all terrain vehicles (7), motorcycles (1), school buses (3), and a tractor (1). Of the 11 deaths involving bicycles and all terrain vehicles, 5 children were not wearing safety helmets.

Number of Deaths

FIGURE 19. Reviewed Motor Vehicle-Related Deaths by Age

70

60

50

40

30

20

10

8

0

< 1

60

23

25

15

1- 4

5 - 9

10 - 14

Age Range (years)

15 - 17

Findings 46% of reviewed motor vehicle-related deaths
occurred among teens ages 15-17 As teens achieved legal driving age, the number of
deaths increased as follows:

Age 15 Age 16

9 deaths 29 deaths

Age 17 22 deaths 19

Figure 20. Reviewed Motor Vehicle-Related Deaths by Race and Gender

2 Other Male 15 A-A Female 13 A-A Male
39 White Female

1 Other Female
61 White Male

Findings 76% (100) of deaths were white children, up
from 64% in 1999 58% (76) of deaths were male children, down
from 67% in 1999

Motor Vehicle Trends
Figure 21. Motor Vehicle Fatality Rates per 100,000: Age 15-17, 1990-2000 70

60

Death Rate (per 100,000)

50 White M ales

40

White Females

30

Black M ales

Black Females 20

10

Findings

0 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

The total number of MV fatalities for 15-17 year olds decreased slightly (from 99 to 91) from 1999 to 2000.

(The total number of deaths among 15 to 17 year olds from all causes was essentially unchanged 228 to 225)

Motor vehicle crashes remain the leading cause of death among teens 15 to 17. All other accidental or violent

deaths only total 80 deaths in this age group

There was no change in the total number of MV crash deaths among white teens; but the total number of

deaths among teens decreased by 1/3 (from 30 to 20)

Opportunities for Prevention Enforce the Teenage and Adult Driver Responsibility Act Support statewide availability of driver education programs Continue to promote bicycle helmet use including education about proper fit and wearing position Promote educational programs for parents and caregivers in settings such as hospitals, child care centers and
health departments to teach proper installation and use of car seats and proper use of vehicle restraints Encourage communities to provide car seats to families with infants and young children who need financial
assistance to purchase safe equipment Encourage pedestrian safety campaigns
20

Drowning
According to death certificate data, 47 children died as a result of drowning which was an 11% decrease from 1999 (53). Child fatality review committees reviewed 28 drowning deaths of chil-

dren under the age of 18 years. Of the 27 cases where flotation device information was indicated, only two (both swimming in pools) were wearing a flotation device.

Figure 22. Reviewed Deaths Due to Drowning by Age

10

9

Number of Deaths

6 5
3

1

0

< 1

1- 4

5 - 9

10 - 14

Finding

Age Range (years)

43% of drowning victims were children between the ages of 5 and 14

9 15 - 17

Figure 23. Reviewed Drowning Deaths by Race and Gender

2 Other Male

2 Other Female

1 A-A Female

10 White Male

9 A-A Male 4 White Female
Finding Three times as many drowning deaths occurred among males as females
21

Figure 24. Place of Drowning
2 Bathtub
10 Pool

Drowning Trends

15 Natural Body

Findings
56% of drowning victims died in a natural body of water
The total number of drowning deaths in pools decreased from 1999 (16) to 2000 (10)
Drowning deaths in bathtubs also showed a slight decrease from 1999 (4) to 2000 (2)

Figure 25. Drowning Fatality Rates per 100,000: Age < 18, 1990-2000

7

Findings

Death Rate (per 100,000)

6 5 4 3 2 1 0
1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

White M ales White Females Black M ales Black Females

The total number of drowning deaths decreased from 53 in 1999 to 47 in 2000. The major change was a drop in male drowning deaths from 42 to 35. There was one more female drowning death in 2000 than in 1999
Total child drowning deaths have remained fairly constant over the past ten years, with an average of 43 per year. The annual numbers fluctuate, but there are no apparent trends. Black males have consistently had the highest rates

Opportunities for Prevention Increase public education efforts that teach water safety and skills, among school age children Promote regulations and enforcement to limit alcohol use by operators of recreational boats Encourage Department of Natural Resources to establish stronger rescue capabilities at state swimming facilities Enact and enforce statewide ordinances related to fences and gates in public and private
swimming pools

Fire Related Deaths

Death certificate data indicated a total of 26 fire-related deaths that represent an increase from 1999 (10). Child fatality review committees reviewed 22

fire-related deaths in 2000. According to committees, in several incidents, a single fire caused multiple child deaths.

Figure 26. Reviewed Deaths Due to Fire by Age
15
11 10

Number of Deaths

5 2

3

3

3

0

<1

1- 4

5 - 9

10 - 14

15 - 17

Age Range (years)

22

Findings Reviewed fire deaths increased from 10 in
1999 to 22 in 2000 (120%) A majority of the victims of fire-related
deaths (73%) were under the age of 10

Figure 27. Reviewed Deaths Due to Fire by Race and Gender
5 A-A Female

4 White Male

5 A-A Male

8 White Female

Finding There were almost equal numbers of fire-related deaths among whites (12) and African-Americans (10)

Fire-Related Trends
Figure 28. Fire-Related Fatality Rates per 100,000 Ages < 18, 1990-2000

7 6 5 4 3 2 1 0
1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

White M ales White Females Black M ales Black Females

Findings After a decade low of 10 fire related
deaths in 1999, there were 26 deaths in 2000. This increase was due to an increase in the number of black victims from 2 to 14. However, the average number of deaths (18.5) for the past four years ('97 to `2000) is less then half of the average number (41) for the preceding seven years These numbers suggest a "real" improvement in the prevention of deaths due to fire and not just statistical fluctuations

Opportunities for Prevention
Continue and expand school fire safety programs that teach critical messages like "stop, drop and roll" and those that help families plan fire escape routes
Continue and expand community programs to provide smoke detectors and batteries to families who can not afford them
Promote public education about the importance of changing smoke detector batteries every six months

Death Rate (per 100,000)

23

In 2000, local Child Fatality Review Committees determined a total of 80 deaths (58 homicides and 22 suicides) to be the result of intentional injuries. Using death certificate data, the total number of

INTENTIONAL INJURY DEATHS
deaths resulting from homicide and suicide (106) increased by nearly 13% since 1999. Thirty of the 92 deaths reported by child fatality review committees with findings of abuse or neglect were homicides.

Homicide

Child Fatality Review Committees reported 58 homicide deaths. The figure below presents reviewed homicide deaths by circumstance of death.

Figure 29 Reviewed Homicide Deaths by Circumstance of Death

Firearm

27

Struck

9

Cut/Stabbed

6

Shaken

5

Drowning

4

Fire

3

Suffocation

2

Motor Vehicle 1

Undetermined 1

0

5

10

15

20

25

Findings:

Number of Deaths

Firearms were the cause of 47% of all reviewed homicides (27 deaths) 26% of homicide deaths (15 deaths) were due to injuries resulting from being struck or stabbed.

Figure 30. Reviewed Homicide Deaths by Age

Number of Deaths

20
15 11
10
5
0 < 1

19

11

11

6

1- 4

5 - 9

10 - 14

Age Range (years)

15 - 17

Findings: Children under five years of age were 38% of all reviewed homicide deaths Teenagers aged 15-17 years were 33% of all reviewed homicides
24

Figure 31. Reviewed Homicide Deaths by Race and Gender

9 A-A Female

2 Other Male

2 Other Female

18 White Male

18 A-A Male

9 White Female

Findings 66% of homicide victims were male, with an equal number of African American and white males. However,
the rate among African American males is approximately twice the rate among white males (see figure 32) 47% of homicide victims were African American compared to 69% in 1999

Homicide Trends
Figure 32. Death Rates for Teen Homicides per 100,000, Ages 15-17, 1990-2000

90

80

70

Death Rate (per 100,000)

60

White M ales

50

White Females

40

Black M ales

30

Black Females

20

10

Findings

0 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

The total number of teen homicides (26) were unchanged from 1999 to 2000

Homicides among African American males continues at a disproportionately high rate, but has been declining

steadily since 1994

Opportunities for Prevention
Promote school and after-school programs teaching conflict resolution, impulse control, anger management and empathy
Increase the availability of community-based parenting education including positive discipline techniques Support legislation promoting responsible gun ownership including use of firearm safety locks and safe
firearm storage

25

In 2000, local Child Fatality Review Committees reviewed 22 deaths of children who took their own lives. Death certificate data indicated a total of 30 suicide deaths. Firearms were used in 59% (13)

Figure 33. Reviewed Suicide Deaths by Age

Number of Deaths

20

18

15

10

5

4

0

10 - 14

Age Range

15 - 17

Suicide
of reviewed suicides. Strangulation (hanging) was the circumstance of death for another 7 reviewed deaths. Two deaths resulted from poisoning.
Findings 82% of reviewed suicide deaths occurred to
teens 15-17 The youngest reviewed suicide victim (12
years old), died of injuries sustained from strangulation due to hanging

Figure 34. Reviewed Suicide Deaths by Race and Gender

5 A-A Male

1 Unknown

10 White Male

Findings 73% of all reviewed suicide victims were white
children 68% of all reviewed suicide victims were males 45% of all reviewed suicide victims were white
males

6 White Female

Suicide Trends
Figure 35. Suicide Death Rates per 100,000, Ages 15-17, 1990-2000

Findings

25

There were slight increases in all race/gender

categories for teen suicides in 2000. The total

20

Death Rate (per 100,000)

number rose from 17 to 24 with AfricanAmerican male suicides increasing from two to five 15

White M ales White Females

The average number of suicide deaths for all age

10

groups under 18 was 30 per year for the past five

Black M ales Black Females

years, a decline from 35 per year for the preceding five years
Opportunities for Prevention

5
0 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

Increase the access and availability of mental health

and substance abuse prevention and treatment services to children and youth

Increase awareness of suicide warning signs among parents, caretakers and communities, and promote

prompt action when warning signs are recognized

Develop community intervention resources for children at risk of suicide

Advocate for safe home storage of firearms 26

FIREARM DEATHS

Forty-four of the deaths reviewed by Child Fatality Review Committees were caused by firearms. Firearm deaths include homicides, suicides and unintentional injuries. Death certificate data indicated a total of 45 deaths resulting from firearms in 2000, a decrease from the 51 such deaths recorded in 1999. Child fatality review reports ask for information not available on death certificates including source of the firearm, type of firearm, who was using the firearm at the time of death and the age of the firearm handler. This information provides important guidance for prevention.

13 Suicide

Figure 36. Reviewed Firearm Deaths by Circumstance of Death
2 Undetermined 2 Unintentional

27 Homicide

Figure 37. Reviewed Firearm Deaths by Age

Number of Deaths

35

30

25

20

15

10

5

2

0

1 - 4

12

1

5 - 9

10 - 14

Age Range

29 15 - 17

Findings 66% of reviewed firearm deaths occurred to
children aged 15-17 Of reviewed firearm deaths among 15-17 year
olds, 55% (16) were homicides and 38% (11) were suicides

Figure 38. Reviewed Firearm Deaths by Race and Gender

1 Other Male 4 A-A Female

17 White Male

16 A-A Male

Findings 45% of reviewed firearm deaths occurred
to African American children 77% of reviewed firearm deaths were
to males

6 White Female

Source of Firearm In 51% [50%] (22) of reviewed firearm deaths, the firearm was obtained from someone the child knew (a
parent, other relative or acquaintance) Parents were the source of the firearm in 9 of the 13 reviewed suicides by firearm The source of the firearm was unknown in 42% [43%] (19) of reviewed firearm related deaths Strangers unknown to the child provided the firearm used in 3 deaths

27

Number of Deaths

Type of Firearm

Figure 39. Reviewed Firearm Deaths by Type of Firearm

40

Findings

30

29

66% (29) of the firearms were handguns compared to 77% in 1999

23% (10) of the firearms were shotguns. There

20

were no shotgun deaths reviewed in 1999

Of the 22 reviewed suicide deaths, 59% (13)

10 10

were committed with a firearm. Of these, 10

0

3

deaths (77%) involved a handgun, and 3 deaths

2

(23%) involved a shotgun

Handgun

Shotgun

Unknown

Rifle

Of the 58 reviewed homicides, 47% (27) were

Type of Firearm

committed with a firearm. Of these, 15 deaths

(56%) involved handguns, 7 (26%) involved

shotguns, an additional two involved a rifle, and

3 listed firearm type as unknown

Usage

84% of the time (37 deaths) the shooter was aiming at himself or at someone else

Two deaths were the result of the shooter "playing" with the firearm

Storage Storage of the firearm was indicated in 41 of the 44 reviewed firearm deaths. Of those, 66% (27) indicated
the storage location of the firearm prior to the death was unknown In 64% (9) of the reviewed firearm deaths in which the storage location was known (41 cases), the firearm
had not been secured to prevent use by children or unauthorized adults

Age of Handler The shooter was under the age of 15 in both of the unintentional deaths When the age of the handler was known (35 cases), 66% were under the age of 18

Firearm Trends

Figure 40. Firearm Death Rates per 100,000, Ages 15-17, 1990-2000
Findings There was little change in firearm deaths
from 1999 (31) to 2000 (32). Deaths among white males increased by four and decreased by four among African American males While rates for African American males remain disproportionately high, firearm related deaths are at their lowest point in a decade

Death Rate (per 100,000)

90 80 70 60 50 40 30 20 10 0
1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

White M ales White Females A-A M ales A-A Females

Opportunities for Prevention

Promote school and community-based risk reduction and firearm safety programs for children, parents and

other caretakers

Promote the use of firearm safety devices, including trigger locks

28

Support efforts to limit minors' access to firearms

RACE, ETHNICITY AND DISPROPORTIONATE DEATHS

Data are presented in this report by race and gender for each type of death to enable more detailed analysis. The terms "White", "AfricanAmerican" (A-A) and "Other" are used to identify racial groups throughout the report. "Other" refers to children of Asian, Pacific Islander, or Native American origin. Death certificate data includes

ethnicity information that can identify children of Hispanic origin. Eighty of 85 deaths identified as Hispanic indicated the race as "White." Three deaths identified as Hispanic indicated AfricanAmerican as the race, and the remaining 2 indicated the race to be Other.

Figure 41. Deaths to Children < 1 and Percent of Population in Georgia By Race and Gender

Percent

35

30

25

20 15

10

5

0 White Male White Female

A-A Male

% Deaths % Population

A-A Female

Findings A disproportionate number of deaths
occurred among African-American infants

All A-A Infants A-A-Male Infants

% of Deaths 56.1 31.7

% of Population 32.2 16.4

A-A Female Infants

24.4

15.8

The infant mortality rate for African-American infants (11.5 per 1,000 births) was more than double the rate for white infants (5.0 deaths per 1,000 births)

Figure 42. Deaths to Children 1-17 and Percent of Population in Georgia, By Race and Gender

Percent

40 35 30 25 20 15 10 5 0
White Male White Female

A-A Male

A-A Female

% Deaths % Population

Findings A disproportionate number of deaths

% of Deaths % of Population

occurred among male children

All Males 1 17

60.7

51.2

Males between the ages of 1 and 17

AA-Males 1 17

25.4

17.5

are about 50% more likely to die than

females in the same age range

White Males 1 - 17

34.2

30.0

29

THE HISTORY OF CHILD FATALITY REVIEW IN GEORGIA

1990 - 1993

tiveness of the review process. Recommendations

for improvement were made to the General

Legislation established the Statewide Child Fatality

Assembly

Review Panel with responsibility for compiling statis- Statutory amendments were adopted to:

tics on child fatalities and for making recommenda-

- Identify agencies required to be represented on

tions to the Governor and General Assembly based

child fatality review teams, and establish penal-

on the data. It established local county protocol

ties for non-participation

committees and directed that they develop county-

- Require that all child deaths be reported to the

based written protocols for the investigation of

coroner/medical examiner in each county

alleged child abuse and neglect cases. Statutory

- Establish additional requirements for

amendments were adopted to:

county child fatality review committees

Establish a separate child fatality review team in each county and determine procedures for con-

1999 - 2001

ducting reviews and completing reports

Change the name of the Statewide Child Fatality Child death investigation teams were initially

Review Panel to the Statewide Child Abuse

developed in four judicial circuits as a pilot

Prevention Panel and require the Panel to:

project, with six additional teams later added.

Submit an annual report documenting the

Team members were identified as law enforce-

prevalence and circumstances of all child fatalities

ment, coroner or medical examiner, district attor-

with special emphasis on deaths associated with

ney representative, and department of family and

child abuse

children services representative. Teams assumed

Recommend measures to reduce child fatalities to

responsibility for conducting death scene investi-

the Governor, the Lieutenant Governor, and the

gations of child deaths within their judicial cir-

Speaker of the Georgia House of Representatives

cuit that met established criteria

Establish a protocol for the review of policies,

Statutory amendments were adopted which

procedures and operations of the Division of

resulted in the Code section governing the Child

Family and Children Services for child abuse

Fatality Review Panel, child fatality review com-

cases

mittees, and child abuse protocol committees

Monitor implementation of the State Child Abuse

being completely rewritten. This was an attempt

Prevention Plan

to provide greater clarity and a more comprehen-

sive, concise format. The name of the Statewide

1996 - 1998

Child Abuse Prevention Panel was changed to the

Georgia Child Fatality Review Panel

The Statewide Child Abuse Prevention Panel

The Panel's budget was increased to allow for 1

established the Office of Child Fatality Review

additional staff person, and establishment of

with a full-time director to administer the activi-

physical office space.

ties of the Panel

An evaluation of the child fatality review process

was conducted by researchers from Emory

University and Georgia State University. The

evaluation concluded that there were policy, pro-

30

cedure, and funding issues that limited the effec-

APPENDIX A CRITERIA FOR CHILD DEATH REVIEWS
Child Fatality Review Teams are required to review the deaths of all children under the age of 18 that meet the criteria for a coroner/medical examiner's investigation.
"Eligible" Deaths or Deaths to be Reviewed by Child Fatality Review Teams O.C.G.A. 19-15-3(e)
The death of a child under the age of 18 must be reviewed when the death is suspicious, unusual, or unexpected. Included in this definition are incidents when a child dies:
1. as a result of violence 2. by suicide 3. by a casualty (i.e., car crash, fire) 4. suddenly when in apparent good health 5. when unattended by a physician 6. in any suspicious or unusual manner, especially if under 16 years of age 7. after birth but before seven years of age if the death is unexpected or
unexplained 8. while an inmate of a state hospital or a state, county, or city penal institution 9. as a result of a death penalty execution
31

APPENDIX B CHILD FATALITY REVIEW TIMEFRAMES AND RESPONSIBILITIES

If child is resident of the county, medical examiner or coroner will notify chairperson of child fatality review committee in the child's county of residence within 48 hours of receiving report of child death (Code Section 19-15-3).
Medical examiner or coroner reviews the findings regarding cause of death.

If child is not resident of county, medical examiner or coroner of the county of death will notify the medical examiner or coroner in the county of the childs residence within 48 hours of the death.
Within 7 days, coroner/medical examiner in county of death will send coroner/medical examiner in county of residence a copy of Form 1 along with any other available documentation regarding the death.
Upon receipt, coroner/medical examiner in county of residence will follow outlined procedures

If cause of death meets the criteria for review pursuant Code Section 19-15-3(e), medical examiner or coroner will complete Form 1 and forward to the chair of the child fatality review committee for review within 7 days of child's death.
Committee meets to review report and conduct investigation into the child death within 30 days of receiving the report.
Committee will complete its investigation within 20 days after the first meeting following the receipt of the medical examiner or coroner's report.
Committee transmits a copy of its report within 15 days of completion to the Office of Child Fatality Review.

If cause of death does not meet the criteria for review pursuant to Code Section 19-15-3(e), the medical examiner/coroner will complete Sections A, B, and J of Form 1 and forward to the chair of the child fatality review committee within 7 days.

If chair believes death meets the criteria for review, chair will call committee together.

If chair of committee agrees that death does not meet criteria for review, then chairperson signs Section J of Form 1 and forward to the Georgia Child Fatality Review Panel.

Send copy of the report within 15 days to district attorney of the county in which the committee was created if the report concludes that the death was a result of: SIDS without confirmed autopsy report; accidental death when death could have been prevented through intervention or supervision; STD; medical cause which could have been prevented through intervention by agency involvement or by seeking medical treatment; suicide of a child under the custody of DHR or when suicide is suspicious; suspected or confirmed child abuse; trauma to the head or body; or homicide.

32

APPENDIX C.1 Total Child Fatalities Based on Death Certificate

White

Black

Other

Infant (Age < 1) Cause of Death Missing Male Female Male Female Male Female

Total

Drowning

0

0

1

0

1

0

0

2

Fire / Burns

0

0

1

0

2

0

0

3

Poisoning

0

1

0

2

0

0

0

3

Suffocation

0

8

6

5

4

1

0

24

Vehicle Crashes

0

4

5

2

3

0

0

14

Other

0

1

1

0

2

0

1

5

Homicide

0

4

2

6

2

0

0

14

SIDS (All)

0

24

23 47

23

0

0

117

Medical Causes

2 233

180 296

209 15

8

943

Total

2 275

219 358

246 16

9

1,125

Ages 1 to 4

White

Black

Other

Cause of Death Missing Male Female Male Female Male Female

Total

Drowning

0

7

3

2

0

1

0

13

Fire / Burns

0

2

1

3

3

0

2

11

Poisoning

0

1

0

0

0

0

0

1

Suffocation

0

5

2

0

0

0

1

8

Vehicle Crashes

0

13

3

4

6

0

0

26

Other

0

1

0

3

2

0

0

6

Homicide

0

4

4

3

5

0

0

16

Medical Causes

0

28

22 21

20

0

2

93

Total

0

61

35 36

36

1

5

174

Ages 5 to 14

White

Black

Other

Cause of Death Missing Male Female Male Female Male Female

Total

Drowning

0

2

3

7

2

0

2

16

Fire / Burns

0

2

2

2

3

0

0

9

Suffocation

0

2

0

4

0

0

0

6

Vehicle Crashes

0

23

19

6

13

1

2

64

Other

0

4

7

2

1

0

0

14

Homicide

0

6

3

7

3

1

0

20

Suicide

0

4

1

1

0

0

0

6

Medical Causes

0

38

21 27

14

2

0

102

Total

0

81

56 56

36

4

4

237

Ages 15 to 17

White

Black

Other

Cause of Death Missing Male Female Male Female Male Female

Total

Drowning

0

9

0

7

0

0

0

16

Fire / Burns

0

0

2

1

0

0

0

3

Poisoning

0

1

1

1

0

0

0

3

Suffocation

0

1

0

0

0

0

0

1

Vehicle Crashes

0

43

26 14

6

2

0

91

Other

0

2

1

4

3

0

0

10

Homicide

0

9

1

11

4

1

0

26

Suicide

0

12

6

5

1

0

0

24

Medical Causes

0

18

10 10

10

1

2

51

Total

0

95

47 53

24

4

2

225

33

APPENDIX C.2 Total Reviewed Child Fatalities

Infant (Age < 1)

Cause of Death Drowning Fire / Burns Homicide Medical Causes Vehicle Crashes Other Accidents Poisoning SIDS Suffocation Total

White

Male Female

0

1

0

1

3

2

6

5

2

4

0

1

1

0

18 17

8

3

38 34

Black

Male Female

0

0

0

1

3

1

12

8

1

1

0

1

1

0

34 18

4

2

55 32

Other Male
0 0 1 1 0 0 0 2 0 4

Female 0 0 1 0 0 0 0 2 1 4

Total 1 2 11 32 8 2 2 91 18
167

Ages 1 to 4

Cause of Death Drowning Fire / Burns Firearm Homicide Medical Causes Vehicle Crashes Other Other Accidents Poisoning Suffocation Unknown Total

White

Male Female

4

1

2

3

0

0

3

4

6

1

9

2

0

0

0

0

1

0

4

3

0

0

29 14

Black

Male Female

0

0

3

3

0

1

1

2

3

6

2

2

1

1

1

1

0

0

0

0

1

0

12 16

Other Male
1 0 0 0 1 0 0 0 0 0 0 2

Female 0 0 0 1 1 0 0 0 0 1 0 3

Total 6 11 1 11 18 15 2 2 1 8 1 76

Ages 5 to 14

Cause of Death Drowning Fall Fire / Burns Firearm Homicide Medical Causes Vehicle Crashes Other Other Accidents Suffocation Suicide Total

White

Male Female

1

2

0

0

2

2

1

0

6

3

6

6

21 14

0

0

1

3

2

0

2

1

42 31

Black

Male Female

5

1

1

0

1

1

0

0

5

3

2

2

3

9

0

0

0

0

1

0

1

0

19 16

Other Male
1 0 0 0 0 0 0 0 0 0 0 1

Female 2 0 0 0 0 0 1 0 0 0 0 3

Total 12 1 6 1 17 16 48 0 4 3 4 112

White

Black

Other

Ages 15 to 17 Cause of Death Male Female Male Female Male Female

Total

Drowning

5

0

4

0

0

0

9

Fire / Burns

0

2

1

0

0

0

3

Firearm

1

0

1

0

0

0

2

Homicide

6

0

9

3

1

0

19

Medical Causes

1

1

5

3

0

2

12

Vehicle Crashes

29 19

7

3

2

0

60

Other Accidents

0

0

0

2

0

0

2

Poisoning

0

2

1

0

0

0

3

Suffocation

1

0

0

0

0

0

1

Suicide

8

5

4

0

0

0

18*

34

Total

*One report missing race information

51 29

32 11

3

2

129

APPENDIX C.3 Reviewed Child Fatalities with Abuse Findings

Infant (Age < 1)

Cause of Death Drowning Homicide Medical Causes Vehicle Crashes SIDS Suffocation Total

White Male
0 3 1 1 3 4 12

Female 1 2 0 0 3 1 7

Black

Male Female

0

0

3

1

3

1

1

0

6

4

1

1

14

7

Ages 1 to 4

Cause of Death Drowning Fire / Burn Firearm Homicide Medical Causes Other Poisoning Suffocation Unknown Total

Male 1 0 0 3 0 0 1 1 0 6

Female 1 0 0 4 0 0 0 0 0 5

White

Male Female

0

0

1

2

0

1

1

2

1

2

1

1

0

0

0

0

1

0

5

8

Ages 5 to 14

Cause of Death Drowning Fire / Burn Homicide Vehicle Crashes Total

White Male
1 0 4 1 6

Female 0 0 1 1 2

Black

Male Female

3

0

1

0

0

1

2

2

6

3

Ages 15 to 17

Cause of Death Fire / Burn Homicide Medical Causes Vehicle Crashes Suicide Total

White Male
0 0 0 0 1 1

Female 0 0 1 1 1 3

Black

Male Female

1

0

2

0

0

0

0

0

0

0

3

0

Other Male
0 1 0 0 0 0 1
Black Male
0 0 0 0 0 0 0 0 0 0
Other Male
0 0 0 0 0
Other Male
0 0 0 0 0 0

Female 0 1 0 0 0 0 1

Total 1 11 5 2 16 7 42

Female 0 0 0 1 0 0 0 0 0 1

Other Total
2 3 1 11 3 2 1 1 1 25

Female 1 0 0 0 1

Total 5 1 6 6 18

Female 0 0 0 0 0 0

Total 1 2 1 1 2 7

35

APPENDIX C.4 Prevention Potential of Reviewed Child Fatalities by Abuse Classification

Cause of Death Medical SIDS Homicide Suicide Vehicle Crashes All Other Acc.
Total

Missing 0 0 1 0 0 0
1

Cause of Death Medical SIDS Homicide Suicide Vehicle Crashes All Other Acc.
Total

Missing 0 0 0 0 0 0
0

Cause of Death Medical SIDS Homicide Suicide Vehicle Crashes All Other Acc.
Total

Missing 0 4 1 1 4 3
13

Confirmed Abuse

Prevention Finding

None

Possible

1

2

0

2

3

6

0

0

0

1

0

3

Definite 0 1 18 0 4 7

4

14

30

Suspected (but not confirmed) Abuse

Prevention Finding

None

Possible

0

6

0

12

0

1

0

2

0

1

2

5

Definite 0 1 1 0 3 9

2

27

14

No Reported Abuse

Prevention Finding

None

Possible

42

23

33

38

3

8

5

9

14

43

13

33

Definite 4 0 16 5 61 29

110

154

115

Total 3 3 28 0 5 10
49
Total 6 13 2 2 4 16
43
Total 69 75 28 20 122 78
392

36

APPENDIX D COUNTY COMPLIANCE WITH REVIEWING ELIGIBLE DEATHS
Category
no reviewable deaths reviewable deaths, none reviewed <2/3 of reviewable deaths reviewed 2/3 or more of reviewable deaths reviewed
37

APPENDIX E 2000 CHILD FATALITY REVIEWS, BY COUNTY, BY AGE GROUPS
Appendix E presents county level data for the Child Fatality Review process in 2000. The data is presented for four age groups (infants less than 1 year old, children from 1 to 4 years of age, children 5 through 14, and teenagers ages 15 through 17). Four numbers are provided for each age group: Total Deaths: The total number of deaths (all causes) for that age group. This number is based on Georgia death certificate data and only includes deaths to Georgia residents under the age of 18. This does include deaths of Georgia residents that occurred in other states and were reported back to Georgia, but it does not include deaths of out-of-state residents that occurred in Georgia. Eligible Deaths: The number of SIDS, accidental, or violence-related deaths (eligible deaths) according to the death certificate classifications. Although other deaths due to medical or natural causes may be eligible for review according to OCGA 19-15-3(e), SIDS deaths are explicitly required to be reviewed, and accidental/violence related deaths should be reviewed as "sudden or unexpected deaths." Thus, this number represents a minimum number of deaths that should be reviewed. This is a subset of total deaths (DTH). Eligible Deaths Reviewed: The number of SIDS, unintentional, or violence related deaths that were reviewed. This number is a measure of how well a county identified and reviewed the minimum number of appropriate deaths. This is a subset of the total "eligible" deaths. Total Deaths Reviewed: This is the total number of child deaths in 2000 for which a Child Fatality Review Report was submitted. It includes deaths due to medical causes (other than SIDS) in addition to those deaths which were identified as eligible for review. This is based on the county of residence identified from the death certificate.
38

Appendix E Child Fatality Reviews, by Death Certificate County of Residence

County

Total Deaths

AGE <1 1-4 5-14 15-17 Total

Appling

222

6

Atkinson

3

14

Bacon

11

2

Baker

1

1

Baldwin

514

10

Banks

2

2

Barrow

5

229

Bartow

11 3 3 1 18

Ben Hill

5

117

Berrien

33

Bibb

31 5 1 4 41

Bleckley

3

3

Brantley

1

1

2

Brooks

1

12

Bryan

3

1

4

Bulloch

9 1 1 2 13

Burke

32

5

Butts

3

3

Calhoun

1

1

2

Camden

7

119

Candler

41

5

Carroll

12 1 3 2 18

Catoosa

33

6

Charlton

1

23

Chatham

26 5 3 8 42

Chattahoochee 1 1

13

Chattooga

3

25

Cherokee

19 5 2 8 34

Clarke

11

2 1 14

Clay

1

1

Clayton

41 7 5 1 54

Clinch

21

3

Cobb

60 12 16 14 102

"Reviewable" Deaths <1 1-4 5-14 15-17 Total

121

4

2

13

"Reviewable" Deaths Reviewed <1 1-4 5-14 15-17 Total

121

4

111

3

1

1

213

3

216

2

1

3

22

42

4 10

1

1

1

1

11

31 1

26 1

1

1

2

1

3

1

1

1

225

11

2

22

6 2 1 7 16

11

2

24

14

8 13

213

822

12

12 3 7 11 33

112

3

216

2

1

3

11

1

1

1

1

1

1

2

1

3

1

1

1

124

11

2

6 2 1 3 12

11

1

1

13

8 12

112

1

1

11 3 7 11 32

Total Deaths Reviewed <1 1-4 5-14 15-17 Total

121

4

112

3

216

2

114

11

1

1

1

1

1

1

2

114

11

2

2

226

12

3

6 3 1 3 13

1

12

1

1

2

1 3 1 8 13

2

114

2

1

3

11

2

14 8 9 13 44

39

40

Appendix E Child Fatality Reviews, by Death Certificate County of Residence

County

Total Deaths

AGE <1 1-4 5-14 15-17 Total

Coffee Colquitt Columbia Cook Coweta Crawford Crisp Dade Dawson Decatur DeKalb Dodge Dooly Dougherty Douglas Early Echols Effingham Elbert Emanuel Evans Fannin Fayette Floyd Forsyth Franklin Fulton Gilmer Glascock Glynn Gordon Grady Greene

9 1 2 1 13

9

3

12

10 2 2 1 15

2

2

4

13 2 3 1 19

121

4

7

7

1

1

2

5

38

102 15 20 16 153

3

3

1

1

23 1 1

25

4

228

1

1

2

6

219

224

6

1

7

31116

41

5

6

129

11

3 2 16

14 2 2 5 23

11114

113 15 11 28 167

5

5

622

10

8 1 3 1 13

41128

3

3

"Reviewable" Deaths <1 1-4 5-14 15-17 Total

"Reviewable" Deaths Reviewed <1 1-4 5-14 15-17 Total

11

13

1

3

4

11114

1

1

2

21115

11

2

3

3

2

2

11114

111

3

2

2

1 1 11 6

1 23 11 12 40

1

1

7 6 5 5 23

211

4

2

2

1

1

112

22

1

1

11

31

4

1

1

3

126

1

157

1

12

16 5 5 19 45

1

1

2

2

1

113

3

126

1

1

211

4

1

1

11

1

1

21

3

1

1

2

114

1

157

1

1

16 3 5 17 41

1

1

2

2

1

113

3

126

1

1

Total Deaths Reviewed <1 1-4 5-14 15-17 Total

3

3

11114

111

3

4

4

1

1

10 8 5 7 30

211

4

1

1

1 1

21

1

1

3

2

1

1

111

19 10 9

1

2

2

111

311

1

12 1
3 24 16 57
3 22 60
1
4 14 27
1

Appendix E Child Fatality Reviews, by Death Certificate County of Residence

County

Total Deaths

AGE <1 1-4 5-14 15-17 Total

Gwinnett Habersham Hall Hancock Haralson Harris Hart Heard Henry Houston Irwin Jackson Jasper Jeff Davis Jefferson Jenkins Johnson Jones Lamar Lanier Laurens Lee Liberty Lincoln Long Lowndes Lumpkin Macon Madison Marion McDuffie McIntosh Meriwether

58 10 21 21 110

5

218

16 3 3 3 25

3

3

2

2

2

2

4

2

2

2

114

17 1 3 3 24

14 1 3 4 22

3

3

32117

2

2

7

18

4

4

1

23

12

3

1

1

2

1

1

521

8

11147

21 1 4 1 27

2

2

11

2

17

1 1 19

111

3

412

7

2

2

1

1

51

28

3

126

421

7

"Reviewable" Deaths

"Reviewable" Deaths Reviewed

<1 1-4 5-14 15-17 Total

<1 1-4 5-14 15-17 Total

10 5 1 12

14 14 43 214 126

10 5 1 12

13 12 40

1

2

126

1

1

1

1

11226

2

147

1

1

12115

2

13

1

1

1

23

11

2

1

1

21

3

1146

2

2

4

2

1

3

11

2

211

4

1

1

4

15

22

121

4

1225

2

114

1

1

21

3

145

2

2

4

2

1

3

11

2

211

4

1

1

4

15

22

Total Deaths Reviewed <1 1-4 5-14 15-17 Total

13 5 2 22

15 13 46

1

3

127

1225

3

115

1

1

21

3

145

2

2

4

3

115

11

2

211

4

1

1

51

17 22

41

42

Appendix E Child Fatality Reviews, by Death Certificate County of Residence

County

Total Deaths

AGE <1 1-4 5-14 15-17 Total

Miller

Mitchell

6

2 2 10

Monroe

32

5

Montgomery 1

23

Morgan

311

5

Murray

22228

Muscogee

49 2 4 6 61

Newton

6 5 2 2 15

Oconee

311

5

Oglethorpe

11

Paulding

8 1 3 1 13

Peach

31116

Pickens

31149

Pierce

21

14

Pike

1

1

Polk

712

10

Pulaski

121

4

Putnam

1

2

3

Quitman

1

1

2

Rabun

1

1

2

Randolph

1

1

2

Richmond

42 6 8 5 61

Rockdale

3 1 4 2 10

Schley

Screven

521

8

Seminole

2

13

Spalding

9

1

10

Stephens

4

138

Stewart

11

Sumter

4

15

Talbot

22

4

Taliaferro

Tattnall

2

57

"Reviewable" Deaths

"Reviewable" Deaths Reviewed

<1 1-4 5-14 15-17 Total

<1 1-4 5-14 15-17 Total

3

227

12

3

22

11

2

1225

8 2 4 4 18

3 3 2 2 10

11

21115

1

113

1146

11

13

1

2

3

21

3

1

2

3

1

1

1

1

1

1

5 2 3 4 14

11226

1

1

2

1

12

1

1

1

124

11

1

1

2

2

33

3

227

1

1

22

11

2

1225

8 1 3 4 16

3 3 2 2 10

11

1135

1

1

1

1

1

1

11

1124

1

1

11

1

1

1

124

Total Deaths Reviewed <1 1-4 5-14 15-17 Total

3

227

1

1

22

11

2

12328

10 1 3 4 18

3 3 2 2 10

11

1135

1

1

1

1

2

1

1

11

1225

1

1

11

1

1

1

124

1

1

Appendix E Child Fatality Reviews, by Death Certificate County of Residence

County

Total Deaths

AGE <1 1-4 5-14 15-17 Total

"Reviewable" Deaths

"Reviewable" Deaths Reviewed

<1 1-4 5-14 15-17 Total

<1 1-4 5-14 15-17 Total

Taylor Telfair Terrell Thomas Tift Toombs Towns Treutlen Troup Turner Twiggs Union Upson Walker Walton Ware Warren Washington Wayne Webster Wheeler White Whitfield Wilcox Wilkes Wilkinson Worth

1

1

2

1

1

1

1

2

21317

9 2 1 1 13

2

24

1

1

11

2

13

3 2 18

21

14

111

3

2

114

213

6

8 2 3 1 14

533

11

4

15

3

14

2

2

2

1

3

11

3

1

4

9 1 3 1 14

3

3

111

3

21

3

11114

1

1

11316

1

12

22

2

215

11

2

2

21

14

221

5

11

11

1

1

11

1

1

213

6

1

1

1

1

2

1

1

1113

2

215

11 22

2 4 11 11

1

1

11

1

1

213

6

1

1

2

Georgia

1125 174 237 225 1761

182 81 135 174 572

125 52 91 113 381

Total Deaths Reviewed <1 1-4 5-14 15-17 Total

1

1

2

2

1113

4

217

211

4

32

5

1

23

11

1

1

2

11

1

1

414

9

1

1

2

167 76 112 129 484

43

APPENDIX F DEFINITIONS OF TERMS AND ABBREVIATIONS USED IN THIS REPORT

A-A African-American
Child Abuse Protocol Committee County level representatives from the office of the sheriff, county department of family and children services, office of the district attorney, juvenile court, magistrate court, county board of education, office of the chief of police, office of the chief of police of the largest municipality in county, and office of the coroner or medical examiner. The committee is charged with developing local protocols to investigate and prosecute alleged cases of child abuse.
Child Fatality Review Report A standardized form required for collecting data on child fatalities meeting the criteria for review by child fatality review committees.
Child Fatality Review Committee County level representatives from the office of the coroner or medical examiner, county department of family and children services, public health department, juvenile court, office of the district attorney, law enforcement, and mental health.
Eligible Death Death meeting the criteria for review including death resulting from SIDS, unintentional injuries, intentional injuries, medical conditions when unattended by a physician, or any manner that is suspicious or unusual.
Form 1 A standardized form required for collecting data on all child fatalities by corners or medical examiners.
Injury Refers to any force whether it be physical, chemical (poisoning), thermal (fire), or electrical that resulted in death.
Intentional Refers to the act that resulted in death being one that was deliberate, willful, or planned.
Medical Cause Refers to death resulting from a natural cause other than SIDS.
Natural Cause Refers to death resulting from an inherent, existing condition. Natural causes include congenital anomalies, diseases of the nervous system, diseases of the respiratory system, other medical causes and SIDS.

"Other" Race Refers to those of Asian, Pacific Islander, or Native American origin.
"Other" as Category of Death Includes deaths from suffocation, choking, poisoning, and falls (unless otherwise indicated).
Perpetrator Person(s) who committed an act that resulted in the death of a child.
Preventable Death One in which with retrospective analysis it is determined that a reasonable intervention could have prevented the death. Interventions include medical, educational, social, legal, technological, or psychological.
Reviewed Death Death which has been reviewed by a local child fatality review committee and a completed Child Fatality Review Report has been submitted to the Georgia Child Fatality Review Panel.
Risk Factor Refers to persons, things, events, etc. that put an individual at an increased likelihood of dying.
Georgia Child Fatality Review Panel An appointed body of 16 representatives that oversees the county child fatality review process, reports to the governor annually on the incidence of child deaths, and recommends prevention measures based on the data.
Sudden Infant Death Syndrome (SIDS) Sudden death of an infant under one year of age which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene and review of the clinical history. In this report, SIDS is not considered a "medical" cause.
Trend Refers to changes occurring in the number and distribution of child deaths. In this report, the actual number of deaths for each cause is relatively small for the purpose of statistical analysis, which causes some uncertainty in estimating the risk of death. Therefore, caution is advised in making conclusions based on these year-to-year changes which may only reflect statistical fluctuations.
Unintentional Death Refers to the act that resulted in death being one that was not deliberate, willful, or planned.

44