Investigation fatalities in children requires special expertise because injury patterns are different than in adults and may be quite subtle. Children who are repeatedly battered may present with multiple types and ages of injuries. Some may have no visible external injuries but have fatal organ damage internally, such as a ruptured liver. There may be few or no injuries to the head as in the case of a baby who is violently shaken.
Essential to a correct diagnosis in all infant deaths is the history. The medical personnel who first see these children and interact with the families have the best opportunity to find out from the caregiver what occurred. All statements should be recorded shortly after they have been made. Frequently, the history of how an injury occurred is inconsistent with the pattern and type of injury discovered by the pathologist.
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