The Legal Dangers of SIDS Investigations

SIDS, commonly known as Sudden Infant Death Syndrome, has an air of mystery around it.  Even though many people have heard of the SIDS diagnosis, they have no idea what it actually is. Sudden Infant Death Syndrome (“SIDS”) is defined as the inability to make a diagnosis.[1] Physicians only label an infant’s cause of death as SIDS after they have exhausted every other possible cause of death. Physicians, lawyers, and parents alike have been struggling with finding the cause of SIDS for centuries. The only thing that is generally known about SIDS is that, for whatever reason, the infant stops breathing causing his or her death. There have been many theories as to the cause of the syndrome, but no one particular theory has been proven to be true as of yet.

            One theory, concocted by Dr. Steinschneider, was that a connection between infants who suffer from apnea and infants who are diagnosed with SIDS existed.[2] Apnea is the obstruction of an infant’s breathing repeatedly throughout the night.[3] Dr. Steinschneider conducted tests in which he would use monitors to record infants’ breathing throughout the night.[4] Regardless of the fact that there was no scientific evidence proving that these apnea monitors protected against SIDS, Dr. Steinschneider concluded that monitor use was responsible for a drop in SIDS related deaths.[5] Unfortunately for Dr. Steinschneider, his conclusions were quickly found to lack any scientific merit when Waneta Hoyt, the mother of two children he used in his studies, admitted to smothering all five of her kids twenty seven years after the fact.[6] After this shocking revelation, there was no other option but to explore the darker theory behind SIDS, infanticide.

            The more heinous theory, and one that no one wants to believe could be the actual cause of infant death, is that SIDS is just a masquerade for infanticide. Death by smothering can be easily mistaken for SIDS. This is because infants are so young that they do not have the strength or ability to fight back when being smothered.[7] Therefore, when the coroner conducts an autopsy, they find no signs of struggle and are unable to distinguish between an infant’s inability to breathe on their own and an infant being slowly smothered.[8] See also People v. Eberle, 265 A.D.2d 881, 697 N.Y.S.2d 218 (4th Dep’t 1999) (where an autopsy report supported both suffocation and SIDS as cause of death, so expert had to base opinion on statements made by defendant instead of evidence). To add to this, since many physicians believed that SIDS was caused by apnea, they were not conducting autopsies on the bodies of infants who died of SIDS and police were not investigating the scenes of death.[9] These issues made it nearly impossible to reopen past cases of infants who died of SIDS and to reexamine their causes of death. Once Dr. Steinschneider’s apnea studies were found to be unwarranted, the medical community started taking SIDS very seriously. Doctors began requiring that children’s medical records be reviewed and that the scene of death be examined in an effort to rule out infanticide.[10]

            SIDS has not only had an impact on the medical community, but it has also greatly affected the legal community. Because of Dr. Steinschneider’s misguided studies, prosecutors have had a very hard time prosecuting cases involving SIDS. Prosecutors had no way of proving beyond a reasonable doubt that an infant was smothered to death, and if they did decide to press charges, they were running the risk of causing even more trauma and emotional distress to parents who lost their children to natural causes.[11]

            When dealing with SIDS cases, it is also important to examine the parents of the child and to look at whether they have any underlying health issues that need to be addressed. In prior studies, there have been links found between SIDS and Munchausen Syndrome by Proxy.[12] Munchausen Syndrome by Proxy is a mental health problem where an individual diagnoses their child with an illness or injury that the child does not have.[13] In some cases, the individuals actually cause the child’s illness or injury to gain sympathy from others because of their own implicit health issues. There are different kinds of Munchausen syndrome, but the specific kind that relates to SIDS is the “active inducer.”[14] Active inducers physically abuse children and are responsible for creating the children’s symptoms. It is thought that they do this to hide their own mental illness.[15] These individuals want to portray themselves as exceptional parents, so they take their children to the hospital immediately after causing the injury or illness.[16] Active inducers have been specifically known to abuse children by asphyxiation or repeated smothering and resuscitation.[17]

This is where Munchausen syndrome intersects with SIDS. Parents who have Munchausen Syndrome will often suffocate their children and rush them to the hospital where they claim that the infant stopped breathing on their own. For example, in 1990, a study of fifty-one apnea monitoring programs was conducted and revealed that forty percent of the programs treated patients whose apnea appeared to be induced by the parent.[18] Once the infants were admitted into the hospital and kept under watch, medical professionals were unable to confirm any symptoms of apnea.[19] In 1997, one physician even went as far as placing cameras in hospital rooms to watch interactions between parents who were suspected of abuse and their infants.[20] Of the thirty nine infants that were monitored, thirty three were being intentionally suffocated by their parents on camera.[21] Not only that, but some of the infants involved in the study had siblings who had previously passed away from SIDS.[22] This study showed that not only were the parents suffocating their children and causing their hospitalization, but some of the parents were likely to have already gotten away with infanticide once before.  In 2007, ten years later, suspicious SIDS cases were unfortunately still being reported. One specific case involved a mother taking her infant daughter to eleven different hospitals for a variety of reasons. Not one of the hospitals found anything out of the ordinary with the little girl, yet she ended up dying under suspicious circumstances which were investigated by the police.[23]

            A SIDS diagnosis does not automatically mean that the infant was smothered by their parents or caretakers. There have been other factors that have been linked to the cause of SIDS such as brain abnormalities, low birth weight, and respiratory infections.[24] Doctors inform parents to be careful when swaddling their babies and to place them on their backs when putting them to sleep because babies who have died from SIDS have been known to sleep on their sides or stomachs.  Even though a SIDS death can be due to natural causes, the medical community cannot deny that at least some infant deaths that have been diagnosed as SIDS have actually been caused by infanticide.  However, because SIDS and intentional trauma are so difficult to identify and investigate, the legal system could frequently mistake abuse for accident and accident for abuse.

[1] 17:12 SUDDEN INFANT DEATH SYNDROME; Handling Child Custody, Abuse and Adoption Cases § 17:12

[2] Catherine L. Goldenberg, Sudden Infant Death Syndrome As A Mask for Murder: Investigating and Prosecuting Infanticide, 28 Sw. U.L. Rev. 599 (1999)

[3] Pediatric obstructive sleep apnea, Mayo Clinic, http://www.mayoclinic.org/diseases-conditions/pediatric-sleep-apnea/basics/definition/con-20035990 (last visited Jul 9, 2016).

[4] Id.

[5] Id.

[6] Id.

[7] Handling Child Custody, Abuse and Adoption Cases § 17:12

[8] Id.

[9] Catherine L. Goldenberg, Sudden Infant Death Syndrome As A Mask for Murder: Investigating and Prosecuting Infanticide, 28 Sw. U.L. Rev. 599 (1999)

[10] Id.

[11] Id.

[12] Kathleen R. Miller, Detecting the Undetectable: An Examination of the Intersection Between Sudden Infant Death Syndrome and Munchausen by Proxy Syndrome, 5 Conn. Pub. Int. L.J. 287 (2006)

[13] Munchausen Syndrome by Proxy, WebMD (2014), http://www.webmd.com/mental-health/tc/munchausen-syndrome-by-proxy-topic-overview (last visited Jun 9, 2016).

[14] Catherine L. Goldenberg, Sudden Infant Death Syndrome As A Mask for Murder: Investigating and Prosecuting Infanticide, 28 Sw. U.L. Rev. 599 (1999)

[15] Id.

[16] Id.

[17] Id.

[18] Michael J. Light & Mary S. Sheridan, Munchausen Syndrome by Proxy and Apnea (MBPA): A Survey of Apnea Programs, 29 Clinical Pediatrics 162, 162 (1990) (citation omitted).

[19] Id.

[20] David P. Southall et al., Covert Video Recordings of Life-Threatening Child Abuse: Lessons for Child Protection, 100 Pediatrics 735, 735 (1997).

[21] Id.

[22] Id.

[23] http://www.ncbi.nlm.nih.gov/pubmed/17970367

[24] http://www.mayoclinic.org/diseases-conditions/sudden-infant-death-syndrome/basics/risk-factors/con-20020269

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