INFANT ABANDONMENT AND MALTREATMENT

2001-2015

North Carolina’s Office of the Chief Medical Examiner 2017North Carolina Child Fatality Prevention Team

Kerry Robbins, MS Lisa Mayhew, MS

Meghan Shanahan, Ph.D. Mary Bynum

Legal Outcomes

▪ 2008-2013

▪ Data

▪ Victim, suspect/perpetrator demographics

▪ Legal information

▪ Location of incident

▪ Relationship of suspect/perpetrator to decedent

▪ Primarily biological mother and father

▪ Legal outcomes database use

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OBJECTIVES

1. Quantify infant abandonment

deaths(first year of life) from 2001-2015

NC OCME 2017

2. Quantify all infant maltreatment deaths (first 3 months) from

2001-2015

Outline

All Infant Death

• Accidental • Homicide• Undetermined• Suicide• Natural

Abandonment:Child left not cared for can include:

AsphyxiaDrowningBlunt in nature

Maltreatment:Abuse and neglect

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Definitions

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Abandoned Infant Deaths• 0-11 months• Viability

• Fetus born at gestational age termed viable ( >22 weeks)

• Live birth• If clearly stated live birth,

counted• If clearly stated not a live birth,

did not count• If unknown, but viable, counted

Infant Maltreatment Deaths• 0-90 days• Maltreatment: abuse and neglect

(WHO)

1. QUANTIFY INFANT ABANDONMENT DEATHS FROM 2001-2015

NC OCME 2017

Infant Fatalities age 0 through 11 months from 2001-2015

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Total: 3,203

Accidents: 572

Homicide: 168

Undetermined: 672

Natural: 1,851

0

500

1000

1500

2000

2500

3000

Accidents Homicides Undetermined Natural

Infant Fatality 2001-2015

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Infant Fatalities age 0 through 11 months from 2001-2015

0

5

10

15

20

25

30

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Abandoned infants

Rate per 100,000

Infant Fatality 2001-2015 By Manner—Accident

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2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Number 31 33 32 40 55 42 48 41 31 32 37 42 34 28 36

0

100

200

300

400

500

Infant Fatalities: Accidents

Infant Fatality 2001-2015 By Manner—Homicide

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2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Number 8 15 10 12 20 16 14 15 6 5 3 13 13 6 11

0

20

40

60

80

100

120

140

160

Infant fatalities: Homicides

Infant Fatality 2001-2015 By Manner—Natural

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2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Number 159 143 156 156 163 143 159 190 164 101 86 68 58 62 34

0

200

400

600

800

1000

1200

1400

1600

1800

Infant Fatalities: Natural

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Number 7 22 15 14 6 17 20 26 50 69 70 88 75 103 104

0

100

200

300

400

500

600

Infant Fatalities: Undetermined

Infant Fatality 2001-2015 By Manner—Undetermined

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Yearly Comparison

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2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Accident 1

Homicide 1 3 2 3 4 4 1 1

Natural 1 1 1 1

Undetermined 1 1 1 1 1

Total 4 3 3 3 6 1 4 1 2 1 1

Full Picture

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• Abandoned Infants• Accident: 2002• Homicide: 2001, 2002 (3), 2003 (2), 2004 (3), 2005 (4), 2007 (4), 2009, 2011• Undetermined: 2001, 2005, 2006, 2012, 2014• Natural: 2001, 2003, 2005, 2011

Total: 29

Responsible adult

Age (years)

Mother 14 Over 18 3

Father 0 Under 18 11

Other 0 Unknown 16

Unknown 16

Age (of infant)

0 15

1 day 13

2 day 1

Context

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Means Number of infant fatalities

Medical Treatment 18

Gun 6

Fire, burns, carbon monoxide 19

Blunt 128

Asphyxia 366

Drowning 26

2. QUANTIFY ALL INFANT MALTREATMENT DEATHS WITHIN THE FIRST 3 MONTHS

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Infant Maltreatment Fatalities age 0-90 days from 2001-2015

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Total: 1,833

Accidents: 279

Homicide:71

Undetermined: 390

Natural: 1,087

0

200

400

600

800

1000

1200

1400

1600

1800

Accidental Homicides Undetermined Natural

Infant Maltreatment Deaths

2001-2015

Infant Maltreatment Fatalities age 0-90 days from 2001-2015

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0

10

20

30

40

50

60

70

80

90

100

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Maltreated infants

Rate per 100,000

Infant Maltreatment (0-90 days) 2001-2015 By Manner—Accident

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Total Infant Deaths-Accident

2001 152002 162003 172004 252005 312006 182007 262008 172009 122010 142011 172012 242013 172014 112015 19 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Number 1 2 0 0 1 0 1 1 0 0 1 0 0 0 0

0

2

4

6

8

10

12

14

16

Infant Maltreatment: Accidents

Infant Maltreatment (0-90 days) 2001-2015 By Manner—Homicide

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Total Infant Deaths-Homicide

2001 42002 72003 32004 62005 112006 102007 52008 72009 32010 12011 22012 22013 22014 32015 4 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Number 4 6 3 6 10 10 4 4 2 3 1 1 2 3 4

0

10

20

30

40

50

60

70

80

Infant Maltreatment: Homicides

Infant Maltreatment (0-90 days) 2001-2015 By Manner—Undetermined

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Total Infant Deaths-Undetermined

2001 52002 102003 102004 122005 52006 102007 102008 132009 302010 262011 392012 572013 472014 632015 53 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

Number 0 1 1 0 1 1 0 0 0 2 1 2 0 2 0

0

1

2

3

4

5

6

7

8

9

10

Number

Full Picture

▪ Infant Maltreatment related deaths▪ Accident: 7

▪ Homicide: 64

▪ Undetermined: 11

▪ Natural: 0

Total: 82

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Infant Deaths Means

Animals 1

Asphyxia 8

Blunt 39

Drowning 4

Environmental 1

Exposure 6

Fire 1

Motor Vehicle 3

Other 5

Sharp 2

Toxin 1

Unknown 11

Yearly Comparison

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2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Total

Accident 1 2 0 0 1 0 1 1 0 0 1 0 0 0 0 7

Homicide 5 6 3 6 10 10 4 4 2 3 1 1 2 3 4 64

Undetermined 0 1 1 0 1 1 0 0 0 2 1 2 0 2 0 11

Total 6 9 4 6 12 11 5 5 2 5 3 3 2 5 4

Demographics

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Infant Maltreatment-child demographics

Sex Race Hispanic

Male: 52 Black: 31 Yes: 10

Female: 31 White: 39 No: 71

Unknown: 1 Unknown 12 Unknown: 2

Infant Maltreatment- caregiver demographics

Responsible adult Age (years)

Mother 33 Over 18 15

Father 28 Under 18 10

Parents 2 Unknown 57

Other 5

Unknown 14

Take Away

▪ Abandoned infants▪ A decrease in deaths attributed to abandoned infants after the passing of the law.

▪ Overall infant fatality within the first year: asphyxia and blunt and take the lead.

▪ Mechanisms first 24 hours

▪ Toxin, Asphyxia, Drowning, Sharp, Gun, Unknown, Exposure

▪ Infant Maltreatment▪ Method of injury: Blunt

▪ Primarily from mother or father as the perpetrator

▪ Overall, either seeing a decrease or no change▪ Decrease in abandoned infants

▪ Deaths in first 3 months of life, steady

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