Child death
review council
hopes to learn
how to protect

Under a new law, deaths of all
children in Hawaii will be
reviewed starting in November

By Lori Tighe
Star-Bulletin

For 10 years, advocates in Hawaii tried to pass a law to mandate review of all child deaths. Experts from courts to hospitals to the state desperately wanted to answer the question, "Why did this child have to die?"

But the advocates struggled. "We didn't have a unified front," said Loretta Fuddy, chief of Maternal and Child Health in the state's Department of Health.

Until last year. A coalition of groups finally banded together and convinced the Legislature to pass the state's first Child Death Review System -- the 39th in the United States. It will begin in November to dissect and analyze child deaths for wisdom to prevent future ones.

"About 200 children die in Hawaii a year," said Fuddy, coordinator of the state Child Death Review Council. "Half are injury-related and half are medical conditions. We want to understand the deaths that can be prevented."

As in Hawaii, injuries are the leading cause of fatalities for children ages 1 to 19, killing about half of the 60,000 children who die in the United States each year, says the American Bar Association Center on Children and the Law.

Hawaii's new Child Death Review System's mission is "to reduce preventable child deaths through systematic, multidisciplinary and interagency review of all child deaths."

Deaths of children under age 18 will be reviewed by the system.

Fuddy will screen all child deaths to decide which will be reviewed by a local team. Oahu and most islands will have a local team.

Reviewers include a wide array of experts from such agencies as the state Judiciary, American Academy of Pediatrics, Child and Parent Advocates, Children's Advocacy Centers, Honolulu Medical Examiner's Office and the state departments of Education, Health and Human Services.

Children who die from medically nondisputable deaths attributed to a condition or disease such as cancer won't be reviewed.

"One thing we find: We need better training documenting a child's death," Fuddy said.

National child-death review experts this week will train many of the state's reviewers on what information to look for, how to collaborate and what the information can reveal.

Scott Currie, senior detective in California's Corona Police Department and member of the Riverside County Child Death Review Committee for seven years, said "a lot of good" can come from a child death review system.

"Kids have everything to gain, primarily protection," said Currie, who will speak at the Hawaii Child Death Review System intensive training conference at the Outrigger Prince Kuhio Hotel Wednesday and Thursday.

The first year Currie joined his county's death review committee, 12 children died of suspected sudden infant death syndrome. The county began educating parents to lay their babies to sleep on their backs to avoid SIDS, and this year the county has had no SIDS cases to date, he said.

Another trend emerged this year in Riverside County, which is near Los Angeles, Currie said. Nine children were injured and two died from swimming pool accidents.

"We'll be looking into public education and possible legislation on pool construction to prevent these deaths in the future," he said.

These child death review committees do not necessarily determine the final cause of death, Currie said. They are a body of professionals discussing the deaths to share information about what most likely caused them.

"The No. 1 thing I gain is knowledge," Currie said. "The No. 1 thing we as a team gain is assurance that everything was done that could have been done in investigating these deaths, and the knowledge is used for any prevention measures in the future."

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Caring for the children

Objectives of the new Child Death Review System:

To establish and maintain a state Child Death Review Council and local Child Death Review Teams;

To describe child death trends and patterns in Hawaii;

To identify the causes and circumstances surrounding every child's death;

To identify risk factors in order to recommend the development of policies, strategies and resources to prevent future child deaths;

To encourage interdisciplinary training and community prevention education through public policy recommendations;

To assure a collaborative response to prevent child deaths.