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PUBLIC FATALITY INQUIRY MEDICAL EXAMINER REBECCA J.'S REPORT CASE #6483
The baby died later on the next morning. Mario Dottori died from what is called, shaken baby syndrome. When this occurs the infant’s brain swells when it is shaken inside the skull. Brain cells are also destroyed. For this to cause severe, life threatening damage it takes up to 40 to 50 shakes (sometimes less). The child becomes unconscious and has central nervous system dysfunction. When it reaches this level the brain is beyond repair.
The reason this death is
being investigated is because the deceased was in for his checkups and
vaccinations, so it was not a death that was happening long term. The
death took about five hours to happen. The infant was unattended during
its death. At first nobody knew the baby was injured. It was not until
the next morning at 4 AM, when the mother knew that her baby was not
breathing. The parents rushed the baby to the hospital. The cause of
death was unknown. Thus sudden death. A healthy cell consists
of many things. One of which is healthy organelles such as the nucleus,
cytoplasm, or vacuole. All parts of the cell must work together to create
a healthy cell. The cell must be able to take in oxygen then use it
and distribute carbon dioxide on the outside of the body. Different
cells such as the muscle cells work with other muscle cells to create
a healthy muscle tissue. When a baby’s brain
is shaken, many things occur. The brain tissues bruise and swell. The
blood vessels tear and the blood pools inside of the skull. When the
blood pools in the skull it creates pressure. That is when brain abnormalities
occur. The cells are being pushed together and some are destroyed. The
mitochondria needs more oxygen than most of the other organelles. When
the brain hemorrhages the mitochondria cannot get as much oxygen as
it needs. So the cell membrane is not letting in oxygen and out carbon
dioxide as fast as the mitochondria needs it. That is when the cell
dies. Without those cells the brain tissues cannot function correctly.
When the tissues don’t work correctly, the nervous system malfunctions
creating chaos throughout the rest of the systems. When the baby was
shaken it created a brain hemorrhage. The brain was swollen and bruised.
When an autopsy was performed the brain had pools of blood throughout
the tissues. The tissues were torn and so were the blood vessels. Healthy
tissues can use oxygen and release carbon dioxide. An unhealthy tissue
cannot take in oxygen as quickly and cannot function without all of
the cells which were in the tissue before the brain was shaken. Dead
tissues do not take in oxygen at all. The cells inside of the tissues
are dead. When the brain itself does not perform its functions, the
rest of the systems in the body do not work properly with the brain
not telling them what to do correctly. When a brain cell dies, the tissue of the brain cannot function correctly, and when that happens, the brain sends incorrect signals to the rest of the systems in the body. The body malfunctions by doing things such as causing unconsciousness, temporary blindness, seizures, and many other life threatening or non life-threatening injuries. Some of these injuries unfortunately
cause death. To prevent such incidents from happening to your baby, you can do some of these things. You can make sure you let a responsible adult take care of the child when you are under the influence of alcohol. DO NOT SHAKE AN INFANT! Any shaking whatsoever to the toddler may cause learning disabilities, vision problems, hearing problems, seizures or even death. Click here for more information on Shaken Baby Syndrome.
PUBLIC FATALITY INQUIRY MEDICAL EXAMINER HEATHER'S REPORT CASE #3451
Who Died: Charlotte Downs
68 years old, 5' 5'', 190 lbs, gray hair, blue eyes, Caucasian female,
Habits/lifestyle/medical
history: has had eight children, smokes a pack a day, one glass of wine
every dinner, travels a lot, does yoga daily, eats a lot of candy and
fatty foods and junk food. Where did she die: Highway
# 1, going east, 58 km west of Medicine Hat When did she die? July 1st,
2002, 14:21 Why did she die? Brain injuries
from crash, crash due to a stroke How did she die: Mrs. Downs
was driving on Highway 1 east bound 58 km from Medicine Hat. The visibility
was prefect and road conditions were excellent. She had a stroke and
lost control of the car. The car crashed into the car ahead of her and
she was then rear-ended by a van. She was dead when paramedics reached
her. She died of brain injuries. Her car did not have an air bag. Notes: This death is being investigated
because it appears to be a violent or unnatural death. There is no apparent
reason for the crash as it was a clear sunny day and road conditions
were excellent. Medical cause of death -
background information: 1. Stroke- a stroke occurs
when the blood supply to the brain is cut off and the cell in that particular
area die due to lack of oxygen. This causes serious and permanent damage.
As the function that these particular cells performed can no longer
be carried out. There are three types of strokes; cerebral thrombosis,
cerebral embolism and cerebral hemorrhage each with its own characteristics.
The type of stroke we are looking at today is the cerebral thrombosis.
This type of stroke occurs when a blood clot forms in an artery going
to the brain. A fatty material called plaque has already narrowed this
artery. The clot gets stuck in the artery clogging the path causing
the damage described above. 2. Brain damage - occurs
when the brain is damaged in some form or another. There are many injuries
that can cause considerable damage including a fracture to the skull,
infection of the cells due to fracture, bleeding under the skull, brain
swelling and the leaking of cerebrospinal fluid. All of which can be
consist with a trauma to the head. The cells of Mrs. Down's brain were in varying states of damage. Many of the cells were not visible as cell alotoysis had occurred and the cells had broken up and disintegrated. This was found in the cerebellum and frontal and parietal lobes. Many of the cells still intact were bleeding microscopically (necrosis). The red blood cells were all spread out, not in vessels. In terms of osmosis in a healthy cell the two main substances are sodium and potassium. Inside the cell there should be a high level of potassium, on the outside high in sodium. However tests showed mainly the opposite, a common occurrence when trauma and death occur. Enough cells were damaged so that the basic functioning of her brain could not be carried out. Healthy Cells A healthy cell is one that is functioning properly. This means that all the organelles are present, health and doing their job. As brain cells the neurons must send out electronic messages.
Organ and Tissue Damage The tissues of Mrs. Down's
brain were torn and shredded. The durra matter was torn. Fragments of
bone were found on the surface of the brain. Blood and cerebral spinal
fluid was mixed. On the organ level the brain was severely injured in
the MVA (motor vehicle accident) the victim had a coup countercoup accident
this means that upon impact the brain in fluid slammed forward against
the front of the skull, this damaged the frontal lobe. Her brain then
bounced off and hit the back off the skull injuring the cerebellum and
parietal lobe. This action was again repeated when the car was hit from
the rear. Over a short period of time this caused massive damage due
to bleeding and bruising. The brain could not send out it electronic
messages. This enables the other organs to not function; in turn causes
Mrs. Down as to die. To give an example, when the part of the brain
responsible for involuntary muscle movement shut down, the heart stopped
pumping which in turn starves all the other cells in the body of oxygen.
System Shutdown Because cells quit working
the tissues could not functioning properly because the tissues were
breaking up, disintegrating and over all shutting down, the organs could
not function. Its kind of like the saying two wrongs don't make a right.
Three unhealthy tissues don't make a functioning organ. Because the
most damage occurred in the nervous system that was the first system
to shut down. The nervous system is one of the most important systems,
as the body cannot live for more than a few minutes without it. When
the nervous systems shuts down all the other systems cannot function.
The lungs do not breathe in air. The heart doesn't pump, no food is
digested, no wastes are excreted and so on. This leads to sudden death
because the whole body loses direction and instruction and dies.
Recommendations The cause of Mrs. Down's death was brain injuries, but if she hadn't had the stroke she would be alive and well today. The fact that she was in the car at the time of her loss of consciousness, played a large factor in her death. So what we are trying to prevent would be stroke. The risk of having a stroke depends on several different factors. Some of them you cannot control such as family history. Your risk increases its self if someone in your family has had a stroke. Other factors include age, gender and race. Factors you can control are diet, amount of exercise and whether you smoke or not. Research has shown that people who drink in moderation have a decreased risk of stroke. Doctors also say that taking a low dosage of Aspirin daily also decreases your risk. So if you have a healthy overall lifestyle your risks decrease. Lifestyle Choices for preventing stroke in adults:
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