A Multidisciplinary Approach to Trauma Analysis in Cases of Child Fatality

Child fatality is an issue of social and forensic significance. Due to the complex nature of these cases, it can be difficult to determine the cause and manner of death (referred to as equivocal death), particularly when differentiating between accidental and inflicted traumatic fatalities. Finite Element Modeling is a tool typically used to elucidate the etiology of fractures. This thesis utilizes a multidisciplinary approach to research the frequency of equivocal deaths among juveniles and the usefulness of FEM as a solution to diagnosing skeletal trauma. The first component examines the problem of misdiagnosed manner of death through retrospective case examinations in Pasco County, Florida, and the second aspect of the study examines the efficacy of Finite Element Modeling in trauma research by comparing two simple hemispherical models that approximate the neurocranium. The child fatality study examines 84 cases of child fatalities in Pasco County, Florida, and finds that the demographic characteristics of the decedents given their relationship to the perpetrator closely mirrored those findings in the published literature. Similarly, the age breakdown of decedents mirrors other studies on child fatalities, where infants and teenagers are most at risk of violent deaths. Most importantly, equivocal deaths were more present in the dataset than previously thought, and nine cases were possibly misdiagnosed in terms of manner of death. The modeling component of this study demonstrates that FEM may not be the most appropriate method of computational modeling due to the restrictiveness of the meshes that are used to create the individual elements in the model. Experimentation with meshfree modeling techniques that allow for more realistic fracture propagation are needed, as well as patient-specific modeling. Finally, skeletal surveys through direct observation and other modes of anthropological analysis in the autopsies of child fatalities are highly encouraged given the results of this study