The 16-day-old male child was born prematurely on 10/29/2022 at approximately 33 weeks gestation, weighing 3.9 pounds, after his mother went into spontaneous labor. The mother had been unaware of how far along she was in the pregnancy and had a termination scheduled for 10/31/22. The child tested positive for cocaine at birth, exhibited withdrawal symptoms, was underweight, and required supplemental oxygen. He was admitted to the neonatal intensive care unit. Around 11/4/22, the child was transferred to a second hospital due to respiratory distress, where he decompensated, experiencing respiratory failure, shock, and multi-organ dysfunction. Despite maximum medical interventions, the child's condition continued to decline. He passed away on 11/14/22 in his mother's arms from a congenital heart defect (interrupted aortic arch). Medical staff confirmed there was no connection between the mother's substance use or lack of prenatal care and the child's death. The death was ruled natural.
Contexts/Conditions
Is there any mention of child drug ingestion or overdose?
Is there any mention of a drowning incident (either intentional or accidental)?
Is there any mention of a firearm incident?
Is there any mention of inappropriate supervision (e.g., child wandered off and drowned)?
Is there any mention of inflicted injury? (e.g. slapped, punched, kicked, choked)
Is there any mention of malnutrition, starvation, or dehydration?
Is there any mention of medical neglect?
Is there any mention of a motor vehicle crash or incident?
Is there any mention of a murder-suicide incident?
Is there any mention of outdoor elements (including hot car deaths)?
Is there any mention of prenatal substance exposure (including fetal alcohol syndrome or neonatal abstinence syndrome)?
The fatality report explicitly states the child "was born prematurely, positive for cocaine, experiencing withdrawal, and underweight." The report further notes that the infant was "Born: With a positive toxicology" and "Exhibiting withdrawal symptoms." The mother "Had a positive toxicology at the time of delivery" and "Used illicit drugs" and "Had heavy alcohol use" during pregnancy.
Is there any mention of sexual abuse?
Is there any specific mention of shaken baby or abusive head trauma?
Is there any mention of prolonged abuse or torture (including restraints, captivity)?
Is there any mention of an unsafe sleeping environment?
Individuals Involved
Was an adoptive parent or guardian involved in the death?
Was a biological father involved in the death?
Was a biological mother involved in the death?
Was a day care worker, babysitter, or nanny involved in the death?
Was a female paramour or friend involved in the death (e.g., girlfriend, stepmother)?
Was a foster parent involved in the death?
Was a male paramour or friend involved in the death (e.g., boyfriend, stepfather)?
Was another adult relative involved in the death? (e.g., grandfather, aunt)
Was a sibling involved in the death?
Child Characteristics
Was the child adopted?
Was the child homeschooled (including "cyberschooling") or taken out of school?
Was the child in foster care at the time of the incident?
Was the child living with relatives at the time of the incident (but not parents)?
Is there any mention of a neurological developmental child disability? (e.g., autism, intellectual disability, nonverbal)
Is there any mention of a physical child disability? (e.g., feeding tube)
The fatality report states the child was born with "a cardiac condition" and "an interrupted aortic arch," a congenital heart defect that required the child to be hospitalized in the NICU from birth. The child also "required supplemental oxygen" and was transferred to a second hospital for a higher level of care due to respiratory distress.
Is there any mention of prematurity or low birthweight?
The fatality report explicitly states the child "was born prematurely" at "approximately 33 weeks gestation" and "weighed 3.9 pounds." The child was described as "underweight" and having "low birth weight" among his health complications.
Is there a history of child protection reports prior to death (for this child or siblings)?
The fatality report documents a CPS report received on 10/31/2022 (when the child was 2 days old) regarding the mother and child testing positive for cocaine at delivery, the child's withdrawal symptoms, and the mother lacking necessities for the child. This report predates the child's death on 11/14/2022 and was an open investigation at the time of the fatality. The report is listed under "CPS - Investigative History Three Years Prior to the Fatality."
Does the child have a history of foster care (but not in care at time of incident)?
Is there a history of a sibling death (separate incident from this death)?
Parent/Caregiver Factors
Was an adult charged or arrested for the child's death?
Is domestic violence by the parent/caregiver referenced?
Is there any mention that the death occurred in a temporary shelter or while homeless?
Is an intellectual disability of the parent/caregiver referenced?
Is the mental health of the parent/caregiver referenced?
Is a history of arrests or criminal charges for the parent/caregiver referenced?
Is substance use by the parent/caregiver referenced?
The fatality report extensively documents the mother's substance use: "The mother used cocaine prior to the confirmed pregnancy, as well as once after, on or around 10/27/22." Additionally, "the mother consumed alcohol during the pregnancy." The CPS report summary also states: "Until August 2022, the mother used cocaine, MDMA, mushrooms, and consumed alcohol." The father confirmed knowledge of the mother's cocaine use.
Notable Details
The fatality report identifies several notable compliance and systemic issues: (1) ACS did not learn of the child's death until 11/22/22, eight days after the child died on 11/14/22, despite having an open investigation. (2) ACS then failed to notify the Regional Office within the required 24 hours, not doing so until 12/1/22—nine days after learning of the death—violating 18 NYCRR 441.7(c). (3) The report notes that "The record did not reflect if the mother was specifically provided substance use referrals, as recommended by the Credentialed Alcoholism and Substance Abuse Counselor consultation held on 11/7/22," indicating a gap in follow-through on a recommended service. (4) The New York City region does not have an OCFS approved Child Fatality Review Team, so the fatality was not referred to one.
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