SUMMARY OF DEATH
Maddison Tsosie was an infant girl (age 0 years, born 2022) who died on April 28, 2023, in San Juan County, New Mexico. In the days leading up to her death, she exhibited decreased appetite and changes in sleep patterns. Family reported no recent injuries or falls. Autopsy revealed two separate skull fractures (left parietal and left occipitoparietal), acute and organizing subdural and subarachnoid hemorrhages of differing ages (some hours old, others 10–25 days old), diffuse axonal injury in a traumatic pattern, bilateral optic nerve sheath hemorrhages, severe hypernatremic dehydration with kidney injury, and bilateral pulmonary thromboemboli. The cause of death was complications of blunt head trauma, and the manner of death was ruled homicide, based on the unexplained skull fractures, diffuse axonal injury, and intracranial hemorrhages of varying ages indicating at least two separate episodes of inflicted head trauma.