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.
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)
The autopsy report classifies the manner of death as homicide due to "Complications of blunt head trauma." The narrative states: "The presence of two separate skull fractures without explanation, diffuse axonal injury, and blood around the brain at varying ages, indicates that the manner of death is best classified as homicide." The family reported no recent injuries or falls, and the injuries occurred at multiple time points, indicating inflicted injury.
Is there any mention of malnutrition, starvation, or dehydration?
The autopsy report explicitly lists dehydration as a finding: "F. Dehydration" with sub-findings including "Dry mucosa membranes and sunken eyes," "Hypernatremic dehydration with kidney injury, by vitreous fluid analysis," elevated sodium (159), chloride (144), urea nitrogen (119), creatinine (1.3), "Polarizable crystals, renal collecting ducts," and "Decreased appetite prior to death." The narrative also states the child's "altered mental status (decreased appetite, change in sleeping patterns, and eventual unresponsiveness) is likely secondary to her injuries and subsequent dehydration."
Is there any mention of medical neglect?
The autopsy report documents that the child had injuries of different ages, with some dating 13–25 days before death, and that she exhibited declining symptoms ("decreased appetite and a change in sleep patterns") in the days leading up to death. She was found to have "Hypernatremic dehydration with kidney injury" severe enough to produce sunken eyes, dry mucosa, and renal collecting duct crystals. No mention is made of medical care having been sought despite these symptoms. While the report does not use the term "medical neglect," the constellation of findings — severe dehydration with kidney injury in a symptomatic, declining infant for whom no medical attention was apparently obtained — reasonably implies it.
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)?
Is there any mention of sexual abuse?
Is there any specific mention of shaken baby or abusive head trauma?
While the terms "shaken baby syndrome" or "abusive head trauma" are not explicitly used, the autopsy findings describe the classic constellation of abusive head trauma: "Diffuse axonal injury, traumatic axonal pattern" (caused by rotational acceleration/deceleration forces), "Bilateral optic nerve sheath hemorrhages" with "Organizing subdural membrane of the right optic nerve," and "Acute and organizing subdural hemorrhages." These findings, combined with the homicide ruling in an infant, strongly imply 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)
Is there any mention of prematurity or low birthweight?
Is there a history of child protection reports prior to death (for this child or siblings)?
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?
Notable Details
Several notable details emerge from the autopsy report. First, the investigating agency is "FBI Farmington," indicating the death likely occurred on federal or tribal land (consistent with the Navajo surname "Tsosie" and San Juan County, which encompasses parts of the Navajo Nation). Second, "A bottle containing apparent herbaceous material in water is also received and saved as evidence," which may suggest traditional herbal remedies were administered to the child in lieu of or alongside professional medical care. Third, the neuropathology findings documented injuries at distinctly different ages — subdural hemorrhage components consistent with "24 hours or less prior to death" and "13-25 days prior to death," and subarachnoid hemorrhage components from "four hours or less prior to death" and "10-14 days prior to death" — suggesting at least two separate episodes of trauma to the head over a period of weeks.
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