After a thorough case investigation, the CDC says many sudden unexpected infant deaths may be explained. Poisoning, metabolic disorders, hyper or hypothermia, neglect and homicide, and suffocation are all explainable causes of SUID. The CDC points out even when a thorough investigation is conducted, it may be difficult to separate SIDS from other types of sudden unexpected infant deaths, especially accidental suffocation in bed. It is also possible that after a thorough investigation and a forensic autopsy, the cause of death may be unknown. If in fact the cause of death is undetermined, Radisch encourages medical examiners to list the cause of death as just that, “undetermined.”
In 2007, the North Carolina Office of the Chief Medical Examiner certified the cause and manner of death for 567 of the children. The majority of the deaths were classified as unintentional, accounting for 45 percent; natural deaths accounted for 35 percent; homicides 11 percent; suicides 5 percent; and in 4 percent of deaths (24) the manner in which a child died could not be determined.
“No one knows how a case will turn out at the onset,” Mayhew says. “That is what the investigative process is for and why it is so important. Regardless of circumstances, every death should receive attention. I don’t care how cliche it may sound, when people die, we are their voice, and they deserve all we can give them. Also, the parents deserve to know how their child died. I personally feel that I work for them as much as I do the state, even though the answers are not always what they want to hear.”