Review of Crib Bumper Deaths Analysis
Review of Crib Bumper Deaths
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Review bumper deaths in cribs from our 2016
Journal of Pediatrics article.
–
43 of the 48 deaths match deaths reviewed in
CPSC’s 2016 staff briefing package.
–
5 bumper deaths from the 1980s not reviewed by
CPSC staff.
Purpose
2
Death Reports
•
37 asphyxia/suffocation
deaths specifically
describe bumper involvement:
–
“wedged between pillow and bumper pad.”
–
“face pressed against bumper pad.”
•
6 SIDS/SUID
- likely bumper-related
–
“head hanging off recliner and face pressed
against crib bumper.”
3
Bumper (Not Clutter) – 32 deaths
•
Wedging between bumper/crib mattress
(
13
),
•
Face against bumper
(
12
),
•
Arm caught between bumper and mattress/side rails --
face pressed against bumper
(
3
),
•
Wedged between crib and bureau after a likely climb
out
(
1
),
•
Strangulations from bumper tie
(
3
).
4
Bumper and Other Object – 16 deaths
•
Wedged - pillow and bumper
(
9
),
•
Wedged - recliner and bumper
(
5
),
•
Wedged - cosleeping twin and bumper
(
1
),
•
Wedged in crib depression- bumper prevented infant
from turning her face to breathe
(
1
).
5
CPSC Staff Team Review:
Addressability of 43 deaths
3
deaths considered “Likely”
17
deaths considered “Unknown”
23
deaths considered “Unlikely
CPSC Team Addressability: “Likely”
Autopsy:
Found with neck
extended and face buried
into a bumper. Nose and
mouth completely blocked
by the bumper confirmed by
lividity pattern on decedent’s
face.
Autopsy
: Decedent found
dead in a crib with her face
into a bumper pad.
Death Certificate
:
Suffocated in corner of crib
against crib bumper.
No photographs
Case #42
Case #32
Case #30
Autopsy:
Positional asphyxia
while laying (sic) face down in
thick, soft crib bumper
padding at the corner of the
crib.
7
Face Against Bumper (Case #20)
Death Certificate:
Positional Asphyxia
Autopsy
:
“infant's face [found] in a corner of the crib
and
covered by a pad along the edge of the crib,
which would cause asphyxiation due to obstruction
of airflow.
A crease noted on the infant's forehead is
consistent with an impression from the edge of the
crib and further supports this conclusion.”
Narrative
:
Pediatric forensic pathologist agreed with
autopsy findings.
CPSC Team Addressability: Unknown
8
Wedging with Bumper (Case #21)
Death Certificate:
Not Available
Autopsy:
Asphyxia
by suffocation. Infant
became wedged between the mattress and the
bumper pad of the crib.
Narrative:
Father found the baby on his
stomach in his crib with his "arms up and his
face into the soft padding" surrounding the
inside of the crib. The father also noted that the
color around the infant's nose and mouth was
white and the rest of his face was red.
CPSC Team Addressability:
Unlikely
9
Face Against Bumper (Case #44)
Death Certificate
: “
Face became pressed
against crib bumper pad while sleeping – Asphyxia;
suffocation.”
Autopsy:
Opinion: …"22 month old male with
severe cerebral palsy died as a result of asphyxia
due to obstruction of the nose and mouth by the
crib bumper pad when he maneuvered into a
position while sleeping from which he could not
extricate himself"
Narrative:
The father recreated the death scene
but there was no photograph.
CPSC Team Addressability
:
Unknown.
“Recreation -Victim’s face pointed away from
bumper.”
Incorrect according to ME.
Positioner
10
Wedging with Bumper (Case #49)
Death Certificate:
Probable Asphyxia,
obstruction of nose and mouth. Face wedged
against bumper
and mattress of crib.
Autopsy:
Probable asphyxia due to obstruction
of the nose and mouth. Found unresponsive lying
with face wedged against the bumper of crib and
the mattress.
Narrative:
Police reports: father found the baby
had "flipped over, crawled up over the [nursing
pillow] and his face was against the padded
bumper and mattress" with his "mouth up against
the bumper almost wedged between the mattress
and the bumper.”
CPSC Team Addressability
:
Unknown
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Wedging with Bumper (Case #58)
Death Certificate
:
A 6 MOM decedent found
in crib with face between bumper pad and
mattress.
Autopsy:
“Suffocation in non-standard sleeping
environment: (A) infant reportedly found face-
down with face wedged between mattress and
bumper pads of crib. (B) numerous pillows,
blankets and stuffed animals present with the
crib.
Narrative:
Mother reported baby’s left arm
was over the pad and he appeared to have been
pulling the bumper pad toward his face.
CPSC Team Addressability:
Unknown
12
Wedging with Bumper (Case #59)
Death Certificate:
Asphyxia; wedging of face in
mattress.
Autopsy:
The cause of death is attributed to
asphyxia from the face being wedged between a
crib bumper
and mattress. The baby reportedly
rolled over a positioner and was found in the
above described position.
Narrative:
The victim was found prone
between a sleep positioner and a bumper, with
his face where the bumper meets or intersects
with the mattress. He recently was diagnosed
with infant asthma.
CPSC Team Addressability:
Unknown
13
Wedging with Bumper (Case #66)
Death Certificate:
Positional Asphyxia
(Wedging). Positional Asphyxia sustained when
became wedged between crib pads
and pillow.
Autopsy:
Positional asphyxia (wedging). Infant
found with face between pillow and crib
bumper.
Narrative:
The victim was found face down
with his head tilted to the left, wedged
between a nursing pillow and the bumper.
Based on the reenactment photos, his face
appears to be into the pillow.
CPSC Team Addressability: Unknown
14
Wedging with Bumper (Case #9)
Death Certificate:
Sudden Infant Death
Syndrome
Autopsy:
Sudden Infant Death Syndrome
Narrative:
Infant found with his face
straight down into a quilt with his head in
the corner of the crib. The fringe of the
quilt may have covered his head. Cyanosis
noted around nose and mouth.
CPSC Team Addressability
:
Unlikely
Victim as Found
15
Conclusion
•
These cases illustrate that crib bumpers can cause
asphyxia/suffocation.
•
There are many more bumper deaths that were
identified by Medical Examiners/pathologists than
by CPSC staff.
•
The CPSC team often disagrees with the Medical
Examiners/pathologists’ diagnoses.
16
Apparent Life-Threatening Events (ALTEs)
from Crib Bumpers
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Incident bumper data
•
Incidents identified from CPSC data bases --
January 1990 to October 2012
•
Identified 146 incidents
•
From these, we identified 11 apparent life-
threatening events
18
Near Suffocation ALTEs
•
Baby Monitor alarmed – 1 MOM infant found
face pressed against bumper.
•
Baby Monitor alarmed – 6 MOF found with
head between crib and bumper – pale, lips
blue.
•
3 MOM found with face in bumper, blue, limp,
not breathing: respiratory distress syndrome
•
2 MOM found lodged in corner under bumper
pad with arm stuck through crib slats. Face
red from not being able to breathe.
•
4 MOM found wedged between bumper pad
and mattress. “DX; transient cyanosis probably
second to position now resolved.”
19
Choking, Ingestion, Strangulation ALTEs
•
13 MOF swallowed a piece of plastic from crib
bumper.
•
Baby monitor alarmed and 7 MOF infant found with
crib bumper strap obstructing her airway.
•
6 MOF “suffered temporary anoxia” from suspected
strangulation from tie down straps. Infant stopped
breathing but cousin rescued her in time.
20
ATLEs from Falls – all went to ER
•
10 MOF “fell from the crib, stepped on
crib bumper” – closed head injury.
•
17 MOF “Mom thinks baby climbed onto
bumper pads and fell out.” Closed head
injury.
•
7 MOF “victim pulled herself up and stepped on crib
padding” – crib was at the highest mattress setting. Head
injury.
•
9 MOF “used her bumper pad as a step,” climbed up and
leaned over the side of the rail. Lost her balance and fell
over the side. Head injury.
21
Comprehensive analysis of crib bumper-related deaths, highlighting specific scenarios such as suffocation due to bumper involvement, wedging incidents, and potential risks associated with crib bumpers. Data from CPSC and autopsy reports emphasize the dangers posed by crib bumpers, leading to recommendations for safer sleep environments for infants.
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Presentation Transcript
Review of Crib Bumper Deaths NJ Scheers, PhD BDS Data Analytics
Purpose Review bumper deaths in cribs from our 2016 Journal of Pediatrics article. 43 of the 48 deaths match deaths reviewed in CPSC s 2016 staff briefing package. 5 bumper deaths from the 1980s not reviewed by CPSC staff. 2
Death Reports 37 asphyxia/suffocation deaths specifically describe bumper involvement: wedged between pillow and bumper pad. face pressed against bumper pad. 6 SIDS/SUID - likely bumper-related head hanging off recliner and face pressed against crib bumper. 3
Bumper (Not Clutter) 32 deaths Wedging between bumper/crib mattress (13), Face against bumper (12), Arm caught between bumper and mattress/side rails -- face pressed against bumper (3), Wedged between crib and bureau after a likely climb out (1), Strangulations from bumper tie (3). 4
Bumper and Other Object 16 deaths Wedged - pillow and bumper (9), Wedged - recliner and bumper (5), Wedged - cosleeping twin and bumper (1), Wedged in crib depression- bumper prevented infant from turning her face to breathe (1). 5
CPSC Staff Team Review: Addressability of 43 deaths 3 deaths considered Likely 17 deaths considered Unknown 23 deaths considered Unlikely
CPSC Team Addressability: Likely Case #42 Case #32 Case #30 Autopsy: Decedent found dead in a crib with her face into a bumper pad. Death Certificate: Suffocated in corner of crib against crib bumper. No photographs Autopsy: Positional asphyxia while laying (sic) face down in thick, soft crib bumper padding at the corner of the crib. Autopsy: Found with neck extended and face buried into a bumper. Nose and mouth completely blocked by the bumper confirmed by lividity pattern on decedent s face. 7
Face Against Bumper (Case #20) Death Certificate: Positional Asphyxia Autopsy: infant's face [found] in a corner of the crib and covered by a pad along the edge of the crib, which would cause asphyxiation due to obstruction of airflow. A crease noted on the infant's forehead is consistent with an impression from the edge of the crib and further supports this conclusion. Narrative: Pediatric forensic pathologist agreed with autopsy findings. CPSC Team Addressability: Unknown 8
Wedging with Bumper (Case #21) Death Certificate: Not Available Autopsy: Asphyxiaby suffocation. Infant became wedged between the mattress and the bumper pad of the crib. Narrative: Father found the baby on his stomach in his crib with his "arms up and his face into the soft padding" surrounding the inside of the crib. The father also noted that the color around the infant's nose and mouth was white and the rest of his face was red. CPSC Team Addressability:Unlikely 9
Face Against Bumper (Case #44) Death Certificate: Face became pressed against crib bumper pad while sleeping Asphyxia; suffocation. Autopsy: Opinion: "22 month old male with severe cerebral palsy died as a result of asphyxia due to obstruction of the nose and mouth by the crib bumper pad when he maneuvered into a position while sleeping from which he could not extricate himself" Positioner Narrative: The father recreated the death scene but there was no photograph. CPSC Team Addressability: Unknown. Recreation -Victim s face pointed away from bumper. Incorrect according to ME. 10
Wedging with Bumper (Case #49) Death Certificate: Probable Asphyxia, obstruction of nose and mouth. Face wedged against bumperand mattress of crib. Police officer pointing to area where child was found. Autopsy: Probable asphyxia due to obstruction of the nose and mouth. Found unresponsive lying with face wedged against the bumper of crib and the mattress. Narrative: Police reports: father found the baby had "flipped over, crawled up over the [nursing pillow] and his face was against the padded bumper and mattress" with his "mouth up against the bumper almost wedged between the mattress and the bumper. CPSC Team Addressability: Unknown 11
Wedging with Bumper (Case #58) Death Certificate: A 6 MOM decedent found in crib with face between bumper pad and mattress. Autopsy: Suffocation in non-standard sleeping environment: (A) infant reportedly found face- down with face wedged between mattress and bumper pads of crib. (B) numerous pillows, blankets and stuffed animals present with the crib. Narrative: Mother reported baby s left arm was over the pad and he appeared to have been pulling the bumper pad toward his face. CPSC Team Addressability:Unknown 12
Wedging with Bumper (Case #59) Death Certificate: Asphyxia; wedging of face in mattress. Autopsy: The cause of death is attributed to asphyxia from the face being wedged between a crib bumperand mattress. The baby reportedly rolled over a positioner and was found in the above described position. Narrative: The victim was found prone between a sleep positioner and a bumper, with his face where the bumper meets or intersects with the mattress. He recently was diagnosed with infant asthma. Positioner CPSC Team Addressability:Unknown 13
Wedging with Bumper (Case #66) Death Certificate: Positional Asphyxia (Wedging). Positional Asphyxia sustained when became wedged between crib pads and pillow. Autopsy: Positional asphyxia (wedging). Infant found with face between pillow and crib bumper. Narrative: The victim was found face down with his head tilted to the left, wedged between a nursing pillow and the bumper. Based on the reenactment photos, his face appears to be into the pillow. CPSC Team Addressability: Unknown 14
Wedging with Bumper (Case #9) Infant s Head Death Certificate: Sudden Infant Death Syndrome Autopsy: Sudden Infant Death Syndrome Narrative: Infant found with his face straight down into a quilt with his head in the corner of the crib. The fringe of the quilt may have covered his head. Cyanosis noted around nose and mouth. Victim as Found CPSC Team Addressability: Unlikely 15
Conclusion These cases illustrate that crib bumpers can cause asphyxia/suffocation. There are many more bumper deaths that were identified by Medical Examiners/pathologists than by CPSC staff. The CPSC team often disagrees with the Medical Examiners/pathologists diagnoses. 16
Apparent Life-Threatening Events (ALTEs) from Crib Bumpers Bradley Thach, MD Neonatologist, St. Louis Children's Hospital Professor of Pediatrics, Washington University 17
Incident bumper data Incidents identified from CPSC data bases -- January 1990 to October 2012 Identified 146 incidents From these, we identified 11 apparent life- threatening events 18
Near Suffocation ALTEs Baby Monitor alarmed 1 MOM infant found face pressed against bumper. Baby Monitor alarmed 6 MOF found with head between crib and bumper pale, lips blue. 3 MOM found with face in bumper, blue, limp, not breathing: respiratory distress syndrome 2 MOM found lodged in corner under bumper pad with arm stuck through crib slats. Face red from not being able to breathe. 4 MOM found wedged between bumper pad and mattress. DX; transient cyanosis probably second to position now resolved. 19
Choking, Ingestion, Strangulation ALTEs 13 MOF swallowed a piece of plastic from crib bumper. Baby monitor alarmed and 7 MOF infant found with crib bumper strap obstructing her airway. 6 MOF suffered temporary anoxia from suspected strangulation from tie down straps. Infant stopped breathing but cousin rescued her in time. 20
ATLEs from Falls all went to ER 10 MOF fell from the crib, stepped on crib bumper closed head injury. 17 MOF Mom thinks baby climbed onto bumper pads and fell out. Closed head injury. 7 MOF victim pulled herself up and stepped on crib padding crib was at the highest mattress setting. Head injury. 9 MOF used her bumper pad as a step, climbed up and leaned over the side of the rail. Lost her balance and fell over the side. Head injury. 21
