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SOAHR 2005-039 DEPARTMENT OF COMMUNITY HEALTH
HEALTH PROGRAMS ADMINISTRATION - BUREAU OF CHILDREN AND FAMILY PROGRAMS
DETERMINATION OF DEATHS OF CHILDREN
Filed with the Secretary of State on
These rules become effective immediately upon filing with the Secretary of State unless adopted under sections 33, 44, or 45a(6) of 1969 PA 306. Rules adopted under these sections become effective 7 days after filing with the Secretary of State.
(By authority conferred on the director of the Michigan Department of Community Health by section 52.205a of 2004 PA 179, section 8 of 1978 PA 312, sections 2226 and 5111 of 1978 PA 368, and Executive Reorganization Order Nos. 1996-1 and 1997-4, MCL 52.205a, 325.78, 333.2226(d), 333.5111, 330.3101, and 333.26324)
Draft October 24, 2005 R 330.1, R 330.2, R 330.3, and R 330.4 are added to the Michigan Administrative Code as follows:
R 330.1 Definitions.
Rule 1. (1) As used in these rules:
(a)"County medical examiner” means the physician appointed by the board of commissioners in a county, responsible for investigating the cause and manner of deaths of individuals, in accordance with MCL 52.201 and 52.202.
(b) “Deputy county medical examiner” means the physician appointed by the board of commissioners in a county, and approved by the County Medical Examiner, responsible for investigating the cause and manner of deaths of individuals, in accordance with MCL 52.201 and 52.202.
(c) “Investigation of a death” means any of the following: gross external examination of the body, autopsy, toxicology, review of medical history, review of incident scene information, interviews with survivors and witnesses.
(d) “Manner” means how the cause of death arose and is classified on the death certificate. Natural deaths are caused exclusively by disease. If an injury, such as mechanical, chemical, electrical causes or contributes to death, then the death is classified on the death certificate as non-natural and is subclassified as accident, homicide, suicide or not determinable.
(e) “Cause of Death” means the actual disease, injury or complications that directly resulted in the death of an individual.
(f) “State of Michigan protocols to determine cause and manner of sudden and unexplained child deaths” means the state of Michigan’s standard of investigation for determination of cause and manner of deaths of children under age two, when circumstances are sudden and unexplained. The protocol
includes three components: the Incident Death Scene Investigation Guidelines, the Child Autopsy Checklist, and the Child’s Medical History Case Review.
(g) “Incident death scene” means the location where the child was first found unresponsive, not breathing, or obviously dead.
(h) “SIDS” or “sudden infant death syndrome” means a cause of death defined as the sudden death of an infant under 1 year of age which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and review of the clinical history.
R 330.2 Child death scene investigation protocol.
Rule 2. Before making a cause and manner determination on the death certificate of deaths of children under age 2, when the circumstances in these deaths are sudden and unexplained, the county medical examiner or deputy county medical examiner shall ensure that an incident death scene investigation, autopsy, and the medical history case review are completed, in accordance with the “2006 State of Michigan Protocols to Determine Cause and Manner of Sudden and Unexplained Child Deaths,” which can be obtained at no cost from the Michigan Department of Community Health, Division of Family and Community Health, 109 West Michigan Avenue, Lansing, Michigan, 48913, or from the Michigan Public Health Institute, Child and Adolescent Health Program, at 2438 Woodlake Circle, Suite 240, Okemos, Michigan, 48864. These protocols may also be obtained on the internet at www.keepingkidsalive.org.
R 330.3 Approval of alternate protocol.
Rule 3. A county medical examiner or deputy county medical examiner may utilize an alternate protocol for all cases within a county to determine cause and manner of sudden and unexplained deaths of children under age 2. An alternate protocol used by a county jurisdiction shall be approved by the department of community health before utilization.
R 330.4 SIDS as cause of death.
Rule 4. A county medical examiner or deputy county medical examiner shall not declare cause of death as SIDS (Sudden Infant Death Syndrome) unless an autopsy, incident death scene investigation, and review of child’s medical history are completed.
