CHILD ATD RECONSTRUCTION OF A FATAL PEDIATRIC FALL

Chris Van Ee

Design Research Engineering
Novi, MI, USA

David Raymond

Vector Scientific, Inc.
Los Angeles, CA, USA

Kirk Thibault

Biomechanics, Inc.
Essington, PA, USA

Warren Hardy

Virginia Polytechnic Institute and State University
Blacksburg, VA, USA

John Plunkett

Regina Medical Center
Hastings, MN, USA

ABSTRACT

The current head Injury Assessment Reference Values (IARVs) for the child dummies are based in part on scaling adult and animal data and on reconstructions of real world accident scenarios. Reconstruction of well-documented accident scenarios provides critical data in the evaluation of proposed IARV values, but relatively few accidents are sufficiently documented to allow for accurate reconstructions. This reconstruction of a well documented fatal-fall involving a 23-month old child supplies additional data for IARV assessment. The videotaped fatal-fall resulted in a frontal head impact onto a carpet-covered cement floor. The child suffered an acute right temporal parietal subdural hematoma without skull fracture. The fall dynamics were reconstructed in the laboratory and the head linear and angular accelerations were quantified using the CRABI-18 Anthropomorphic Test Device (ATD). Peak linear acceleration was 125 ± 7 g (range 114-139), HIC15 was 335 ± 115 (Range 257-616), peak angular velocity was 57± 16 (Range 26-74), and peak angular acceleration was 32 ± 12 krad/s2 (Range 15-56). The results of the CRABI-18 fatal fall reconstruction were consistent with the linear and rotational tolerances reported in the literature. This study investigates the usefulness of the CRABI-18 anthropomorphic testing device in forensic investigations of child head injury and aids in the evaluation of proposed IARVs for head injury.

INTRODUCTION

Defining the mechanisms of injury and the associated tolerance of the pediatric head to trauma has been the focus of a great deal of research and effort. In contrast to the multiple cadaver experimental studies of adult head trauma published in the literature, there exist only a few experimental studies of infant head injury using human pediatric cadaveric tissue [1-6]. While these few studies have been very informative, due to limitations in sample size, experimental equipment, and study objectives, current estimates of the tolerance of the pediatric head are based on relatively few pediatric cadaver data points combined with the use of scaled adult and animal data. In effort to assess and refine these tolerance estimates, a number of researchers have performed detailed accident reconstructions of well-documented injury scenarios [7-11] . The reliability of the reconstruction data are predicated on the ability to accurately reconstruct the actual accident and quantify the result in a useful injury metric(s). These resulting injury metrics can then be related to the injuries of the child and this, when combined with other reliable reconstructions, can form an important component in evaluating pediatric injury mechanisms and tolerance. Due to limitations in case identification, data collection, and resources, relatively few reconstructions of pediatric accidents have been performed. In this study, we report the results of the reconstruction of an uncharacteristically well documented fall resulting in a fatal head injury of a 23 month old child. The case study was previously reported as case #5 by Plunkett [12].

CONCLUSIONS

The results of this reconstruction are consistent with the current injury criteria based on both linear and angular acceleration. The CRABI-18 test device is an important tool in the assessment and evaluation of injury prevention and forensic investigation. This study further underscores the efficacy of this device.

For full PDF paper please see medicalmisdiagnosisresearch BoxNet files for same title or view online from source:

http://profbriefings.co.uk/lse/Plunkett%20No%205.pdf

Fall Down Stairs Caused Bleeding And Swelling In Brain

Head wins appeal over falling death of three-year-old playing Batman game on the steps of his school

By LUKE SALKELD

19 May 2008

Headteacher James Porter has won his appeal against the conviction over the death of a three-year-old boy in a playground fall

A headmaster who was held responsible for the death of a three-year-old boy in a playground fall has won an appeal against his conviction.

James Porter, 66, was blamed for Kian Williams’s death because he was said to have wrongly allowed small children access to a flight of steps from which the child jumped while pretending to be Batman.

Kian banged his head, causing bleeding on the brain, and died five weeks later.

Mr Porter, a teacher for more than 30 years, was ordered to pay £20,000 in fines and legal costs after being found guilty of health and safety breaches.

He was said to be “delighted” after the verdict was overturned yesterday, in a ruling described as having “critical importance” to controversial health and safety legislation.

The original ruling had fuelled rows over the “cotton wool culture” which teachers say is hindering their jobs.

Mr Porter’s solicitor said yesterday’s successful appeal would have a far reaching and positive impact on schools across the country.

Steffan Groch said in a statement on behalf of the headmaster and his wife: “James and Sylvia Porter have run Hillgrove school for over 30 years, during which time they have achieved the highest standards of care and an exemplary safety record.

“While their sympathies are very much with Kian’s family they feel the court’s judgment today has vindicated their own position and also struck a blow for the teaching profession who would have faced an almost impossible burden had the conviction remained.

“The Porters would like to thank the many well-wishers who have supported them during this ordeal and are now looking forward to getting back to their day-to-day work in running the school.”

Scroll down for more…

Kian Williams was allowed access to a flight of steps from which he jumped while pretending to be Batman

Mr Groch said he believed the ruling would be of critical importance in defining the health and safety standards that teachers and employers in general will have to satisfy.

He added: “You can’t wrap children in cotton wool. You have to allow them to experience risk.”

Last night Mr Porter chose not to comment on his ordeal, but Mr Groch said the headmaster was “delighted with the verdict” after three judges at the Court of Appeal said the conviction was “unsafe”.

He said: “Mr Porter and his wife have found the whole process very difficult. They are very relieved, but they always maintained that their school was safe.

“They have had a lot of support throughout, and this verdict will have a real impact on the wider issue of health and safety rulings.”

Kian, described by teachers as “lively and energetic”, jumped down four steps at Hillgrove private school in Bangor, Gwynedd, but lost his footing.

Although he broke no bones during the accident, he suffered swelling to the brain and died in hospital a few weeks later from an MRSA strain of pneumonia.

An inquest into Kian’s death in February 2005 recorded a verdict of accidental death.

The accident happened in July 2004 at £3,000-a-year Hillgrove School in Bangor, North Wales, which has been run by Porter and his wife, Sylvia, 61, since 1975.

During the six-day prosecution brought by the Health and Safety Executive, Mold Crown Court heard there was only one teacher supervising 59 pupils in the playground. Gates have since been erected at the steps where Kian fell.

Porter, the proprietor and head of the school, was found guilty by an 11-1 majority verdict of failing to do enough to make the school steps safe.

He was fined £12,500 and also ordered to pay prosecution costs of £7,500.

Yesterday he was in court to hear Lord Justice Moses, Mr Justice Openshaw and Sir Richard Curtis overturn the conviction, which his lawyer described later as a “common sense judgment”.

Lord Justice Moses, who described the accident as a “terrible tragedy” said: “In our view the evidence in this case was all one way.

“There was no evidence on which a jury, properly directed, could reasonably conclude that this child was exposed to risk by the conduct of the school.”

Porter was described during the trial as having an exemplary safety record.

It was argued by the Health and Safety Executive, which brought the prosecution, that more staff should have been on duty, and there was no reason why the gate erected following the accident could not have been put up before.

But Lord Justice Moses said there was no evidence of risk other than the risk that everyday a child might go unsupervised down a flight of stairs.

The judge expressed the court’s sympathy for Kian’s parents, who have previously denied being vindictive in pursuing a case against the Porters.

Following the guilty verdict last year, Kian’s mother, Jackie Williams, said: “Every parent knows you should put stairgates up to stop children climbing up or falling down steps, but there was no barrier to stop Kian falling.

“Schools and nurseries should be safe environments so a parent feels totally safe leaving their children.”

But at yesterday’s hearing, Lord Justice Moses said: “In the 29 years before this accident, during which this appellant and his wife ran the school, there had never been any complaints about standards of health or safety.”

Read more: http://www.dailymail.co.uk/news/article-567352/Head-wins-appeal-falling-death-year-old-playing-Batman-game-steps-school.html#ixzz0j6kYDTZO