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Roles of Team Members
Copyright Michigan Public Health Institute September 2005

Core members of CDR teams are responsible for responding to child deaths or for protecting children’s health or safety. A CDR team should always have representatives from the following agencies or professions:

Additional and ad hoc members from other agencies, providers and professions involved in protecting children’s safety and health should be considered for CDR team membership and certainly provisions should be made for their inclusion on a case appropriate basis:

Periodically, CDR teams may consider inviting individuals with particular expertise to participate in a specific review or to brief the team members on the subject of their expertise. Ad hoc members can help the team when thoughtfully included. Be sure to orient these persons to the CDR process and your confidentiality provisions.

Ad hoc members include those persons directly involved in a death. Those persons may want to attend with their supervisors or their agency team representative. For example, you could invite the person that conducted the scene investigation or the case worker that provided services to the family.

1. Law Enforcement:
Law enforcement is often the first to respond to a scene and has responsibility for ensuring public safety, investigating the deaths of children, determining if crimes have occurred and making arrests.

The law enforcement member can:

Provide the team with information on:

  • The case status and investigation of the death scene.
  • The criminal histories of family members and suspects.
Provide the team with expertise on law enforcement practices such as:
  • Death scene investigation, interviews and interrogations of witnesses and others.
  • Evidence collection.
Support the team with assistance, particularly by acting as a liaison to other law enforcement agencies by:
  • Persuading officers from other agencies and/or jurisdictions to participate on the CDR team when there is a death in that jurisdiction.
  • Providing access to and information from other law enforcement agencies.
  • Providing assistance to member agencies in working with area law enforcement.
Help build bridges by:
  • Learning about the policies and practices of other agencies through team participation.
  • Acting as liaison between the CDR team and the jurisdiction’s other law enforcement agencies.
  • Explaining to the team how to improve coordination with law enforcement agencies.
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2. Child Protective Services:
CPS is responsible for investigating allegations of child abuse or neglect and for recommending or providing services to children and families when abuse or neglect is alleged or confirmed. In addition, CPS is the liaison to the broader child welfare agency and many community resources.

The CPS member can:

Provide the team with information on:

  • The case status and investigation summary for deaths the CDR team is reviewing.
  • The family’s and child’s history and socioeconomic factors that might influence family dynamics, including unemployment, divorce, previous deaths, history of domestic violence, history of substance abuse and previous abuse of children.
  • Other children in the home and previous reports of neglect or abuse in the care of an alleged perpetrator and the disposition of those reports.
Provide the team with expertise by:
  • Using specialized knowledge to design better intervention and prevention strategies and identify ways to integrate these strategies into the system.
  • Identifying local and state issues related to preventable deaths.
Support the team by:
  • Educating the team regarding child protection issues and how the CPS system works.
  • Working to improve the human services system’s responsiveness to a suspicious child death.
  • Training other team members about warning signs of abuse and neglect.

  • Providing linkages to the juvenile court system when it is needed to assure protection of surviving children.

  • Protecting potentially at-risk siblings or other children in the home.

  • Providing or identifying services that can be offered to the family.

Help build bridges by:
  • Learning about the policies and practices of other agencies through CDR team participation.
  • Explaining to the CDR team how to improve coordination with social service agencies.
  • Assisting the criminal investigation by sharing specialized knowledge on child maltreatment.

  • Acting as a liaison between other jurisdictional CPS units and other local and state child welfare agencies.

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3. Prosecutor/District Attorney:
This office is responsible for prosecuting the deaths of children when a criminal act was involved. This office often defines, by the cases they take to trial, what the standards of acceptable practices regarding child safety are in a community.

The prosecutor/district attorney can:

Provide the team with information on:

  • The case status for deaths the team is reviewing.
  • Previous criminal prosecution of family members or suspects in a child death.
  • Explanations when a case can or cannot be prosecuted.

  • Legal terminology, concepts and practices.

Support the team by:
  • Assisting in the development and implementation of strategies in the legal and criminal justice systems to prevent child deaths and serious child injuries.
  • Assisting in the development and implementation of strategies to improve the prosecution of child deaths and serious child injuries.
Help build bridges by:
  • Learning about the policies and practices of other agencies through CDR team participation.
  • Acting as a liaison between the team and prosecutor/district attorney’s offices in other jurisdictions.
  • Meeting and becoming comfortable with professionals in other agencies on whom the prosecutor may rely in child homicide cases.
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4. Medical Examiner or Coroner:
This office is responsible for determining the cause and manner of death for children who die under suspicious, unexplained or unexpected circumstances. Usually a coroner is an elected official who is not required to be a physician or have specialized training in forensics. A medical examiner is usually a physician and may have training or licensure in pathology and/or forensics.

The medical examine or coroner can:

Provide the team with information on:

  • The status and results of the office’s investigation into a child death and explanation of the manner and cause determination..
  • The autopsy report and other investigation records, such as toxicology reports, scene investigations and medical history records.
Provide the team with expertise by:
  • Educating the team on the elements and procedures followed by the Medical Examiner’s or Coroner’s office in investigating a child’s death.
  • Giving specific information as to the nature of the child’s injuries to aid investigators.
  • Educating the team on causes of child death.

  • Educating the team on medical issues including child injuries and child deaths, medical terminology, concepts and practices.

Support the team by:
  • Providing the team with records, such as the child’s medical records, which are accessed by the medical examiner or coroner in their investigation.
  • Providing access to and information from other medical examiners or coroner offices.
Help build bridges by:
  • Learning about the policies and practices of other agencies through team participation.
  • Explaining to the team how to improve coordination with medical examiner/coroner offices.

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5. Public Health:
This agency is responsible for birth and death records, other health statistics and for developing and implementing public health strategies to prevent injuries and deaths. The agency also is the lead agency for maternal and child health (MCH) and is responsible for programs which improve the health and safety of pregnant women, infants and children. The agency may have established Fetal-Infant Mortality Review Teams (FIMR). Public Health can often provide information on neighborhoods and families. Public Health nursing staff may have information from home visits. Some public health agencies may provide direct health care services. Most will have immunization records.

The public health member can:

Provide the team with information on:

  • Contacts made between the family and the public health agency.
  • Birth and immunization records and death certificates.
  • Statistical data.

  • Access to epidemiological/health surveillance data.

  • Programs for high-risk families.

Provide the team with expertise by:
  • Providing information on the development and implementation of public health prevention activities andprograms.
  • Providing information and assistance on data collection and analysis.
Support the team by:
  • Accessing information from other health professionals who provided services to the child and family.
  • Accessing statisticians and epidemiologists to assist in data collection and analysis.
Help build bridges by:
  • Learning about the policies and practices of other agencies through team participation.
  • Acting as liaison between the team and the community’s other health care providers.
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6. Pediatrician or Other Family Health Provider:
These professionals have expertise in health and medical matters concerning children. When selecting these professionals, seek out persons who have practices that serve high numbers of children or who are active in the community.

The pediatrician or other family health provider can:

Provide the team with information on:

  • Services provided to the child or family if seen by the health professional.
  • General health issues, including child development, injuries and deaths, medical terminology, concepts and practices.
Provide the team with expertise by:
  • Offering expert opinion on medical evidence in a child death.
  • Giving a medical explanation and interpretation of events from the point of view of examining thousands of living children.
  • Sharing general knowledge of injuries, SIDS, child abuse/neglect and childhood disease.
Support the team by:
  • Accessing medical records from hospitals and other medical care providers.
  • Providing the medical information needed for a successful prevention campaign.
Help build bridges by:
  • Learning about the policies and practices of other team member agencies through team participation.
  • Acting as a liaison between the team and the jurisdiction’s medical community.
  • Explaining to the team how to improve relationships with the community’s medical providers.
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7. Emergency Medical Services:
 EMS personnel are often the first on the scene when a child dies or is seriously injured. EMS usually prepare run records of their response that they can share at reviews.

The EMS member can:

Provide the team with information on:

  • EMS run reports.
  • Details on the scene, including the persons at the scene.
  • Medical information related to the emergency procedures performed.
Provide the team with expertise by:
  • Giving detailed explanations of EMS procedures and protocols.
  • Sharing general knowledge based on EMS training and experience.
  • Helping the team understand and/or participate in critical stress debriefings.
Support the team by:
  • Understanding EMS procedures and protocols.
  • Addressing issues regarding scene preservation practices.
Help build bridges by:
  • Learning about scene preservation practices essential to investigation and prosecution.
  • Acting as liaison between the team and the jurisdiction’s EMS community.
  • Working with law enforcement and district attorneys to resolve issues related to scene investigation.

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