Reviewing the tragic, preventable deaths of children is no easy task.
While heartbreaking, the goal is to find out why it happened, how it happened and ways it can be prevented.
"It's a difficult conversation," but a needed one, said Christina Keller, co-chair of the regional Child Fatality Review team, required under Indiana law. These are preventable deaths, and "if we can reduce the number of children dying in Indiana counties every year, that makes it all worth it."
The regional team consists of Vigo, Vermillion, Sullivan, Clay and Parke counties. Keller, media coordinator with the Vigo County Health Department, is co-chair with Megan Richardson, of the Indiana Department of Child Services in Vigo County.
By state law, county or regional teams are to review all deaths of children under age 18 that are not medically expected. The local teams are then to provide information to a Indiana Statewide Child Fatality Review Committee, which is supposed to identify trends and assist with strategies to prevent injuries, disability and deaths of children.
Participants must sign confidentiality agreements and cannot publicly discuss individual cases.
While team members cannot discuss individual cases, one of those reviewed last year involved the case of a 5-year-old disabled girl who died from medical neglect and starvation in January 2016, according to autopsy findings.
After a lengthy investigation, the child's parents were arrested in March 2017 on several neglect charges, including a Level 1 felony charge of neglect of a dependent resulting in death.
The panel also is expected to review the tragic death of 9-year-old Cameron Hoopingarner, a severely disabled child who weighed 15 pounds at the time of his death on Feb. 21; an autopsy determined the boy died of starvation.
Four people — including his two guardians — were arrested and charged in connection with the 9-year-old's death in northeastern Vigo County. The defendants face several neglect charges, including a Level 1 felony charge, neglect of a dependent resulting in death.
Ensuring advocacy
When death appears to be the result of abuse or neglect, "Part of our job is to make sure advocacy takes place in those cases," Keller said.
Raeanna Moore, a Vigo County deputy prosecutor who serves on the team, believes the panel undoubtedly will focus on fatalities related to abuse/neglect and how they can be prevented. Once the team learns about the circumstances and facts in specific cases, it also will likely discuss "what could we have done to help families not end up in this situation," she said.
One of the reasons Keller serves as co-chair is to take the information gained and help educate the public on ways to prevent those deaths, whether they be related to drowning, unsafe sleep or other possible causes. She plans to use Facebook and perhaps other tools to post fact sheets, reminders and other information that aids in prevention.
For example, when temperatures rise this summer, she plans to include information reminding adults not to leave young children in hot cars, which can lead to heat stroke death.
The law outlines who must be on the team, including representatives of the coroner's office; law enforcement; health department; DCS; schools; mental health community; and prosecutor's office. The local team has included representatives of hospitals, the Indiana Department of Natural Resources, doctors and lawyers.
Team members also can help disseminate information to the public, such as hospitals working with new mothers on issues such as safe sleep; DCS when meeting with families; or the Department of Natural Resources on ATV safety.
"The great thing about the collective team is that we reach a lot of people," Keller said.
A weighty task
The teams are required to review all deaths of children under the age of 18 "that are sudden, unexpected or unexplained, all deaths that are assessed by DCS, and all deaths that are determined to be the result of homicide, suicide, accident, or are undetermined," according to the Indiana Department of Health web site.
The team tries to meet about every three months, and typically, about 25 people will attend. The team reviews each child fatality; the review can include police reports and photos, and if DCS was involved with a case, a representative will provide information about its involvement.
The group will examine how a child died and how it could have been prevented; it also examines legal aspects of the case, whether arrests occurred and if a grieving family received wraparound services or counseling after the child's death, particularly in cases where DCS or Hamilton Center have been involved.
A team meeting might last 1 1/2 to two hours, depending on the number of fatalities under review.
While it's not required, the team also looks at child fatalities involving natural causes, as well as miscarriages and still-births that happen after 20 weeks. "We don't want anyone to fall through the cracks," Keller said. Under a new Indiana law, doctors aren't required to fill out death certificates for miscarriages prior to 20 weeks, she said.
In the five-county region, two areas of concern have been deaths resulting from an unsafe sleep environment and drowning. In one case, a preventable death was attributed to materials used in a bed-side sleeper; the product was recalled on a national level.
Educating the public
There are many resources available to educate the public about safe infant sleep environments, and some of those provide free pack-and-plays — which are safe for babies to sleep in, she said.
Drownings are more of a concern in the summer, and not just in pools, but also small ponds.
In Keller's opinion, the review teams are not just another bureaucracy. The information and statistics can be used to inform communities and prevent injury and death. The work of the teams throughout the state could could lead to changes in policy and law, safety recalls and perhaps, in some cases, legal consequences.
While dealing with the unexpected deaths of children is heart-wrenching, "If you don't talk about them and how they can be prevented ... then it's not going to get any better," she said.
Another member of the team is Rick Stevens, Vigo County School Corp. assistant director of student services.
"I've been on it for five years. It's a heartbreaking committee, the stories you listen to and see and hear," he said. The goal is prevention — so those tragedies aren't repeated. "A lot of times people may not be aware of the dangers," he said. "We try to be proactive so it doesn't happen again."
Moore, who represents the prosecutor's office on the panel, said, "We work well together. It's a good cross section of the community."
Vigo County has had a team for several years, even before the the 2013 change in state law requiring every county to have a child fatality review team. "When the law changed, we didn't view it as affecting us," she said.
But what did change was the makeup of the panel, which now includes the four other counties; the five counties are part of the Department of Child Services Region 8.