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2011 Report of the Paediatric Death Review Committee and Deaths Under Five Committee Released

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2011 Report of the Paediatric Death Review Committee and Deaths Under Five Committee Released

Ministry of the Solicitor General

TORONTO -- Dr. Bert Lauwers, Deputy Chief Coroner for Investigations and Chair, today announced the release of the combined 2011 Report of the Paediatric Death Review Committee and the Deaths Under Five Committee.

Working under the leadership of the Office of the Chief Coroner for Ontario, the purpose of the Paediatric Death Review Committee and the Deaths Under Five Committee is to assist the Office of the Chief Coroner in the investigation and review of deaths of children and to make recommendations to help prevent deaths in similar circumstances. Committee members include coroners, medical and child welfare experts, police, pathologists, a child maltreatment expert and a Crown Attorney.

The 2011 report contains data from deaths reviewed in 2010 when the Paediatric Death Review Committee examined the circumstances surrounding the deaths of 134 children between the ages of 0 and 19 years. The Deaths Under Five Committee reviewed 108 deaths. The purpose of the reviews is to objectively analyze the circumstances leading up to, and surrounding the deaths and to develop recommendations aimed at preventing deaths in similar circumstances. The review does not assign blame or responsibility. Most of the recommendations suggested by the committees through the reviews are focused on promoting best practices within the child welfare and medical systems, and educating the public on child safety measures.

The 2011 report highlights a study conducted by the Office of the Chief Coroner into 158 accidental deaths of children aged 11-13 and 14-15 from the years 2004 to 2007 with recommendations. Increased education on the use of seat belts, life jackets, smoke alarms, helmets and consideration of higher age requirements for the operation of off-road vehicles are recommended

As in previous years, the most vulnerable ages for paediatric deaths are for infants under 12 months and children aged 12 to 18 years. Most deaths were by natural or accidental means and many of them were preventable. The involvement of a Children's Aid Society did not appear to be a factor in the majority of child deaths and in fact, most children die while in the care of their families. In cases where there was involvement by a Children's Aid Society, most deaths could not have been foreseen or prevented by the agency.

The Office of the Chief Coroner would like to remind all parents about the dangers of bed-sharing with their infants and the importance of providing a safe sleeping environment for them.

Unsafe sleeping environments - Infants should sleep alone, on their backs and on a surface specifically designed for infant sleep. The Paediatric Death Review Committee stresses the importance of not bed sharing, particularly with infants under the age of 12 months. Examples of unsafe sleeping environments include: adult beds, couches, armchairs and infant swings.

The sleeping environment should not contain bumper pads, toys, pillows or covers designed for adults.

Additional Resources

Media Contacts

  • Dr. Bert Lauwers

    Deputy Chief Coroner - Investigations

    416-326-4805

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