The new Sudden Unexplained Infant Death Investigation (SUIDI) Reporting Form replaces the 1996 Guidelines for the Death Scene Investigation of Sudden, Unexplained Infant Death and the Investigation Report Form (SUIDIRF). The 1996 SUIDIRF was developed to establish a standard death scene investigation protocol for all sudden, unexplained infant deaths (SUID). However, a 2001 national survey indicated that the form was not being used widely because it was poorly organized, lengthy, and cumbersome. By definition, sudden infant death syndrome (SIDS) can be diagnosed only after a thorough examination of the death scene, a review of the clinical history, and performance of an autopsy fail to find an explanation for the death. Yet we know that some SUID are not investigated and, when they are, cause-of-death data are not collected and reported consistently.

Some deaths that would have been classified as SIDS before 1999 are now being classified as accidental suffocation or unknown/unspecified cause, suggesting that diagnostic and reporting practices have changed. This trend information concerned the Centers for Disease Control and Prevention (CDC) because inaccurate or inconsistent cause-of-death determination and reporting hamper the ability to monitor national trends, ascertain risk factors, and design and evaluate programs to prevent these deaths.

To standardize investigations of, and reports on, the causes of sudden infant deaths, CDC collaborated with a number of organizations to 1) revise the 1996 Sudden, Unexplained Infant Death Investigation Reporting Form and 2) develop a training curriculum and materials for investigators of infant deaths. CDC disseminated the reporting form and conducted Train-the-Trainer classes throughout the United States.

The new SUIDI reporting form is important for several reasons:

• It contains 25 questions that medical examiners and coroners should ask before beginning an autopsy.
• It guides investigators through the steps involved in an investigation.
• It allows investigators to document their findings easily and consistently.
• It improves classification of SIDS and other SUIDs by standardizing data collection.
• It produces information that researchers can use to recognize new health threats and risk factors for infant death so that future deaths can be prevented

Improvements in the SUIDI Reporting Form

• It now contains only questions to which answers will 1) establish cause and manner of death and 2) support investigators’ findings in court.
• It contains new questions about recently identified risk factors.
• Answers to the questions can be checked off quickly, which allows for easy, consistent data collection.
• The questions are in a sequence that works well for infant death investigations.
• The form is divided into sections, with each section being the responsibility of a particular member of the death investigation team.
• Supplemental forms for collecting information about contacts and evidence are available for jurisdictions that do not have their own.

50 State Summary of SIDS Laws* (The National Conference of State Legislatures)

1. CDC. Guidelines for death scene investigation of sudden, unexplained infant deaths: recommendations of the Interagency Panel on Sudden Infant Death Syndrome. MMWR 1996;(45):1–22.
2. Hauck F. Final Report: National Survey to Evaluate Use of the Sudden Unexplained Infant Death Investigation Report Form (SUIDIRF). Charlottesville, VA: University of Virginia Health System; 2001.
3. Clark, S.C. National Survey of Medical Examiners 2004. Unpublished report.
4. Willinger M, James LS, Catz C. Defining the sudden infant death syndrome (SIDS): deliberations of an expert panel convened by the National Institute of Child Health and Human Development. Pediatr Pathol 1991;11(5):677–84.
5. Task Force on Sudden Infant Death Syndrome. The changing concept of sudden infant death syndrome: diagnostic coding shifts, controversies regarding the sleeping environment, and new variables to consider in reducing risk. Pediatrics 2005;116:1245–1255.
6. Shapiro-Mendoza CK, Tomashek KM, Anderson RN, et al. Recent national trends in sudden, unexpected infant deaths: more evidence supporting a change in classification or reporting. Am J Epidemiol, (in press).
7. Malloy MH, MacDorman M. Changes in the classification of sudden unexpected infant deaths: United States, 1992–2001. Pediatrics 2005;115(5):1247–53.

Page last reviewed: 6/21/07
Page last modified: 6/21/07
Content source: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion