Sudden Unexpected Death in Infancy (SUDI) - The Role of the Pathologist

The involvement of a pathologist with forensic and pediatric training in all stages of the assessment of sudden and unexpected infant death (SUDI) is crucial as pathologists are among a limited group of medical practitioners who have been trained in evaluating the interaction of injuries, disease processes, and post-mortem changes. However problems exist, with variations in the quality of pediatric autopsy practice and in diagnostic categories that are applied. While the development of standard definitions and protocols has improved this situation, use of the term SUDI as an umbrella term has also assisted in evaluating trends and reducing the impact of diagnostic shift. The following paper reviews the contributions that may be made by pathologists in cases of SUDI, from an initial evaluation of a death scene, through the autopsy process, discussions with families, research and participation in multidisciplinary death review committees.