Child Atd Reconstruction of a Fatal Pediatric Fall

The current head Injury Assessment Reference Values (IARVs) for the child dummies are based in part on scaling adult and animal data and on reconstructions of real world accident scenarios. Reconstruction of well-documented accident scenarios provides critical data in the evaluation of proposed IARV values, but relatively few accidents are sufficiently documented to allow for accurate reconstructions. This reconstruction of a well documented fatal-fall involving a 23-month old child supplies additional data for IARV assessment. The videotaped fatal-fall resulted in a frontal head impact onto a carpet-covered cement floor. The child suffered an acute right temporal parietal subdural hematoma without skull fracture. The fall dynamics were reconstructed in the laboratory and the head linear and angular accelerations were quantified using the CRABI-18 Anthropomorphic Test Device (ATD). Peak linear acceleration was 125 ± 7 g (range 114-139), HIC15 was 335 ± 115 (Range 257-616), peak angular velocity was 57± 16 (Range 26-74), and peak angular acceleration was 32 ± 12 krad/s 2 (Range 15-56). The results of the CRABI-18 fatal fall reconstruction were consistent with the linear and rotational tolerances reported in the literature. This study investigates the usefulness of the CRABI-18 anthropomorphic testing device in forensic investigations of child head injury and aids in the evaluation of proposed IARVs for head injury. INTRODUCTION Defining the mechanisms of injury and the associated tolerance of the pediatric head to trauma has been the focus of a great deal of research and effort. In contrast to the multiple cadaver experimental studies of adult head trauma published in the literature, there exist only a few experimental studies of infant head injury using human pediatric cadaveric tissue [1-6]. While these few studies have been very informative, due to limitations in sample size, experimental equipment, and study objectives, current estimates of the tolerance of the pediatric head are based on relatively few pediatric cadaver data points combined with the use of scaled adult and animal data. In effort to assess and refine these tolerance estimates, a number of researchers have performed detailed accident reconstructions of well-documented injury scenarios [7-11] . The reliability of the reconstruction data are predicated on the ability to accurately reconstruct the actual accident and quantify the result in a useful injury metric(s). These resulting injury metrics can then be related to the injuries of the child and this, when combined with other reliable reconstructions, can form an important component in evaluating pediatric injury mechanisms and tolerance. Due to limitations in case identification, data collection, and resources, relatively few reconstructions of pediatric accidents have been performed. In this study, we report the results of the reconstruction of an uncharacteristically well documented fall resulting in a fatal head injury of a 23 month old child. The case study was previously reported as case #5 by Plunkett [12]. BACKGROUND As reported by Plunkett (2001), A 23-month-old was playing on a plastic gym set in the garage at her home with her older brother. She had climbed the attached ladder to the top rail above the platform and was straddling the rail, with her feet 0.70 meters (28 inches) above the floor. She lost her balance and fell headfirst onto a 1-cm (3⁄8-inch) thick piece of plush carpet remnant covering the concrete floor. She struck the carpet first with her outstretched hands, then with the right front side of her forehead, followed by her right shoulder. Her grandmother had been watching the children play and videotaped the fall. She cried after the fall but was alert