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When the significance of a positive finding is uncertain or cannot be established with reasonable probability (as might occur in so-called "gray-zone" cases such as a death consistent with SIDS but occurring with bed sharing), a cause-of-death statement similar to the following may be used:

Part I
A.   Sudden Unexplained Infant Death
Due to, or as a consequence of:
Part II. OTHER SIGNIFICANT CONDITIONS: Conditions contributing to death but not resulting in the underlying cause of death in Part I
           Bed sharing with 2 adults. Found face down on soft adult mattress.

In such cases, it would be appropriate to undertake SIDS counseling or referral procedures. It would also be acceptable to report the bed sharing and face down position in "Describe How Injury Occurred,"  even though it is not definite that an injury occurred. To clarify this, words such as "Undetermined if external causes were involved" may also be shown in the "Describe How Injury Occurred" section. The manner of death may be listed as undetermined or natural, but in such a case, undetermined is recommended. Either way, the death would be ICD-coded as R95, Sudden Infant Death Syndrome. See comments on Screen 7.


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Fulton County Medical Examiner

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Atlanta, Georgia 30312
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