[Unexplained deaths in minors in the Amsterdam-Zaandam region in 1990-2004 and the estimated number that will be considered for further investigation into the cause of death (the NODO procedure)].

OBJECTIVE

To determine how often deceased minors are examined by a forensic physician and the rate of unexplained deaths, and to estimate how often further investigation into the cause of death (the so-called NODO procedure) would be initiated.

DESIGN

Descriptive, retrospective study.

METHOD

Statistics Netherlands (CBS) provided the number of deceased minors and the manner as well as cause of death for the Amsterdam-Zaandam region in the period 1990-2004. Data regarding residence, age, year of death, manner of death and cause of death were collected for all post-mortem examinations performed on minors during the same period using the registration system of the Department of Forensic Medicine of the Amsterdam Municipal Health Services.

RESULTS

A total of 2134 minors living in the Amsterdam-Zaandam region died in the period 1990-2004, according to the CBS. In this 15-year period the CBS registered 140 deaths (7%) that remained unexplained after post-mortem examination: 91 were registered as natural deaths due to unknown or unclear causes and 49 were registered as sudden infant death syndrome. In 306 cases (14%) the post-mortem examination was performed by municipal forensic physicians. Of these cases, 61 (20%) remained unexplained after post-mortem examination. In the remaining cases, post-mortem examination was performed by the treating physician.

CONCLUSION

The estimated annual number of cases that will be referred for the NODO procedure in the Amsterdam-Zaandam region is at least 10: 4 based on unexplained deaths after examination by a municipal forensic physician and 6 based on natural deaths with no known cause of death according to the treating physician. Nationwide, at least 125 of the expected 1800 childhood deaths will be referred annually.