PURPOSE: State law mandates—an autopsy at state expense on any infant who dies suddenly when in apparent good health, the use of Sudden Infant Death Syndrome as cause of death on death certificates when autopsy results confirm this, prompt notification of autopsy results and provision of information regarding Sudden Infant Death Syndrome to the parent(s) or guardian(s). This rule provides procedures for meeting these requirements.

1. (1) In the event of the sudden and unexplained death of any infant one (1) week to one (1) year of age—

   1. (A) The coroner or medical examiner shall advise the parent(s) or guardian(s) of the deceased infant that an autopsy shall be performed at state expense for the purpose of confirming Sudden Infant Death Syndrome (SIDS). For a SIDS autopsy, the coroner or medical examiner shall notify the nearest child death pathologist who has been certified by the Missouri Department of Health and shall arrange for an autopsy. Pathologists certified by, and following the protocols of, the Department of Social Services State Technical Assistance Team shall be deemed certified by the Department of Health;
   2. (B) The pathologist who performs this autopsy shall report in writing the preliminary results to the coroner or medical examiner who authorized the autopsy. The pathologist or coroner/medical examiner shall comply with the reporting requirements of the State Technical Assistance Team, Child Fatality Review Program;
   3. (C) The Missouri Department of Health shall ensure, through verification with the coroner/medical examiner, the certified child death pathologist, or other representatives duly authorized by county government, that the results of the autopsy were shared with the parent(s) or guardian(s) of the child, and that the parent(s) or guardian(s) were provided with informational material and counseling sources;
   4. (D) The Missouri Department of Health shall pay for non-Medicaid SIDS autopsies at the same rate as that paid for SIDS autopsies covered by Medicaid, The Missouri Department of Health shall pay for transportation of 19 CSR 40-3

the body to and from the nearest facility utilized by the pathologist at the actual cost of said transportation up to but not to exceed a maximum of one hundred fifty dollars ($150). Any additional fee charged by the pathologist shall not be paid by the family; and

1. (E) The medical examiner or coroner shall notify the medical certifier of the autopsy finding. The medical certifier, by affidavit, shall authorize a correction on the death certificate within ten (10) days of notification from the medical examiner or coroner.

1. (2) The Missouri Department of Health, coroners and medical examiners, within their current limits of confidentiality, without revealing the identity of the family of the autopsied infant, may release to qualified investigators medical information gained from autopsies to be utilized in scientific research.

AUTHORITY: section 194.117, RSMo 1994.* This rule was previously filed as 13 CSR 50- 155.010. Original rule filed April 12, 1979, effective Sept. 14, 1979. Amended: Filed June 4, 1990, effective March 9, 1992. Amended: Filed April 14, 1992, effective Dec. 3, 1992. Emergency amendment filed Oct. 15, 1992, effective Oct. 25, 1992, expired Feb. 21, 1993. Emergency amendment filed Feb. 11, 1993, effective Feb. 22, 1993, expired June 21, 1993. Amended: Filed Oct. 15, 1992, effective May 6, 1993. Emergency amendment filed Aug. 26, 1993, effective Sept. 4, 1993, expired Jan. 1, 1994. Amended: Filed Aug. 26, 1993, effective April 9, 1994. Amended: Filed Nov. 13, 1998, effective May 30, 1999. *Original authority 194.117, RSMo 1978, amended 1991, 1993.