DEPARTMENT OF COMMUNITY HEALTH  
HEALTH PROGRAMS ADMINISTRATION -BUREAU OF CHILDREN AND  
FAMILY PROGRAMS  
DETERMINATION OF DEATHS OF CHILDREN  
(By authority conferred on the director of the Michigan Department of  
Community Health by section 52.205a of 2004 PA 179, section 8 of 1978 PA 312,  
sections 2226 and 5111 of 1978 PA 368, and Executive Reorganization Order Nos.  
1996-1 and 1997-4, MCL 52.205a, 325.78, 333.2226(d), 333.5111, 330.3101, and  
333.26324)  
R 330.1 Definitions.  
Rule 1. (1) As used in these rules:  
(a)"County medical examiner" means the physician appointed by the board of  
commissioners in a county, responsible for investigating the cause and manner of deaths  
of individuals, in accordance with MCL 52.201 and 52.202.  
(b) "Deputy county medical examiner" means the physician appointed by the board  
of commissioners in a county, and approved by the County Medical Examiner,  
responsible for investigating the cause and manner of deaths of individuals, in  
accordance with MCL 52.201 and 52.202.  
(c) "Investigation of a death" means any of the following: gross external  
examination of the body, autopsy, toxicology, review of medical history, review of  
incident scene information, interviews with survivors and witnesses.  
(d) "Manner" means how the cause of death arose and is classified on the death  
certificate. Natural deaths are caused exclusively by disease. If an injury, such as  
mechanical, chemical, electrical causes or contributes to death, then the death is  
classified on the death certificate as non-natural and is subclassified as accident,  
homicide, suicide or not determinable.  
(e) "Cause of Death" means the actual disease, injury or complications that directly  
resulted in the death of an individual.  
(f) "State of Michigan protocols to determine cause and manner of sudden and  
unexplained child deaths" means the state of Michigan's standard of investigation for  
determination of cause and manner of deaths of children under age two, when  
circumstances are sudden and unexplained. The protocol includes three components:  
the Incident Death Scene Investigation Guidelines, the Child Autopsy Checklist, and the  
Child's Medical History Case Review.  
(g) "Incident death scene" means the location where the child was first found  
unresponsive, not breathing, or obviously dead.  
(h) "SIDS" or "sudden infant death syndrome" means a cause of death defined as the  
sudden death of an infant under 1 year of age which remains unexplained after a  
thorough case investigation, including performance of a complete autopsy, examination  
of the death scene, and review of the clinical history.  
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Courtesy of www.michigan.gov/orr  
History: 2007 MR 17, Eff. Sept. 10, 2007.  
R 330.2 Child death scene investigation protocol.  
Rule 2. Before making a cause and manner determination on the death  
certificate of deaths of children under age 2, when the circumstances in these deaths  
are sudden and unexplained, the county medical examiner or deputy county medical  
examiner shall ensure that an incident death scene investigation, autopsy, and the  
medical history case review are completed, in accordance with the "2006 State of  
Michigan Protocols to Determine Cause and Manner of Sudden and Unexplained Child  
Deaths," which can be obtained at no cost from the Michigan Department of  
Community Health, Division of Family and Community Health, 109 West Michigan  
Avenue, Lansing, Michigan, 48913, or from the Michigan Public Health Institute, Child  
and Adolescent Health Program, at 2438 Woodlake Circle, Suite 240, Okemos,  
Michigan, 48864. These protocols may also be obtained on the internet at  
www.keepingkidsalive.org.  
History: 2007 MR 17, Eff. Sept. 10, 2007.  
R 330.3 Approval of alternate protocol.  
Rule 3. A county medical examiner or deputy county medical examiner may  
utilize an alternate protocol for all cases within a county to determine cause and  
manner of sudden and unexplained deaths of children under age 2. An alternate  
protocol used by a county jurisdiction shall be approved by the department of community  
health before utilization.  
History: 2007 MR 17, Eff. Sept. 10, 2007.  
R 330.4 SIDS as cause of death.  
Rule 4. A county medical examiner or deputy county medical examiner shall not  
declare cause of death as SIDS (Sudden Infant Death Syndrome) unless an autopsy,  
incident death scene investigation, and review of child's medical history are completed.  
History: 2007 MR 17, Eff. Sept. 10, 2007.  
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Courtesy of www.michigan.gov/orr  
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