Police hurried to a house on the southwestern end of Danville on Nov. 24. Something was wrong there — an infant was not breathing.

Someone notified a Danville police officer a 2-month-old was unconscious in the home, according to a search warrant filed in Danville Circuit Court. When officers arrived, the child was not responsive.

“Attempts to revive the child were unsuccessful and [she] was pronounced dead at Sovah Medical,” the warrant states.

The infant girl’s death currently is an open investigation, and forensic testing may take weeks. Her case highlights the pitfalls investigators and medical examiners face when investigating deaths on the farther poles of the age spectrum.

The difficulty of investigating deaths young and old lies in the lack, or abundance, of medical history, Lt. Mike Wallace said. When a young child dies, they hardly have any medical history for that particular person. Anything could be a cause, and each detail at the scene or test the medical examiner performs could hold the key to an infant’s death.

Conversely, investigators have to take care not to attribute an older person’s death to medical or age-related causes. Because many have extensive medical histories, a surfeit of reasons can cloud the investigation.

“You could have a situation where an elderly person has passed away and there are no signs of foul play, and a person could have a medical history,” Wallace said. “And unless a medical examiner actually takes a look at that body … the cause of death could be missed.”

That initial determination is important, Wallace noted because “you only get one shot at it.”

***

Investigating the death of a child, Wallace said, simply is hard. Beyond the emotionally-charged nature of the work, infant deaths require a significant amount of testing. Analysis of blood work, toxicology and stomach contents — along with bruising, hemorrhaging and manifold other details — are taken into account to eliminate possible causes of death. The tests are extensive because, often, babies have little medical history.

“With a baby, that history is not there most of the time,” Wallace said. “At times an infant will die and there does not appear to be any reason for that to have taken place.”

Tracie Cooper, the district administrator in the Roanoke Medical Examiner’s Office, said, when it comes to sudden unexplained deaths — infant or otherwise — a full battery of tests is conducted to paint a clearer picture of what happened.

For unexplained infant deaths, Cooper said, that can take a while.

“It usually takes an average of eight to 12 weeks,” she said. “It depends on the circumstances … but normally they get more testing.”

Medical examiners also rely partially on the police investigation to give context to their determination. If a person is found dead and something does not add up to investigators, they convey it to the medical examiner. Obvious causes of death can be, comparatively, open and shut. But for whodunits or unexplained deaths, the testing is more rigorous.

“If it is an obvious cause of death, less testing needs to be performed,” Cooper said. “The doctors have to rule out other diseases.”

The medical examiners in Roanoke test for blood toxicity, neuropathic issues, congenital problems, organ failures and bacteria to determine a cause of death.

When handling infant deaths, investigators look closely for details. Where the infant is found, who the child was found with, and a baby’s condition typically are sought. But a child’s fragility can complicate an investigation. Some infants can choke on bedding and die. Others asleep in the same bed as a parent can be rolled onto and crushed.

And through it all, the investigators have to keep parents apprised of a most terrible situation.

“What do you tell a parent — they’re looking for answers — other than sometimes children just die,” Wallace said. “That is not a sufficient answer by any stretch of the imagination.”

“Really what is a sufficient answer?”

***

Almost 14 years before police found the infant girl dead in her house, friends of Mamie Lee Jackson, 82, knew something was wrong after she showed up at church. When police arrived at her house Dec. 17, 2004, documents filed in Danville Circuit Court show, Jackson was dead in her bed — blood spread on a pillow lying next to her.

Investigators thought Jackson’s death could have been a consequence of old age, but one police supervisor thought something was off and referred the case to the medical examiner’s office, Wallace said. Their determination: strangulation, according to court documents.

The police report filed in circuit court indicated Jackson looked as though she was getting ready for church. The medical examiner’s report noted the marks on her neck as “consistent with the suspect ligature having been the victim’s own nightshirt.”

The case “reached a dead end,” according to court testimony, but then a family member coaxed a confession out of the woman who would be given two life sentences for the killing.

Months after the medical examiner’s office weighed in on the death, Sherine Carolyn Wilson, then 32, pleaded guilty to killing Jackson during the course of a robbery, according to court documents. She had robbed her to get money to buy crack cocaine, according to court testimony.

“You have to be careful not to assume that because a person is old … that age is what has killed them, or sickness is what has killed them,” Wallace said. “If there are no clues at the scene that a person was murdered – outside of the medical examiner or someone confessing – it can be hard to figure out.”

That rings true for many cases of elderly deaths; medical history can muddy investigation into a potential homicide. Had that supervisor not been present, her death could have been mistaken as natural.

“You have to look at the situation,” Wallace said.

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James Whitlow reports for the Danville Register & Bee. Contact him at jwhitlow@registerbee.com or (434) 791-7983.

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