PARENTAL NEGLIGENCE LEADING TO CHILDREN'S DEATH [A CASE REPORT]
Dr. I. L. Khandekar*, Dr. P.N.Murkey**
Resident, Dept. of Forensic Medicine MGIMS, Sevagram, Wardha*, Reader, Dept. of Forensic Medicine MGIMS, Sevagram, Wardha**
The young innocent fellow who had seen nothing in life succumbed to death just because of simple parental negligence.

Kerosene poisoning is not uncommon in pediatric age group and its use in daily life is known to everybody, still its handling is very casual and accidental deaths are occurring very frequently now a day also.

Here, we are including two case histories and autopsy findings of toddlers aged 1½ year and 1 year old, victims of kerosene poisoning, revealing the evidence of pulmonary edema contributing to the cause of death.

Also three more children who received thermal injuries like scalds by one or other means succumbed to death because of complication like septicemia.

Introduction:
Poisoning in children is a global problem. In India, also, poisoning is an important emergency but not as common as problems like infectious diseases and malnutrition, accidental poisoning is very much common in children of age group 1-5 years due to newly acquired independent mobility, innate curiosity and predilection for exploring the environment with mouth, eyes and fingers. Acute accidental poisoning is a important pediatric emergency. Its incident varies from place to place2. But if this is related to parental negligence it needs to think about. Kerosene poisoning is the commonest with incidence of 56% and that to in the age group of 1-5 years, it is 67% as shown by Ranbir (1995) from Imphal 2. Accidental burns also not uncommon in this age group i.e., 10% of total population comprises burn injuries in 0-9 years age group according to Pranab Choudhary (2002) from sevagram3. Kerosene is form of petroleum distillate commonly used for heating and lighting purposes and for internal combustion of engines in the form of petrol or as lubricant in the form of Vaseline or paraffin.

It produces general gastro-intestinal symptoms like nausea, vomiting, diarrhea. Also it produces smell in breath, vomit and urine. Respiration later on becomes shallow, cyanosis develop and ultimately pulmonary complication like bronchopneumonia, pneumonitis and pulmonary edema leading to death as well as CNS complication like unconsciousness leading to profound coma may occur.

Case History I: In the month of August 2003, a young toddler of age 1½ years male from Hinghanghat, District Wardha, while playing in the kitchen consumed kerosene which was kept in a glass on the floor. At that time his parents were having their lunch. He died within 12 hours from consumption.

Postmortem Examination:
Cyanosis was present on external examination. All organs were congested, lungs on cut section showed blood stained frothy fluid, and stomach contained 10 cc yellowish brown fluid with kerosene like smell. On histopathological examination lungs showed pulmonary edema which must have caused his death.

Case II: Similar case like above occurred in the month of March 2003, infant aged 11 months who was brought dead from Mansawali, Dist. Wardha. He had consumed kerosene in similar way while playing around in kitchen, when his parents were busy doing another household work. PM findings revealed congestion in all organs grossly and pulmonary edema microscopically.

Case III: In the month of Nov.3, a child of age 1 year was brought for PM examination for accidental thermal injury, scalds. Here, the deceased was playing with neighbouring children in their house, where she fell in hot oil container as the neighbour had restaurant in their house. She died within 4 days after receiving scald injury. On PM examination, infected dermoepidermal burns leading to septicemia caused her death.

Case IV: Similar 2 years old female child from Dist. Amravati accidentally fell down in hot water while playing around in house. She received 39% dermoepidermal scald injuries and died after 10 days with septicemia.

Case V: In the same way, a 4 years old male child while playing at neighbour's house, fell in boiling milk container and received 48% scalds injuries. He died during treatment within 20 days because of septicemia.

Conclusion:
So, from the above cases, which occurred in a span of just one year, made us think whether who is responsible for such accidents? Is it not because of parental negligence? Present trend of lifestyle, has been very stressful and busy. For competitive or needful, whatever the reason may be, it is separating the young ones from their basic needs, the most important is parental attention. We all must remember this and aware the parents about their duty and care towards the young ones, apart from their carrier.
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Khandekar L I D, P.N.Murkey D.. Available From : http://www.pediatriconcall.com/fordoctor/ Conference_abstracts/report.aspx?reportid=474
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