Are "accidental" gun deaths as rare as they seem? A comparison of medical examiner manner of death coding with an intent-based classification approach

Judy L Schaechter, Isis Duran, Jacqueline De Marchena, Glendene Lemard, Maria Elena Villar

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Objectives. Unintentional firearm death is often considered a nearly negligible proportion of overall gun death. These rates are based on medical examiner (ME) and coroner death classifications, which affect derived epidemiologic data and subsequent prevention measures. The aim of this study was to compare the proportion of pediatric unintentional gun deaths in Miami-Dade County based on manner of death coding by the ME with an intent-based classification of child gun deaths. Methods. ME and police records for all pediatric fire-arm fatalities in Miami-Dade County from 1994 to 1998 were reviewed. The ME's assignment of manner of death as homicide, suicide, or accident was compared with an intent-based classification of intentional homicide, intentional suicide, and unintentional firearm death based on expressed or implied evidence of intent to harm. Results. There were 123 pediatric firearm deaths in Miami-Dade County from 1994 to 1998. A significant difference between ME coding and the intent-based classification was found for homicide (94 vs 78) but not for suicide. A significant difference was also found between the ME's coding for "accident" and the investigator's classification of "unintentional" firearm death (4 vs 26). Conclusions. The incidence of unintentional pediatric firearm deaths is significantly underreported by the Miami-Dade County ME when the classification of "accidental" firearm death is used. Reviewing the manner of death classification criteria or establishing an intent code on official death documentation is recommended. Furthermore, clinicians should be aware that the true incidence of unintentional gun death may be higher than that reported as accidental.

Original languageEnglish
Pages (from-to)741-744
Number of pages4
JournalPediatrics
Volume111
Issue number4
DOIs
StatePublished - Apr 1 2003

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Coroners and Medical Examiners
Firearms
Homicide
Suicide
Pediatrics
Accidents
Incidence
Police
Clinical Coding
Documentation

Keywords

  • Homicide
  • Manner of death
  • Medical examiner
  • Pediatric firearm death
  • Suicide
  • Unintentional

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Are "accidental" gun deaths as rare as they seem? A comparison of medical examiner manner of death coding with an intent-based classification approach. / Schaechter, Judy L; Duran, Isis; De Marchena, Jacqueline; Lemard, Glendene; Villar, Maria Elena.

In: Pediatrics, Vol. 111, No. 4, 01.04.2003, p. 741-744.

Research output: Contribution to journalArticle

Schaechter, Judy L ; Duran, Isis ; De Marchena, Jacqueline ; Lemard, Glendene ; Villar, Maria Elena. / Are "accidental" gun deaths as rare as they seem? A comparison of medical examiner manner of death coding with an intent-based classification approach. In: Pediatrics. 2003 ; Vol. 111, No. 4. pp. 741-744.
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abstract = "Objectives. Unintentional firearm death is often considered a nearly negligible proportion of overall gun death. These rates are based on medical examiner (ME) and coroner death classifications, which affect derived epidemiologic data and subsequent prevention measures. The aim of this study was to compare the proportion of pediatric unintentional gun deaths in Miami-Dade County based on manner of death coding by the ME with an intent-based classification of child gun deaths. Methods. ME and police records for all pediatric fire-arm fatalities in Miami-Dade County from 1994 to 1998 were reviewed. The ME's assignment of manner of death as homicide, suicide, or accident was compared with an intent-based classification of intentional homicide, intentional suicide, and unintentional firearm death based on expressed or implied evidence of intent to harm. Results. There were 123 pediatric firearm deaths in Miami-Dade County from 1994 to 1998. A significant difference between ME coding and the intent-based classification was found for homicide (94 vs 78) but not for suicide. A significant difference was also found between the ME's coding for {"}accident{"} and the investigator's classification of {"}unintentional{"} firearm death (4 vs 26). Conclusions. The incidence of unintentional pediatric firearm deaths is significantly underreported by the Miami-Dade County ME when the classification of {"}accidental{"} firearm death is used. Reviewing the manner of death classification criteria or establishing an intent code on official death documentation is recommended. Furthermore, clinicians should be aware that the true incidence of unintentional gun death may be higher than that reported as accidental.",
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