Panel analyzes child deaths, serious injuries from abuse or neglect
Courtesy of Kentucky Lantern
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Easy access and exposure to guns and drugs are killing Kentucky children.
That’s according to the Child Fatality and Near Fatality External Review Panel, which released its 2024 report last week.
Kentucky toddlers—four years old and younger—are ingesting substances and dying at “an alarming rate,” the report found.
Of the fatal overdose and ingestion cases the panel reviewed for 2023, most—80%—were “potentially preventable,” according to the report. The majority of substances kids ingested in 2023 were opiates, including the powerful synthetic fentanyl.
In one case, a 1-year-old ingested fentanyl and died. Officials who responded found a “bag of crystal methamphetamine in the bed where the child and mother were sleeping” and oxycodone, an opioid, in the closet.
Dr. Melissa Currie, a Norton Children’s child abuse pediatrician and member of the panel, said ingestion cases in Kentucky’s children concern her because of “how sick the kids are getting and potentially dying.”
“It’s getting worse,” she told the Lantern.
The panel is also tracking a substance called xylazine, which was found in 5% of the cases. This non-opioid sedative or tranquilizer, mainly used in veterinary services, has been increasingly found in the heroin and fentanyl supply.
The Child Fatality and Near Fatality External Review Panel was created in 2012 to conduct comprehensive reviews of child deaths and serious injuries from abuse or neglect. The independent panel of physicians, judges, lawyers, police, legislators and social service and health professionals meets regularly to analyze such cases. It produces an annual report on its findings and recommendations for improvements.
Among other recommendations, the panel says kids need substance screenings when getting medical care and the state needs to “conduct an aggressive public safety campaign targeting proper medication safe storage.”
The panel reviews just the “small portion” of cases that attract official attention, Currie pointed out.
“We’re only reviewing those where someone had a concern for abuse or neglect, sufficient to, No. 1, call and make a report, and, for No. 2, (Child Protective Services) to actually accept it for investigation,” she said. “And so that automatically whittles down the number. So I think it’s really helpful to understand that the total numbers in the report are only a fraction of the kids that are actually … having ingestions of, if not illicit substances, then, at least, dangerous substances.”
That includes, she said, some unregulated THC products purchased at gas stations and wrongfully assumed to be safe.
“We’re seeing kids who are coming in, getting a hold of what parents are, I think, reasonably assuming are legal substances—that should still be kept out of reach of children,” she said. “There’s no question about that.”
Gun deaths — accidental and other
The panel once again is asking lawmakers and policymakers to find ways to encourage safe storage for guns to keep them out of the hands of children.
In 2023, the panel reviewed 12 cases of gunshot injury—11 of which were fatal—involving children. Of those 12 incidents, nine were preventable, the report states.
There were four cases of homicide, which means a caregiver was the shooter, four of suicide and four of accidents. The average age of children involved in gunshot suicide or homicide is 14 years. Accidents typically occur among children as young as 3.
In all these cases, the report states, unsafe storage of guns was a risk factor. Rep. Kim Banta, R-Ft. Mitchell, filed a bill this year to hold parents civilly liable for unsafe storage of guns if minors in their care obtain access and cause harm. It’s been assigned to the House Judiciary Committee but has yet to get a hearing.
In one case reviewed by the panel, a 7-year-old fatally shot his 4-year-old brother while playing with a .410 shotgun in a game of “cops and robbers.” The children regularly played with the gun, which was loaded and beside the refrigerator.
While the number of children who died and nearly died from incidents involving guns has declined following the worst years of the COVID-19 pandemic (2020 and 2021), there are still more than in 2019.
The decline itself is “hopeful,” the report says, but “it is important to note the panel has reviewed 79 firearm incidents in the last five years resulting in 54 deaths, and 25 near fatalities. The near fatalities often result in lifelong complications, including profound disabilities.”
Those can include, Currie said, developing a limp, living with a brain injury from lack of oxygen, requiring a feeding tube, living life from a bed or in a wheelchair and more.
“It can be devastating,” she said. “Widespread brain injury from lack of oxygen applies to our opioid ingestions as well. Those kiddos can stop breathing and suffer tremendous damage to their brain from the lack of oxygen over and above the damage that the drug itself is doing.”
Education component is ‘huge’
How sick or injured a child will be from ingestion or gunshot depends on many factors, Currie with Norton said. Those include the type of substance, how much a child got, if they inhaled or ingested it, where they were shot and more. Some can become symptomatic within seconds, while others take hours.
When it comes to drugs and substances, Currie said, “their outcome largely is dependent on someone recognizing that they may have had an ingestion” and getting them help quickly. Narcan, even if it’s expired, won’t hurt a child, she said. If a child is having trouble breathing, call 911.
“If a caregiver … is on medication-assisted therapy for opioid use disorder—so, someone is taking buprenorphine containing products like suboxone or methadone—I highly recommend that all of those homes should have Narcan,” she said. “Narcan is never going to cause harm to a child.”
Parents and caregivers not fully realizing the lethality of drugs and guns is a “huge” issue, Currie said.
“We know that some folks who are thick in the throes of addiction are not in a mental space to think about the wellbeing of others, including their children, who they may love very, very much, but not be capable of placing their safety as a priority due to the effects that addiction has on a person,” she said. “That’s one layer. The other complexity layer is that guns have, unfortunately, become a political issue. And so if education is provided in a way that is perceived as being political, then folks aren’t able to hear it and incorporate it and do the right things to keep their kids safe.”
Panel policy recommendations
The 103-page report lays out a roadmap for improving the safety of Kentucky’s youngest citizens.
Some of the recommendations made by the panel include:
- The Cabinet for Health and Family Services should convene a workgroup to create a standardized safe drug storage guideline for all providers and the public.
- The Department for Public Health should conduct an aggressive public safety campaign targeting proper medication safe storage and saturating these critical tools throughout Kentucky communities. The campaign should also encourage the use of fentanyl and xylazine testing strips and Naloxone in pediatric ingestions.
- The Department for Community Based Services should create a Practice Guidance Specific to Safe Storage of Medication.
- The governor’s office should convene a task force with the goal of developing and implementing a robust Plan of Safe Care to address the needs of substance-exposed infants and their caregivers.
- The Kentucky General Assembly, through the Judiciary Committee, should explore model legislative strategies to encourage and support safe storage of firearms. This would include Child-Access Prevention and Safe Storage Laws, funding for evidence-based prevention education and provision of gun locks with every firearm sold to give responsible gun owners the tools to securely store weapons.
- The Child Abuse and Neglect Prevention Board should work collaboratively with community partners to fund and raise awareness regarding safe storage practices of firearms.
According to Currie, “the potential to make the problem better is huge if we educate the right people and we get the right policies in place, the right statutory language in place.”
Kentucky Lantern is part of States Newsroom, the nation’s largest state-focused nonprofit news organization.
