Area PF informed by Hospital / Emergency Department / GP / Police of SUDI

1. Area Procurator Fiscal instructs a police report. Report sent to Area Procurator Fiscal next lawful day.
2. Area Procurator Fiscal notifies Healthcare Improvement Scotland of SUDI. This is done via the Area Procurator Fiscal SUDI return card

On receipt of police report, the Area Procurator Fiscal will notify the paediatric pathologist requesting a post-mortem examination.

1. Paediatrician and paediatric pathologist to have dialogue. The paediatric pathologist & identified paediatrician (or SUDI paediatrician) have any relevant discussions prior to the post-mortem examination being performed. »
   This dialogue ensures that the paediatric pathologist has the required background information surrounding the circumstances of the SUDI (eg is aware of any investigations performed within the Emergency Department setting, etc).
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2. Pathology department staff to accommodate parent wishes in providing a memory box with keepsakes.
3. Paediatric pathologist notifies Healthcare Improvement Scotland of SUDI. The paediatric pathologist should access the SUDI notification card return, complete it and return to Healthcare Improvement Scotland. »
   This notification process ensures Healthcare Improvement Scotland can make contact with the relevant SUDI paediatrician in that area and alert them to the incident if not already aware.
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4. Healthcare Improvement Scotland notifies the SUDI paediatrician of SUDI. This initial notification of a SUDI having occurred in their area is done via email and followed up with a letter containing details of the infant if secure NHS email is not available. »
   Which ever notification comes to Healthcare Improvement Scotland first (either via the Area Procurator Fiscal or the paediatric pathologist), Healthcare Improvement Scotland will then notify the SUDI paediatrician.
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5. SUDI paediatrician to contact the Area Procurator Fiscal requesting copy of post-mortem examination report when available. This is done via letter.

Paediatric pathologist to forward on initial post-mortem examination findings to Area Procurator Fiscal

1. Area Procurator Fiscal to send copy of post-mortem examination findings to SUDI paediatrician.
   1. Copies of the post-mortem examination findings may be issued to healthcare professionals who had previously requested them in writing from the Procurator Fiscal, such as the GP or paediatrician.
2. Paediatric pathologist and paediatrician to have dialogue prior to 1-2 week parent meeting. »
   An initial meeting with bereaved parents/family is organised one to two weeks following the death to explain any initial post-mortem examination findings and/or ongoing tests. Prior to this meeting make any necessary arrangements with the identified paediatrician involved (or SUDI) regarding who will lead the meeting and if there are any likely delays (eg scheduled leave, etc.) that may impact on the availability of the final post-mortem examination report.
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3. Identified paediatrician will make contact with the bereaved parents/family at approximately 6-8 weeks after the death. This meeting with the family is mainly to provide reassurance that the results will be available as soon as all further pathology investigations are completed.

Area Procurator Fiscal authorises Healthcare Improvement Scotland to co-ordinate SUDI review meeting

1. SUDI review meeting arranged. Ideally, this meeting should take place approximately 16 weeks following the death and will involve: pathologist, identified paediatrician (or SUDI), GP, health visitor and social services (if already involved with the family).