the Editor's Desk
It appears that there is little going on this summer relative to
Society activities. Or little going on that anyone is willing to share
with the editor of this newsletter. I was able to extract a small amount
of content from some of our able committee chairs and this information
Plans are set for the fall meeting in Dallas and the registrations are
already coming in. If you are planning on attending the Dallas meeting and
staying at the Fairmont Hotel, you should make your reservations as soon
as possible; rooms are filling up fast. We are working hard to surpass the
entertainment level achieved at the Dallas fall meeting in 1986. And there
will be a bit of science, for those of you who are into such things.
Pediatric Forensic Pathology - The Society’s Next Steps
In my Spring message, I commented about the “important overlap of
pediatric and forensic pathology.” We live in a modern medicolegal
environment challenged by ancient antipathies of honor and shame as well
as charity and greed. Even though there has been an ever-increasing
recognition of the physical findings of child abuse and neglect,
unscrupulous physicians and lawyers counter it using newly recognized or
manufactured genetic and medical disorders to defend perpetrators.
However, not all of pediatric forensic pathology is litigious. Accurate
diagnoses contribute significantly to the healthy grieving of a deceased
child and planning of future pregnancies. Therefore, the Society should
accept the challenge to further integrate these disciplines as another
outreach opportunity. Pediatric and forensic pathologists can and should
work together to elevate the levels of expertise in pediatric forensic
pathology in medical examiners offices and hospitals, to enhance
diagnostic accuracy, and to improve the quality and integrity of
medicolegal testimony. In the United States, there are apparently only
four individuals who are board certified in both pediatric and forensic
A recent editorial despairing of chronic problems in forensic
pathology in the UK appropriately opined that the quality of forensic
pathology services must be guaranteed (BMJ 2002; 324:1408-9). Obviously,
hospital-based autopsies must be held to a high standard as well. Although
there are auditing mechanisms for hospital-based anatomic pathology
autopsies, such as from the College of American Pathologists, they do not
focus on cases with specific medicolegal importance. Tissue findings with
forensic importance in hospital practice may not be recognized depending
upon the particular interest and expertise of the examining pathologist.
For example, the unexpected finding of a thin subdural hematoma and brain
swelling in a child undergoing hospital autopsy with proper parental
consent may signify clinically unrecognized nonaccidental trauma, and
should prompt notification of the medical examiner. Or failure of the
forensic pathologist to recognize the potential significance of lipid
deposition in the liver and muscle tissues during performance of a
medicolegal postmortem examination may preclude identification of a
genetic disorder important for future pregnancy planning. These scenarios
can be minimized when pediatric and forensic pathologists share their
expertise. It is important that surgical pathology specimens can also
generate findings of medicolegal or genetic significance.
With these thoughts in mind, I asked our members to complete a brief
survey, the results of which I am now pleased to report. There were 131
responses from 6 continents, 10 countries, 34 US states and 79 cities.
Seventy three percent were from the United States; with most from Texas,
California and Ohio. Canada and the United Kingdom were represented more
than other countries. Among respondents, 99% resided in a community with a
medical examiner or coroner. Forty eight percent of our pediatric
pathology groups had at least 1 member actively engaged in forensic
The responses document the widespread contributions of our Society
members to forensic pathology. Although some “preferred not to”, 99%
of the respondents believed it was important to consult with forensic
pathologists, and 74% did so with 53% consulting less than 5 times per
year and 20% greater than 10 times per year. Congenital heart disease,
other congenital anomalies, and sudden infant death led to consultations
in 51% to 63% of responses; neoplasms and nonaccidental injuries were less
Forty nine percent served as expert witnesses with 23% and 37% of the
respondents testifying in criminal and civil trials, respectively. Twenty
four percent refused to testify as an expert witness - the flip side: 76%
would make themselves available given the circumstances. A few respondents
commented on their frustration with the ethics of attorneys who asked for
their consultations. But it is important to remember that successful
unscrupulous behavior on the part of an attorney requires the complicity
of an equally unscrupulous physician!
Forty five percent participated in Child Death Review Teams. Having
served on such a committee in San Diego for several years, the need for a
pediatric pathologist is not only necessary, but also welcomed as is the
expertise of individuals in other areas pertaining to child death, the
causes and manner of which bring them under the jurisdiction of the
medical examiner or coroner. Only a minority of deaths discussed in these
committees is a result of homicide.
Given our members’ extensive interest and involvement in pediatric
forensic pathology, I discussed with the SPP Executive Committee and with
Dr. Joni McLean, the President of NAME, the advantages of creating a
closer relationship of our Society with the National Association of
Medical Examiners (NAME) and the advantages of formalizing the
relationship between the SPP and NAME. We agreed that designation of
liaisons could be an important first step to communicate the interests and
goals common to both organizations. Therefore, we are fortunate indeed
that Drs. Jeff Hubbard and Wendy Gunther, both of whom are members of the
SPP and NAME, have accepted appointment as co-liaisons reporting on
matters of interest and importance in pediatric forensic pathology to the
governing bodies of both societies at their annual business meeting.
Jeff and Wendy will also explore ways to bring to fruition a pediatric
forensic pathology focus group into the Society as favored by 58% of the
survey respondents. The desirability of developing this group is perhaps
best reflected in the following response from one survey respondent: “I
am very much in favor of a forensic focus group in SPP to provide guidance
and advice in a subject I feel very ill-equipped for but I have to deal
In collaboration with the SPP Education and Practice Committees, the
liaisons will work with members of the SPP and NAME to develop workshops
for both societies, to encourage members to submit abstracts to SPP and
NAME meetings, and to submit manuscripts with forensic themes to Pediatric
and Developmental Pathology. Hopefully the latter will increase
subscriptions to our journal from medical examiners’ and coroners’
I want to close by emphasizing that the other good work and activities
of the Society and its officers and committees are not being neglected
despite my focus on pediatric forensic pathology issues. My efforts are a
continuing response to Ron Jaffe’s challenge to Society presidents to
“pick a theme and to try and implement an enduring program.” No doubt,
Derek deSa, your President-Elect, will do the same.
Any pediatric pathology fellowship program director
wishing to update information about their training program now posted on
the SPP web site should contact Alba Greco.
The Practice Committee gratefully acknowledges the
contributions made by Drs. Gareth Jevon and Debra Heller, who completed
their terms on the Committee, and Dr. Leon Metlay, who completed his term
on the Slide Survey Subcommittee at the Spring Meeting.
Current activities of the Practice Committee include
finalizing the Position Paper on Pediatric and Perinatal Autopsies,
gathering data on pediatric pathology practice patterns with the Staffing
and Activities project, and putting together the SPP Slide Survey for next
A draft of the position paper is posted in the
"Members Only" section of the SPP website, together with links
to supporting documents on the websites of the College of American
Pathologists and the Royal College of Pathologists. SPP members are
encouraged to review the position paper and send comments to Dr. Pysher at
email@example.com. Members with
consent forms or informational brochures that might be of use to others,
or who know of other useful links on this subject, are encouraged to
contact Dr. Leon Metlay at firstname.lastname@example.org
who has been coordinating the links attached to the position paper.
Members who want to participate in the Staffing and
Activities survey should contact Dr. Gareth Jevon at email@example.com.
The Slide Survey Subcommittee, chaired by Dr. Gloria
Kohut, is soliciting input for improving the survey, and, as always,
welcomes submission of instructive cases. Please contact Dr. Kohut at firstname.lastname@example.org.
The Long Range Planning Committee report is brief. The
committee will meet in September at the Dallas meeting. As the new
committee chair, I welcome suggestions and feedback from the membership
about strategic planning issues. Correspondence can be emailed to me at email@example.com.
Although the committee itself is small, broad input from the membership is
The Resident Clinical Presentation Award is a new
program that was initiated by our Society this year to promote the
interest of pathology residents in our subspecialty. Applications, which
consisted of one-page case reports that highlighted differences between
pediatric and adult pathology, were solicited from residency programs
throughout North America. A total of 22 applications were received and
these were reviewed by an ad hoc committee of pediatric pathologists from
four institutions, none of whom were given the identities of the
applicants. Based on the committee's review, the following three
individual's received awards:
Brigitte Nixon, M.D. (University of Washington,
Dinesh Rakheja (University of Texas - Southwestern, Dallas)
Amy Hareema (University of California, San Francisco)
The awards will fund travel expenses for each of the
recipients to attend the fall meeting of the SPP in Dallas. At that
meeting, they will present their cases to the Society and participate
fully in the camaraderie that characterizes our field. I know that you
join me in congratulating these future pediatric pathologists and I hope
that you will introduce yourselves to them at our interim meeting.
Two new members of the Bylaws Committee include
Stephanie Young and Faisal Qureshi. Maureen Sander (interim chair)
presented reports at the SPP Council and Business meetings in Chicago in
February. The committee has pursued no new matters in the interim.
In keeping with the Articles and By-laws of the
Society, the Nomination Committee invites nominations, from the membership
of the Society, for the position of President-Elect, and 2 (two)
Councilors. It is expected that the nominee will have indicated his/her
consent to be nominated and willingness to serve. Nominations may be made
in writing to the committee chair (firstname.lastname@example.org)
or to any member of the Nomination Committee (Susan Simonton, Cheryl
Coffin, Ricardo Drut, Ron Jaffe, Claire Langston ).
The committee is also soliciting names of individuals
who are interested in serving on SPP committees, as positions become
available. Names should be provided to me no later than September 1, 2002
since the committee's recommendations must be submitted to Council at the
fall 2002 meeting of the SPP.
Please remember that the success of our Society depends
upon the diligence, commitment and hard work of the individuals who fill
these positions, whether as officers or committee members.
-- Larry Becker
I am sure I speak on behalf of the entire Society in
expressing our profound sadness and sense of loss on the passing of one of
our most distinguished members, Dr. Larry Becker, from the Hospital for
Sick Children in Toronto.
Larry was a rare combination of the consummate
gentleman, treasured friend, insightful scholar, outstanding
neuropathologist, inspiring teacher, and effective administrator. He was
the ideal physician, a role model for all of us in so many ways. I am sure
many of us have fond memories of our experiences and friendship with
Larry. In addition to many other experiences, I particularly remember a
week with Larry in Australia where he dazzled us with his illuminating
lectures, witty humor, great dancing - the best North America had to offer
to those "down under" at a conference on SIDS that was markedly
enhanced by Larry's contributions. Our thoughts and prayers go to his
family, friends and colleagues during these very sad times.
It is my hope that many of you will contribute to the
lectureships to be established in Larry’s name. Donations will be
The Hospital for Sick Children Foundation, 555
Avenue, Toronto M5G Canada
The SIDS Foundation, 586 Eglinton Avenue East,
Ste 308, Toronto M4P 1P2 Canada
The home address for Dr. Becker's family is Dr. Edna
Becker, 1 King George's Road, Etobicoke, Ontario M8X 1K6 Canada.
Becker Memorial Page
New Pediatric Laboratory Medicine On-line Resource
Cheryl M. Coffin, M.D.
Theodore J. Pysher, M.D.
Ronald Weiss, M.D., M.B.A.
Department of Pathology
University of Utah
Salt Lake City, UT
We are pleased to announce a new Web site devoted to pediatric laboratory
medicine at www.childx.org. Children's Health Improvement through Laboratory
Diagnostics (CHILDx, pronounced "Child Diagnostics") is a
multi-institutional, multidisciplinary group of pediatric pathologists,
laboratory medicine specialists, laboratory scientists, and pediatric
subspecialists that seeks to improve the healthcare of children by working with
pediatric laboratory medicine and other healthcare professionals. CHILDx is
supported by ARUP Laboratories and the University of Utah Department of
Pathology. The Web site includes a variety of information about resources,
current issues, and CHILDx activities. Resources on the Web site include:
- Frequently asked questions (FAQ) regarding
pediatric laboratory medicine.
- Links to other Web sites with information
related to pediatric laboratory medicine.
- A compilation of useful publications for the
pediatric laboratory professional.
- Links to PubMed for topics relevant to
pediatric laboratory medicine.
- Information about the mission vision and
accomplishments of CHILDx.
- Information about current CHILDx activities.
We invite you to visit the Web site and to contact one of us
or CHILDx with your questions, comments, suggestions for additions to the FAQ
list, Web site links, and literature resources. We want this to be a useful
clinical, educational, and academic resource for pediatric pathologists and
other laboratory medicine and healthcare professionals. We welcome your candid
feedback and suggestions for further improvements.
Thank you for your consideration. We look forward to hearing from you.
SPP Fall Meeting
September 26-28, 2002
Please follow the links for more
from these PDF
- Meeting Information:
Children's Medical Center Tour Information
Sights and Sounds of Dallas
- SPP's Annual Perinatal Symposium
"Developmental Biology of the Placenta"
Sunday, September 29, 2002 at the Fairmont Hotel in Dallas (CME
Information and Registration Form