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Cause of infant’s death ‘undetermined’ by autopsy

Hypothermia is a possible cause of death for Aubrey Kina-Marie Littlejohn, a 15-month-old Cherokee baby who died in January, according to a state autopsy report released last week.

The autopsy also showed indications of multiple bruises to the head and a broken arm.

Relatives had repeatedly warned Swain County Department of Social Services of suspected abuse and neglect by the baby’s caretaker, but DSS failed to take action. Swain DSS is now under investigation for an alleged cover-up, including falsifying records to hide any negligence on their part.

Aubrey had been living in a trailer with of her great aunt, Lady Bird Powell, 38. Relatives say there was no heat in the trailer. When Aubrey was brought to the Cherokee Indian Hospital the night she died, she was dressed in only a T-shirt. Her core body temperature was only 84 degrees and she was pronounced dead shortly after arrival.

The doctor performing the autopsy could not decisively pinpoint a cause of death and officially deemed it “undetermined.”

“The cause of death certainly wasn’t obvious,” said Dr. Donald Jason, a pathologist at Wake Forest University Baptist Medical Center.

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However, hypothermia remains a possible cause of death.

“We certainly have not ruled out hypothermia,” Jason said.

Hypothermia is difficult to confirm unequivocally through an autopsy and requires “a thorough scene investigation to support a cause of death as hypothermia,” Jason wrote in his report.

It will ultimately take “really good police work” to figure out what happened, Jason said.

“Just like in all science, one has a hypothesis that can be formed from what people say happened or reasonable guesses. The autopsy is one test,” Jason said.

Law enforcement failed to take the temperature inside the trailer. Their reports merely reflect that it was “cold,” Jason said.

Swain County Sheriff Curtis Cochran said the investigation has not been called off just because the autopsy came back with an undetermined cause of death.

“We are still investigating. When the investigation is concluded, we’ll sit down with the District Attorney’s office and determine what if any charges will be coming out of this,” Cochran said.

While the autopsy did not confirm homicide, it likewise did not confirm death from natural causes.

“Questions have been raised. I don’t think they are answered by the autopsy alone,” Jason said.

The autopsy showed multiple bruises to the head that seem to have occurred within a day prior to death. It would not have been possible to receive all the bruises from a single fall, Jason said. However, whatever struck the child’s head was not severe enough to be linked to the cause of death or to the brain swelling.

It also revealed that both bones in Aubrey’s forearm had previously been broken. The break was consistent with a blow to the forearm, rather than a fall, Jason said. Jason said the injury would have been quite noticeable, however, Aubrey was never taken to the hospital or a doctor for it, according to law enforcement records.

In addition to claims by family members who say DSS had reason to suspect abuse and neglect but failed to act, court papers involving other children in Powell’s care reveal that Swain County social workers had reports of physical abuse of Aubrey months before her death.