Ruling Holds Day-Care Providers Liable In Sudden Infant Death

By LYNNE TUOHY
The Hartford Courant
June 05, 2001

Day-care providers throughout Connecticut have been put on notice, in an unprecedented ruling, that they could be held civilly liable for the death of an infant in their care due to Sudden Infant Death Syndrome.

The ruling is an offshoot of the equally unprecedented jury verdict in January ordering Barbara Horne of Bolton to pay $800,000 to the family of 2-month-old Shelby LePage, who died in Horne's care.

Although Horne had been instructed by LePage's mother to permit the baby to sleep only in her car seat or in a swing at Horne's home, Horne placed the baby in a crib and did not reposition her when she saw Shelby had rolled onto her stomach.

Although it sent waves of panic through the day-care provider community, the verdict applied only to Horne. But the ruling issued by Rockville Superior Court Judge Samuel Sferrazza Friday afternoon clearly establishes that all day-care providers with knowledge of the sleeping positions used to minimize the risk of SIDS have a legal obligation to infants in their care to prevent them from sleeping on their stomachs.

The ruling establishes, for the first time in this state, a legal "duty of care'' by child-care providers to do everything in their power to prevent a SIDS death on their watch. Sferrazza in the ruling denied a motion by Horne's lawyers to set aside the verdict. Her lawyers contended that she owed no such duty of care to Shelby to reposition her to minimize the likelihood the baby might die of SIDS.

Sferrazza noted there is no other Connecticut case confronting the issue of whether such a legal obligation exists in cases involving SIDS - the causes of which are still cloaked in mystery.

"By clinical definition, SIDS is unexpected and, therefore, untreatable,'' Sferrazza wrote. But, he added, "It is currently recognized that SIDS strikes a significantly higher percentage of infants who sleep on their stomachs than those who sleep in other positions.''

Although the pathology of SIDS remains unclear, incidence of SIDS have been reduced 42 percent since the American Academy of Pediatrics recommended in 1992 that babies be put to sleep on their backs. In 1994, a highly publicized national campaign began, utilizing the slogan, "Back to Sleep.''

Judy Jacobson, executive vice president of the national Sudden Infant Death Syndrome Alliance, said at the time the verdict was returned against Horne, "This campaign has truly made a difference in keeping probably 2,000 or more babies alive. It's not a guarantee, but it certainly has become a standard of care and it should be followed. If a caregiver is not following the standard of care, they will be subject to litigation. That's the society we live in.''

Shelby died on her second day in Horne's care. Some SIDS researchers have noted that babies accustomed to sleeping only on their backs are particularly vulnerable the first day or two they are in someone else's care and are permitted to sleep on their stomachs.

Because Horne's lawyers did not raise the issue, Sferrazza in his ruling did not analyze whether public policy concerns should enter into consideration of whether day-care providers have a legal obligation to do everything in their power to prevent SIDS death.

Sferrazza based his ruling solely on whether a reasonable person, knowing what Horne knew about the role of sleep positions in SIDS deaths, "would anticipate that SIDS would be a likely consequence of [Horne's] failure to place the infant in, or restore her to, a supine position.''

Gerald Sack, who represents the LePage family, said Monday the duty of care issue was the "legal underpinning'' of the jury verdict in their favor. Sferrazza's follow-up ruling, Sack said, "affirms the general principle that a child-care provider does have a legal duty in this context.''