DOJ Medical Examiner determines cause and manner of death for 22-Month-old Baby, Tamir Lake

Attorney General Denise George announced at a press conference today, the result of the Department of Justice Medical Examiner’s investigation into the cause of death of 22-month-old Tamir Lake who…

Attorney General Denise George announced at a press conference today, the result of the Department of Justice Medical Examiner’s investigation into the cause of death of 22-month-old Tamir Lake who died on May 5, 2020. The cause of death is “seizure due to severe encephalopathy due to non-accidental blunt force head injuries occurring in December 2018”. The manner of death is ruled “homicide”. Tamir Lake was in the protective custody of the Department of Human Services at the Queen Louise Home for Children from March of 2019 to the time of his death.

At the press conference, DOJ Medical Examiner Dr. Jaqueline Pender provided a summary of her cause and manner of death investigation and determination including the autopsy performed on the body of Tamir Lake.
The conclusion of the investigation and preparation of the autopsy report was completed and finalized early Tuesday morning.

The Office of the Medical Examiner, a division of the V.I. Department of Justice investigates and determines the circumstances, manner, and cause of all violent, sudden, suspicious, unusual, or unlawful deaths occurring in the Virgin Islands as mandated by law. The law requires the Medical Examiner to fully investigate the essential facts concerning the death including an autopsy and his or her opinion necessary to establish the cause of death, or to determine the means and manner of death.

Tamir was placed in the child protective custody of the Department of Human Services and placed at the Queen Louise Home for Children in March 2019. They maintained custody of Tamir pursuant to the authorization and order of the V.I. Superior Court. On the morning of May 5, 2020, Tamir Lake died while in the care of the Dept. of Human Service’s Queen Louise Home for Children. The medical examiner’s office responded to the scene and took possession of Tamir’s body.

An external examination and complete autopsy were performed on May 7, 2020 and an investigation ensued.

The medical examiner laid out a timeline from the investigation during a press conference held on July 21, in summary as follows:

7-2-2018: Tamir Lake is born, premature but with good APGAR Scores of 9/10 and 9/10 (The Apgar score is a method to quickly summarize the health of newborn children, rated from 0-10 at 1 minute after birth and 5 minutes after birth)

8/6/2018: Tamir was discharged home in a healthy condition

11/9/2018: During a 4-month wellness check- Tamir was found to have gastric reflux, passed six 4-month-old milestones and failed 3- not able to bear weight, hold himself up, and unable to reach

12/12-12/14 2018: Tamir was brought to the ER at JFL with 5-6-day history of fever, vomiting, cough, runny nose According to his Chest x-ray: His Lungs were clear A CT Head scan was performed, and it revealed a brain hemorrhage He showed spasms of his upper extremities. A decision was made to airlift Tamir to Miami due to the need of more advanced Pediatric care for seizure activity, sepsis, and a brain bleed

12/14/2018: Tamir was airlifted & Admitted to Nicklaus Children’s Hospital in Miami 12/2018: A CT Brain scan revealed, Multiple skull fractures (including comminuted fractures, meaning bone broken into pieces), intracranial bleeding (subdural and subarachnoid hemorrhages), Cerebral edema (brain swelling), Diffuse axonal injury (DAI: the result of traumatic shearing forces that occur when the head is rapidly accelerated or decelerated, usually as a result of violent shaking of the head or blunt force impact of the head) An MRI Brain scan revealed, Global Hypoxic Ischemia (Entire brain deprived of oxygen and blood resulting in cell death) An EEG was performed (measures brain electrical activity) and revealed severe encephalopathy (permanent brain damage) A Skeletal Survey revealed multiple bone fractures of right and left upper and lower extremities, all in different healing stages. There were specific type of bone fractures caused by twisting and pulling of the limbs, of his right humerus (right arm), left fibula (left forearm), and right tibia and fibula (right leg). Tamir was diagnosed with blindness caused by damage to the brain’s occipital cortex. Tamir was intubated and admitted to the Pediatric Intensive Care Unit

12/28/2018: Genetic test result was negative for osteogenesis imperfecta (The term “osteogenesis imperfecta” means imperfect bone formation. People with this condition have bones that break (fracture) easily, often from mild trauma or with no apparent cause)

1/2/2019: Tamir was discharged out of the hospital to stay with Foster parent in Florida while still receiving outpatient care at Nicklaus Children’s Hospital until healthy enough to return to STX

3/2019: Tamir was determined healthy enough to fly back to St Croix. By this time, he had been diagnosed with cerebral palsy caused by traumatic damage to the brain that results in movement disorders, intellectual disabilities, seizures, muscle contractures, and functional gastrointestinal abnormalities., DHS took protective custody of Tamir Lake and he was placed at the Queen Louise Home, specifically at the Sister Emma Cottage which is a special unit at the Queen Louise Home campus that provides intensive 24-hour care for children and young adults with severe developmental and physical disabilities. Tamir was on medication for gastric reflux, muscle spasms, and seizures due to CEREBRAL PALSY diagnosis

5/5/2020: As per Tamir’s pediatrician, Dr. Ricketts, Tamir had an uneventful morning. He was reported as happy and giggling with other children and was put down for a morning nap. Approximately 20-30 minutes later, staff check on Tamir, and he was found dead in bed, laying on his back.

5/7/2020: An external examination and complete autopsy were performed on May 7, 2020. A further investigation ensued.

An external examination autopsy shows a well-cared-for child in a clean diaper with dilated pupils and blue fingernail beds, consistent with death due to a seizure.

A post-mortem CT scan of the full-body showed no acute injuries to the body or evidence of any injuries other than the healed injuries that had occurred before December 12, 2018.

AG George indicated that the matter will be referred promptly to the Virgin Islands Police Department for child abuse and homicide investigation. “Tamir Lake had a tragic life and a tragic death, we will seek justice for Tamir,” Attorney General George stated.