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Coroner's Finding: Hayes, Teegan Rose Dana

Deceased

Teegan Rose Hayes

Demographics

<1y, female

Date of death

2011-11-06

Finding date

2018-05-31

Cause of death

hypoxic brain injury following respiratory arrest due to accidental suffocation whilst co-sleeping

AI-generated summary

A 24-day-old infant died from hypoxic brain injury following accidental suffocation whilst co-sleeping with her intoxicated mother. The parents were known to child protection services (CPS) due to intellectual disabilities, severe parental alcohol abuse, poor supervision, and neglect. Fifteen notifications had been made before the infant's birth, but CPS failed to conduct proper risk assessments, apply cumulative harm frameworks, or take protective action. Critical deficits included incomplete risk documentation, failure to assess parental functioning, poor inter-agency communication, and inadequate investigation practices. Had CPS properly assessed prior notifications and understood cumulative harm, they would likely have been aware of the birth and removed the infant at that time, preventing her death.

AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes.

Contributing factors

  • co-sleeping with intoxicated parent
  • parental alcohol abuse
  • adult bedding and pillows in bed with infant
  • parental intellectual disability
  • parental lack of understanding of safe sleeping practices despite education
  • failure of child protection services to assess and act on 15 prior notifications
  • failure to identify cumulative harm to children
  • inadequate risk assessment procedures

Coroner's recommendations

  1. CPS provide ongoing training to child safety officers in identifying and responding to situations where infants under 12 months are at risk due to unsafe sleeping practices
  2. Deputy Secretary, Child and Youth Services, provide this finding to the Chair of the working party for the Vulnerable Infants and Babies Strategy to inform development of the Tasmanian Strategic Framework for Vulnerable Infants and Babies
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