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St. George • The picture is serene. A baby asleep in a car seat with a dog resting its head on top.

The text for the meme, a photographic message shared among strangers across the social media universe, offers polarity with its jagged-blade comment: "If you need to be told not to leave us alone in a hot car or we might die you're too stupid to have either of us."

The Facebook post was one of many responses to news that a 2-year-old boy died in Winchester Hills earlier in June after family members forgot he was in a hot van.

Not surprisingly, the boy's death stirred intense emotions within the community. Among those expressed via The Spectrum's social media page, some evinced compassion for the family whose child died. Others expressed forms of outrage, questioning how anything could take priority over a child's care and why someone didn't recognize that a child that age couldn't unbuckle himself from the car seat. Some asked how a caregiver didn't recognize the child wasn't getting food or diaper changes over the course of the six hours before he was discovered in the van.

And, as is apparently to be expected with social media in Utah, some comments turned the incident into an opportunity to harangue members of the state's dominant religious culture over their alleged prejudices, corruption and family planning decisions.

But amid the competing calls for compassion and accountability, the reality remains that the child's death as the result of an apparent accidental heatstroke incident was by no means a unique situation limited to a local family or a single ideology.

Unabated death count • The National Highway Traffic Safety Administration reports that more than 700 children have died of vehicular heatstroke, medically known as hyperthermia, since 1998. As is common with statistical matters, numbers vary from source to source. KidsAndCars.org, a safety organization website that tracks news and statistics related to vehicular incidents, puts the number of fatalities at around 800.

Nine of those were Utah cases. Only four states have managed to avoid becoming part of the statistics. And some question whether the numbers shouldn't be higher, because many potential car heatstroke deaths may instead be reported by medical examiners as something related but distinct, such as fever or homicide.

Two of the 17 fatal cases reported this year received significant national media attention after criminal charges were filed — in Arkansas, day care workers allegedly ignored safety protocols that should have alerted them to a 5-year-old left in a transport van and in Texas, a woman allegedly punished her two daughters by leaving them in a car as she slept for hours under the influence of marijuana.

A statement by the Washington County Sheriff's Office indicates a criminal investigation of the Winchester Hills incident is underway, as is standard in a state where the law specifically targets leaving a child alone in a car. But the Sheriff's statement also indicates that early evidence in the latest incident points to "a tragic accident" more than an incident with criminal intent.

The national average for children's hot car deaths currently stands at 37 incidents per year — there were 39 last year and 24 in 2015. The deadliest year within the recorded period was 2010, when there were 49.

The majority of vehicle hyperthermia incidents occur in the hottest southern states. But two of the fatalities reported this year occurred in Idaho, according to NoHeatStroke.org, another website that tracks hyperthermia statistics. One of last year's incidents involved the young daughter of a police officer in upstate New York.

Utah's car hyperthermia death rate ranks it 31st among all the states in terms of per capita percentages, according to the meteorologist at California's San Jose State University who manages NoHeatStroke.org.

Victims nationwide range in age from 5 days old up to 14 years old, with the vast majority not surprisingly being the youngest children, who are likely to be strapped into car seats and potentially unable to free themselves from the straps or from a closed car door.

Most of the incidents not involving allegations of deliberate homicide tend to have some common characteristics.

• A child asleep in the back seat.

• An adult caregiver distracted by anticipating a to-do list for the day.

• A recent change in the family's daily routine.

• An adult caregiver convinced the child was already safely in the custody of another person.

Those are warning signs a caregiver should take heed of before a tragedy happens.

Legal response • Another sign might be simple exhaustion brought on by illness or some other physical factor. That was one of the findings in the case of a hot car fatality in Hurricane three years ago, the most recent event in Washington County prior to this week.

The child's mother in that situation reported she had been unwell for several days and her 11-month-old daughter had been teething, which combined to cut their sleep short. The mother reported her normal routine was altered the day of her daughter's death and that she believed she had delivered her sleeping child to a safe location.

Instead, the girl remained in a car parked for two hours on a side street near her home on an August day.

That incident also provoked a mix of sympathy and criticism as people struggled to understand how it could have happened. Supporters created an online fundraising project to help the family, while an anonymous person who later apparently revealed himself to be a Layton resident created a Facebook page calling for "justice" for the child, stating he believes the local community let the girl down.

Washington County Attorney Brock Belnap consulted with experts in criminal behavior and psychological impairment during the investigation of the 2014 incident before determining that justice would not be served by recommending charges for a jury trial in the accidental homicide.

"In light of the terrible penalty (the mother has) already paid, it doesn't make sense in my mind (to file charges), and isn't in the interest of justice," Belnap said. "We have to look at . what goals are to be achieved."

An autopsy by the State Medical Examiner's Office ruled the Hurricane death an accident as a consequence of hyperthermia. Belnap said he was aware that members of the public alarmed by the incident still might expect some form of criminal punishment.

"We wrestle with that (decision) all the time in talking about what is the standard of proof. Sometimes we say we're just going to let the jury determine that," he said. "But a lot of times we make a decision on 'What would a reasonable person do in this circumstance?' — and that's very subjective."

Washington County Sheriff's Lt. David Crouse said late June that the investigation into Winchester Hills incident was underway but an initial report has been sent to the Washington County Attorney's Office for review.

"Obviously, we're going to have to wait for a while for a report on the autopsy from the (state Medical Examiner's Office)," Crouse said. "It just depends on their workload. Hopefully we'll have it in the next few weeks."

Belnap said that after reviewing the investigation material, he discovered he and some of his deputies know the family. He was in the process of seeking another agency to handle the investigation to avoid the appearance of a conflict of interest, he said.

Act fast • The U.S. Department of Transportation's Parents Central website advises passers-by who see a child alone in a car not to wait "more than a few minutes" for the driver to return before getting the child out of the car and, if necessary, calling 911.

A phone call to emergency responders can provide extra support if the passer-by is concerned about creating a hostile situation with another adult.

"In addition to death, it is estimated that annually hundreds of children experience varying degrees of heat illness from being left in cars. This danger exists despite public education efforts and lobbying for laws against leaving children unattended in vehicles," a report published in 2005 in the journal Pediatrics stated.

The report measured the temperature rise in a dark sedan over a 60-minute period on 16 sunny days when temperatures ranged from 72 to 96 degrees, and found that regardless of the outside temperature the heat increase inside the vehicle did not vary significantly from an average of about 40 degrees over the ambient temperature. Most of the temperature increase occurred within 15 minutes, with 80 percent of the rise occurring during the first half hour.

If the vehicle was air conditioned before the study, it still reached ambient temperature within five minutes of the air conditioning being turned off and then continued to heat up at a rate similar rate to the other studies. Cracking a window open created less than a half degree of difference in the average mean rate of temperature rise and no difference in the final maximum.

The report found that children can suffer hot car-related illnesses and death even at temperatures well below southern Utah summer levels if they are left in the vehicle.

Although ethical concerns generally limit the scope of studies on how heat stress may affect infants and small children, a collected body of evidence indicates that children are more vulnerable than adults to heat-related illness. One 1995 study in the European Journal of Applied Physiology found that children between 9 months and 4 ½ years old who were placed in 95-degree rooms for half an hour "had a rectal temperature that increased more rapidly and was significantly higher than their mothers' (temperature)."

Hot car deaths join "backover" incidents as one of the leading preventable causes of children's fatalities in Utah connected to motor vehicle use, although "frontover" fatalities have been increasing dramatically nationwide with the popularity of large trucks and SUVs, such as the one involved Easter weekend in the Arizona death of former NFL tight end Todd Heap's daughter.

KidsAndCars.org reports that at least 50 children are victims to backover incidents every week in the United States. The vast majority of the incidents do not result in fatalities, and the advent of rearview cameras on newer vehicles has provided an additional safety measure, but the website estimates that, on average, 232 deaths occur in backover incidents each year.

While the number of Utah's reported backover fatalities is a fraction of those reported in California and Texas between 1990 and 2012, the Beehive State still ranks among the top five nationally for those types of incidents.

Fighting a deadly trend • Many caregivers in hot car deaths find themselves mystified by their own lack of awareness during the moments leading up to the tragedy.

A physician whose daughter died in 2008 provided one of the two dozen-plus tales of hyperthermia heartbreak posted on kidsandcars.org, trying to explain her mindset before her 11-month-old daughter's death.

"The week that Jenna died was the first week of a new routine for us. All summer long, I had been taking my son and Jenna to the same baby-sitter. The day she died I needed to drop my son off at his new preschool/daycare (where Jenna was scheduled to start in just a few weeks) and then take Jenna to the babysitter's house, which was directly across the parking lot from my work," she wrote in a lengthy statement.

"… I kept my eye on Jenna in the baby safety mirror and sang and talked to her until she fell asleep about five minutes later. My goal had been to get Jenna to the babysitter's before she fell asleep so she could get her morning nap. … When I saw in my rearview mirror that she had fallen asleep, I started to think about that morning nap. I came up with a plan for how to get her into the babysitter's house without waking her up so she could continue her nap. I am a very visual person, and one of the reasons I believe I'm successful in the things I do is because I think things through very thoroughly, paying attention to details," she added.

"Somehow, and I know it is hard to understand, my brain flipped a switch as I continued my drive toward work. As the remaining 15 minutes passed, I went from knowing she was in the backseat to firmly believing she was safely at the babysitter's. After I thought through dropping her off, I began thinking about what I needed to accomplish at work once I got there. … One of the more painful things I heard strangers say about me once the news carried stories of Jenna's death was, "How could you not think of your child all day? How could you forget your child?" In my mind I hadn't forgotten her. I had misremembered. I thought she was dropped off safely," she wrote.

She also wrote that the sting of criticism in response to the news reports pales in comparison to "the actual loss of my child. I miss my baby with an intensity that only a grieving parent can understand."

David Diamond, a professor of psychology, molecular pharmacology and physiology at the University of South Florida, said science provides some explanation of the phenomenon.

"There is no doubt that competition between brain memory systems in normal, attentive parents is the basis of why children have been forgotten in cars. When the basal ganglia out competes the hippocampus/PFC system we subconsciously make fatal memory errors. This is a phenomenon that occurs without awareness in the best of parents," he stated in a news release in early June.

Advocates suggest that new technology should become standard for drivers who have small children in a rear seat as well. In an era when buzzers remind drivers to put on their seatbelts or take their keys out of the ignition, a dashboard reminder involving child seats could be next.

Some people have suggested low-tech solutions, such as putting stickers on the steering wheel to remind drivers if the back seat is occupied, or to keep a stuffed animal in the child's car seat that gets moved up front by the driver when the child seat is occupied.

On June 7, three members of the U.S. House of Representatives introduced legislation they're calling the Hot Cars Act of 2017, an acronym for Helping Overcome Trauma for Children Alone in Rear Seats.

The bipartisan sponsors of the bill said the measure would require the Transportation Department to issue a final rule requiring cars to be equipped with an electronic system to alert drivers if a passenger remains in the back seat when a car is turned off.

"No child should endure the tragedy of dying while trapped in a hot vehicle. The unfortunate reality is that even good, loving and attentive parents can get distracted. Studies have shown that this can happen to anyone, anywhere," Democratic Congressman Tim Ryan of Ohio said in a press statement.

"The belief is that it can't happen to you, always someone else. Unfortunately it happens over and over again, even to the most conscientious parents. Technology is available and it can be placed in new vehicles to protect innocent children. It's really that simple," Republican Congressman Peter King of New York added.

The timing of the bill's introduction coincided with NHTSA's National Vehicular Heatstroke Prevention Campaign, but no timeline for action on the bill was announced.