Jay Hudson Bassett was just 8 months old when he was rushed, unconscious, to the hospital on Thanksgiving of 2012.

“He was a love," said his grandmother, Shelly Medeiros. "He would smile and sparkle. I swear to God."

When Medeiros saw Bassett in the emergency room, she quickly fixated on a bruise above his left eye. Her daughter and Bassett’s father were in the waiting room. Medeiros says she went up to him.

"I put one hand on one leg, and one hand on his other leg, and said, 'What happened to my baby?'" she said.

When a child dies under questionable circumstances, it’s the start of a long and complicated forensic process to untangle what happened. And by then, it may be too late to prosecute anyone. The system sometimes fails to provide justice for the state’s most vulnerable.

When Bassett died, police records show the hospital initially said it was a case of sudden infant death syndrome. But Medeiros kept calling the medical examiner’s office to get an official ruling.

"I was pressuring them because I was upset that they knew there was something not right about the case," she said. "But nobody was working on it. They didn’t have the manpower."

By that time, the parents had moved to Ohio. There’s no evidence either of them is a suspect in the still-open police investigation, but Medeiros believes that, at the very least, they know what happened because police records show they were with Bassett when he stopped breathing.

WGBH News and our partner the New England Center for Investigative Reporting reached out to both of them, including a visit to their home by one reporter, and they declined to comment. They now have another child — a grandchild Medeiros has never met.

'Justice For Jay'

Sitting in her North Attleboro apartment, Medeiros says she harassed the state medical examiner’s office for a year and a half.

"Finally, one day I called vital statistics and a guy named Mark said to me, ‘Oh yeah, we do. By the way, we do have his death certificate and it’s been changed,'" she said. "I was like, 'You’re kidding.'"

He mailed her a copy of the updated death certificate. She keeps it tacked to her refrigerator with a magnet.

"Here it is: blunt force trauma to the head and neck, inflicted by others," she said.

It took 18 months for the death to be ruled a homicide. Now, three years after Bassett died, no one’s been charged with his death.

"The fact that it took so long changed the whole scenario," Medeiros said. "If it had been done when I wanted it done, somebody would be in jail right now. There’s no doubt in my mind."

It turns out this story isn’t that unusual in Massachusetts. NECIR analyzed 102 death certificates of children the Department of Children and Families determined died of abuse or neglect between 2009 and 2013. In those cases, they found the medical examiner’s office took an average of 242 days to issue a death certificate.

The state medical examiner's office faced a crisis in 2007 when it was severely understaffed and fell deeply behind in its reporting. Massachusetts’ Secretary of Public Safety, Dan Bennett, called it was a terrible situation they’re still climbing out of, but he says it’s not like bodies are piling up anymore.

“You can do the autopsies. Those are happening right away," he said. "But it’s that paperwork that stacks up and up and up, and they get behind on, because they don’t have enough medical examiners.”

An internal review team recommended the state have 17 full time medical examiners. Today the office has just seven full timers and four part timers. Bennett says that’s because there are shockingly few candidates.

“There’s only approximately 30 people that graduate from medical school per year who are qualified in that area,” he said.

And there’s a lot of competition to hire them. So the Massachusetts medical examiners office has started something of a farm system. It’s a fellowship program to bring in one or two a year. In the meantime, they’re hiring more administrative staff to help with all that paperwork.

The president of the National District Attorneys Association, Syracuse District Attorney Bill Fitzpatrick, says delays like those seen in many Massachusetts cases can be a problem for prosecutors.

“Because maybe not only the parents have moved out of state, but other witnesses have moved as well," Fitzgerald said. "And then you get into other problem areas, you know, extraditions, and crossing state lines, bringing somebody back."

Even when the medical examiner’s office does make a ruling, that often doesn’t mean a prosecution can happen, if it’s warranted. Worcester District Attorney Joe Early couldn’t speak about individual cases, but he says in cases like Bassett’s, finding out what happened can be challenging. For one thing, children often have multiple caregivers.

“You have to pinpoint which one was with the child at or around the time of death," he said. "You can’t necessarily believe the stories you’re told. You try to go based on the information you get from the medical examiners’ office, which may come back inconclusive.”

In Medeiros's case, the medical examiner finally said her grandson was a victim of a homicide. But she’s still waiting for someone to be held accountable for that.

“Justice for Jay, that’s what I want," she said. "That’s all I want. I want somebody to do something because he was such a special person."