Category Archives: shaken baby syndrome

May 13, 2013 · 10:19 am

Good Medicine: Connect at a Conference

Biomechanic John Lloyd, PhD, reviewing medical imaging with a parent at the 2012 EBMSI conference.

Biomechanic John Lloyd, PhD, reviewing tissue properties and the laws of physics with Tonya Sadowsky at the 2012 EBMSI conference.

Two exciting conferences are coming up this summer and fall, one for people who want to understand more about the troubling diagnosis of infant abusive head trauma, and another for professionals eager to witness the evolving debate.

The Evidence Based Medicine and Social Investigtion group (EBMSI), which is hosting the August conference, is a remarkable organization to begin with, a coalition of families who have weathered abuse allegations and are now offering help to the newly accused. With an expanding circle of volunteers and supporters, founders Zabeth and Paul Bayne are holding their third conference this summer, August 2–4 in Surrey, British Columbia.

Zabeth and Bethany Bayne, August 2012

Zabeth and Bethany Bayne, August 2012. Zabeth and her husband were accused of shaking Bethany when she was just a few weeks old. The parents reported one of her older brothers had fallen on her.

The conference is intended both for accused families and for professionals and paraprofessionals who work with child abuse cases. The 2013 faculty includes published experts and front-line practitioners in the arena. The setting is intimate, and the schedule provides time for consultation with the speakers.

Last year I posted summaries of the talks by forensic pathologist Dr. John Plunkett and attorney Zachary Bravos at EBMSI. Other speakers this year include pediatric neuroradiologist Dr. Pat Barnes—who testified for the prosecution in the Louise Woodward case but has since revised his opinion—and pediatric bone expert Dr. Charles Hyman.

For information about the conference, please go to http://www.sbstriad.com/

For information about the conference, please go to http://www.sbstriad.com/

A group of forensic pathologists, meanwhile, is attempting to move the debate forward with a “World Congress on Infant Head Trauma,” November 15–17, at the Center for American and International Law in Plano, Texas.

The conference, sponsored by the publishing arm of the National Association of Medical Examiners, is intended to “find common ground and debate controversial topics in pediatric forensic pathology.”

The conference features a series of presentations and responses by each of two teams, whose specific positions are not articulated in the conference publicity.  One team is headed by forensic pathologist Dr. Greg Schmunk, the other by forensic pathologist Dr. John Plunkett.

Speakers will submit both written and oral arguments, and an editorial board will publish a summary of the dialog in 2014. Dr. Chris Milroy will act as conference director and editor-in-chief of the published proceedings.

The content is limited to head trauma, not the larger question of infant abuse, with a specific focus on shaken baby syndrome. From the web publicity:

During their presentations and submissions to the Editorial Board, contributors are asked to consider and answer (using an appropriate scientific basis) the question “is it possible that shaking an infant results in the classical triad?”

Exciting times in the arena.

-Sue Luttner

If you are not familiar with the professional debate surrounding shaken baby syndrome, please see the home page of this blog.

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April 22, 2013 · 1:29 pm

Forward, Into the Book Stores

audreyCover

Audrey Edmunds’s book was released in late 2012.

Just three years ago, the only books I could find about shaken baby syndrome told the prosecution’s story: Medical texts offered confident advice about  symptoms and  timing [1]. One  guide for practitioners, The Shaken Baby Syndrome: A Multi-Disciplinary Approach, specifically recommended the kind of seamless co-operation among hospitals, social services, and the police that has been winning convictions in these cases for thirty years and counting [2]. And a number of personal books told the stories of families ravaged by the loss of a precious child to presumed shaking [3,4].

Now the other storyline is hitting the shelves: Two women have already published books about their experiences as exonerated baby-shakers, and more are on the horizon.

It Happened to Audrey

It Happened to Audrey is the memoir of Audrey Edmunds, a wife, mother, and child care provider who spent a decade in prison before her conviction was overturned in 2007 after an appeal by the Wisconsin Innocence Project.

AudreyQuoteWritten with her friend Jill Wellington, a journalist, the book traces Audrey’s harrowing journey, from her horror and feelings of guilt the day a 6-month-old girl fell unconscious in her care, through the unimaginable accusations, trial, and years in prison for an assault that she knew had never happened. The experience not only shattered Audrey’s world but gave everyone around her a new perspective. In this excerpt, for example, a seasoned reporter sees a new side to the crime beat:

Meanwhile, my journalist friend, Jill Wellington, was working at a television station in Michigan the day after the verdict came in. Her hands trembled as she punched in the phone number for the Dane County Courthouse. “Hello, I’m a news reporter in Michigan and I’d like to get the verdict in the Audrey Edmunds case.”

“Well, of course, she’s guilty,” the woman who answered the phone replied tersely.

Jill was stunned at this abrupt, ill-considered comment. One of Jill’s coworkers knew a producer at Dateline, NBC. Jill called him and asked if he would investigate my case. A week later, she called the producer again and was shocked at his reply.

“I talked to some of the newspaper reporters who covered Audrey’s case,” the producer said. “They all say she’s guilty.”

Anyone who has been falsely accused of injuring a child will resonate with this book.  I hope it’s also read by social workers, investigators, and people who assume that an innocent person cannot be convicted in our justice system.

When Truth No Longer Matters

heather'sCroppedMeanwhile in Britain, accused parent Heather Toomey has written a remarkable account of her historic battle with social services, When Truth No Longer Matters.

Through unwavering focus and the support of extended family, Heather managed to keep herself, her husband, and their two young sons together while she and her husband fought accusations of shaking the younger boy. Seven years later, the child was diagnosed with a bleeding disorder that explained the subdural hematoma behind the original shaking diagnosis.

At the time, however, the Toomey family was branded as child abusers, under constant pressure to “tell the truth” so as to “clear up” what had happened to their baby. They abandon their home and move in with relatives, so as to satisfy the supervision requirements. They struggle to stay ahead of the financial burdens and attend unending court-imposed appointments. They tolerate frequent, intrusive visits; evaluations; interrogations; and bureaucratic hurdles, all while trying to maintain the kind of positive attitude the social workers demand.

“The authorities have taken a capable mother and turned her into a paranoid mess,” Heather writes, convincingly.

Finally, she and her husband give in to the pressure and sign a “threshold agreement,” in which they admit to failing their young son in return for having their case closed. She writes:

We still firmly believe that the cause is medical, but we have no doctor prepared to back up our belief . . .  whichever way we look at it, it is less of a leap to admit to failing him than it is to admit to abusing him.

With the parents subdued, their children’s names are removed from the “at risk” register, and the constant interference comes to an end. They are allowed to return to their own home. “The case conference concludes that there were never any concerns raised about us as parents or about the children’s welfare during the entire time of their involvement,” Heather recounts. “Our children have never been at risk from us, only from those who failed to  investigate anything other than suppositions and accusations.”

heatherToomehyTheir son’s bleeding disorder was diagnosed years later, after they’d been badgered into capitulation—but at least they’d kept their family intact.

Like Audrey’s story, Heather’s from-the-heart narrative will validate the experiences of accused parents and caregivers. Again, I hope the book also finds an audience among social workers, investigators, and prosecutors, who need to listen to the child-abuse experts, but not without keeping an open mind to the bigger picture.

You can read more about Heather’s story on her web site, at http://www.searchfortruth.co.uk/index.html

Edges of Truth: The Mary Weaver Story

Exonerated babysitter Mary Weaver has collaborated with ministerial writer Deb Brammer on a book about Mary’s ordeal, Edges of Truth: The Mary Weaver Story, scheduled for release in the fall of 2013. Weaver was one of the first babysitters convicted of shaking an infant in her care, in the early 1990s, and one of the first exonerations.

The tag line for the book is:

“When a baby is brutally murdered, an innocent babysitter is accused and uncertainty forces experts to define the edges of truth.”

Vaccine-Induced Encephalitis

And a couple of years ago a physician and a journalist together published a book questioning one aspect of shaken baby syndrome, Shaken Baby Syndrome and Vaccine-Induced Encephalitis: Are Parents Being Falsely Accused? By Harold Buttram, MD, and journalist Christina England (AuthorHouse, 2011).

copyright 2013, Sue Luttner

If you are not familiar with the controversy surrounding shaken baby syndrome, please see the home page of this blog.

Footnotes:

[1] Shaking and Other Non-Accidental Head Injuries in Children, by Drs. Robert A. Minns and J. Keith Brown, Mac Keith Press, 2006

[2] The Shaken Baby Syndrome: A Multidisciplinary Approach, edited by Drs. Stephen Lazoritz and Vincent J. Palusci, The Haworth Maltreatment & Trauma Press, 2001

[3] Grandma’s Baby: A True Story of One Family’s Struggle with “Shaken Baby Syndrome” and what they call “Shaken Family Syndrome,” by Karen Wise, R.N., Trafford Publishing, 2006

[4] What Happened to Christopher? by Ann-Janine Morey, Southern Illinois University Press, 1998

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April 8, 2013 · 12:49 pm

Old Cases, New Cases, Sad Cases, True Cases

An exasperating series of convictions and exonerations has reminded me both how big a price child-care providers are paying in this arena and how hard it is to pin down the facts about shaken baby syndrome.

Mary Weaver, 41 years old in 1993, when accused of shaking an infant in her care

Mary Weaver, 41 years old in 1993, when accused of shaking an infant in her care

Mary Weaver, Exonerated

If more people had been paying attention in the 1990s, for example, the story of 11-month-old Melissa Mathes would have been a valuable case study in both timing and mechanism.

On a January morning in 1993, care provider Mary Weaver called 911 for help when the infant Melissa fell unconscious about 45 minutes after arriving at her home. Autopsy revealed a healing skull fracture, but doctors concluded the girl had been shaken to death—and based on the common wisdom that the symptoms of a serious shaking are immediate and obvious, prosecutors targeted Weaver.

Her first trial ended with a hung jury, her second in a conviction and a life sentence. Then new witnesses came forward, to report that Melissa had been knocked unconscious in a fall before arriving at Weaver’s on that critical day. Weaver was granted a new trial in 1996, and was acquitted by a jury in 1997.

The case changed the mind of forensic pathologist Dr. Vincent Di Maio, for many years the editor-in-chief of The Journal of Forensic Medicine & Pathology. Called in for his opinion, Di Maio read Melissa’s medical records and realized the common knowledge about timing of infant head injuries was wrong. The girl had been seen by her family doctor three times for the flu in the week before she quit breathing in Weaver’s care.

“That case is very disturbing,” DiMaio told me in 2000, “because everybody agrees that the skull fracture is seven days old, and everybody agrees that the doctor saw this child and thought she looked normal… But we know she already had cortical necrosis [dead brain tissue] and thrombosis [clots inside the vessels]… Whether or not you believe the babysitter killed the kid, you know a serious brain injury went unnoticed by a professional observer.”

The case has not appeared in the medical journals, but Mary Weaver was in the news last month when her name was added to the National Registry of Wrongful Convictions, maintained by the University of Michigan Law School and the Center on Wrongful Convictions at Northwestern University School of Law. The registry offers a summary of Weaver’s case, and her local newspaper covered the registration story.

Kelly Kline, Not Guilty

Fifteen years after Weaver’s exoneration, Ohio child care provider Kelly Kline found herself in the same spot, fighting shaking allegations even though the child who fell unconscious in her care had a healing skull fracture revealed at autopsy.

Akron Children's Hospital

Akron Children’s Hospital

Even more remarkable in the case of 15-month-old Ella Young, the treating physicians had a plausible explanation for the fracture:  The girl had fallen down the stairs at her mother’s split-level home a week before developing breathing problems at Kline’s house. Dr. Richard Daryl Steiner, however, a pediatrician at Akron Children’s Hospital, concluded that the fracture was irrelevant and Ella had died of shaking injuries inflicted immediately before her meltdown. He and Summit County Medical Examiner Dr. Lisa Kohler both testified for the prosecution at Kline’s trial

Dr. John Plunkett, at the 2012 EBMSI conference

Dr. John Plunkett, at the 2012 EBMSI conference
(for information about the 2013 conference, http://evidencebasedmedicineandsocialinvestigation.org/home/)

Forensic pathologist Dr. John Plunkett testified for the defense, arguing that the fall six days earlier could have set off a slow neurological response that reached a critical threshold without a violent trigger.

The good news is that the jury found Kline not guilty—the Wooster Daily Record, which had earlier published the charges without question, including Kline’s name and address, also covered the not guilty verdict this past fall.

The tragedy is that child protection professionals continue to press these cases. Kline says she understands that she was lucky to be found innocent, but she and her family are still struggling to recover from the financial and emotional costs.

badge“I see a police officer, and I know it’s not rational, but my hands shake. I can’t think,” she said in early April, months after the innocent verdict. She’s trying to shed her anger at the officers and social workers who dealt with her over the year and a half she stood accused. “Not one person ever tried to help me or listen to my story,” she said, “They just accused me and accused me.”

Throughout more than one difficult interrogation, Kline never wavered from her original story, although keeping her head wasn’t easy, she recalled. “Lieutenant [Kurt] Garrison told me, ‘All fingers are pointed toward you. The forensic science says you did this. Dr. Daryl Steiner says you did this. There are no other suspects’ . . . He had me so frustrated the way he was turning it around, he almost made me believe I did something wrong.”

Ashley Howe, from the police interrogation tape

Ashley Howe, from the police interrogation tape

Ashley Howes, Compensated

At 13, Ashley Howes was not an experienced babysitter. She was the daughter of a family acquaintance, expecting to act as a “mother’s helper” for the weekend, playing with a pair of sisters, 5 years and 19 months old.

The girls were having a good time, and on Sunday afternoon Ashley agreed to extend her stay. But then, less than an hour after she was left alone with the sisters, Ashley called 911 for help with an unconscious toddler, her charge Freya.

The shaking diagnosis came quickly. Police picked up Ashley at the hospital and took her to the station, where they interrogated her for a total of 19 hours, turning on the video recorders at about 3 am. You can see what the Seattle police considered to be the damning portion of the interview in the 48 Hours coverage of the case.

Ultimately, Judge Mary Roberts excluded the tapes from evidence, noting that detectives had ignored what she considered Ashley’s recorded invocation of her right to remain silent. With the tapes excluded, prosecutor Kathy Van Olst then asked the court to withdraw the charges, with the argument that the tapes were essential to proving the necessary timeline.

The 48 Hours coverage in 2006, after the charges were withdrawn, offered this background information on shaken baby syndrome:

According to most doctors, the only other way Freya could have sustained these kinds of head injuries would have been from a high-speed car accident or a fall from a great height, two things she was not involved in that weekend…

Dr. Brian Johnston, the chief of pediatrics at Harborview Medical Center, says he thinks Freya suffered an inflicted injury.

“In severe or fatal shaken baby cases, the symptoms would be apparent immediately after the shaking. They have difficulty breathing. They lose consciousness,” says Johnston.

Johnston did not treat Freya that night but has studied shaken baby cases. Does he think a 100-pound child could create enough force to kill a 26-pound baby?

“A 100-pound child is the size of many average-sized grown women. Unfortunately, we know that people that size are capable of inflicting these injuries on children,” says Johnston.

After the charges were withdrawn, the police, the district attorney’s office, and Freya’s family all told reporters for 48 Hours that they still believe Ashley is guilty. Her defense attorney Bryan Hershman, however, said, “I don’t want this little girl to live the rest of her life with people saying she got off on a technicality. She didn’t. She’s innocent.”

IMG_4464Ashley Howes was not convicted, but at the age of 13 she endured hours of hostile interrogations by a series of police officers who insisted she had murdered a little girl. She spent nearly a year under house arrest with an ankle monitor, not even allowed onto her own back lawn, and when she finally returned to school, any hopes of a normal adolescence were put to rest by taunts and jeers at the presumed baby-killer.

Ashley’s story was in the Seattle Times in March when the city reached a financial settlement with her parents, who had filed a civil suit in 2011 against the police for their callous and deceptive treatment of their daughter.

What I wish is that the doctors who make these black-and-white pronouncements about causation and timing would speak personally with the people they’re accusing, and not just send the police in to badger out confessions. I think they are missing out on a lot of valuable information. The police claim that Ashley confessed to “shaking” Freya twice, for example.  One of those two incidents was earlier in the day while she was giving the girl a bath, before the parents left the house.  If Ashley shook Freya violently at that time, and the symptoms are as immediate as Dr. Johnston says, would Freya’s mother really have called Ashley’s mother later in the afternoon and asked to keep her longer? If that “confession” isn’t accurate, what about the other one? I just don’t understand their sureness in the face of these uncertainties and conflicting tales.

Toni Blake and Suzanne JohnsonChristmas, 2001

Toni Blake and Suzanne Johnson
Christmas, 2001

Suzanne Johnson, Supported

Grandmother and child care provider Suzanne Johnson was convicted in 1999, during the first wave of shaking accusations. Counting time served waiting for trial, she is now 15 years into a mandatory sentence of 25 years to life.

Johnson’s conviction politicized her young jury consultant, Toni Blake, who was sure her client was innocent. While studying the medical literature for Johnson’s trial, Blake realized how unprepared most defense attorneys are for infant head injury cases, so she now offers a primer on shaken baby syndrome on the web site for her consulting business, Second Chair Services.

After years of work by Blake and others, the California Innocence Project has now taken on Johnson’s case.

Later this month the project is starting an Innocence March to the state’s capitol in Sacramento, where marchers will ask for pardons from Governor Jerry Brown for 12 convicted prisoners. The first leg of the walk, from San Diego to Ocean Beach, is dedicated to Johnson. Blake reports that Innocence Project attorneys have drafted a habeas corpus brief in the case that will be filed in 2013.

Inspired by the walk, supporters of Suzanne Johnson have started a Facebook page under the name Team Sue, at https://www.facebook.com/pages/Team-Sue-California-Innocence-Project-Innocence-March/479414115446391. You can read more about her story on her Innocence March entry.

Marina England, Convicted

A case of witnessed shaking has led to a felony conviction for aggravated battery in Illinois, where a mother told police she arrived to pick up her two daughters and found care provider Marina England screaming at the 3-month-old and shaking her. 

The child seems to have shown no behavioral changes or diagnostic signs like bleeding or swelling, but Ariel Cheung writing in the The Register-Mail reports that two days after the incident, when the infant was brought in for an abuse evaluation, Dr. Channing Petrak, medical director of the University of Illinois Pediatric Resource Center in Peoria, diagnosed “a mild traumatic brain injury, more commonly known as a concussion.”

I’m not sure what criteria Dr. Petrak used to reach her diagnosis, but according to the news report, her testimony was key to the judge’s verdict.

If you are interested in more on witnessed shakings, please see this blog posting from the fall of 2012. If you know of other witnessed shakings, please submit a comment. If you tell me it’s intended as a private communication, not a public comment, I will not post it but respond privately.

copyright 2013, Sue Luttner

If you are not familiar with the medical debate surrounding shaken baby syndrome, please see the home page of this site.

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March 9, 2013 · 7:03 pm

Fathers Caught in the Jaws of Justice

The crush of the stories is getting to me, both the number of them and the cruelty.

Justice Richard L. Buchter in New York drove the point home last week during the sentencing of Hang Bin Li, the immigrant father convicted last month of manslaughter in the death of his infant daughter Annie. According to the New York Times coverage, Buchter called Li’s treatment of his daughter “shocking, sickening, sadistic” before imposing a sentence of 5 to 15 years.

The New York Post reported that Li tried to tell the judge he was innocent, saying, “I didn’t know how or why this happened. I wrote what my statements were to the police, three times of what happened.”

But the judge cut him off. “These are the same lies the jury rejected,” he said.

No one is listening.

Jason Curtis with his son Jackson -photo courtesy the Curtis family

Jason Curtis with his son Jackson
-photo courtesy the Curtis family

And the tragedies keep coming. Jason Curtis in Iowa, for example, was convicted last month of first-degree murder in the death of his son Jackson, 5 months old when he quit breathing during a nap.

Curtis’s story was simple:  He was at home with the baby while the child’s mother was at work. He thought Jackson was asleep, but when he checked on him mid-morning, he found the boy unresponsive. He immediately dialed 911.

Doctors found no bruises, abrasions, red marks, or fractures, but bleeding and swelling inside the boy’s skull convinced them he had been assaulted—more than once.

Like many children diagnosed with shaking injuries, Jackson had a complex medical history. He had been prescribed a series of anti-biotics and anti-fungal medications, and he had been hospitalized at the age of three months for failure to thrive.  On the day he quit breathing, he was being treated for a respiratory infection. Autopsy revealed a large chronic subdural hematoma and multiple small rebleeds.

“Every time they gave him a new medication, he got sicker,” says Roni Hays, Curtis’s aunt, who also points out that during ten doctor visits over Jackson’s five months of life, not a single medical record noted evidence of abuse.

threesleepEven one of the prosecution experts testified that nothing in the child’s brain could “unequivocally” be considered evidence of trauma. Daily trial coverage in the local newspaper included the testimony of defense experts Dr. Waney Squier and Dr. Peter Stephens, who disputed the abuse diagnosis.

Prosecutor Matt Wilber told reporters after the verdict that his office had targeted Curtis from the beginning, because of a “prior child abuse conviction.” Patty Parham, another of Curtis’s aunts, told me that a couple of years ago both Curtis and the children’s mother had taken plea bargains on the advice of their public defenders, when their four-month-old daughter was found to have a fractured arm and clavicle. Curtis pled guilty to child endangerment and the girl was returned to her parents. (If you assume all plea bargains equal confessions, please see this posting.)

Jackson Curtis

Jackson Curtis

“Jason would never hurt a child,” Parham insists. “If you ever saw Jason with his kids you’d know it. His children are everything to him.” Friends and relatives commenting on his petition site concur. A former supervisor of Curtis’s at an adult care facility wrote that Jason “always gave dignity and respect to our residents.”

In Ohio, meanwhile, another father has been convicted of shaking his  son to death, in a murky case full of pre-judgment and miscommunication. Brandon Wilson reported that some weeks before his son quit breathing, the 10-month-old had fallen down several stairs, and then later had fallen from a shopping cart at a local store. The parents had taken him to an urgent care facility because of continued vomiting, but that was still weeks before his medical crisis. In a taped police interview after the child’s death, detectives insisted that something must have happened just before the boy collapsed, and that’s when Wilson “acknowledged that he had shaken the baby.”

The police heard a confession to shaking, but his words as reported sound to me more like an attempt to revive a non-responsive infant. The Portsmouth Daily Times coverage reported this impression from the tape:

Earlier in the interview when Wilson began to acknowledge that he had shaken the baby somewhat, Wilson said – “But I was not shaking that baby to hurt the baby or anything like that. I was just concerned about—you know what I mean? It was just—he was limp. It seemed like he was dead already when he was laying there.”

Later in the interview, he reiterated – “Well, I don’t really know how—I was not shaking him, like, really forcefully, but I was just trying to get him to wake up.”

Experts for the prosecution testified that children do not die from short falls like those Wilson had reported.

Annie Li, courtesy the Li family

Annie Li, courtesy the Li family

But I can’t help protesting:  What makes the doctors so sure these parents are lying? Their families seem to believe them.

Hangbin Li’s wife, the mother of his deceased daughter, asked the judge for leniency, calling Hangbin a good father and saying, “I was there that day, I saw everything. He didn’t intentionally hurt Annie.”

I had gotten to know Jason Curtis a little bit, through email, while he was realizing the state was really going to prosecute him for the death of his son. He was polite, thoughtful, and not a bit pushy. I was relieved when I heard that Dr. Squier was taking on his case—and I was shocked when I heard he’d been convicted of first-degree murder.  When his family members described him to me as patient and gentle, it only confirmed my impression.

I wish the child-abuse experts would stop and listen to the parents and caregivers, and to the people who know them.  I am not saying that children are never abused, or that shaking a baby is not dangerous. Indeed, I’m sure shaking a baby can be fatal.

Jackson Curtis

Jackson Curtis

But I’ve logged my time in the medical library, and in the courthouse, and I know that the pattern of cranial bleeding and swelling that now defines Abusive Head Injury does not prove abuse, even though a number of respected professionals seem to sincerely believe that it does. (See, for example, this article by intensivist Dr. Steven Gabaeff, which comes with a downloadable collection of original sources.) How many more cases like that of Tammy Fourman or Patti Kwan do we need before doctors slow down and listen to the evidence that a number of physiological processes can result in this cluster, not only violent assault?

I’ve seen two important changes in the arena over the past 15 years.

First, physicians and attorneys from outside the child-protection community have been drawn in, as they’ve encountered troubling accusations and convictions in their own practices. The result is a new wave of published research that questions the model of infant head injury that’s been winning for 30 years in the courtroom.

Second, the affected families are finding each other over the internet. Just now they are staggering under the weight of their individual burdens, but together they could become a voice loud enough to be heard.

copyright 2013, Sue Luttner

If you are not familiar with the debate surrounding shaken baby syndrome and abusive head trauma in general, please see the home page of this web site.

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February 20, 2013 · 11:51 am

Dr. Norman Guthkelch, Still on the Medical Frontier

Dr Norman Guthkelch, Oct. 2012

Dr. Norman Guthkelch on the Medill campus

At 97, retired pediatric neurosurgeon Dr. Norman Guthkelch has ridden more than one wave of change in the practice of medicine.

He remembers that his mentor Sir Geoffrey Jefferson, Britain’s first professor of neurosurgery, cautioned his students against relying too heavily on x-rays. Jefferson would warn, “The eye has rested upon the evidence of fracture, and the mind has traveled no further.”

“X-rays created a meaningless distinction between ‘fractured skull’ and ‘no fracture,’” Guthkelch explains, “whereas the important thing is the degree of damage to the underlying brain.”

Guthkelch’s medical training was interrupted by World War II:  In 1944 he went straight from his residency in Manchester into the army, and found himself neurosurgeon-in-charge of a small team attached to a general hospital. During the Battle of the Bulge, he was in surgery for 36 hours, breaking for food but not for sleep.

“That time gave me an advantage over surgeons with no battle experience,” he reflects. “I’d seen enough blood. Operating for its own sake was not an attraction.”

twinsAfter the war, Guthkelch returned to a fellowship under Jefferson, who had honed his own understanding of head injury during World War I. Relieved to be treating a general population, Guthkelch found himself especially charmed by his youngest patients, a delight noted by his mentor. “Jeff told me when I came back to finish off my training that my future lay in developing pediatric neurosurgery,” Guthkelch says. “He was quite right.” As Jefferson had held Britain’s first professorship in neurosurgery, Guthkelch in his turn received the nation’s first pediatric neurosurgery appointment, at the Royal Manchester Children’s Hospital. “It was only by a few weeks,” he chuckles, “but I was the first.”

One of his observations was that children in neurological distress were sometimes suffering the effects of subdural hematoma—that is, blood underneath the dura mater, the tough but flexible membrane that lines the interior of the skull. A subdural hematoma does not invade the brain, but it can exert dangerous pressure on the tissues below. And while a pool of subdural blood may dissolve on its own, it may also expand, causing further problems.

Guthkelch published his first paper on pediatric subdural hematoma in 1953, when he wrote in the British Medical Journal:

“It should be emphasized that infantile subdural effusion is not a rare condition. Study of the records of the Royal Manchester Children’s Hospital for the four years covered by this series shows that, of all surgical conditions of the central nervous system occurring in the first two years of life, only spina bifida and hydrocephalus were seen more often than subdural haematoma… Similarly, Smith and her co-workers (1951) have reported finding subdural effusions in almost a half of their cases of bacterial meningitis in infancy, and Everley Jones’s (1952) figures are similar.”

At that time, before CAT scans or MRIs, doctors inferred the presence of subdurals in living patients from the symptoms: convulsions, vomiting, and headaches in adults or fussiness in babies. The only way to confirm a subdural hematoma was to penetrate the subdural space. With an infant, the surgeon could pass a needle between the unfused plates of the immature skull. A problematic pool could then be drained, slowly, over several days to avoid a sudden change in pressure. In his 1953 paper Guthkelch described the procedure developed by pioneering pediatric neurosurgeon Franc Ingreham at the Children’s Hospital Boston, and reported on his own findings while treating 24 cases.

guthkelchQuote.The paper that brought Guthkelch into the shaken baby arena is the advice he offered in the  May 22, 1971, issue of the British Medical Journal under the title, “Infantile Subdural Haematoma and Its Relationship to Whiplash Injury.” At that time in Britain, Guthkelch says, shaking a child in the course of discipline, “or not even discipline, correction, shall we say,” was considered acceptable. He recommended that health workers discourage the habit, as it was causing damage to developing brains. He cited cases in which parents had told him of shaking their child, and he referenced a paper by U.S. radiologist John Caffey, who had noted the combination of subdural hematoma and long-bone fractures in a few very young children. Guthkelch’s paper on shaking aroused not much interest in England, he recalls. He mailed a copy to Dr. Caffey at his hospital in Pennsylvania and began his own local education campaign. “My great allies in this were the case workers, who were a tremendous resource,” he recalls. “They were usually trained nurses, whom the health system would pay to make rounds in economically depressed areas.”

Although he likes many aspects of the British health-care system, Guthkelch has a major quibble with one provision:  Mandatory retirement for surgeons at age 65, a milestone that began looming for him in the 1970s. “I wasn’t ready to retire,” he objects.

normanCloseBut he had an obvious back-up plan:  The States. His mother had a close friend in Philadelphia, and he’d been brought up on on Ernest Hemingway and Gertrude Stein. He accepted an invitation to the Pittsburgh Children’s Hospital, where he reports feeling immediately at home. ”You Americans are very lovable people,” he grins.

He was surprised, however, to realize that his colleagues were diagnosing a condition known as “Caffey’s syndrome,” believed to result from violent shaking of an infant. Caffey’s paper on infant shaking, published in the U.S. a year after Guthkelch’s in Britain, had enjoyed far greater circulation, and few had noticed the footnote citing Guthkelch’s original paper. “No one was asking me about it, and I didn’t really have anything further to say about it,” Guthkelch shrugs.

He stayed in the field until 1992, as improvements in medical imaging  and surgical technique transformed the way doctors diagnose and treat problems of the brain. Neurosurgeons were collaborating with radiologists as they honed their abilities to decipher the lights and shadows of CT scans and MRIs. “I loved every minute of it,” he beams.

He’d intended to retire in the 1980s, when he left Pittsburg Children’s and moved with his wife to Tucson, Arizona. The local university hospital, however, asked him to take on a temporary position at the neurosurgery unit, where he remained for another eight years. Then he finally found time to work on his translation of the New Testament from the Greek, to organize a lifetime of bird photographs, and to spend more time with his wife as her health began to fail.

Drayton Witt and his wife.Courtesy Arizona Justice Project

Drayton Witt and his wife
Courtesy Arizona Justice Project

Then he was approached by law professor Carrie Sperling with the Arizona Justice Project. She and her students were working for the release of Drayton Witt, a young father convicted of second-degree murder ten years earlier for the presumed shaking death of his son.

Sperling says she was electrified to learn that the grandfather of shaken baby theory lived two hours south of her. She and her students were convinced that Witt was innocent: His son Steven had suffered a short lifetime of serious health problems, including hospitalization for seizures that were never explained, not even fully controlled with medication. Sperling was was unsure of the reception she would receive from Dr. Guthkelch, “but he turned out to be an amazing man,” she says, “an amazing, gracious man.”

Guthkelch read Steven Witt’s medical records with growing dismay. He later told National Public Radio reporter Joseph Shapiro in a radio and podcast interview, “I think I used the expression in my report, ‘I wouldn’t hang a cat on the evidence of shaking’” in that case. Sperling’s team successfully petitioned to vacate Witt’s conviction, and later the charges were dropped.

Carrie Sperling, at an Innocence Network meeting

Carrie Sperling, at an Innocence Network meeting

“It was Carrie who opened my eyes to how much of this is going on,” Guthkelch sighs.

He says he never intended that the presence of subdural hematoma and retinal hemorrhages, with or without encephalopathy, should prove that a child had been shaken, only that shaking was one possible cause of the bleeding. “I am frankly quite disturbed that what I intended as a friendly suggestion for avoiding injury to children has become an excuse for imprisoning innocent parents.”

Sperling suggested he read law professor Deborah Tuerkheimer’s 2009 law-journal article on how shaken baby syndrome is handled in the courtroom. “She certainly nailed it,” he says of Tuerkheimer’s work. Some months later he saw some “harsh, unprofessionally harsh” criticism of that paper. When he tried to talk about it with people he knew from the child-protection community, he realized how wide the schism was. “There are cases where people on both sides, both of whom I admire equally, are barely able to speak to one another,” he told NPR.

He contacted Tuerkheimer, and the two of them hit it off. They speak regularly on the phone, he reports, and “we find we are of one mind on this subject.”

Dr. Guthkelch meets with students from the Medill School of Journalism.Photo by Alison Flowers, courtesy of the Medill Justice Project

Meeting with students from the Medill School of Journalism
Photo by Alison Flowers, courtesy of the Medill Justice Project

After his wife’s death, Guthkelch moved to a suburb outside of Chicago, where he’s continued trying to be an ambassador between the two sides. When he learned that journalism students at the nearby Medill Justice Project had taken on a shaken baby case, he reached out to them. One result is a first-rate podcast  that includes interviews with both him and Dr. Robert Block, president of the American Academy of Pediatrics.

When Dr. Sandeep Narang, pediatrician and attorney, published an argument that courtroom testimony about child abuse is best left to trained child-protection physicians, not paid experts, Guthkelch wrote the introduction to a rebuttal by a team of advocates for the innocent accused. (For a quick summary of Narang’s article and Guthkelch’s response, see this page.)

Dr. Ron Uscinski and Dr. Norman Guthkelch,October 2012

Dr. Ron Uscinski and Dr. Norman Guthkelch
October 2012

Guthkelch also spends what time he can reviewing cases. “Let me be quite frank,” he says, “For a 97-year-old I’m fairly well preserved, but my memory is not what it once was.” Producing a medical report takes careful concentration and more double-checking, as does following and responding to  the literature.

But he perseveres. “I want to do what I can to straighten this out before I die,” he says, “even though I don’t suppose I’ll live to see the end of it.”

Which reminds me of something Carrie Sperling said about him when I spoke with her at the Twelfth International Conference on Shaken Baby Syndrome/Abusive Head Trauma in the fall of 2012.  ”I felt a little bit bad about getting Norman Guthkelch involved, because I knew he would become controversial” she said in a video dispatch posted on the Medill site. “I did warn him, but I don’t think there’s any way to warn people of how the wrath can come down on you when you get involved in this sort of thing. But in the end, everyone I’ve talked to who’s talked to Dr. Guthkelch…  It’s amazing the effect he’s had on the experts I know, on the people I know.  I’m hoping that he lives a long, long time so that he can  meet with as many people as want to meet with him and talk to as many people as want to talk with him.”

copyright 2013, Sue Luttner

If you are unfamiliar with the debate about shaken baby syndrome, please see the home page of this blog.

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February 6, 2013 · 5:29 pm

Quick Hang Bin Li Verdict Devastates

Annie Li, courtesy the Li family

Annie Li at one month, courtesy the Li family

While attorneys on both sides claim partial victories, supporters of Hang Bin Li say they are “devastated” by the mixed verdict delivered last Friday, when a New York jury found Li innocent of murder but guilty of manslaughter in the 2007 death of his infant daughter Annie. The news was especially shocking because no one had expected a verdict so soon.

During nine days of testimony over three weeks, the jurors heard from nine medical experts for the prosecution, including the local medical examiner, a child-protection pediatrician, a pediatric ophthalmologist, a pediatric radiologist, two pediatric critical-care physicians, and a specialist in osteogenesis imperfecta (OI), a disease of the bones. All agreed that Annie had died from abusive head trauma. Many said shaking was involved.

Defense attorney Cedric Ashley opened his case last week by calling Dr. Zhongxue Hua, a respected medical examiner from a neighboring jurisdiction. I can’t find coverage of Dr. Hua’s testimony in the English-language press, but I’m told he said that Annie had signs of mild OI and unusual heart findings.

Ashley also called the Lis’ landlady Mrs. Zhou, wrapping up his case in a day and a half. Both sides made closing arguments on Thursday afternoon, and the jury returned its verdict the next day. An outspoken supporter of Hang Bin Li wrote in an email:

Put yourself in the Jury’s shoes. If 9 Medical witnesses for the Prosecution kept denying something, but only 1 Defense Medical witness saying something else. Your mind is unsure, but common sense tells you, “How could all 9 people be wrong, and only 1 person is sober and correct?”

In a telephone interview after the trial, Ashley said his decision to call only one expert witness was not based on limited resources but on his opinion that, among the witnesses in this case, “only two persons had the expertise to determine the manner of death, and those were the forensic experts, the medical examiners.”

Ashley cautioned against drawing any lessons or conclusions from this “nuanced” case, which he said was not about shaken baby syndrome. “The prosecution threw shaken baby syndrome at this couple,” he said, “Our case  was about accidental, non-intentional head trauma exacerbated by OI.”

The Li case has received daily coverage in three Chinese-language newspapers in New York, and periodic coverage in the English-language press. The New York Times quoted prosecutor Leigh Bishop’s saying after the trial that the verdict was “perfectly reasonable,” because “we didn’t have enough information about his mind-set at the time he inflicted the injuries” to prove murder.

Reporters Corey Kilgannon and Jeffrey E. Singer wrote about their conversations with the jurors:

Several jurors said that they felt an obligation to see Mr. Li punished for Annie’s death, but that they could not arrive at a guilty verdict on the murder charge because they lacked the evidence to decide that her injuries resulted from a depraved mental state on Mr. Li’s part, a finding required for guilt on that charge.

“We spoke up for the baby and said, ‘You can’t do this,’ ” one juror, Luisito Castro, said.

Annie Li in 2007, courtesy the Li family

Annie Li in 2007, courtesy the Li family

Ashley characterized the outcome as a partial victory. “He’s not facing 25 years to life,” Ashley told reporters. The manslaughter charge carries a maximum sentence of 5 to 15 years in prison, and a minimum of 1 to 3 years. Li has already spent nearly 5 years in custody—4 years and 10 months—while waiting for trial.

The Lis have both denied that either of them did anything to harm Annie—and their community agrees. Their defense was paid for by donations from supporters, many of them other Chinese immigrants.

Hang Bin and Ying Li, and their community, were drawn unexpectedly into this arena, but the attorneys and medical experts at Hang Bin’s trial were seasoned veterans. Prosecution witness Dr. Carole Jenny, for example, is one of the major forces behind the relatively new medical-board speciality of child-protection pediatrics.  A former prosecutor, Cedric Ashley is on top of the medical arguments, making him a rare defense attorney in this complex arena. Prosecutor Leigh Bishop—whose actress friend Katie Holmes made headlines in early January by stopping in at the courthouse to hear opening statements—was on the faculty at last fall’s Twelfth International Conference on Shaken Baby Syndrome/Abusive Head Trauma. In 2007 Bishop successfully prosecuted Yoon Zapana, whose son Victor Zapana published an essay about his mother’s conviction in the November 27, 2012, issue of The New Yorker.

In the Zapana trial, as in the Li trial, the defense called a single medical expert while Bishop called a spectrum of medical specialists. I’m reminded of an email I received about a year ago, the reflections of a defense expert who found himself outgunned at a similar trial.

While I have heard of cases won with only one or even zero defense experts, I think it’s rare.  I don’t know of any data on the subject, but my observation is that a defense team that includes the full range of specialists is a better bet, as illustrated by a series of exonerations earlier this winter and the Russ Van Vleck trial in 2011.

The Lis’ story might not be over with the trial. Michael Chu, the neighborhood travel agent who hosts the Hang Bin and Ying Li Rescue Committee in his business office, is now educating himself about the appeals process. “One thing is very clear,” he says, “We won’t give up easily.”

If you are unfamiliar with the debate surrounding shaken baby syndrome in the courtroom, please see the home page of this site.

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January 5, 2013 · 12:56 am

Charges Dropped Against Ying Li; Hang Bin Li Jury Selection Begins

Annie Li in 2007, courtesy the Li family

Annie Li in 2007, courtesy the Li family

The New York Post reports that manslaughter charges were dropped against Ying Li on Wednesday—the day before jury selection started in the trial of her husband Hang Bin Li, accused of shaking and slamming their infant daughter Annie to death in 2007. Ying Li was accused of not seeking help for the girl immediately after the presumed assault, which both Lis have maintained through four years of imprisonment never happened.

In the hearing to drop all charges, prosecutor Leigh Bishop said the doctors at Flushing Hospital had told her that Annie’s injuries were so severe that even immediate medical attention wouldn’t have saved the girl’s life. Reporter Christina Carrega quoted Bishop, ”The people believe that they could sustain the endangering the welfare of a child charge, but since she spent four years in jail already, it would exceed the maximum sentence of one year if she was convicted.”

Supporters of the couple say that new medical evidence points to a genetic bone disorder as the cause of Annie’s meltdown. Hang Bin Li made headlines this past October, when he turned down a plea bargain that would have let him out of prison immediately.

“Ying’s dismissal is good news, but the battle is not over yet,” said supporter Michael Chu, who relayed this statement from Ying Li:

“They can lock us up for 50 years, but that’s not going to change the fact that Hang Bin and I are innocent… We’re powerless but we won’t shut up or give up. We’ll go all out seeking help to fight for our innocence!”

Jeffrey E. Singer and Corey Kilgannon at the New York Times published this excellent coverage last winter, and then provided more information in the spring, when Ying Li was released from prison after a bail reduction.

A press release from 2008 detailing the charges against the Lis cited a witness who said the child was exhibiting symptoms five hours before the call to 911.

I don’t find coverage of the upcoming trial in an English-language Google search, but a blogger who supports the couple reports that three Chinese-language news sites covered the partial jury selection this week. The blog says the trial is scheduled to start next Wednesday, Jan. 9, when I hope it will be covered in the papers I can read.

January Update:  Hang Bin Li was convicted in early February, as described at this post.

 

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December 29, 2012 · 11:50 pm

Fathers in the Cross-Hairs

courtesy the Aspelin family

Kristian Aspelin and the newborn Johan, 2010, courtesy the Aspelin family

Exonerated fathers are on a streak lately, after years of pain and struggle for the families involved.

Earlier this month NPR reported the dropping of felony assault charges against Kristian Aspelin, a San Francisco father of two who said his 3-month-old son Johan had slipped out of his hands and onto the kitchen floor. The medical examiner rejected that explanation, concluding from the autopsy that the boy had been shaken and slammed to death.

Key to Aspelin’s legal victory, reporter Joseph Shapiro concludes, was having the resources to hire a quality defense team. By selling his house, cleaning out his savings, and borrowing from family and friends, Aspelin was able to present the prosecution with exonerating reports from six medical experts and a biomechanical engineer, plus a video re-enactment of the fall as he had originally reported it. Charges were dropped without a trial.

Of course, the Aspelin family’s ordeal is not over:  Social services still requires Kristian to live apart from his wife and surviving son, now 4. The web site Medical Misdisagnosis Research reposted this article about the case last year.

diceSuing the County

In Las Vegas, meanwhile, a father found innocent at trial has filed suit against the county for continuing to keep him apart from his family after the verdict. In this touching story, Associated Press reporter Ken Ritter describes the faith and persistence of Nigerian immigrant Victor Fakoya, who enjoyed the support of his family and community through his two-year ordeal.

Fakoya had been home caring for his own two daughters and a 2-year-old boy, the son of a family who was living with them. He dialed 911 when the boy started vomiting.  The child died, with a skull fracture revealed at autopsy, and doctors concluded he had been assaulted immediately before his meltdown. According to the AP report:

The jury in [Fakoya's] first trial deliberated two days but failed to reach a verdict. A second jury acquitted Fakoya. Five days later, county officials pressed a Family Court case against Fakoya, alleging that he was unfit to return to his own family because a child died as a result his abuse.

Fakoya has filed a suit for $10 million, naming “Clark County, the district attorney and Child Protective Services officials.”

Few suits like this one have succeeded in the past, but Anglican minister Rev. Dorian Baxter in Canada announced his victory last month over the Children’s Aid Society, achieved after he had illicitly recorded a meeting in which social workers admitted he was innocent of molesting his daughters but threatened to prosecute him if he didn’t agree to their conditions. He told his tale in a bit of a sermon, at this link.

Not Guilty Verdict, Unreported

The Arizona press seems to have missed the “not guilty” verdict in the trial of Robert Gilcrist, a young father who said he had dropped his daughter while removing her from her car seat. She seemed fine for several hours, he reported, but the next morning her breathing was not right and she did not seem to recognize him. When paramedics arrived, the girl was breathing normally, and she was rated as fully conscious on the Glasgow Coma Scale, 15 out of 15.

RedCactusHer condition deteriorated, however, and diagnositic scans revealed brain swelling, which peaked about 24 hours into hospitalization. She was left with permanent brain damage, and doctors concluded that a short fall could not cause such a serious injury. Their reports included opinions that “retinal hemorrhages indicate that there was a rotational component to this, such as may be seen with shaking” and “[i]f the victim suffered these injuries on Saturday evening, she would not have survived until Sunday morning.”

At the time, Gilcrist was living with his daughter in a church outreach home, and the infant’s mother was living in a motel across the street while enrolled in a rehabilitation program.

The exciting thing about this case is that the rights of an indigent defendant were respected in Phoenix, Arizona, where defense attorney Rick Tosto pulled together a team of experts including Dr. Steven Gabaeff, emergency medicine; Dr. Pat Barnes, pediatric neuroradiology; Dr. Jan Ophoven, forensic pathology; Dr. Khaled Tawansy, ophthalmology; and Dr. John Lloyd, biomechanics.

A Family at Last, Five Years Later

Finally, the Daily Mail in England reports on a family finally united after the father was wrongfully accused in 2007 of shaking the older of his two daughters. The girl made a complete recovery, and further examination of the medical records revealed that the incident could have been related to her difficult birth or a cyst in her throat, whose presence was not revealed to the original jury.

The good news is that all these fathers were ultimately exonerated. The bad news is that these prosecutions continue, seemingly unabated.

-Sue Luttner

If you are not familiar with the debate about shaken baby syndrome, please see the home page of this blog, at http://onsbs.com/. Unfortunately, child protection professionals also teach that a short fall can’t cause serious injury to a baby, which is a  misconception.

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December 9, 2012 · 3:40 am

Cracks in the Stone Wall

audreyCoverAs ill-considered and improbable shaken baby convictions accumulate, the stories of injustice find their way out.

It Happened to Audrey

Headlining this week’s good press, Audrey Edmunds’s book has hit the shelves. It Happend to Audrey, written with journalist Jill Wellington, is a from-the-heart dispatch from the front lines of the struggle.

Edmunds recounts her horror the morning a baby she was caring for seemed to choke on a bottle and quit breathing—and then her disbelief and terror as a diagnosis of shaken baby syndrome sent her to prison. Anyone who has been accused will recognize the warping of reality as investigators, social workers, and the courts accept the diagnosis, ignoring actual evidence that should have raised questions.

Four years after Edmunds’s conviction, the same medical examiner autopsied another little girl, who had been brought to the hospital with recurrent vomiting in the mid-morning. When the breathing problems and seizures started 17 hours later, medical imaging revealed a brain injury that had gone unnoticed all day by a series of medical professionals—a documented case of the “lucid interval.” Dr. Robert Huntington reported this case to a medical journal, and was forced to reconsider having testified to immediate symptoms at Edmunds’s trial. A state appeals court ultimately overturned her conviction in 2007, after years of work by law students under the direction of Keith Findley at the Wisconsin Innocence Project. Edmunds recalls her thoughts during a hearing along the way, as a series of child-abuse experts reiterated why they believed seven-month-old Natalie Beard had died from a violent assault at the hands of her last caregiver:

“No matter what their research, theories, formulas or experience said about Natalie Beard, there was only one truth:  I did not shake or inflict traumatic brain injury on that child. The state’s presentation was pure conjecture. I was always thoroughly beaten by the ongoing lies.”

katie

Katie Couric

Edmunds and Findley have taped a segment with Katie Couric, and are scheduled to appear on the Katie program tomorrow, Monday, December 10, at 3 pm, at least in my time zone.

Montana Innocence Project

Meanwhile in Montana, reporter Jessica Mayrer has published a well researched article in the Missoula Independent that considers the cases of three state inmates convicted of shaking infants.

Robert and Gabriel Wilkes, 2008

Robert Wilkes with Gabriel, 2008

  • Robert “Dave” Wilkes said his 3-month-old son Gabriel started making gurlging noises and then stopped breathing while lying on the floor of their new apartment. The prosecution convinced a jury that Wilkes had shaken his son to death. Now the Montana Innocence Project says their doctors have found evidence the boy suffered from a liver disease that could have caused his melt-down.
  • Michael Reim of Helena requested a trial by judge this year instead of by jury, because of the complex medical evidence against him. After listening to prosecution doctors who said Reim’s son had been shaken, and to defense doctors who said the boy suffered from a clotting disorder, the judge ruled that Reim was guilty of abusing his son.
  • Young mother and infant-care provider Nevada Ugalde of Billings said she left an 8-month-old in a crib while doing laundry on a June day in 2008, and returned to find him on the floor. At her trial, doctors testified that she must have assaulted the boy, as he couldn’t have suffered fatal injuries falling out of a crib 32 inches onto carpet.

Cathy Lynn Henderson

And in Texas the Court of Criminal Appeals has vacated Cathy Lynn Henderson’s 1995 conviction, also based on testimony that a short fall could not cause fatal injuries.  At her trial, Medical Examiner Dr. Roberto Bayardo had called Ms. Henderson’s account of dropping the baby onto a concrete floor “impossible” and “incredible” as an explanation for his injuries.

In 2007, however,  after reading Dr. John Plunkett’s paper on short pediatric falls and the evolving biomechanical literature, Dr Bayardo told the appeals court that he would no longer call the infant’s death a homicide but instead would list the cause of death as “undetermined.” Dr. Plunkett and a number of other experts also testified at the hearing. The court ruled in favor of Ms. Henderson, writing:

The court further found that Dr. Bayardo’s re-evaluation of his 1995 opinion is based on credible, new scientific evidence and constitutes a material exculpatory fact. The trial court concluded that applicant has proven by clear and convincing evidence that no reasonable juror would have convicted her of capital murder in light of her new evidence.

Interrogation Tactics Under Fire

Finally, with thanks to The Amanda Truth Project for the story, a teenage mother in Massachusetts whose videotaped confession was thrown out last year is now suing the city of Worcester. Police sergeant Kevin Pageau and his partner had bullied and lied to Nga Truong during hours of interrogation the day after the death of her toddler son. Reporter David Boeri at WBUR in Boston, which had sued for the release of the interrogation tapes, quotes the tapes and comments on them in his report:

Pageau: “Somebody hurt that baby, and we need to know who it was, and we’re going to find out who it was — either the hard way or the easy way.”

Truong: “I’m telling you everything.”

Pageau: “No, you’re not. Stop. Don’t lie to me.”

The detectives had no evidence. And the autopsy stated no cause of death. But the two detectives knowingly and deliberately told the teenager otherwise:

Pageau: “‘Cause that medical examiner told me that that baby was smothered. Does that change your story? We have scientific evidence that that boy was smothered to death.”

Pageau was not telling the truth, as he later testified. Lying to witnesses is often part of the playbook for detectives. But Superior Court Judge Janet Kenton-Walker would later rule that the detectives went beyond making knowingly false statements. She found they engaged in a pattern of deception, trickery and implied promises targeting “a frightened, meek, emotionally compromised teenager who never understood the implications of her statements.”

-Sue Luttner

If you are not familiar with the debate surrounding shaken baby syndrome in the courtroom, please see the home page of this blog site.

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December 3, 2012 · 9:32 am

A Critical Look at a Key Witness

Photo by Cheryl Havared Harrell

Photo by Cheryl Havard Harrell

The case of Jeffrey Havard in Mississippi could be the tip of a wrongful-conviction iceberg, according to an excellent in-depth report by Radley Balko at the Huffington Post.

Havard has been on death row since 2002, convicted of murdering the 6-month-old daughter of his girl friend. Havard said he was lifting the little girl from the tub after a bath when she slipped from his hands, hitting her head on the toilet as she fell. Private medical examiner Dr. Steven Hayne, however, concluded the girl had died of shaken baby syndrome. The Mississippi Innocence Project has been fighting the conviction.

The reporter calls SBS “a diagnosis that comes with the implication that the last person to be alone with the child was the one who killed her,” observing:

“Because the symptoms can only be produced by violent shaking, the diagnosis also comes with a built-in indictment of the suspect’s state of mind. It’s a diagnosis that does much of the prosecutor’s work for him.”

Balko has written about Hayne several times over the past decade, as the medical examiner has become more controversial. Hayne has apparently been the favorite pathologist of Mississippi prosecutors for years, reliably providing autopsy reports and testimony that work in the courtroom. New information about Hayne is now available—ironically, through the discovery phase of a defamation suit Hayne pressed against the Missippi Innocence Project after they started questioning his work. Balko writes:

“What they’ve found since implicates not only Hayne, but a host of police officials, prosecutors, even judges who knew Hayne was deficient and offering dubious testimony, but did nothing to stop it. ‘We’ve known for a while that there was a problem here,’ says Tucker Carrington, the director of the project. ‘But I really had no concept of the depth and breadth of the malfeasance. This isn’t just Hayne. It’s … well, it’s almost everybody. The state has known all along that it was pulling the wool over everyone’s eyes.’”

According to Balko, Hayne was already under a serious cloud at the time of Havard’s trial, yet the court refused Havard the money to pay for a second opinion. The story is astonishing, and I recommend reading it:  http://www.huffingtonpost.com/radley-balko/steven-hayne-jeffrey-havard_b_2213976.html

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