Stephanie’s story—my first case

The article below summarizes the story of a friend’s adult niece, convicted of shaking a baby in her care just before the Boston nanny trial made national news. These words reflect my conclusions a decade ago. As of May 2011, the fundamental arguments remain the same.

October 2001

How an unproven model of shaken baby syndrome is sending innocent people to prison

If you had asked her five years ago, Stephanie Olsa would have told you our justice system works. If anything, she says, she figured the courts were too careful about protecting the rights of criminals. She never imagined that at age 30 she’d be serving five to fifteen at a women’s prison in Coldwater, Michigan, convicted of a violent crime she still denies while her husband raises their son without her.

In the spring of 1996, Stephanie was caring for 6-month-old Dinah Nelson when the child developed breathing problems and seizures that led quickly to hospitalization. The doctors said it was Shaken Baby Syndrome, and Dinah must have been assaulted at the sitter’s. Stephanie said the doctors were wrong, but she couldn’t prove it in court.

Shaken Baby Syndrome, or SBS, is the child-abuse phenomenon of the moment. Proposed in the early 70s to account for a few extreme cases, the term is now commonly applied to all forms of what doctors prefer to call “abusive head trauma,” probably the single leading source of infant death from abuse. Various experts estimate that 600 to 3,000 babies a year in the U.S. are shaken and slammed violently enough to cause death or permanent, profound injury. Statisticians are scrambling to put a mechanism in place to track the true incidence.

Researchers are still arguing the medical details, but the presumed scenario is this: Someone, usually in a moment of exhaustion and exasperation, shakes a crying baby, most likely throwing the child down afterwards, possibly onto a soft surface like a crib or sofa. With its large head and weak neck muscles, the infant suffers mild to fatal brain damage. There might be no other signs of abuse—no bruises, no scratches, no broken bones. Witnesses are rare. And the survivors, even those who eventually learn to talk, can never tell us what really happened.

Shaken Baby Syndrome has a particular appeal in the law-enforcement community, where a belief that the symptoms are immediate and obvious streamlines investigation and carries tremendous weight with a jury. A prosecutor who believes there can be no delay between the shaking and the symptoms is routinely left with one suspect—the caretaker—whose guilt is easy to argue.

Presumably because Dinah Nelson didn’t die, Stephanie’s story received only a few inches in the local paper, even though she was sentenced during the first wave of media fascination with Louise Woodward, the British au pair convicted of shaking 8-month-old Matthew Eappen to death in Massachusetts. Both Woodward and Olsa were prosecuted on the theory of immediate symptoms—but in Olsa’s case, even the prosecution agrees the baby had a prior brain injury, already days old on the day she was rushed to the emergency room.

And Stephanie was not a teenage nanny. She was a suburban wife and mother, with a long and spotless babysitting record, taking a break from her career as a golf pro to be home with her own son Eamon. A compact woman with the short hair of an athlete and an upbeat, pixie-like charm, she was well liked in her neighborhood and well respected at Catholic Central High School, her alma mater, where she coached the golf team. “I can’t imagine that she did it,” says her pastor, Father Louis Stasker, one of the scores of friends and neighbors who still say they believe Stephanie is innocent.

A number of prominent child-abuse specialists—like pathologist Dr. Robert Kirschner at the University of Chicago Children’s Hospital—insist that the symptoms of a serious shaking are indeed immediate and obvious. In the 1994 text Child Abuse: Medical Diagnosis and Management, edited by Dr. Robert Reece of the Tufts University School of Medicine, Kirschner argues that the immature brain of an infant reacts differently to trauma, so differently that babies simply cannot experience the  “lucid interval”—the well-recognized period after a head injury when a patient might appear perfectly normal, only to collapse hours or even days later when bleeding or swelling inside the skull reaches a critical point.

Kirschner’s arguments are endorsed by most child-abuse experts, like Dr. Randell Alexander, who estimates he’s testified in 150 SBS cases. Alexander says research on infant victims of accidental injury supports his conviction that a serious shaking injury will be immediately apparent.

Not everyone agrees.

“SBS symptoms can emerge over time,” says Dr. Lorry Frankel, chief of critical care services at the Louise Salter Packard Children’s Hospital at Stanford University. “We’ve seen it, and you find cases in the literature.”

Frankel says that SBS can appear to be cumulative. In a typical autopsy, he explains, “you find these lesions of different ages. You assume that it’s additive, that the injuries are exacerbated in subsequent shakings.” Then, too, a diagnostic feature of SBS is brain swelling, which itself causes secondary damage.  Hard facts on the syndrome are scarce, Frankel says. “First, it’s always uncertain exactly what happened. Second, you’ve got these compounding injuries.”

In a 1993 Pediatrics article that gave the official stamp of approval to a diagnosis of SBS, the American Academy of Pediatrics noted:

“Shaken baby syndrome is characterized as much by what is obscure or subtle as by what is immediately clinically identifiable. A shaken infant… may have a history of poor feeding, vomiting, lethargy, and/or irritability occurring intermittently for days or weeks prior to the time of initial health care contact.”

Stephanie had been watching Dinah Nelson for about five hours on Saturday, March 30, 1996. The baby had been cranky, Stephanie says, and had thrown up her midday bottle, but she looked normal—both to Stephanie and to Jeffrey Metz, an exterminator who was in Stephanie’s home that afternoon setting squirrel traps in the walls.

Metz testified that shortly after he arrived that day he saw Stephanie pick up and soothe a crying baby. The baby quit crying: normal baby behavior. Over the next half hour, Metz saw Stephanie and the infant in the kitchen two or three times, as he came through to ask questions and examine the walls. He didn’t notice anything unusual about either of them; he doesn’t think the baby was crying.

Then, maybe 15 minutes before Dinah’s mother was due to pick her up, something went wrong. Stephanie says she was feeding Dinah a bottle when the baby seemed to choke. Trained in infant first aid, Stephanie turned Dinah head-down over her arm and patted her back to dislodge the obstruction. She says Dinah threw up some formula; when she heard the baby breathing again, she gave thanks to God and to her own mother, who had insisted on the first aid classes years before.

After the choking, though, Dinah seemed sleepy, lethargic. Stephanie tried to wake her up by talking to her. It didn’t work. Then the baby’s breathing seemed wrong—Stephanie was realizing there was a problem just about the time Dinah’s mother arrived. While Stephanie continued to hold Dinah, Mary Beth Nelson called 911. The dispatcher asked if the child had a history of breathing problems, and the baby’s mother replied, “No. This is something that’s happened within the last two days.”

By the time Dinah reached the emergency room, she had started mild, periodic “posturing,” arching her back and jerking her arms. Her eyes were deviating to the right. She was fitted with a breathing tube and given sedatives and anti-seizure medication. X-rays revealed both fresh and healing bone injuries. A computed tomography (CT) scan showed possible brain swelling. She was transferred to nearby Butterworth Hospital, where pediatric critical-care specialist Dr. Dominic Sanfilippo ordered Mannitol to fight the brain swelling.

Medical social worker Jerry Bonnema was assigned to the case. According to Bonnema’s notes, Sanfilippo requested his services that night “as injuries are suspected to have been caused by shaken baby by babysitter.”  Bonnema counseled the parents, called Child Protective Services, and then called the police. He wrote at that point, “Mom appeared extremely hyper & tense. She was hyperverbal and overly focused on prosecuting babysitter. Mom needs to relax, allow herself to focus on baby.”

Police officers drove to Butterworth at 3 o’clock Sunday morning to take the complaint—the doctor wasn’t available, but Bonnema and the victim’s mother agreed about what he’d said. Recommended procedure in a child-abuse investigation is to interview family members separately, preferably before they’re aware of the abuse diagnosis. These officers were receiving a complaint, though, not questioning suspects. Asked about previous incidents with that sitter, Mary Beth Nelson reported that Dinah had supposedly rolled off Olsa’s couch a few weeks earlier, during a diaper change.

A fall from a low height is the single most common lie offered to explain child-abuse injuries—police training materials use the term “killer couches.” Reported chokings, as well as attempted resuscitations, are also on the list of stories investigators are trained to doubt. Such insights and the medical evidence might be all a child-abuse prosecutor has to work with. The doctor in this case was sure about the timing of Dinah’s injuries. The police looked as carefully as they thought they needed to. They saw what they expected to see.

Unaware of her presumed guilt, Stephanie tried to visit Dinah Sunday afternoon at the hospital. The nurses wouldn’t confirm that the child was on the premises, wouldn’t accept the balloon and teddy bear she’d brought. “I figured it was intensive care, of course they wouldn’t let me in,” Stephanie recalls, “but I thought it was strange they wouldn’t tell me if she was even there.” Still, she says, it didn’t occur to her to start looking for a lawyer.

Detective Rex Marks received the incident report on Monday morning. His first stop after lunch was the hospital, where, according to his notes, Sanfilippo “offered his professional opinion… that if the care provider was alleging a choking, then that was the time the injuries were inflicted.” By this time, there was no physical evidence left that might have proved or disproved the choking:  The bottle and the kitchen floor had been cleaned and dried, and Stephanie’s trash had been picked up. The soiled baby clothes would be turned over to the police already washed and folded.

Stephanie heard about the child-abuse diagnosis on Monday afternoon. She was heading up the street with a pair of 2-year-olds—one of them her own son Eamon—when her neighbor Sue Troke came outside, newspaper in hand. The Grand Rapids Press reported that police were investigating injuries to the infant Dinah Nelson as a possible case of child abuse by shaking. “They must have got it wrong,” Stephanie told her, “Nobody’s talked to me about it.”

But then a car pulled up, John Smith from Child Protective Services. Stephanie told him about the choking, the resuscitation, the sleepiness, the breathing. He thanked her and left. Ten minutes later, he was back, this time with a pair of police officers.

In an untaped interview, Detective Marx asked Stephanie to demonstrate how she had reacted to the choking. She showed him. “Then they were at me,” she recalls, “over and over, how hard I shook her, how long before we called the ambulance.” For the first time, she says, it occurred to her that maybe she had caused Hannah’s injuries—perhaps she’d panicked and been rougher than she thought. She started crying. Officer Chris Postma later testified that Stephanie’s tears had come at the wrong time—inappropriate emotional response, another cue that you’ve identified the perpetrator. Marx wrote in his report that Stephanie had told them “it was a panic reaction when the shaking began.”

The warrant was issued the next day. Bail was set at $100,000 cash, no bond accepted. No one at either hospital had met Stephanie or talked with her about the incident. Detective Marks waited a week before taking a statement from the exterminator.

If anyone had asked, Stephanie’s neighbors would have described her as warm, playful, sensible, and, always, good with children. She was the one who stayed by the play structure and kept an eye on the toddlers during the block party. “If you knew Stephanie, you’d know she’s just not capable of a crime like this,” says Patty Clifford, who lives around the corner and used to leave her sons with Stephanie one morning a week while she met with her Bible study group. “When she watched the kids, she didn’t just turn on the TV and make the snacks,” Clifford explains. “She got down on the floor and played with them. It’s who she was.” Full-body x-rays of Stephanie’s son Eamon revealed no fractures, fresh or healing.

Medical testimony dominated the four-week trial. Dinah’s injuries were described again and again, with special attention to the violence required to cause them. One doctor compared SBS to putting a baby’s brain in a blender. The following week Sanfilippo said no, not a blender, more like a paint mixer at the hardware store.

A diagnosis of shaken baby is based on a distinctive cluster of symptoms:

  • bleeding between the dura and the arachnoid membrane, the two outer layers of a three-ply lining around the brain and spinal cord,
  • diffuse brain swelling, or cerebral edema, and
  • bleeding within the lining of the eye, known as retinal hemorrhage.

Dinah Nelson had all these and more.

She had a broken rib, estimated to be at least 10 days old, and a fractured ankle bone no more than 72 hours old. She had a skull fracture of indeterminate age, and evidence of old bruising on the surface of the brain. She had blood of at least two different ages in her spinal fluid—the “chronic” bleed was estimated to be no less than 14 to 21 days old, the “acute” bleed no more than 24 hours old. Doctors concluded that Dinah had been abused more than once, over a period of weeks. The last assault left her with permanent brain damage.

None of the laboratory tests or medical images could narrow the window for Dinah’s fresh injuries to anything less than 24 hours before she reached the hospital—but the doctors testified that Dinah’s brain injury was so severe that the symptoms must have been immediate. “Without intervention, the interventions we did,” Sanfilippo said, “she would have died in hours.”

Two forensic pathologists and one pediatrician with a specialty in neurologic disorders testified for the defense, arguing that Dinah’s injuries were chronic and complex, that brain swelling can start slowly and then accelerate, that the culminating event could have occurred a full day before the serious symptoms emerged.

Prosecutor Helen Brinkman attacked their credentials. The forensic pathologists, she said, “cut open dead people… they don’t judge symptoms.” The pediatrician didn’t treat patients, she charged, “he dispenses Ritalin six times an hour, that’s what he does.” She pleaded with the jury not to be duped by the people being paid “ungodly amounts of money” to confuse them.

The pediatrician, Dr. Robert Lerer, was donating his fee from the Olsa case to an international medical relief fund. A few years earlier, he’d written a journal article calling for a peer review process to discourage doctors from stretching the medical facts on the witness stand. “He’s trying to deceive you,” Brinkman told the jury, whose members saw the article only from across the courtroom. “This man is arrogant enough to write an article on how to deceive jurors. He writes an article about how doctors can do that, and then he turns around and comes in here and does the very same thing.”

Stephanie’s sister Alison Price said she was there the day Hannah rolled off the couch. Price testified that she’d seen the fall and that Hannah’s only injury was a red nose, like a rug burn. Brinkman told the jury that Price was making it up: “She didn’t see what happened; she wasn’t there.” That was the day, Brinkman argued, that Olsa had inflicted the broken rib and the old brain injuries.

Stephanie’s neighbor Renee Parks confirms that two of her daughters, then 8 and 6, were at  Stphenie’s the afternoon Hannah rolled off the couch—both Stephanie and Alison say the girls were in the room at the time. Investigators never questioned Parks or her daughters. The prosecution successfully petitioned the court to prohibit the children’s testimony at trial.

Dinah usually stayed with Stephanie two days a week. That month it was less—the baby and her mother had been out of state, visiting relatives. Defense attorney David Dodge asked the jury if it made sense to assume that a series of injuries was inflicted during a few brief visits with Olsa, when the child had spent most of the month with a variety of other caretakers, none of whom reported any bruising or tenderness. Brinkman attacked his credibility: “Only Mr. Dodge could make a visit to grandma’s sound sinister.”

Presented in court with the tape of the 911 call, Hannah’s mother explained that she’d meant to say Dinah had been throwing up for two days, not that she’d had breathing problems for two days. Mary Beth herself had stayed home from a party the night before the incident, in part because the baby had been sick. Dinah’s father—who had been caring for the child at home that day, after working graveyard shift the night before—went to the party alone. He also threw up that night.

None of this was in the police report. The day Dinah was hospitalized, Mary Beth Nelson told the police and doctors at both hospitals that Dinah had been fine when she dropped her off at Stephanie’s in the morning. In court, she agreed she’d warned Stephanie that the child had been throwing up—a classic sign of head injury. A story that changes as the facts emerge is also a cue for identifying the perpetrator, but police didn’t request the 911 tape until after Stephanie was arraigned. By that time they were building their case, not investigating.

The medical records are peppered with references to Mary Beth Nelson’s tendency to hysteria. On April 2, three days after her daughter was hospitalized, Mary Beth began shouting at nurses and her husband, ultimately ordering them all to leave the room. The medical social worker who was summoned in the aftermath wrote, “Mom appers to be upset and has difficulty in expression of her anger without becoming hysterical… Family appears to need continuous and ongoing support from all [Butterworth Hospital] staff.” On April 3: “Mom’s mood tends to be somewhat labile with potential for escalation very quickly. Appears mom is able to be diffused with intervention.”

In the winter of 1996 Mary Beth Nelson was working part-time at a bank and taking classes toward a teaching credential. One Monday about a month before the incident, she returned to Stephanie’s unexpectedly mid-morning, to take Dinah home instead of going on to work after class. Both women agree that Mary Beth was upset and that she told Stephanie she needed to find a cheaper babysitter—she wouldn’t be bringing Dinah back.

Then, the following Sunday evening, Mary Beth called and apologized. Stephanie claims that Mary Beth told her the real reason she’d been upset the previous week was that her professor had said she wasn’t cut out to be a teacher. At Stephanie’s first trial, Mary Beth confirmed that she’d had an unpleasant talk with her teacher. At Stephanie’s second trial, Mary Beth said her only concern that morning had been the money—she didn’t remember any problems at school. She was unable to find a cheaper sitter, so she returned to Stephanie’s.

But one of Mary Beth’s fellow students, Tina Richmond, remembers the winter morning when Mary Beth got “really upset” and “stormed out” during a class discussion of their student teaching experiences. Mary Beth had been complaining about her placement, Richmond recalls. “The professor didn’t say it right out, you should never do that, but she told her maybe she should consider a different field.” The teacher denies criticizing Mary Beth in front of the class, but says she did have a private talk with her about the importance of a positive attitude.

Whatever else Mary Beth and Stephanie did or didn’t talk about that Sunday evening, Stephanie agreed to watch Dinah the next day. She’d already planned a neighborhood outing, though, to an indoor playground called the Discovery Zone, and Dinah would have to come along. Stephanie’s neighbors later testified that Dinah was cranky that day, as usual. She screamed when put on her back for diaper changes, and she fussed even when being held.

A few friends and neighbors were allowed on the stand as character witnesses. By that time the investigation was long over, and the prosecution’s job was to refute their testimony. “Yep, all the children adored her, and she adored them,” Brinkman told the jury, “But one child didn’t adore her. One child really didn’t adore her, and she couldn’t handle it.”

The prosecution maintained that there had never been a choking, that Stephanie had simply “lost it” and attacked the crying baby, 15 minutes before the mother was due to pick her up. “There was no feeding, there’s no formula, and she’s lying,” Brinkman told the jury. “We’re talking a rage attack, simple—this woman hated that child.  She finally got—not finally, she would repeatedly get to the point that she would take it out on this child. But I can prove that on March 30th, she did it, based on these injuries.”

There was never any other evidence against Stephanie—no tell-tale threads or skin cells or blood samples, no witness to any assault on any child at any time. The exterminator saw and heard nothing alarming while he moved freely through the house. Stephanie says she expected his presence to prove her innocence, or at least to cast reasonable doubt. The prosecution saw it as proof that Hannah’s injuries had been inflicted in the few minutes after the workman saw the baby apparently normal and before the child’s mother arrived.

Stephanie’s first trial ended in a hung jury, her second in a conviction. She turned down a number of plea bargains along the way because, she says, “I didn’t do anything.” Now her appeals have been rejected, her son is growing up without her, and her parents are paying off a second mortgage taken to pay legal fees. Stephanie’s husband and son have moved in with the Price family—everyone agrees it gets tense, but they think it’s the best arrangement for Eamon, who thrives on the flow of uncles, aunts, and neighbors.

Stephanie still maintains her innocence, and so the court sees no remorse. That went against her at sentencing, and it’s on the list of factors the parole board is obliged to consider.

Stephanie is only one in a throng of unrepentant babysitters. In a 1995 study of perpetrators in shaken baby cases, Dr. Suzanne Starling noted that not a single babysitter in her sample population had confessed, even though non-relative care providers accounted for an extraordinary 17 percent of the crimes—in most statistical profiles, excluding sexual abuse, babysitters from outside the family account for no more than 2 or 3 percent of child physical abuse.

Starling speculates that babysitters have less motivation to confess—family members come clean, she suggests, because they think the truth might help save the baby’s life.

In Iowa, babysitter Mary Weaver maintained her innocence for four years before she was released in 1997 on new evidence. Weaver had been caring for a cousin’s 11-month-old daughter for less than an hour on the day the baby developed breathing problems. At the hospital, the girl was found to have a skull fracture some 7 to 10 days old and, like Dinah Nelson, both new and old subdural bleeding. Based on the theory of immediate symptoms, the prosecution targeted Weaver.

Her first trial ended with a hung jury, her second with a conviction and a life sentence. She was granted a third trial after new witnesses came forward to report that the child had been knocked unconscious in a fall before being placed in Weaver’s care on the critical day.

In Los Angeles, single mother Maurania Gonzales spent 7 months in jail after she was charged in the shaking death of her 18-month old son, Andre. After a series of defense doctors submitted exonerating reports, the prosecution sought out its own second opinion—a total of five outside doctors concluded that the boy could indeed have died from an accidental fall onto concrete, as Gonzales had insisted all long. Andre had seemed fine after the fall, Gonzales reported, but fell unconscious 4 hours later.

Back in Michigan, child care provider Steven Church remains in prison for the shaking death of 6-month-old DeShon Green. DeShon’s mother worked night shift. She had dropped the boy off, apparently asleep, at 9 pm. Church says he heard the child crying between 3 and 4 am, and went in to check on him. He claims he found DeShon in distress; the state says he shook and slammed the boy into unconsciousness. DeShon died 36 hours later, with old brain injuries revealed at autopsy.

Like virtually all SBS defendants, Church was represented by a lawyer with no previous SBS experience. Like Stephanie, he was prosecuted by Helen Brinkman.

Brinkman says she has no second thoughts about any of her cases: “I never prosecute unless I’m convinced the person was guilty.” In the shaken baby cases, she says, “I depend entirely on my experts. The doctors can tell.”

Dr. Vincent DiMaio, the chief medical examiner of Bexar County, Texas, and the editor of the American Journal of Forensic Medicine and Pathology, calls shaken baby an unproven hypothesis. “I’m not saying these deaths are from natural causes,” he clarifies, “I’m saying that these children are not just being shaken. They are also being hit on the head or thrown against something. It’s an impact injury.”

Until a couple of years ago, he says, he would have agreed that the symptoms of a fatal infant head injury must be immediately obvious, but then he was asked to review the medical records of Melissa Mathes, the baby in Mary Weaver’s case—the child had been seen by her family doctor three times for the flu in the week before she quit breathing at Weaver’s house. “That case is very disturbing,” DiMaio says, “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.”

DiMaio is also clear on this point: “If the child has old injuries that have not completely healed, the child will be more susceptible to fresh injuries. That’s standard pathology.”

Stephanie Olsa, Mary Weaver, Stephen Church, Louise Woodward—all four sitters were convicted of shaking babies on the basis of medical testimony that the attacks must have been violent and the symptoms immediate. All four of the infants had prior injuries, three of them prior brain injuries undisputed by the prosecution. Still, the presumption of immediate symptoms prevailed in court.

The defense in the Woodward case argued that Matthew Eappen’s fatal collapse was caused by the rebleeding of an old brain injury. After the trial, child-abuse doctors Kirschner and Reece, with Dr. David Chadwick of the San Diego Children’s Hospital, collected 70 signatures on an open letter that dismissed the rebleed theory and decried media coverage that treated it as credible.

Then CBS’s 60 Minutes interviewed new experts, doctors who’d agreed to review Matthew Eappen’s medical images pro bono. Neuropathologist Floyd Gilles and radiologist Marvin Nelson at the Children’s Hospital of Los Angeles concluded the child’s problems were triggered by oxygen deprivation, possibly as long as 48 hours before the serious symptoms emerged—and they noted evidence of an old brain injury. Reece and Kirschner gathered 120 signatures on a second letter that rejected the new diagnosis and reiterated that a child can’t look normal after a fatal head injury.

Still, experts outside the child-abuse community tend to accept evolving symptoms of SBS, even in fatal cases. “Is it common? No. Does it happen? Yes,” shrugs Brad Alpert, a pediatric intensivist at the University of Texas at Houston, “Timing has to be only one part of the puzzle.”

When Stephanie was tried, the medical journals contained one paper on the timing of SBS injuries, a 1994 literature review. Pathologists Marcus Nashelsky and Jay Dix from the University of Missouri–Columbia University Hospital found only three cases that met their criteria (death from shaking, with no evidence of impact). In two, the symptoms were immediate; in the third, a caretaker had confessed to shaking the child four days before seizures started. Clinging to the common knowledge, the authors speculated, “One wonders whether the infant was reshaken shortly before onset of seizure activity.” The prosecution cited the paper as further proof of Stephanie’s guilt.

Since Stephanie’s trial, forensic pathologist M.G.F. Gilliland has published a larger study, based on data she and colleagues collected over eight years at the Southwestern Institute of Forensic Sciences in Dallas, Texas. In 54 of Gilliland’s 76 fatal shaking and slamming cases, serious symptoms emerged within 24 hours; in 22 cases, the interval was longer. “Certainly the symptoms can be immediate, and they often are,” Gilliland says, “but the common knowledge that they must be is not uniformly correct.”

The medical social worker who counseled Dinah’s parents was part of a child protection team, one of the tools that hospitals have developed to meet their moral and legal responsibilities in the era of child-abuse awareness. Doctors and other professionals are required by law to report any suspicion of child abuse; the penalties for not doing so include time in jail. Nevertheless, studies still find that children who die from abuse have often been treated for injuries in the past and returned to the same caretakers. Everyone is looking for ways that caring professionals can work together against a terrible and elusive enemy.

Into this era was born Shaken Baby Syndrome, a diagnosis that eliminates all doubt about how to proceed. Experts like Kirschner and Alexander travel the country to train other doctors and testify in court, explaining what they see as the simple truth:

•     the syndrome can result only from an intentional, violent assault, not from an accident in the home

•     the symptoms will be immediate and obvious, even to an untrained observer.

There is no room in this model for people who slip in the shower or fall down the stairs; there’s no room for evolving symptoms. And as long as the justice system applies the model without question to any SBS-like death or injury, there’s little chance of gathering evidence to the contrary.

The people who prosecute child abuse are only doing their jobs when they embrace a medical model that’s proving so potent in the courtroom. Doctors who find their opinions confirmed by legal outcome seldom wonder if the police are looking as closely as they should, especially when the suspect is an unknown babysitter, not the parent who’s been seen grieving at the victim’s bedside. Meanwhile, people are in prison on the basis of sincere but unproven medical opinion, and the convictions are feeding back into the system, distorting what little is known about a subtle but emotionally charged medical condition.

“I have no doubt that the people who targeted Stephanie believe in what they’re doing, but I believe they’re wrong,” says Father Stasker, still the pastor at St. Paul the Apostle Church, where the congregation in 1996 included not only the Olsas and the Nelsons but also parishioners in and out of the legal system. “It was an emotional time,” he recalls. “So many people rose to Stephanie’s defense, you couldn’t stay out of it.” After the verdict, the Nelsons wrote a letter of complaint to the bishop and switched to a second, and then a third, parish. Does Stasker know who injured Dinah Nelson? “I have a fear, but I have no opinion based on facts,” he says. “I’ve tried to approach all parties in a spirit of healing.”

Although he’s still sure she’s innocent, Stasker declines to condemn the system that put Stephanie prison. “We probably have a better legal system than most,” he says, “but the search for vengeance rarely brings out the best in us.”

Note:  Some names have been changed for privacy, but not Stephanie’s or the professionals’.

(c) 2011 Sue Luttner

21 responses to “Stephanie’s story—my first case

  1. Tee

    My sister was arrested today for allegedly shaking a baby that was in her care for less than 3 hrs. The mother dropped the baby off to her and she noticed his breathing was labored but the mother stated that he had bronchitis and was just in the ER the night before. She assured my sister he was fine so my sister took him into her care. He fell asleep and when woke up crying about 30 mins later. She assumed he was fussy and hungry and went to make his bottle. His breathing still shallow, she called his mother and again, she insisted it was just the bronchitis. However as she started to feed him she lifted him and noticed he was slumped over and unresponsive so she called 911.
    The baby was taken to the ER and later reported that he has bleeding on his brain. No other bruises or injuries to support abuse. Police and social workers were at my sisters home that night and removed her own children while “investigating:.
    Yesterday the baby died. My sister was at social services at the time and they had police come in to arrest her. After reading these stories, I am so scared. My sister has a flawless history in child care and has never had any abuse allegations before. How do we prove her innocence?

  2. Pingback: Shaking Theorists Repel Criticism | On SBS

  3. Cindy R

    I have seen many articles of those innocent but accused of SBS/AHT I now add myself to this growing list, about to be sentenced of this class X felony. I fear my lawyers are uneducated in the medical field of this Mis-diagnosis.
    I have 2 months to find an appeal lawyer who can help with EXPERIENCE in SBS/AHT, those I’ve been referred are not. Without saying too much more in details…..this process is being filed for grounds for appeal.
    We wasted big $ on specialists not used in the trial, worry us to commit to someone Not experienced in SBS. This is in ILLINOIS,can someone help ?

  4. Jessica D.

    Right now my husband and I are being accused of shaking our baby boy. He had 2 episodes of loss of consciousness. My husband called 911 right when it started happening. They took him by ambulance to the er and they just said he was fussy. The second time it happened was about a month later and it was literally 15 minutes after I left for work. He called my father b/c it was a sunday and we own a restaurant so he didn’t want to pull me out of work if it was nothing again. This time at the er they still didn’t see trauma. I left work and went to the er and we had a doctor from our pediatrician group come in. Once again they see no problems the only thing is he has had high white blood cell count in both instances. He tells us that we can either go home and just see our pediatrician in the morning or if we want we can stay the night for observation and they can call in a neurologist. Of course we both agreed for staying the night! at that time the neurologist diagnosed him with Gastroesopheageal reflux disease and his loss of consciousness came because both times he had just been fed and he would always spit up or choke on a bottle. We go to our pediatrician in a few days and his head has been growing steady at a rate of 1in per month since birth she suggests a mri to make sure he doesn’t have hydrocephalus. The next week my mom was holding my son and he started to randomly start crying and then passed out. Let me tell you about my son he ONLY cries when he is hungry or has a dirty diaper. The most relax calm baby i’ve seen. We go to children’s hospital to have his mri done. My father goes with me so my husband can stay at home with our 1 1/2 yr old daughter. When he gets into recovery they let me go in and soon we were back to our room where we kept asking if we could feed him yet. A nurse comes in and tells us that we are being admitted and she couldn’t tell us why. We get moved into a room and within 10 mins this doctor comes in walks right up to where i am holding my son and points her finger in my face and says “your son has bleeding on the brain and you shook him” We were just all dumbfounded my dad calls my mom she leaves works picks up my husband and leaves my daughter with my grandparents. They arrive at the hospital and my parents wait in the waiting room. Finally a pediatric neurosurgeon comes in and tell us that he is fine he won’t need surgery and that THIS ISN’T SHAKING BABY SYNDROME. He has a condition known as BESS or benign extra axial space. We go out to tell my parents this and mom informs me that police are already at our house looking for my daughter. 2 police officers come to the hospital and split us up. the male cop takes my husband first then my father. He informs them that he is recording them. I went first with the female officer and i tell her there is no way my husband shook our son. My mom then was interviewed. We go back to our room and our son goes thru a ton of test including full body scan, ret cam, eeg ect. He has no broken bones or fractures, he isn’t having seizures but he does have retinal bleeding. the hospital staff wouldn’t let my husband or dad stay at the hospital so they go home and promise the officer that they would come in the next morning to give a statement. The next morning we have an intern come in to do rounds. He informs us that they have ruled out shaking baby syndrome and his condition of BESS and the reflux has caused his injuries. My mom then asked how does he know this and he goes “Its in your charts” When you have BESS the extra space allows the csf fluid to move and can make blood move behind the eye. My mom then calls in the director or children’s hospital and then repetitively tells us that he is wrong and that this is shaken baby syndrome. They pull the intern out and they are gone for almost an hr till they come back in and makes him repeat that this is shaken baby syndrome. Cps comes in then and takes our children away , my brother and his wife apply for and get the children and our temporary custody hearing is next week. My parents were originally approved to take the children BUT my father wouldn’t go to the police with my husband so he stepped in and wouldn’t let us.It has been a hell ride, they wouldn’t giive us the medical records had to go to court to get them and they STILL wouldn’t give them and had to go back to court and right before the attorney general agreed to them just don’t make them sign them. We got some of the medical records but i still think there are those reports that the intern was talking about. Our temporary custody hearing has been put off for what will be almost 3months we go back in dec. I’ve been researching and researching. we’ve gone back to another pediatric neurosurgeon who said that he can’t diagnose this as sbs. he went to a neurologist for children’s hospital and said to cps and us he don’t know why he is even seeing us that he isn’t have any neurology problems he has no problem with eye sight and he is meeting all his goals. He rolls over front to back he sits us for extended periods of time(about 45 minutes last night) he grasps everything a normal 6 month old does. the daycare even says that he is the happiest baby they’ve ever seen and only cries when hungry or needs to be changed. It really is a modern day witch hunt. He has 2 conditions that both causes subdural hematoma’s and retinal bleeding and his macrocephaly is normal b/c big heads run in both sides of the family and my daughter had it she was always 98th% for everything just like he is. Just waiting 2 1/2 more weeks and getting depositions from doctors. Found out they have made our police case inactive, we haven’t heard from them since right after the hospital. I don’t sleep all i do is read read and read. we have court appointed lawyers and i’ve done all the research all we want is our kids home.

    • I am so sorry to hear of another family drawn into this tragedy. Your story sounds like many others I have heard.

      I have sent you a private email with some suggested resources. Many good wishes, and feel free to stay in touch.

  5. Pingback: Finding a Voice, and a Community | On SBS

  6. Pingback: Babysitting My Niece Stories | News Latest Update

  7. Great article. I am trying to find more information on child abuse cases such as these. I, myself, have been accused of 1st child abuse. (Charged in October 2011). Its been continued time and time again for various reasons. My attorney is doing their best but I feel that they are in over their head. I’m running out of time and options. My trial is set for September. I’m trying to see what if any options I might have. I have been out of work for months since being laid off, and with this matter showing up on my background check I am having a hard time finding work. I don’t want to give up on myself but I’m not sure what I can do to help the situation.

  8. Tim


    I am currently in the UK and have a friend that has recently been given a life sentence for killing his baby. The details of the case are detailed in a separate message.

    I cannot stand by and let an innocent man spend a minimum 17 years in prison for a crime he did not commit. He has a 4 year old son that adores him and always asks when his daddy is coming home. Every one of his friends have stood by him and we are all doing as much as we can to get him released. Could you please advise in any way possible, as my friend is innocent? I would not have stood by him if there was even a 1% chance he harmed his baby.

  9. Mindy

    I left my house at 6am monday morning and at 630, not 30 minutes later, i got a call from my fiance who was watching my daughter that she was breathing but unresponsive. Within 5 minutes i was already at the house and had called 911 on the way. she had a siezure just before being taken on the ambulance. Its a small town, la crosse, ks… so they life watched her to wichita for further care. an MRI was done when she arrived and found two SMALL brain bleeds(subdural hematomas). There were no skull fractures or broken bones, only TINY bruises, one on her tummy, and one on the back of her arm(I’m assuming from the medical staff at our small town ER holding her down while she was having a siezure to place the IV). There were no other injuries- but I’m told that without a doubt, the only father my children has know, had to have shaken the child because “medical evidence proves it”. I hit a deer 4 days previous to the incident, and read on WIKIPEDIA that chronic subdural hematomas can develop over weeks to days, but often cannot be distinguished between acute(immediate) bleeding. When I told the medical staff and detectives about hitting the deer with the children in the car, I was told that I was covering up the abuse. My mother had been chosen to be the children’s guardian, my daughter FULLY RECOVERED IN 6 DAYS and was released from the hospital only to be put in a FOSTER HOME. I am so devistated. Now “DCF” and “ST FRANCIS” are bringing up mental health sercvices I recieved two years ago, as well as a DUI probation, and making me sign releases to speak with all of my former counselers and probation officers from BEFORE I WAS EVER A MOTHER TO THIS CHILD. I feel as if i will never get my children back. THE FOUNDER OF SBS has made a statement, which is on wikipedia, on wikipedias page on shaken baby syndrome. HE MAKES THE STATEMENT THAT SHAKING IS NOT ALWAYS THE CAUSE OF SUBDURAL HEMATOMA, and even goes on to say that it is overdiagnosed, check the page yourself.

  10. mgdgurl


  11. kris sherman

    The Medical Association has written this unproven diagnosis for doctors to follow and have not changed it even though there are experts all over the world that disagree and claim it is not possible. Vaccines can and do cause this retinal and subdural hemorrhaging. It is written on the vaccine package insert. It also states that if a child is vomiting, crying for more than 3 hours, or is having seizures, discontinue further vaccines. Doctors ignore these recommendations which further damages the childs brain to the point that they stop breathing and are taken to hospital. Most of the cases I have read about, the child was very fussy, vomited alot, had high-pitched crying (which means neurological damage in progress) or was having seizures. If asked, you would find out that they had just had a round of VACCINES in the week prior. If you look at the adverse vaccine reactions on the website NVIC.ORG you would CLEARLY see the DAMAGE caused by this insane Medical proceedure. If you look up the ingredients in them you would see why their tiny brains hemorrhage and yes it does break bones too. It poisons their whole immune system. Just research it. I did after my twin nephews had seizures after their MMR vaccine. Non-vaccinated babies dont have the massive problems that the vaccinated have. Thousands of INNOCENT people in prisons for SBS need to be released. When is it going to happen. Canada has realized this false diagnosis and they are releasing people BUT NOT THE U.S.

  12. Thanks for a great article! I am currently writing a book about the Mary Weaver case. It is a good example of what you are saying here. Mary had never hurt the child but was convicted of first degree murder and sentenced to life in prison without parole. Then witnesses stepped forward and a neurologist who had followed the case and was convinced Mary was innocent. After 2 years in prison Mary was re-tried and acquitted. How sad that today innocent people continue to be sent to prison because of medical misconceptions about shaken baby syndrome!

    • Hello my name is Sade Henderson. I live in Baltimore, Maryland, and I’m being accused of shaken baby syndrome. I’ve never shook my baby, never hurt her and now my life is falling apart. These people have taken my child away from me .. she is still at Johns Hopkins University but I can’t have any contact with my baby an its hurts so bad to know that these people are falsely accusing me and depriving me and my little girl of each other and trying to lock me away. I want my baby back in my life I would never hurt her. She is my whole world an the reason why I breathe. But they are convinced I mistreated my baby. So I may lose my sweet baby forever and do jail time… smh the justice system…

      • Dear Sade,

        I’m so sorry to hear of another family drawn into this legal nightmare.

        If you don’t have an attorney already, you must get one immediately. Also: You need to get copies of your daughter’s complete medical records, including prenatal, delivery, and well baby, as well as all reports from whatever incident prompted the diagnosis (ambulance, ER, whatever there is). You need copies of the actual images from x-rays, CT scans, etc., not just the reports—you should be able to get them on DVD, which is cheaper than paying for the films. As the child’s mother, you can probably get these records if you act quickly, before the state tries to terminate your rights.

        As I said, if you don’t have an attorney, you need one. If you have one already, have him or her contact Katherine Judson at the Innocence Network ( for referrals to medical experts to review the records. Public defenders can be very effective if you can provide them with the support they need.

        There are also parent support groups for people in your position. The most active one is on Facebook, at You have to first join Facebook and then ask to be part of that group before you can see the discussions.

        For more references, you can see the Resources page of my blog, at

        Many good wishes.

  13. Pingback: Shaken: A Forensic Misadventure | Reporting on Health

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