Category Archives: Falsely accused

Falsely Accused: Organized Parents in France Earn Credible Coverage

A coalition of wrongly accused parents in France has caught the attention of Le Monde, which Wikipedia calls “one of the most important and widely respected newspapers in the world.”

Association Adikia put up their web site just last month, although some of the members have had a Facebook presence for some time. Last week Le Monde published a letter from key organizers explaining who they are, what the problem is, and what they plan to do.

Here is a Google translation of the published letter:

We are wrongly accused of abusing our children as a result of misdiagnosis”In a tribune in “Le Monde”, a hundred parents testify to their fight, accused of violence on their children while they are suffering from a rare disease. They created the Adikia association to advance their cause to justice.

We are more than a hundred parents wrongly accused of abusing our own children as a result of misdiagnosis. Two and a half years ago, one of us created a Facebook group to tell her story. This is where we found ourselves over the months after experiencing the same dramatic situation.

While we consult pediatric emergencies for our babies who are uncomfortable, doctors detect signs a priori suggestive of abuse. These are mainly fractures, bruises, or bleeding inside the skull and eyes (subdural hematomas and retinal hemorrhages). These last two signs are typical of the “shaken baby syndrome”.

In our case, however, our children have various rare diseases. For example, the son of Virginie (creator of the group) is suffering from hypofibrinogenemia, a rare genetic abnormality of blood coagulation. As indicated by the report of the High Authority of Health on the subject, disorders of coagulation form an important class of differential diagnoses of shaken baby syndrome.

Unjustified accusations

The son of Vanessa (president of the association) is one of the many babies in our association with external hydrocephalus. Clinical studies suggest that this pathology may favor the occurrence of subdural haematomas. Marielle’s daughter has osteogenesis imperfecta, or glass bone disease, which can cause fractures. Emi has hypophosphatasia and her son has bone fragility associated with vitamin D deficiency.

In an emergency, however, doctors must diagnose quickly and act if they feel the child is at risk in their family. They make a report, which leads to the almost automatic placement of our children. They are withdrawn while we are taken into custody and questioned by the police.

As if dealing with the suffering of our babies was not enough, we must also suffer unjustified accusations of abuse. Worse, we must live with the idea that our babies will have to spend the next months or years away from us, when they are sick and need all our love. Their first steps, their first laughs are stolen forever. Strong emotional ties with parents are essential for the neuropsychological development of babies, as pediatrician Catherine Gueguen has shown. We have all had suicidal thoughts, but we must absolutely stand firm for our children.

The placements end when the juvenile judges finally feel that we are not dangerous. In a way that is difficult to understand, we are criminally prosecuted when the judicial expertises are carried out. Specialized maltreatment doctors seem to validate the violence systematically, even in the presence of rare and unknown diseases. We have a hard time getting specialists in rare diseases to do their own expertise, even more when the medical records of our children are seized by the courts!

The example of the little Luqman is characteristic. At 16 months, he spent 13 away from his parents. More than a year ago, he had hemorrhaging leading to a diagnosis of shaken baby syndrome. An extremely severe vitamin K deficiency (necessary for blood clotting) was quickly detected. It appeared later that Luqman had abetalipoproteinemia, a rare genetic disease that could cause such a deficit. According to several doctors, this disease could explain the symptoms.

Shaken baby syndrome

Today, Luqman is still placed, and his parents are indicted. For the legal experts who have access to the whole file, the signs presented are characteristic of shaken baby syndrome and the diagnosis of abuse is therefore certain. Can we really be certain that this disease, which affects less than one in a million babies, can not cause subdural haematomas and retinal hemorrhages?

We have trouble making it clear to the various speakers that the words of doctors and experts never have absolute truth. We must all show the greatest humility before the complexity of the human body. We do not know everything about medicine, far from it.

We have created our association – Adikia – to support and inform those unfairly accused, to make our testimonies known to the public, and to gain more weight in court. We would like doctors to take every precaution, as far as possible, and for the judges to consider all the elements of the files. Decisions as serious as long-term placements or prison sentences must not be made solely on the basis of medical evidence, however clear and categorical.

We would also like to be involved in improving the reporting and diagnosis criteria for suspicion of abuse. Our goal is to avoid unfounded accusations and unjustified placements as much as possible while respecting the sound and indispensable principle of child protection.

Virginie Skibinski and Vanessa Keryhuel, for the Adikia association.

Association Adikia had already reached out to other parents’ organizations, including Protecting Innocent Families in the U.S., which now shares the logo created for them all by Italian artist Chiara Zini. For more of Zini’s work, see the beautiful and touching site una Mamma, un Papá.

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

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Shaking: “A False and Flawed Premise”

Kristian Aspelin and his son Johan

Kristian and Johan Aspelin

February opened with a pair of important and complementary postings, a bold academic statement signed by 34 physicians, attorneys, and child-protection professionals with “deep concerns” about shaken baby theory in the courtroom, and a beautifully written examination of the Johan Aspelin case that illustrates why the experts are so concerned.

Published in the British journal Argument & Critique, the Open Letter on Shaken Baby in the Courts: A False and Flawed Premise argues that a diagnosis of shaking “risks blurring the line between diagnosis and verdict,” and that “SBS has never been proved as anything more than an hypothesis.” Citing the dearth of scientific research underlying the theory, the authors write:

Noticeably, the requirement for scientifically based evidence is far more rigorous in medical negligence cases than in the family or criminal courts where believing something to be true appears to have achieved sufficient evidential value to sway the determinations of the court.

The letter also notes that the justice system has tended to suppress arguments about shaken baby syndrome:

One of the consequences has been the vilification of experts prepared to advance competing theories and the suppression of sensible debate.

Dr. Waney Squier

Dr. Waney Squier

One example of such vilification is unfolding now in England, where pediatric neuropathologist Dr. Waney Squier is facing a challenge to her license triggered by complaints to the General Medical Council (GMC), reportedly from the Metropolitan Police, that her courtroom testimony exceeds her area of expertise and ignores the opinions of her peers. Dr. Squier has been testifying on behalf of accused parents for about the past decade, since her own research, clinical experience, and reading of the literature convinced her that the prevailing model of shaken baby syndrome is flawed.

My favorite report about Dr. Squier’s GMC hearings, which opened in the fall and continue intermittently, is a legal-training company’s blog posting that features praise from readers for her intellectual honesty in the face of peer pressure. A general practitioner offered this striking parallel with an historical report to the GMC:

Surely the Met investigating a Dr who happens not to agree with the consensus — and holds an expert view — is a little like the tobacco companies (circa 1960s) reporting Sir Richard Doll to GMC for his novel theory that tobacco caused lung cancer.

WhatRealllyHappenedJohan copyIn the U.S., meanwhile, an in-depth treatment of the Johan Aspelin case published last week on Medium by reporter Elizabeth Weil also reveals striking new facts, like the botching of Johan’s initial intubation at San Francisco General, which caused the complete collapse of one lung and serious damage to the other. And that Johan received several times the recommended dosages of two different sedatives, which, Weil writes, “left him essentially paralyzed and unable to communicate distress as air was pumped into his compromised lungs.” The article notes:

Nowhere in the police investigation transcripts does it suggest that doctors considered Johan had a brain injury and retinal hemorrhaging due to low blood-oxygen levels and high carbon dioxide pressure, problems that may result from faulty intubation.

Johan’s mother Jennie Aspelin learned about the error and resulting crisis only because she’d contacted the organ-donation agency to find out why there had been no recipient reported for Johan’s lungs, as there had been for his other organs. Even then she received only the oblique message that it was “a matter of function,” enough to send her on a focused search for the full medical records.

Johan

Johan Aspelin

In November of 2010, Johan’s father Kristian Aspelin told emergency responders that he had fallen in the kitchen while holding 3-month-old Johan, but child-abuse expert Dr. Chris Stewart rejected that explanation and told police that the boy had been violently shaken to death.

In December of 2012, the county dropped murder charges against Kristian, after defense attorney Stuart Hanlon turned over a collection of exonerating reports from outside experts as well as a carefully assembled medical time line that included the hospital’s mistakes. By that time, the family had lived apart for two years, when they’d  lost their baby and needed each other more than ever. They’d sold their house and taken on a staggering debt to cover legal bills, and they’re not slated for any compensation from the state.

Dr. Mark Feingold

Dr. Mark Feingold

But the people who train child abuse physicians continue to teach that children seldom if ever suffer serious injury in short falls, and that only abuse causes severe retinal hemorrhages. In a January, 2015 lecture titled “Is There a ‘Shaken Baby Syndrome’?,” for example, which earns the medical viewer one continuing education credit, child abuse pediatrician Dr. Mark Feingold reported that hypoxia does not cause “macroscopic subdurals” and that children do not suffer serious injury in short falls:

A lot of our opponents say, “Well, the child died. That’s too bad. But it was a short fall, just like Mom said. He fell from Mom’s arms.” The evidence shows that children who fall more than 20 feet can die, but children who fall less than 3 feet almost never die, and when they do, it’s a different kind of accident. It’s a playground accident. It’s an older child. They die of a large subdural that causes lots of pressure. And the RH if present are not the kind we see in abuse cases (emphasis added). But nonetheless, different versions of “I was carrying the baby and I tripped and fell” are often offered.

Slipping and falling with the baby is the explanation Kristian Aspelin offered, like countless parents and caretakers before him and countless more to come, while pediatricians are being trained to reject that story, and to dismiss the hypoxia that frequently accompanies head injury as a source of compounding symptoms.

The retinal hemorrhages in Johan’s eyes were widespread and multi-layered, the kind that child abuse pediatricians insist do not result from short falls or lack of oxygen to the brain. So were the hemorrhages in the eyes of the toddler in the care of René Bailey, who said the little girl had fallen off a chair—Bailey’s murder conviction was vacated in December. Doctors also pointed to extensive retinal hemorrhages when diagnosing shaking injuries in the cases of exonerated babysitters Jennifer Del Prete and Audrey Edmunds and exonerated father Drayton Witt, and in an exasperating case local to me in which paramedics pulled a rubber band from the child’s throat during resuscitation and the only physical evidence of abuse was the triad. It seems to me that the world now offers quite a few examples of extensive retinal hemorrhages from plausible, non-abusive accidents and medical conditions.

RHKelloggWhen I started researching shaken baby theory more than 15 years ago, I routinely read in trial transcripts that doctors considered the presence of retinal hemorrhages a sure sign of child abuse, but since then the situation has grown more complicated. When researchers started looking systematically, they rediscovered that retinal hemorrhages have a long list of non-traumatic causes, including diabetes, anemia, bleeding disorders, increased intracranial pressure, increased intrathoracic pressure, and certain types of infections. A startling one quarter of neonates born spontaneously arrive with retinal hemorrhages, more in deliveries that involve instruments. In light of this new understanding, child abuse experts now recognize other causes of retinal hemorrhages but insist that most of them result in only a few small hemorrhages near the optic nerve, not in widespread, multi-layer hemorrhages, which they continue to interpret as evidence of whiplash shaking.

I don’t know how we will move forward, but I welcome the growing chorus of voices in the journals, in the press, and in the courtroom, who demonstrate through their work and their testimony that the Open Letter on Shaken Baby is representing the situation correctly in its message to the courts:

In short, we would inform members of the judiciary and legal profession in those countries which utilise the SBS construct, that it does not have the undivided support of the relevant professional community, an essential consideration in the assessment of expert testimony.

The letter was edited by Argument & Critique’s managing editor Dr. Lynne Wrennall, whose doctorate is for work in child welfare, from a draft prepared by solicitor Bill Bache and veteran child social worker Charles Pragnell. The signers include 16 physicians, a handful of scientists, and a variety of social work professionals, from both academia and the field.

For the observations of Phil Locke at the Wrongful Convictions Blog, see his posting about the Open Letter.

The film company Mighty Myt is making a film about Johan Aspelin’s case, In a Moment: The Johan Aspelin Story.

copyright 2015, Sue Luttner

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

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Decisions Address Timing, Coercion

subduralImage

Not from this case, merely an example of subdural bleeding

Two different judges in two separate cases have looked carefully at the facts in front of them and found the kind of fundamental problems that plague shaken baby prosecutions.

In October, District Court Judge John Telleen in Scott County, Iowa, addressed an issue I’ve been wanting someone in authority to notice for years now, the implications of a pre-existing subdural hematoma.  Judge Telleen’s oral decision declaring an accused father not guilty included this observation:

All of the State’s evidence or the vast majority of it related to the 12 hours before admission on November 5. Frankly, I believe it’s clear that nothing happened on or about November 4 or November 5 that could possibly have caused a subacute subdural hematoma that had been in existence from anywhere from three days to ten days prior to that.

Like Judge Matthew Kennelly following the Del Prete hearings, Judge Telleen was left doubting both shaking theory and its application to the case at hand:

[I]t is my understanding from the testimony that I found credible that there are no scientific studies that support or document that shaking causes brain hematoma or brain bleeds…

[F]rankly I have some serious doubt whether a crime was even committed here much less that the defendant did it.

The judge noted that the infant, only three weeks old when clear neurological symptoms emerged, had been sick since birth, and he chided the child abuse pediatrician for making the “default diagnosis” of abuse without doing a full work-up to eliminate metabolic or bleeding disorders, or even a vitamin D deficiency, as the child had healing fractures that could possibly, but not definitively, be dated back to birth

The state’s ophthalmologist had apparently testified that he couldn’t be certain the child was abused, and conceded that a sharp rise in intracranial pressure (ICP) could account for the retinal hemorrhages. Judge Telleen said:

Dr. L was a credible witness. He was a straight shooter. He said he couldn’t place it beyond 51 percent, his opinion that he thought it was caused by non-accidental trauma. However, he freely acknowledged as an honest witness that increased intracranial pressure can cause retinal hemorrhage, he couldn’t rule that out.

There seems to have been no press coverage of the innocent verdict, so there was never any public correction to the initial news stories, which quoted an affidavit that the father had “engaged in three or more acts of child endangerment, including at least one act that resulted in serious injury.”

December update: The local paper has now covered the decision, at http://www.press-citizen.com/story/news/2014/12/24/uihc-shaken-baby/20858227/

Defense attorney Kent Simmons said his client turned down a plea agreement that would have avoided jail time, because he did not want to admit to doing something he didn’t do.  “I told my client he was a very brave man,” Simmons said. “And Judge Telleen is an honest, bright, and fair jurist.”

judgeAngelLopezAnd I’ve just learned about a decision this past spring in Oregon, where Appeals Court Judge Angel Lopez affirmed a trial court’s decision barring a confession from the courtroom, concluding that the father’s statement was made involuntarily. After hours of taped interrogation that focused on his daughter’s injuries, the detectives had turned off the recorder for 25 minutes and then turned it back on to capture the disputed confession. The published decision includes this touching quote from the trial judge:

Here was a man who had a baby in the hospital for shaken baby syndrome or some traumatic issue. Several times during the discussion with him he was asked to tell the truth because that would predicate what the treatment would be for the baby. Implicit in that is if he didn’t, the baby was going to end up worse off.
I see that as compelling. I see the going back and forth by saying—minimizing to the defendant what’s going to happen to him if he [comes] clean and he confesses. I believe that the statements, given these facts and circumstances, were involuntarily made, and that’s based on the totality of circumstances. There’s no one thing that jumps out at me but there are a lot of things that together tell me that his will was overborne by two detectives in that hospital room over two days.

With supporting quotes from the interrogation transcripts, Judge Lopez added his own analysis:

Having made clear that G had serious medical issues that could be ameliorated by a confession—an assertion that, as a matter of medical fact, is without any support in the record—the officers also appealed to defendant’s paternal responsibilities, his religion, stated that defendant was the only one who could help G, and stated, in effect, that the way to provide that help was to tell the officers that he had accidentally shaken her.

I am always glad when someone in a position of authority stops to consider what it must be like for an accused parent, frantic with worry for their child, to be harangued by detectives intent on extracting a confession.

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Jury Finds Adrian Thomas Not Guilty

adrianThomasThe retrial of convicted father Adrian Thomas produced a not guilty verdict today, a decision reached by jurors who did not learn about the 9-hour interrogation examined in the award-winning 2012 film Scenes of a Crime or hear testimony from the detectives who conducted it. Thomas’s initial conviction in 2010 for the presumed shaking death of his 4-month-old son was overturned in February, when an appeals court determined that the interrogators’ heavy-handed tactics made the resulting confession inadmissible.

At both trials, defense experts argued that Matthew had died of sepsis, a full-body infection that leads to rapid collapse through tissue failure. The sepsis diagnosis was  confirmed by blood tests ordered by forensic pathologist Jan Leestma, hired by the defense team. The state pathologist had not mentioned the sepsis in his autopsy report, although he did not deny it after Leestma brought it to his attention.

AdrianThomasStandsMatthew had no bruising, no red marks, and no fractures. His first blood test when he was rushed the hospital had came back positive for streptococcus pneumoniae. He had also arrived at the hospital with a temperature of 97.2 F, which dropped 3 degrees over the next half hour. His mother had reported a fever of 100.4 F the previous day, a figure that was dismissed as “not high” by prosecution expert Dr. Carole Jenny, who insisted that the sepsis infection was secondary to inflicted head trauma.

Coverage by reporter Bob Gardner at the Times Union offered this quote from the prosecution after the verdict:

“After the Court of Appeals threw out the his statements of guilt, we did the best we could with what we had left,” said Assistant District Attorney Christa Book. “I’m sorry that I could not bring Matthew justice.”

For a summary of the interrogation and a review of the film, please see this blog posting.

For the opinion vacating Thomas’s initial conviction, follow this link.

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Filed under abusive head trauma, AHT, coerced confessions, Falsely accused, parents accused, SBS, shaken baby syndrome

Short Falls, Long Sentences

The innocent verdict in Yolo County last month has me reflecting on a few of the people I know who are in prison on the basis of medical opinion that (1) short pediatric falls are seldom if ever fatal and (2) the symptoms of a serious infant head injury will be immediately obvious.

Because the doctors are so sure, police and social services move ahead with confidence, and juries tend to convict. Tragically and exasperatingly, the legal outcomes then seem to support the common knowledge, which remains a matter of opinion, not proven fact.

Rico Green

Rico Green

Rico Green

Rico Green in Oklahoma, for example, is serving a life sentence following the 2010 death of his girl friend’s toddler, 13-month-old Gericho. “Anybody that knows Rico knows that’s not him,” says Antoine Hubbard, a family friend who has pulled together the case records, hoping to file an appeal. “Rico’s a gentle guy. He’d never do something like that.”

gericho

Gericho 2010

Gericho’s mother had just started a new job and Rico was watching Gericho, as he often did. He called 911 mid-day, with a report that the boy was unconscious after falling down a few steps—but at the hospital, doctors said a short fall couldn’t account for the injuries.

During extensive police interviews, Rico reported an incident earlier that morning when he had “snatched up” Gericho and scolded him, when the boy had grabbed the toilet plunger after his bath and pretended he was going to bite it, a game he’d learned was provocative. In the videotaped portion of the interrogation, the final half hour, the detectives do most of the talking, insisting that Rico, enraged, shook the boy at that time.

Rico shows a remarkably even temper on camera, seemingly more puzzled than angry as the detectives refuse to accept the story he repeats again and again: What he feels bad about is yelling at Gericho and making him cry.  “I know he’s a one-year-old,” Rico explains, “He probably doesn’t understand.” The detectives keep at it, though, until Rico finally seems to accept their theory that he was so angry during the plunger incident he didn’t realize how hard he had shaken the boy when he grabbed him. What sounded like a confession to them looked to me like acquiescence, and not the behavior of a man prone to violent outbursts.

Rico’s trial lasted three days and featured 13 prosecution witnesses. The public defender called no witnesses on his behalf, and the jury convicted Rico of murder in the first degree. Antoine Hubbard is now looking for pro bono legal help.

Jeff and Gracelynn Baker, 2010

Jeff and Gracelynn Baker, 2010

Jeff Baker

In Idaho, mature father Jeff Baker is serving a life sentence for the death of his daughter Gracelynn, not quite three months old the afternoon in 2010 when her father found her struggling to breathe shortly after he’d fed her. The babysitter who had been caring for the girl earlier in the day later told police she had accidentally dropped the baby into a sink while bathing her, but Baker was convicted of murder, in what doctors testified was both a shaking and a slamming assault.

Pediatric neuroradiologist Dr. Patrick Barnes, called in by the defense, noted that Gracelynn’s breathing tube was misplaced in two of the scans he reviewed. Baker, who has written his own appeal from prison, sent me excerpts from the medical records showing the catastrophic drop in his daughter’s blood-oxygen levels that night, and the “reintubation” procedure the following morning. The state has appointed an attorney to represent Baker at the upcoming hearing on his appeal.

Tiffani Calise

Tiffani Calise

Tiffani Calise

Tiffani Calise was only 19 years old the night she called 911 for help with a toddler who she said had slipped and fallen in the bathtub. She was arrested two weeks later, in August of 2010, and she hasn’t been out of custody since. She is now missing her own daughter’s childhood while serving a sentence of 15 years to life for the presumed murder of her friend’s child. Her first appeal was turned down, but supporters are working on another.

Leo Ackley's Facebook profile shot not long before the accusations

Leo Ackley with Baylee — His Facebook profile shot not long before the accusations

Leo Ackley

Last year’s successful appeal on behalf of Leo Ackley turned to disappointment this spring, when the Michigan Court of Appeals  reversed that decision, calling it “clear error.”

At issue was whether trial counsel Kenneth Marks provided ineffective assistance in 2012 by failing to look for a different expert witness after the first pathologist he approached, Dr. Brian Hunter, told him he believed 3-year-old Baylee’s injuries were caused by abuse, not the fall from a bed that Ackley had reported. In hearings last summer, Hunter testified that he told Marks the issue was controversial, and he suggested other pathologists who believed a short fall could be fatal. He did not charge for the initial consultation.

Marks concedes that he did not contact either of the experts Hunter had suggested, but chose to spend the $1,500 he’d been granted to hire Hunter, not as an expert witness but as a trial consultant, preparing him to cross examine the state’s pathologist. All parties seem to agree that Marks successfully forced Dr. Joyce deJong to admit on the stand that doctors did not know what level of force was necessary to cause the brain injury that killed Baylee. Still, Ackley was convicted of murder and sentenced to life in prison.

kaylee

Baylee

Appeal attorney Andrew Rodenhouse argued that because the case hinged on expert medical opinion, a reasonable defense required a physician on the stand to support Ackley’s claim of innocence. Marks should have contacted one of the suggested experts, Rodenhouse said, petitioning the court for more funds if necessary, or he could have at least subpoenaed the little girl’s pediatrician, who had noted at a check-up that Baylee was doing better with the mother’s new boyfriend in her life. In the fall of 2013, Chief Circuit Judge James C. Kingsley agreed and set aside Ackley’s conviction.

In an opinion released in April, though, a new panel of judges concluded:

“[Marks’] decision not to consult a second expert constituted trial strategy. Defense counsel is not required to continue seeking experts until he finds one who will offer favorable testimony.”

Rodenhouse says he is entirely committed to both Ackley’s case and the larger fight against misguided accusations of infant shaking. He points to the re-opening of the Adrian Thomas conviction in New York and last week’s remarkable reversal by a Minnesota trial judge of a jury decision and declares, “There is a momentum. We’ve got to keep it going.”

Sean O’Geary

Sean O'Geary

Sean O’Geary

The Innocence Project of Iowa, meanwhile, has confirmed that it’s examining the case of Sean O’Geary, in prison since 1998 in the death of his girl friend’s 2-year-old daughter Mercedes.

The girl’s grandmother had dropped her off on Friday afternoon with a report that she’d had the flu for a couple of days. Both Sean and his girl friend said Mercedes fell onto the coffee table the next day, while jumping on the couch, and both of them reported hearing a loud thump later that night, after everyone was in bed. It was Sean who went to check on her, though, and so it was Sean who was accused of shaking and slamming her to death. He said he found her climbing back into her crib, and she seemed fine at the time, but on Sunday evening she was rushed to the hospital with convulsions.

giovo

Michael Giovo Jr. with Skyler

Michael Giovo Jr.

Without realizing it,  Michael Giovo Jr. offered investigators one of the leading stories that child abuse professionals are trained to doubt:  A fall from a couch.

Michael said he had stayed up watching television on Thanksgiving night in 2008, after his girl friend had gone to bed. When he heard 4-month-old Skyler crying, he picked him up from his crib and settled him on the couch while heating a bottle. Michael did not witness the fall, he said, but heard a cry and returned to find Skyler on the floor. The boy seemed to recover and spent the night in bed with him, Michael reported, but he and his girl friend rushed the boy to the hospital the next day, when he started twitching. Giovo is now serving life in prison.

Reporter Jonathan Able at the Tampa Bay Times said that Michael had no idea during hours of police questioning that he was accused of assaulting his son:

He said he went along with the interview voluntarily because police said he was not a suspect. “If I knew they were going to make me a suspect I would have asked for a lawyer right then.”

Atlanta, Georgia, September 2010

Atlanta, Georgia, September 2010, at the NCSBS conference

The 2010 conference sponsored by the National Center on Shaken Baby Syndrome featured a mock trial in which a babysitter reported an unwitnessed fall from a bed, a distance of 36 inches, possibly with an impact against a wooden stool. The imaginary infant had both new and old fractures, as well as acute subdural hematoma, retinal hemorrhages, and brain swelling. On the mock stand, the prosecution doctors all agreed that a short fall would not account for the injuries, and that the child had been violently assaulted after she was dropped off at the babysitter’s, the last point at which she was observed to be alert, eating, and playing.

Hundreds of doctors attended that conference and returned to their hospitals with a clear message: Short falls don’t kill. The problem is that it’s a question of faith, not a question of scientific fact. Despite the common knowledge, biomechanical research has shown that short falls can produce large forces. In a report submitted on behalf of death-row inmate Jeffrey Havard in the fall of 2013, for example, biomechanical engineer Prof. Chris Van Ee wrote, “it is clear that low level falls of even 2-3 feet can result in injurious level head impacts resulting in skull fracture and intracranial hemorrhage.”

I wish the doctors who rely so readily on the common knowledge, and the police and social workers who leap into action at the word of the doctors, would slow down and listen to the defendants more carefully. I think there is still a lot to learn.

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

For more stories of caregivers and parents convicted in short-fall cases, please see http://www.marshamills.org/thestory.aspx,  http://brianpeixoto.com/,http://www.freeamandabrumfield.com/, and http://www.theamandatruthproject.com/heartofthematter.htm, and these are only the ones with web sites.

copyright 2014, Sue Luttner

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A Yolo County Jury Believes the Father

SamStone

Sam Stone, 2012

A jury in Yolo County, California, has found 40-year-old Quentin Stone not guilty of child endangerment and abuse, in a case that highlights the limitations of the common knowledge about both the potential danger of short falls and the timing of symptoms following infant head injury.

The story begins in early September of 2012, when Stone brought his son Sam, then two months old, to the Kaiser clinic with a report that the boy had fallen from a bed onto a hardwood floor. Sam showed no symptoms at the time, and doctors found nothing alarming during their examination. The boy was brought in again the next day with a report of projectile vomiting, and again he was examined and sent home. A series of emails and another in-person visit document his parents’ ongoing concern with Sam’s continued vomiting and episodes of “breath holding” over the following days and weeks.

Sam Stone had both a twin and an older brother.

Sam Stone had both a twin and an older brother.

Then on October 3, Sam collapsed and his father rushed the unconscious boy to the hospital, where scans revealed both fresh and chronic subdural hematomas.  Doctors diagnosed Sam as the victim of abusive head trauma. According to trial coverage by Sarah Dowling at the Democrat News, prosecutor Steven Mount dismissed Stone’s claim that his son had fallen off a bed in September:

Mount said except for Stone’s testimony, there is no evidence that a fall even happened. Instead, Stone could have gotten angry with the child or simply wanted to stop him from crying. Regardless of the motivation, Mount said that Stone could have shaken the child, coming up with the “fall story” to cover it up.

Stone had said he wasn’t in the room when the boy fell. He had left Sam in the middle of a king-sized bed and gone briefly out to the garage. When he returned, Sam was on the floor. Sam’s twin brother Henry was asleep in a swing, but Stone thought their other son Jack, two-and-a-half at the time, might have pulled the boy off the bed.

Public defender Monica Brushia said she was sure from the beginning that her client was innocent. “Just reading the police report, I knew the doctors had misdiagnosed Sam, which led to his death… This was a very difficult and emotional case.” Both she and co-counsel Martha Sequeira cried real tears while preparing for trial, Brushia reports, and again when the verdict was read.

Brushia shared a Facebook posting from one of the jurors, whose account of the trial included this paragraph:

Today, an innocent man was set free of blame and accusation of the death of his son. Mr Stone didn’t abuse his child, he did everything he could do to save him. The sad fact is Dr’s make mistakes, sometimes they miss things, sometimes they are wrong. The death of this child really was at the hands of 2 Kaiser Dr’s, who went against what another Kaiser specialist had warned.

OnTheCouchMr. Stone is now trying to regain custody of his surviving sons, with whom he is allowed only weekly supervised visits.

The prosecution relied on expert testimony from Dr. Kevin Coulter, pediatrics division chief at the University of California, Davis, Medical Center, and forensic pathologist Dr. Bennet Omalu, also on the UCD Medical Center faculty and chief medical examiner of San Joaquin County. The defense called forensic pathologist Dr. John Plunkett, pediatric neuroradiologist Dr. Pat Barnes, and ER physician Dr. Steven Gabaeff.

Dr. Plunkett’s report included a few paragraphs that might be educational for anyone working on one of these cases. On the subject of chronic subdural hematoma, for example, Plunkett wrote:

Sam had a large chronic SDH and a small acute left-sided SDH when Woodland and Davis’ personnel evaluated him. A chronic SDH, sometimes referred to as an hygroma, must begin either as an acute SDH or as an intradural effusion. A predominance of blood or blood products typifies a hematoma. A high protein-content fluid with medical imaging signal features similar to cerebral spinal fluid (CSF) characterizes an effusion. It is often not possible (clinically or radiographically) to determine whether a chronic SDH began as intradural bleeding or as an effusion. If the chronic SDH started as acute bleeding, the acute SDH may be large and require surgical evacuation, may resolve and heal with no apparent signs and symptoms, or may become “chronic”. If the acute hematoma does not resolve, it develops a membrane that is extremely fragile and has many new, immature blood vessels. These blood vessels may rupture, causing “new” bleeding and an increase in the size of the initial SDH. There have been a number of studies to determine why some acute hematomas become chronic. The best explanation appears to be that the unique characteristics of the clotting system in the hematoma itself allow the bleeding to persist rather than to heal. The Medical Imaging literature has documented this phenomenon in studies following hospitalized SDH patients with serial CT and MR scans, which show new bleeding in established hematomas in the absence of trauma. “New” trauma is not required for this progression.

And regarding the origin of subdural bleeds, which can be caused by impact but also by a number of non-traumatic circumstances:

Impact may cause dural compartment bleeding in an infant. The infant skull is not rigid, and may deform significantly during an impact, even without fracture. This deformation, or inbending, distorts the underlying brain, and may stretch the bridging veins, may physically alter the dural venous plexuses, and/or may activate the trigeminal (“V”) cranial nerve. If these changes exceed the tensile failure threshold for the veins or the plexuses, they rupture and bleed into the dural border cell layer (“the subdural space”). If the rupture involves relatively large vessels, the bleeding may be significant and lead to rapid compromise of brain function and death, even with timely and appropriate surgical intervention. Alternatively, the bleeding may be relatively slow and even asymptomatic for a considerable time, and only lead to clinical signs if there is an increase in head circumference or an increase in intracranial pressure, the latter triggering vomiting, seizures, and/or compromise of respiratory function. The impact may be apparently innocuous and extremely low velocity. Scientific studies using adult human volunteers (scaled to the infant), cadavers, non-human primates, and other experimental animals; accident reconstruction; computer modeling; and finite element analysis have established and validated infant human brain injury g and Head Injury Criterion (HIC) thresholds. The current federal head-injury standard for a 6-month-old infant represented by the CRABI-6 dummy is a Head Injury Criterion threshold of 390 and a peak g threshold of 50 (50 times the acceleration due to gravity). The researchers have not established thresholds for a 3-month-old infant. However, they are lower than for a 6-month-old infant. A simple headfirst impact to a non- yielding surface from as little as a two-foot fall will usually exceed these thresholds. Fatal impact head injury in an infant does not require a motor vehicle accident or a fall from a two- story building.

These thresholds imply an “all” (risk of severe injury or death) or “none” (no risk of severe injury or death) event. However, biological systems including human beings are seldom “all” or “none”. Further, underlying conditions such as an abnormality of the blood coagulation system, individual cerebral vascular anatomy, cerebral atrophy or increased extra-axial fluid, and an individual’s unique metabolic pathways may alter the threshold and outcome for impact trauma.

Sam had a history of a significant impact event, but I will discuss briefly non-impact causes of dural bleeding for completeness. I do not think that any of these conditions caused or contributed to Sam’s initial acute bleeding with the possible exception of birth or an increase in extra-axial subarachnoid space (so-called “benign” expansion of the subarachnoid space, or BESS).

A number of “natural diseases” and metabolic abnormalities predispose to, or are associated with, SDH. However, anatomical research suggests that damage to the dural venous plexuses rather than traumatic stretching of the bridging veins causes the SDH in these cases. Examples include but are not limited to:

  • The birth process itself, including C-section delivery;
  • Lumbar puncture resulting in intracranial hypotension;
  • A variety of infections caused by bacteria and viruses;
  • Breakthrough bleeding associated with cortical venous thrombosis (CVT), or sagittal sinus thrombosis (SST) or other large-sinus thrombosis;
  • Inborn errors of metabolism such as glutaric aciduria and Menkes Disease;
  • Inherited or acquired coagulation abnormalities, such as hypofibrinogenemia, Vitamin K deficiency, or thrombocytosis;
  • Structural abnormities such as an arachnoid cyst, increased extra-axial fluid, or subdural hygromas;
  • V ascular malformations such as, but not limited to, A V malformations;
  • Poorly understood inflammatory processes such as hemophagocytic lymphohistiocytosis and post-vaccination reactions; and
  • Spontaneous, in which the bleeding develops with no recognizable cause.
Finally, hypoxia or anoxia may cause subdural hemorrhage either as a primary or as a secondary event. For example, hypoxic damage to the dural venous plexuses rather than mechanical trauma is the most likely cause for intradural hemorrhage that may lead to subdural hemorrhage when hypoxia is associated with an increase in intracranial pressure.

 

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Journey With “Justice”: A Rough Road

journey

Dan Schrock, the author of Journey With “Justice”: Our Family’s Experience With “Shaken Baby” Allegations, is a gentler spirit in person than he is on the printed page. He has even found a message of hope in his daughter’s conviction for an infant shaking he is sure never happened.

“The temptation is to say ‘the police did this’ and ‘the prosecutor did that,'” he concedes, “But behind all this is a society that loves children and is willing to do anything to protect them.” Even the investigators who amplified his family’s pain by lying to potential witnesses, he argues, were only trying to hold someone accountable for his granddaughter’s catastrophic collapse.

Natalia Benson was three months old in July, 2005, the morning she wakened her mother, Barb Schrock, at 3 am with a high-pitched scream, followed by breathing problems and a call to 911. Within two days, Natalia had become a ward of the state, diagnosed as a shaken baby, and Barb was the only suspect.

Barbara Schrock, 2011

Barbara Schrock in prison, 2011

Like so many infants in these circumstances, Natalia came into the world in fragile health. She weighed 3 pounds 11 ounces at birth, after a labor induced at 34 weeks due to her mother’s soaring blood pressure. She spent her first three weeks of life in the Neonatal Intensive Care Unit, and she still weighed only 6 pounds when 3 months old. Barb had called the doctor’s office the previous day, concerned that the baby seemed not herself, and had made an appointment for that morning, a few hours after the girl’s collapse. A month earlier, she had taken Natalia to an after-hours clinic because her breathing didn’t seem right:  At that time the infant was diagnosed with a sinus infection and put on antibiotics.

Despite Natalia’s complex medical history and lack of bruising or abrasions, the pattern of bleeding and swelling found inside her skull convinced the doctors that the girl had been shaken. Oddly enough, the doctors also agreed that she had suffered a more serious brain injury weeks earlier, although that didn’t seem to interfere with the assumption that she had been violently assaulted immediately before her collapse.

DSC02771Dan Schrock’s main achievement in Journey is his careful tracking of the evolving case against his daughter:  Early in the story, he transcribes the initial police interviews with family members, and he carries his thorough knowledge of these transcripts through the narration. His book illustrates clearly how misinformation, propagated early on by police trying to corner their suspect, confused the facts and tainted both the investigation and the trials. He also compares the medical testimony from different doctors, revealing how the physicians could  reach different conclusions from the same scans and records, but still return to their unanimous confidence that the last caretaker with the child before her collapse was guilty of assault.

Journey With “Justice” is not a light read:  It is Dan Schrock’s from-the-heart protest against the murky thinking and questionable tactics that condemned his daughter to lose both her family and her liberty. He and his wife have also been denied any visitation with their surviving granddaughter, at the instigation of the girl’s father and his family. “They believe her mother killed her sister,” Schrock sighs, “And they don’t want our side of the family in her life.”

He told me he wrote Journey so that his granddaughter would some day have a record of what really happened, and as a testament to the support his family received from their church community. In that he has succeeded. Especially when he talks about the case in retrospect, now that he has the leisure of hindsight, he is a living testament to the value of faith. His indignation comes through, and his love for his daughter, but I found no bitterness in his message.

Barb Schrock should be getting out of prison in the next few months. It is comforting to know that she will have an accepting family and community to help her move forward when this phase of her ordeal is over.

Update: Barbara Schrock was released from prison in early summer, 2014.

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

copyright 2014, Sue Luttner

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Filed under abusive head trauma, AHT, Falsely accused, parents accused, SBS, shaken baby syndrome