Tag Archives: doubts about shaken baby

Good News, Bad News: the Tragedies Continue

Attorneys Khari Tillery & Paige Kenab, exonerated father Zavion Johnson  -photo courtesy Northern California Innocence Project

After maintaining his innocence for 17 years, a California father was freed this winter when Sacramento Superior Court Judge James Arguelles overturned his murder conviction, citing evolving medical thinking about infant head trauma.

Zavion Johnson said in 2001 that he had accidentally dropped his 4-month-old daughter Nadia in the bathtub, but he was convicted by medical testimony that the girl had been shaken to death. Then, in the years since his trial, two of the prosecution experts changed their positions. Prompted by Khari Tillery, a private attorney working pro bono, and Paige Kenab of the Northern California Innocence Project, both doctors provided affidavits saying they now believe a household fall could explain the child’s injuries.

The prosecution’s own filing in the case recognized that the original medical testimony, now recanted, had been key to Johnson’s conviction. In an excellent treatment of the exoneration, Sacramento Bee reporter Darrell Smith quoted a juror who said the panel had relied entirely on the medical evidence:

“All of the doctors said these injuries to Nadia could only have been caused by severe shaking of the baby… One doctor after another, they presented this united front that the medical evidence speaks… We agreed that it didn’t seem to fit him [Johnson]. He really loved his baby and took care of her. We felt he did do it, but that it was badly out of character.”

Zavion Johnson & Paige Kenab

Zavion Johnson was accused at the age of 18, released at 34. Because the jury believed the doctors over Johnson—and over 13 character witnesses, including the child’s mother—he has spent almost half his life, all of his adult life, behind bars. In an email after his release, celebrating the many people who had donated their time and expertise to the appeal, Kenab wrote, “Zavion took his first hot shower since he was 18 years old last night, laid down in a real bed with a real pillow, and from the moment he walked out, told us over and over again how different the air smelled. Thank you.”

The case was closed in January of 2018, when the state dismissed all charges, according to J0hnson’s entry in the National Registry of Exonerations.

Tiffani Calise reported a bathub fall

I’m eager to see this new thinking at work on behalf of other innocent parents and caretakers convicted by flawed testimony about short falls—like the six people I wrote about in my 2014 post Short Falls, Long Sentences, who all remain in prison.

I see progress, but it’s slow and halting. Child care provider René Bailey in New York was released from prison in 2014, when Judge James J. Piampiano vacated her murder conviction, citing what he called “a compelling and consequential shift in mainstream medical opinion” about pediatric short falls. Unlike Johnson’s prosecutor, however, Bailey’s refiled the charges.

Prof. Adele Bernhard

On the eve of a scheduled retrial last summer, Bailey agreed to a plea deal that avoided the risk of a second conviction and more jail time. Under what’s known as an “Alford plea,” Bailey stated in open court that she was pleading guilty to assault because she believed the state would be able to prove its case against her at trial. “She was not forced to say she did something she didn’t do,” pointed out her attorney, Prof. Adele Bernhard, director of the New York Law School Post-Conviction Innocence Clinic. “This is a compromise and not a very happy one,” Bernhard conceded, “but one that allows René to move on with her life and start to move forward.”

The court accepted Bailey’s plea and set a sentence of 12 and a half years, less than the 13 years she had already served, so she remains free but on probation.

In New Jersey, meanwhile, a panel of appeal judges has upheld the conviction of Michelle Heale, a mother and babysitter who said the toddler in her care had choked on a packet of applesauce. Her conviction was based on the triad, with no signs of impact.

In Kentucky, a young man has been sentenced to eight years in prison after accepting a plea deal—the newspaper report says he was accused of shaking but doesn’t specify the charges. He had reported an accidental fall.

Sarah Martin in happier times

And I’ve recently come across a 2016 murder conviction in Oregon, where mother and babysitter Sarah Martin is serving a life sentence for the death of a 7-month-old who quit breathing in her care. She said she thought the boy had choked on a whole grain snack.

On the bright side, a judge in North Carolina dropped murder charges against a Marine veteran who had been in jail for more than five months, after a local pathologist contacted the district attorney to say the man’s daughter had died of a rare heart condition. The video (click on the arrow in the opening image on the WFMY page) continues beyond the end of the text version, after this provocative statement from defense attorney Taylor Brown:

“It is extremely frightening to know that this could happen to anybody. And in fact if you spend 10 minutes on the Internet, you will find out that it is happening all over the country,” he said.

Reporter Erica Harper says she took that advice and found a number of disputed cases on line—the graphics show browser listings for a few of the classic critiques of shaking theory, like the NPR interview with Dr. Norman Guthkelch; the 2016 Washington Post exposé; and the Time magazine treatment of the Annie Li case in New York.

But none of these treatments seems to have had a noticable impact, any more than Lee Scheier’s 2005 treatment in the Chicago Tribune, Emily Bazelon’s 2011 treatment in the New York Times, or the 2011 collaboration among ProPublica, PBS “Frontline,” and NPR—all of which I’d hoped would help wake up the world to the ongoing injustice.

Because short falls are a theme of this posting, I end it with a video demonstration prepared by emeritus physics professor Richard Reimann, who used  an SBS demonstration doll to illustrate one difference between shaking without impact and a short fall. See also his analyses of various fall scenarios, with excellent illustrations.

copyright 2018, Sue Luttner

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

 

 

 

 

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Dr. John Plunkett, Champion of Justice, 1947–2018

Dr. John Plunkett

Dr. John Plunkett, the forensic pathologist who galvanized a network of physicians and attorneys fighting for justice in shaken baby cases, died peacefully early this month in Minnesota, surrounded by family and friends, two weeks short of his 71st birthday.

“John Plunkett was an American hero. He should be remembered as an iconic figure to anyone who cares deeply about injustice,” said attorney Randy Papetti, who worked with Dr. Plunkett on the landmark Drayton Witt exoneration—only one of 50 successful appeals Dr. Plunkett had a hand in over the years, according to the official obituary.

Dr. Waney Squier

“John was a great inspiration to me and to a whole generation of doctors and lawyers,” emailed Dr. Waney Squier, a British pediatric neuropathologist who received the Innocence Network (IN) Champion of Justice Award in 2016, the same year Dr. Plunkett received the IN Lifetime Achievement Award. “He showed us how to think critically,” she continued. “He showed us courage, compassion, and humility. He taught me to wear cowboy boots and chew tobacco.”

Dr. Jan Leestma

Dr. Plunkett’s influence ran deep. Dr. Jan Leestma, author of the classic text Forensic Neuropathology, recalled that meeting John Plunkett in the 1980s—from opposite sides of the courtroom—helped convince him to look more closely at shaking theory. Leestma reviewed “virtually all the literature at the time,” he said, and changed his position. He then became an early and influential voice calling for more scientific rigor in both the research and the testimony regarding shaken baby syndrome. Dr. Leestma’s testimony on behalf of British au pair Louise Woodward in 1997 helped expose the nation to the emerging debate.

With his wife Donna at the premiere of The Syndrome

Comments about Dr. Plunkett in private and public forums—such as the Facebook page for the documentary “The Syndrome,” which captured Dr. Plunkett’s passion and sincerity on screen—offer praise and thanks from attorneys he educated, families he helped, and physicians he inspired. The word “hero” shows up a lot.

“John mentored me through a rapid learning curve,” wrote assistant federal defender Doug Olson, who described Dr. Plunkett as “brilliant… He was patient with his explanations and kept me on track… He was a maverick who understood science and stood up for what he believed in, but he also had a big heart and cared about people.”

“John was a thorough, detail-oriented expert witness [in multiple cases],” public defender Alicia Cata in Arizona posted on a list serve, “often not collecting a dime for all his work.”

Katherine Judson, an IN attorney, added a personal note, “And so kind, so generous, and fun, and funny.” Law professor Keith Findley, who worked with Dr.Plunkett on the groundbreaking Audrey Edmunds appeal, echoed that sentiment, describing Dr. Plunkett as “a deeply thoughtful and caring, but also fun-loving and quite funny man.”

Dr. Pat Lantz

Pathologist Dr. Patrick Lantz, taking the Latin approach popular with physicians, wrote, “Primus inter pares,” which translates as “first among equals,” a phrase commonly applied to the unofficial leader in a group with no formal hierarchy.

The families he defended described Dr. Plunkett as “warm,” “caring,” and “dedicated.” One couple whose family was shattered by a shaking diagnosis wrote in the mortuary guest book, “He was a wonderful resource but also a wonderful friend… Fly high, Doctor, you will be missed.”

A Pioneer in the Field

Dr. Plunkett encountered his first shaken baby diagnosis in 1986, in a death he concluded could have been accidental—the mother reported that her daughter had fallen from the arm of a couch while reaching for a shelf above. But the child abuse experts testified that children do not die from household falls and they believed the little girl had been shaken to death. Unconvinced, Dr. Plunkett started reading the published research about infant shaking and found, he once told  me, “the least scientific literature I had ever seen.”

He lost that first case, but had become one of the few forensic pathologists in the nation to have studied the literature and recognized the problems with shaking theory. He found himself called into other cases, increasingly disturbed by the power of misinformed medical testimony in the courtroom.

“I was a practicing physician,” Dr. Plunkett told me last year, “I didn’t write articles. But I had to start. People need to know that families are being destroyed because doctors don’t understand injury mechanisms.”

After the Woodward conviction, child abuse experts published a letter to the journal Pediatrics complaining about both press coverage that treated the defense theory as credible and the experts who offered it. “Let those who would challenge the specificity of these diagnostic features first do so in the peer-reviewed literature, before speculating on other causes in court,” the doctors wrote. Characteristically, Dr. Plunkett rose to the challenge, with his first published article on the topic, “Shaken Baby Syndrome and the Death of Matthew Eappen: A Forensic Pathologist’s Response,” in which he questioned everything about the syndrome from the specificity of the findings to the timing of the injuries. He followed that paper in 1999 with a case study presenting a child whose death was caused by a brain aneurism.

Attorney Mark Freeman

“I admire John for having the courage to stand up and say the emperor has no clothes,” wrote attorney Mark Freeman in an email last week. Freeman described Dr. Plunkett as “gracious—and incredibly helpful” when he met him in 2009, while helping a friend who was accused of shaking his baby. Although Freeman’s specialty is not criminal law, he has stayed in the network to help orient other attorneys handling their first SBS cases or pursuing civil suits.

Dr. Plunkett’s willingness to speak out earned him both personal and professional criticism, including criminal charges of “false swearing” in 2005, after his testimony helped win an innocent verdict in Oregon. A judge eventually acquitted Dr. Plunkett, who was slowed down briefly but not stopped by the harassment.

Researcher, Catalyst

In 2001, Dr. Plunkett challenged the common knowledge that children don’t die in short falls by publishing a collection of 18 fatal pediatric fall reports, of distances from 2 to 10 feet, which he pulled from the records of the federal Consumer Product Safety Commission.

With Dr. John Galaznik at a 2012 conference

Shortly after that, he organized the Evidence Based Medicine Symposium (EBMS), an on-line forum that allowed physicians from different specialties to communicate with each other about shaken baby theory. “John’s web contributions cannot be emphasized enough,” posted Dr. Leestma. “This list serve brought people together… Godspeed, my friend.”

“His work made progress possible,” emailed intensivist Steven Gabaeff, who has published his own papers on SBS (here and here). “He was generous, good natured, brilliant, warm, hard working… and he did so much to raise awareness of our shared concerns. He was the catalyst for getting the attorneys involved.”

In 2005, Dr. Plunkett published an editorial in the BMJ, co-authored with British neuropathologist Dr. Gennian Geddes, with the self-explanatory title, “The evidence base for shaken baby syndrome: We need to re-evaluate the diagnostic criteria.” (The same issue contained a paper by Dr. Lantz about retinal folds.)

Dr. Plunkett also coauthored papers with automotive-research pioneer Dr. Werner Goldsmith and biomechanics expert Chris Van Ee. He organized two conferences of the EBMS, and he recruited presenters for the 2013 World Congress on Infant Head Trauma, a forum organized by the publishing arm of the National Association of Medical Examiners to foster direct debate between proponents and skeptics of shaken baby theory.

At an Innocence Network meeting

Forensic pathologist Dr. Carl Wigren attended the 2013 World Congress because he’d been hearing rumblings that the common knowledge about shaken baby might be wrong—and what he heard there convinced him that Dr. Plunkett and his team were right. He wrote that Dr. Plunkett “is the epitome of the person I strive to be. Understanding medicine is one responsibility of a physician, but applying and transmitting that knowledge to assist those in need is the gift that John possessed in spades.”

Julia Jonas at the Innocence Project of Minnesota remembered that when she was a young lawyer, Dr. Plunkett was the only medical examiner in the county willing to take cases for the defense. “He never made me feel ignorant and often made me feel empowered,” she wrote, and she credited him with changing attitudes: “He has trained several of our local medical examiners to be the truly independent experts that they should be, and not simply another voice for the prosecution. He will be greatly missed, but his legacy will live on.”

At a panel discussion at the University of Missouri-Kansas City School of Law

In a blog post marking Dr. Plunkett’s death and praising his work, Radley Balko at The Washington Post wrote, “Plunkett deserves credit for being among the first to sound the alarm about wrongful SBS convictions.”

Dr. Plunkett spent 39 years as a forensic pathologist, the official obituary reports. He directed the pathology lab at Regina Medical Center in Hastings, Minnesota, for 26 years and served as the coroner for Dakota County. The obituary does not mention that in his youth he played acoustic guitar in coffee houses, with a band called The Four.

He is survived by his wife of over 47 years Donna McFarren Plunkett, the love of his life, and sons Matt (Jen), and Ben; two grandchildren Fiona and Cailin; siblings Patrick (Anita), Marnie Olson (John), Tim (Lucy), Paul (Susan), Michael (Dawn), Ann, and Peggy; brothers-in-law Neil (Diane), and Russ (Tish); and many nieces and nephews.

A Personal Note

I had my first phone call with Dr. Plunkett in 2000, when he was about to publish his short fall paper. I had been researching shaken baby for two years at that point, after the niece of a friend was convicted of shaking a baby in her care. I’d been comparing the medical testimony in the trial transcripts with the scientific facts available in the medical journals, and puzzling over the gap. Could I, not a medical professional, but a technical writer and careful reader, possibly have identified fundamental problems with the evidence base for a well-accepted but unproven theory that was almost unbeatable in court?

Dr. Plunkett assured me that I had done just that. “You start to look at this with even the rudimentary elements of scientific thinking,” he confirmed, “And you say, ‘What is going on here?'”

He then gave me my first lesson in the physics of short falls, and I was hooked.

He became the medical advisor to my book, and for 15 years, my book proposal has promised he would write the introduction, an introduction neither one of us ever crafted. I guess I will be dedicating the book to him instead.

Copyright 2018, Sue Luttner

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

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The Forensic Unreliability of the Shaken Baby Syndrome: The Book

Arizona trial attorney Randy Papetti has brought nearly 20 years of experience and research to his valuable new analysis of shaken baby theory in the courtroom, The Forensic Unreliability of the Shaken Baby Syndrome, now shipping from Academic Forensic Pathology International.

Papetti is not a criminal attorney but a recognized leader in his primary field, commercial litigation. In 2013, he was selected by Best Lawyers and his local peers as the Lawyer of the Year for “Bet-the-Company Litigation.” In 2011, he was inducted into the invitation-only American College of Trial Lawyers. His shaken baby work has all been pro bono.

Randy Papetti

Papetti was only doing a favor for a friend, he told me in a telephone interview, when he agreed to help with his first alleged shaking case, an appeal of a murder conviction. The convicted father had reported a fall from a high chair, but the child abuse experts had insisted that shaking must have been involved. Papetti started researching the medical and legal arguments, he said, and found himself face to face with the difference between medical opinion and proven scientific fact.

Drayton Witt and his wife, courtesy Arizona Justice Project

Papetti won that appeal, and other attorneys started approaching him with their own shaking cases. He was a key player in the 2012 freeing of Drayton Witt, whose son died after a short lifetime of serious health problems, including a seizure disorder. It was the Witt case that brought pioneering pediatric neurosurgeon Dr. Norman Guthkelch back into the arena, four decades after he lay the groundwork for the diagnosis by proposing that shaking an infant could cause subdural bleeding. Like Papetti, Dr. Guthkelch rejected the medical thinking that had convicted Drayton Witt. Guthkelch then spent the final years of his life fighting what he considered a “tragic misinterpretation” of his work.

“Witt was a powerful case,” Papetti said. “It showed how easily a mistaken diagnosis based on the ‘triad‘ can convict.” By then law professor Deborah Tuerkheimer had published her first journal argument against shaking theory, and her New York Times op ed. Papetti thought the tide was turning. “The information was out there, people could see that shaking theory was unreliable.”

Instead of reconsidering their model, however, proponents of shaking theory “took a course I never imagined they would be able to take, claiming there never was a triad,” Papetti marveled in our interview. In his book, he noted that changing the name of the diagnosis from “shaken baby syndrome” to “abusive head trauma” did not address the fundamental problem that the entire theory was speculation. “It merely changed the diagnosis’ name for legal purposes.”

Papetti said he was “stunned” to see how child abuse professionals have lashed out personally at defense experts and attorneys: ridicule at conferences, perjury charges, letters to employers. “That’s not the way the game is played,” he said. Attorneys in civil practice fight hard in the courtroom, he claimed, but can still respect their opponents professionally and maintain personal friendships.

In his book, Papetti traces the evolution of shaking theory in both the medical literature and the courts. He illustrates how the two have co-evolved, distorting each other, and he examines the cooperative relationship among child abuse experts, the police, and social services. He writes:

These institutional realities, not science or clinical validation, best explain how SBS has persisted and why the medical profession is unlikely to correct it any time soon.

“Things tend to get worse before they get better,” he told me, “And I’m afraid that’s where we are now, still getting worse.” At this point, proponents of shaking theory staff the medical schools and the childrens’ hospitals, dominate the professional organizations, and conduct the bulk of the research. Critics tend to be independent thinkers who have researched the literature and reached their own conclusions.  “The imbalance of power has distorted everything completely,” Papetti said. “At the end of the day, are you really asking a judge to not allow the testimony of these luminaries because a few brave souls disagree?”

So he keeps chipping away at a calcified theory with the facts, hoping to explain it all clearly enough that judges will see how decades of unproven medical testimony have led to a criminal justice crisis of staggering proportions.

For postings about other books on shaken baby, please see “Flawed Convictions: Breaking Academic Ground,” “Forward, Into the Bookstores,” “An Important Story, Well Told,” and “‘Journey With Justice’: A Rough Road.

Copyright 2018, Sue Luttner

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

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Shaking Accusations Gone Wrong

The interrogation

A series of legal developments in the past few weeks highlights the devastating effects of misguided abuse diagnoses on innocent families.

In Sacramento, California, father Jesus Flores was found innocent in June of shaking his son Mason, but despite the verdict, Mason is being adopted by another family. Flores lost parental rights during the years he spent in jail awaiting trial.

The child’s mother, Sara Guzman, also lost custody, ironically because she refused to believe that Flores had injured their son. Reporter Lois Henry quoted Guzman in the Bakersfield Californian:

“They told me the only thing messing me up from getting Mason back was that I stood by Jessie (Jesus),” Guzman said. “They said I needed to go against him. But that wasn’t right. I knew he wasn’t the kind of man who would ever hurt his baby.”

After watching video of the police interview, reporter Henry disputed statements from both the diagnosing doctor and the detective that Flores had confessed to shaking his son. Henry wrote:

Flores uses a doll to show detectives how he rocked Mason earlier in the day to try and comfort him.

In the video, Flores cradles the doll, supporting its head and rocks him back and forth.

He tearfully asks if that could have been what hurt his son?

“Could that have caused it?” he asks over and over. “If it did, then I’m the worst father…”

One of the detectives would later testify that Flores demonstrated shaking the doll, causing its head to violently snap back and forth.

Not even close. (See video at bakersfield.com)

The reporter is right: Not even close. Check the video. The detective hands the doll to Flores at 12:03:38 am on March 22, 2015, and 15 seconds later Flores demonstrates the motion he will repeat through the rest of the interview—which I would call more up-and-down than back-and-forth, but certainly not violent.

The jurors who found Flores innocent heard about Mason’s complex medical history, and the new brain bleeds that appeared while the boy was in the hospital and then again in foster care. On the interrogation tape, however, long before anyone had looked at past medical records, the detectives never waver from confidence in the father’s guilt. Ignoring Flores’s obvious pain and confusion, they reject his story again and again, prodding him to quit lying and “accept responsibility.” Even when he breaks down and accepts their accusations, Flores says only that he “might have” rocked the boy harder than he realized, he doesn’t remember.

Another disturbing video was released last week in Detroit, showing a father’s pain at learning that his daughter had died—information he heard in open court when he was charged with her rape and murder. (On the page with the print coverage, scroll down to the second large graphic for the video.) James Lee Saltmarshall, 22, has now been released, after an autopsy disproved the medical findings that had triggered the charges against him. The video treatment includes a from-the-heart statement from Saltmarshall’s attorney:

“You have somebody charged with the most salacious thing you can charge him with, the worst thing, raping and killing his infant daughter. And now it’s a big ‘Oops’?…

“How do you fix it? I don’t know.”

In South Carolina, meanwhile, Wayne County dropped charges against an accused father who’d been in jail for two years—and indicted the babysitter instead. As summarized by reporter Angie Jackson in The Post and Courier:

Eugene Anthony Wright, 49, was initially charged with homicide by child abuse. At the time of his daughter’s death, he was accused of slamming her to the floor in his Dorchester Gardens apartment in North Charleston.

The Attorney General’s Office said after further investigation, it was determined that Wright could not have committed the crime and the charge has been dismissed.

The indictment of the babysitter, Jackson wrote, “does not detail the evidence against her.” I speculate that the key point is whether the effects of a serious pediatric head injury are or are not immediately obvious, a question still under debate in the journals and in the courtroom, along with the potential for serious injury in short household falls. Earlier coverage of the case seemed to put the father at the scene, but it’s hard to know the story from what’s available.

In a long-lingering case in California, foster mother Jovannee Reynolds has been sentenced to four years of probation, after a plea bargain in which she “took responsibility” for the death seven years ago of a days-old baby named Mikayla who quit breathing in her care.

Reporter Pablo Lopez wrote in the Fresno Bee:

On Friday, [defense attorney Curtis] Sok told the judge that the case took seven years because it turned into a battle of medical experts – one who said Mikayla died of shaken-baby syndrome and two who suggested she suffered her fatal injury in her mother’s womb.

Reynolds had told police she had “patted the baby on the back” when the little girl seemed to be having trouble breathing. Reynolds was originally charged with murder, but the plea agreement reduced that to manslaughter. According to the Bee coverage, prosecutor Christopher Gularte gave this explanation:

Because of the conflicting medical opinions, Gularte told [the judge] that the prosecution could not prove the murder charge. Instead, Gularte said both sides settled on the manslaughter charge because of Reynolds’ admission to police about patting the baby on her back. In essence, her use of force in patting the child was more than a reasonable person would do.

While I am pleased that Ms. Reynolds will face no jail time, I am sobered that the county insisted on pressing charges against her, and that the act of patting a baby on the back when it’s struggling to breathe has been declared manslaughter. Ms. Reynolds and her husband had started caring for Mikayla about a week before the child’s collapse, when she was only five or six days old, after her mother, a known drug user, had tested positive for methamphetamine. I’m guessing there were no actual signs of trauma, just the brain findings, or the news reports would mention them.

Updates

The Medill Justice Project has published a poignant look at the effects of his mother’s incarceration on the son of child care provider Jennifer Del Prete, released in 2014, after a successful appeal of her 2005 conviction.

A Florida court has agreed to hear an appeal by the Innocence Project of Florida on behalf of child care provider Stephanie Spurgeon, in prison on a manslaughter conviction in a shaking case. She the Tampa Bay Times coverage.

copyright 2017, Sue Luttner

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

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Filed under abusive head trauma, AHT, parents accused, Uncategorized

Steps Forward, Steps Backward, Part II

The second half of a posting started on March 7

Re-creation of the reported fall

In another small step forward, a father in Michigan has been found not guilty of murder or abuse in the death of his 11-week-old son, after spending 16 months in jail waiting for trial.

Mark Hontz had reported falling down the basement stairs with the boy in his arms, landing on the infant when they reached the floor. Doctors at the University of Michigan, however, rejected that explanation for the child’s injuries. At the preliminary hearing, forensic pathologist Dr. Jeffrey Jentzen pointed to anterior rib fractures and neck damage, which he said were “more consistent” with the compression and whiplash that occur during squeezing and shaking than with a fall down stairs.

Dr. Jentzen’s testimony reflected an opinion I’ve heard before about pediatric stairway falls:

“Well actually, going down stairs is not a single fall down, for example, ten feet. It is ten individual falls down a single foot, so there’s not the long distance fall that you would expect.”

In the journal Pediatrics in 1988, Drs. Mark Joffe and Stephen Ludwig at the University of Pennsylvania proposed that model in their paper “Stairway Injuries in Children,” illustrating their point with the figure to the right. That paper had concluded that “nonaccidental injury should be suspected” when children receive serious injuries in an alleged stairway fall.

The photos at the top of this page show the stairs to Mark Hontz’s basement, with the figure at the starting and landing spots he reported. A biomechanical engineer brought in by the defense pointed out that an adult falling forward down stairs does not fall one step at a time, as the feet are no longer under the center of mass. Instead, the body falls forward, propelled by the force of gravity, until the motion “is arrested by contact with the ground or steps.” The engineer calculated that the infant experienced a vertical fall of 9 feet, landing with an approximate speed of 16 miles per hour.

Investigators conducted a series of interviews with Mark Hontz, finally confronting him with the medical opinion that his son did not die from a fall down the stairs. “Hontz offered no other explanation,” the police report says, which is another way of saying that, even under intense pressure during repeated interrogations, the father never changed his story.

Illustrating the value of a thorough defense, attorney Sharon Clark Woodside also called in a forensic pathologist, a child abuse pediatrician, and a pediatric radiologist to rebut the prosecution theory.

Witnessed Shakings

Two witnessed shakings in separate hemispheres this winter seem to have produced no injuries, nor any questioning of shaking theory.

Dismayed diners at an Australian cafe called authorities about a man shouting and shaking his 5-month-old daughter, according to a news story by reporter Allison Harding. After paramedics checked the child and cleared the father to take her home, Harding wrote, other patrons attempted unsuccessfully to block his car. The father later pled guilty to unlawful assault and has sought treatment for “long-term mental health issues.” His wife reportedly stood by him in court, calling him a responsible and loving father.

cottonwoodaz

Cottonwood, Arizona

Concerned bystanders in Cottonwood, Arizona, called police and recorded video of a 19-year-old mother shaking and slapping her 10-month-old daughter at a street corner, according to coverage in the Verde Independent. Responding officers arrested the mother, a transient already known to local police and described as “combative.” Authorities later discovered that the child was missing from foster care in another state, kidnapped by her parents during a family visit. The Independent’s coverage quoted Cottonwood Police Sergeant Tod Moore, who said, “I have seen too often in shaken baby cases where permanent brain damage or death occurs. We appear to be very fortunate this time.” I note that Sgt. Moore has probably seen serious injury in cases where the doctors diagnosed shaking. In the one witnessed case he’s probably handled, doctors at the local hospital found no injuries.

More Fathers in the News

Convictions of and accusations against fathers continue to pass through the headlines.

One case in Pennsylvania has it all: no external signs of assault, the presumption of immediate symptoms, and a retreat from the term “shaken baby syndrome”—but with a computer animation shown at trial illustrating the presumed effects of a violent shaking. From an article before the verdict by reporter Laurie Mason Schroeder of The Morning Call:

Prosecution expert Dr. Debra D. Esernio-Jenssen, medical director of the Child Advocacy Center at Lehigh Valley Hospital, testified that Quinn suffered from symptoms of abusive head trauma, formerly called “shaken baby syndrome.”

Using a computerized animation, Esernio-Jenssen demonstrated how, she said, a baby’s brain would hemorrhage from being snapped back and forth in the hands of an angry adult.

On the subject of timing, Leigh Valley Live reporter Sarah Cassi wrote in an article reporting the conviction:

[Dr. Esernio-Jenssen] testified the baby would have shown immediate symptoms following the “severe, lethal episode of head trauma” she suffered, meaning the injuries occurred while [the father] was alone with the child.

Depressingly, the father’s defense attorney seems to have focused on blaming the child’s mother, arguing only that the injury had been inflicted before the girl was left in his client’s care.

A father in Tennessee has been sentenced to 15 years for aggravated child abuse, convicted after a 4-day trial, according to coverage in the Johnson City Press. The child’s mother still insists her husband is innocent—in a moving clip from the trial posted by WCYB, she said, regarding her son, “We wanted a real answer because we knew he wasn’t abused.”

The story of a young father accused in Wisconsin, meanwhile, received mixed coverage in a single treatment, with a headline about possible doubts but six opening paragraphs focused on the prosecution theory of shaken baby syndrome—the unfolding article then cites the Audrey Edmunds case and reveals that the defense attorney is fighting hard against the diagnosis.

Foster Mom Charged

And in Florida, investigators have reached the improbable conclusion that a 43-year-old mother and foster parent—active in the local child protection community—became enraged enough to batter a 17-month-old to death in the 7-minute gap between the time a social worker left her home and the time she dialed 911 for help with an unconscious toddler. Coverage in the Tampa Bay Times describes a boy with a complex medical history, including developmental delays and physical signs of early neglect. The child used a feeding tube, and he had been discharged from the hospital just a few hours before his collapse, after three days of treatment following a choking incident. Faith in the diagnosis of abusive head trauma, with a guarantee of immediate symptoms, apparently overrides the logical assessment of established medical facts.

Sam Stone

Sam Stone

This story reminds me of Quentin Stone in California, a father acquitted in 2014 by jurors in Yolo County who accepted that the child’s fatal collapse had resulted from an evolving head injury suffered in an accidental fall. Stone had taken his son to the hospital several months before his medical crisis, just to make sure he was OK, he said, after the boy had rolled off a bed. Doctors found no injuries and released him, but over the following weeks, the Stones had sought medical advice repeatedly for their son’s ongoing vomiting and apparent “breath holding.” Despite that well documented history, the prosecution charged Stone with murder after the boy’s fatal collapse, based on medical opinion that the brain findings proved abuse and the symptoms would have been immediate.

Also in Yolo County,  a public invitation this winter to the annual Rotary Club of Davis fund-raising dinner noted that a team of Rotarians had taken a trip three years ago to Kenya, East Africa, “to educate physicians, medical students and nurses on how to identify abusive head trauma in children.” The article did not say where the Rotarians got their own medical training, but it reported that the team “trained nearly 1,200 professionals throughout Kenya.” According to the shaken baby page on the web site for Rotary District 5160 (northern California), the Davis chapter also provides shaken baby simulator dolls to schools and hospitals.

Fractures in the News

Finally, a television station in Indiana ran a provocative segment on a family trying to regain custody of their two sons, removed because of fractures discovered in their first-born when he was four months old. “I understand them getting involved at that point,” says mother Ally Allen on camera, “The frustration came in that they never tried to find an answer.”

Knowing they had not abused their son, Ally says, she and the child’s father started looking for another doctor who could give them an accurate diagnosis. They found Dr. David Ayoub, a pediatric radiologist in Illinois who determined that the infant suffered from rickets, a lack of mineralization in the bones that predisposes to fractures. Once considered a disease of the past, rickets remains “a significant cause of nutritional disease for infants,” according to the American Academy of Pediatrics.

The family’s second child was removed from them at birth because of the pending charges. While they wait for their case to work its way through dependency court, Ally and her partner can see their sons only for a few hours at a time during scheduled visitations.

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

copyright 2017 Sue Luttner

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Filed under abusive head trauma, AHT, parents accused

Shaking debate back in the courts and in the news

uphill-gunnThe landscape in the shaken baby debate is shifting again, with a series of developments that have locked in gains, slowed losses, and even claimed new ground in the struggle against unproven science in the courtroom.

In New York state last week, an appeals court affirmed the 2014 reversal of the murder conviction of care provider René Bailey, who said she was out of the room when a little girl jumped or fell from a chair. Prosecution experts had testified, however, that only shaking could explain the brain findings, and that children don’t die from short falls. In his decision reversing the conviction, Judge James Piampiano accepted the argument by Bailey’s appeal attorneys that changes in medical thinking since her 2001 trial constituted new evidence.

Last week’s ruling rejected an appeal by the state, noting that “advancements in science and/or medicine may constitute newly discovered evidence” and explicitly mentioning the evolving SBS research. Coverage in the Democrat and Chronicle led with the optimistic proclamation:

“For the first time, a New York appellate court has ruled that evidence once used to convict people in shaken-baby cases may no longer be scientifically valid.”

That same evidence failed earlier this month to convince a South Dakota jury, which found Aaron Bruns innocent of murdering his 3-month-old son Levi in what appears to be a pure shaking case. Coverage in The Daily Republic offers this summary of the father’s report:

During the trial, Bruns said he thought Levi was choking, so he quickly picked him up and tipped him upside down to clear his airway. Five minutes later, according to Bruns, Levi turned pale, and his eyes rolled to the back of his head, leading Bruns to run him to a nearby hospital.

fox9Other individual victories seem to have triggered a resurgence of press coverage highlighting the controversy. In Minnesota, for example, reporter Tom Lyden at Fox 9 pulled together a provocative treatment with the title “Critics, parents, question diagnosis of shaken baby syndrome,” featuring a local father acquitted at trial; a family whose own experts convinced the county to drop charges; and a mother now fighting the loss of her son. The treatment closes with a statement from the American Academy of Pediatrics (AAP), which persists in shifting the question from whether the brain findings prove abuse (No, they do not) to whether shaking is even dangerous (Yes, of course it is):

“There is no legitimate medical debate among the majority of practicing physicians as to the existence or validity of AHT/SBS…  Claims that shaking is not dangerous to infants or children are not factual and are not supported by AAP policy, despite being proffered by a few expert witnesses in the courtroom.”

presidentialsealThe assertions of the AAP notwithstanding, the real uncertainties about shaken baby theory were acknowledged this fall, briefly but officially, in a presidential report on forensic sciences in the courtroom, undertaken in the wake of the 2009 study that found “serious deficiencies” and called for “major reforms” of the nation’s forensic science system. The follow-up report, published this fall by the President’s Council of Advisors on Science and Technology (PCAST), notes that DNA evidence has disproved past forensic techniques like bite-mark matching and visual hair analysis, and it recommends strategies for bringing courtroom testimony in line with scientific knowledge. Footnote 15 cites an “urgent” need to examine shaken baby theory, which has not been addressed in past studies:

“PCAST notes that there are issues related to the scientific validity of other types of forensic evidence that are beyond the scope of this report but require urgent attention—including notably arson science and abusive head trauma commonly referred to as ‘Shaken Baby Syndrome.'”

For my posting on arson science, please see “Bad Science Goes Up in Smoke.”

SquierProfileNoCaptionAll these developments come in the same season as the decision to reinstate Dr. Waney Squier’s right to practice medicine, and the release of a literature review by a panel of Swedish scientists who concluded that shaken baby theory has not been proven, both of which have generated international news coverage. New Scientist, for example, published a news report about the Swedish study, with a sidebar on Dr. Squier’s case and a promo that nailed the character of the debate, calling it “toxic and polarised.”

The ripples are still spreading in the wake of Dr. Squier’s reinstatement. Even non-subscribers can give a thumbs-up to the letters to the BMJ in support of her, submitted by Michael Birnbaum, QC, and, further down the page, Dr. Jennian Geddes. I’m told our clicks will help the editors understand the scope of the problem. (If you haven’t done so yet, you can also go give a thumbs-up to the earlier letters from a group of more than 250 professionals and from pediatric radiologist David Ayoub.)

The Sunday Times last week published a more detailed treatment of Dr. Squier’s story than appeared in the early news reports—you have to register with the Times to see the article, but the process is free and reasonably painless.

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

Leo Ackley

The past few weeks have also brought a number of disappointments—in Michigan, a second trial resulted in another guilty verdict against Leo Ackley, whose first conviction had been vacated on appeal, and an appeals court affirmed the conviction of Joshua Burns, who has served his jail time and reunited with his family, although he remains on probation. Both appeals had been pressed by the Michigan Innocence Clinic, which has been focusing on shaking cases.

Leo Ackley’s family insists they will keep fighting for him, and last month the Michigan Innocence Clinic won a grant to help defend clients who may have been wrongfully convicted in shaking cases. Despite two disappointments this season, the clinic will surely keep up the pressure against a flawed theory that’s been winning in court way too long.

I hope the press, the public, and professionals in the arena stay tuned as the debate unfolds.

copyright 2016, Sue Luttner

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

 

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Filed under abusive head trauma, AHT, shaken baby, shaken baby syndrome, Uncategorized