Tag Archives: Joshua Burns

Innocent Family Petition Hits a Nerve

Geers twins

Geers twins

When child protective services separated Melissa and Anthony Geers from their five sons last spring, Melissa says, the pain was staggering. The worst part was watching the effects on their children: the 9-year-old’s full-blown panic attack, the 8-year-old’s holding his mom “so tight I couldn’t breathe,” the sudden interruption of breast-feeding for the 4-month-old twins (Melissa pumped throughout their foster placement).

The state filed to terminate the Geers’ parental rights just weeks after x-rays revealed rib fractures in both twins—but withdrew the suit 10 weeks later, after the Geers submitted opinions from eight outside experts who attributed the fractures to fragile bones, citing two underlying causes: First, the boys had a metabolic disorder that impedes bone formation. Second, like most twins, the youngest Geers had arrived early, 7 weeks early in their case. Because the rate of bone mineralization ramps up during the final trimester of gestation, premature infants in general are prone to weak bones.

photo by Doug Smith, Washtenaw Watchdogs

Anthony & Melissa Geers. Photo by Doug Smith, Washtenaw Watchdogs

But those explanations entered the record only because the Geers did their own research and called in their own experts. The state tore her sons’ lives apart, Melissa says, based on the opinion of one child abuse doctor “who never met me, my husband, or our kids.”

“We have two sons, now 10 and 8, who were traumatized by this experience,” she points out. “They don’t do the things they used to do. They are afraid. The child abuse experts need to understand what they are doing to children.”

Since their story hit the news, Melissa says, they have been contacted by an astonishing number of families with their own stories of ill-considered abuse diagnoses—most of them with far less happy outcomes. “How are the child abuse doctors not aware of all these other things?” Melissa asks. “That’s the part that bothers me the most. Why are they not doing their due diligence?”

GeersQuoteThe Geers say they understand how valuable it was to have a supportive community during their ordeal, as documented by Click on Detroit and later by Melissa herself in an essay on Medical Kidnap. Melissa says she and her husband now feel compelled to do what they can to shed light on a broken system. Earlier this fall, the Geers joined demonstrators at the University of Wisconsin Board of Regents meeting, where supporters of Joshua and Brenda Burns protested the Burns family’s treatment by the university’s Mott Children’s Hospital. As reported on this blog in the spring, the Burnses’ daughter Naomi was diagnosed as a shaken baby at Mott in 2014. While Naomi seems to have recovered fully, Joshua is serving a one-year sentence in the county jail. As he approaches his December release date, Joshua had been granted weekly visits with his family, through a glass window and a telephone handset, after a year and a half of no contact at all with Naomi—but those visits were cancelled after the first one. (For an insider’s view of the regents meeting, including video statements by Melissa Geers and Brenda Burns, please see the Washtenaw Watchdogs coverage.)

Accused father Andrew Sprint

Accused father Andrew Sprint

The Burns family and the Geers family found each other, and they also found the Protecting Innocent Families (PIF) petition, which calls for an objective, scientific review of the evidence base underlying today’s guidelines for diagnosing child abuse. The petition form includes an optional field where signers can identify the name of a defendant or family they are supporting. Of about 2,700 people who have signed the petition so far, slightly more than 1,000 have filled in the support field. The signers have named 338 individuals and families. The most frequently named case, with 270 signatures, is the Burns family, the subject of the Torn Family web site, which includes a link to the petition. The Geers family is the second most-often named, with 96 signers, presumably from their Facebook site.

Other defendants named in significant numbers were a mix of past cases that helped inspire the petition—like the stories of Kristian Aspelin, Brian Peixoto, Tiffany Cole-Calise, Amanda Brumfield, and Leo Ackley—and unfolding cases like those of Rebecca and Anthony Wanosik and Cynthia and Brandon Ross, reunited with their children this summer; Cindy Rosenwinkel, convicted in 2015; and single father Andrew Sprint, who declared his innocence outside the Children’s Justice Conference this past spring in Seattle.

GeersQiuoteWhen PIF launched the petition in March of 2015, the immediate goal was to collect the names of 1,000 people who had seen a medical misdiagnosis of child abuse tear apart an innocent family. Three weeks after the petition went live, 1,000 people had signed and signatures were still coming in. The rate has slowed since then, but new names continue to arrive, and PIF has decided to launch another publicity campaign before implementing its labor-intensive plan for taking the petition to Congress. Signers who indicated they would be willing to contact Congress personally should expect to be hearing from PIF volunteers.

In addition to calling for a review of the scientific literature, the petition objects to the suppressive tactics used by the state and by professional organizations. Both families and professionals feel extraordinary pressure, the petition argues:

Even when charges are dismissed, caretakers acquitted, or verdicts overturned, families are emotionally and financially devastated, with many unwilling to speak out because they are still traumatized or they fear stigma or retaliation. Doctors and other experts who question or criticize these diagnoses also suffer retaliation, including threats against their jobs and licenses.

Dr. Waney Squier

Right now in England, for example, neuropathologist Dr. Waney Squier is facing hearings by the General Medical Council, where she is accused of testifying “outside her field of expertise,” giving biased opinions, and not paying “due regard to the views of other experts.” Last fall, The Telegraph reported that the original complaints against Dr. Squier came from the Metropolitan Police, who were tired of losing shaken baby cases because of her testimony on behalf of accused parents.

Dr. Squier has long been the target of direct and indirect harassment from her opponents. As reported in 2012 on this blog, a fictional character with a curriculum vitae remarkably like Dr. Squier’s confessed on the BBC program Silent Witness to having conducted her research using illegally harvested infant brain tissue. In fact, the real Dr. Squier had been readily cleared when the same accusations were levied against her—and some observers suspect those accusations were merely a ploy to keep her out of the courtroom during the resulting investigation.

Dr. John Plunkett

Dr. John Plunkett

In the U.S. in the early 2000s, forensic pathologist Dr. John Plunkett was forced to defend himself against charges that he lied under oath after he testified on behalf of an Oregon defendant in a child head injury case. In “The Battle of the Expert,” ABA Journal reporter Mark Hansen traced the byzantine course of the case against Dr. Plunkett, which ended with an acquittal in 2005.

 

Drs. Squier and Plunkett have also brought their criticisms of shaking theory into the medical journals. When Dr. Squier and her colleagues proposed an alternative to torn bridging veins as the source for thin-film subdural hematomas in 2009, their ideas were dismissed, but their model is now finding acceptance by doctors on both sides of the debate. Still, instead of considering the reasoned objections of their critics, some proponents of shaken baby theory demonize defense experts at conferences and in the press. After charges were dropped against Irish nanny Aisling Brady McCarthy earlier this fall, for example, Kevin Cullen at The Boston Globe quotes Dr. Eli Newberger calling shaken baby critics “defense whores”:

Newberger is dismissive of the revisionist views that defense attorneys are increasingly tapping.

“On the clinical testifying roster are a whole lot of people who will cut their consciences for money,” Newberger said. “They’re hired out as defense whores. I just find this vile.”

The Protecting Innocent Families petition is an effort to bring together the many people who are affected by misguided diagnoses of child abuse, including the accused families, their extended communities, and the medical and legal professionals who defend them.

If you agree that we need an objective, scientific review of the evidence base for today’s guidelines for diagnosing child abuse, please sign the petition, at http://bit.ly/InnocentFamilyPetition. If you have a web site or Facebook page, please post the  url. If you are a medical or legal professional, please consider sharing the url with your colleagues and clients (that’s http://bit.ly/InnocentFamilyPetition).

A number of individuals and families not mentioned above have also received quite a few votes of support, including Angela and Danny Frasure, Cor and James Thompson, Andrew Valdez, Megan Griffin, Marsha Mills, Rachel and Gourab Sahoo, Kacie and Raymond Hernandez, and a handful of people who would rather not be named publicly.

copyright 2015, Sue Luttner

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

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

Does the Brain Injury Prove Abuse, or Not?

Demonstration at the sentencing in the spring

Demonstration at the sentencing

The two shaking convictions in the news this season, ironically, are both based on brain findings alone, with no bruising, bone injuries, or other signs of assault—at least five years after the experts started saying that they never diagnose shaken baby based on the triad alone. In the widely reported case of Joshua Burns in Michigan, in fact, the diagnosis was based on only two of the three markers, retinal hemorrhages and subdural  hematoma.

BurnsProtestJune

Demonstration at CS Mott Children’s Hospital

A commercial airline pilot active in his local church and community, Joshua Burns was convicted of child abuse in December of 2014. Supporters immediately launched a web site and media campaign protesting his innocence, and now the Michigan Innocence Clinic is appealing his conviction.  Naomi Burns, now 18 months old, seems to have recovered fully. Her mother Brenda Burns has regained custody, but Joshua has been denied any contact with his daughter since April of 2014.

Michelle Heale sentencing reorted on Asbury Park Press

Michelle Heale sentencing, Asbury Park Press

In New Jersey, meanwhile, child care provider Michelle Heale has been sentenced to 15 years in prison, with the requirement that she serve at least 85% of her sentence. She was convicted of aggravated manslaughter and child endangerment in April.

Michelle said 14-month-old Mason Hess choked while eating a tube of applesauce, but doctors concluded from the brain findings that he had been shaken to death. The only visible evidence of trauma was a bruise on his forehead, suffered several days earlier in a fall in his home. He had been sick with coughing and copious mucous, and had just started taking medication the day before.

The coverage of the sentencing last week brings home how an abuse diagnosis amplifies the pain for everyone. The child’s mother asked the judge to impose the maximum sentence for “the monster who stole our son’s life,” and her husband addressed Michelle directly:

We truly believe that you should die for what you did to Mason, just not yet. But when you do, your true sentence will begin. We know that the devil himself has saved a special place in hell for you because only the most evil being would hurt an innocent child, an innocent child who cannot protect himself.

Judge Francis J. Vernoia imposed only half the maximum sentence of 30 years, but he chastised Heale for refusing to “take responsibility” for Mason’s death. Kathleen Hopkins at the Asbury Park Press wrote:

Vernoia noted, however, that Heale is at risk of committing another offense because she has refused to take responsibility for her actions. The judge said that despite overwhelming evidence of her guilt, Heale told a doctor during a mental examination that her conscience is clear.

The judge saw overwhelming evidence of her guilt, but I don’t.

The prosecuting attorney told the court that the child suffered “severe brain, spine and retinal damage,” but the injury to the spine was microscopic blood identified at autopsy, a finding consistent with the time the boy spent on a respirator. In fact, the prosecution was based on subdural hematoma, retinal hemorrhage, and brain swelling.

The historical context:  In 1998, after Judge Hiller Zobel released convicted British au pair Louise Woodward with a sentence of time served, several dozen child abuse experts signed a letter to the journal Pediatrics protesting media coverage sympathetic to the defense. The letter made this statement about the diagnosis of infant shaking:

The shaken baby syndrome (with or without evidence of impact) is now a well-characterized clinical and pathological entity with diagnostic features in severe cases virtually unique to this type of injury—swelling of the brain (cerebral edema) secondary to severe brain injury, bleeding within the head (subdural  hemorrhage), and bleeding in the interior linings of the eyes (retinal hemorrhages). 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.

Whether or not you accept that guideline—which I don’t—the prosecution of Michelle Heale is consistent with it.

In about 2010, however, after the Audrey Edmunds reversal, I started hearing a different message at child abuse conferences.

At the Eleventh International Conference on SBS/AHT, for example, Dr. Robert Block, then the incoming president of the American Academy of Pediatrics, rejected “the so-called triad,” with the comment:

Only people who are not active physicians working with children, naïve journalists, and professors with a biased agenda would propose that only three signs and symptoms support a diagnosis.

And in 2011, Dr. Carole Jenny presented at the New York Abusive Head Trauma/Shaken Baby Syndrome Training Conference, using a PowerPoint that featured this statement:

No trained pediatrician thinks that subdural hemorrhage, retinal hemorrhage and encephalopathy equals abuse. The “triad” is a myth!

But the conviction of Michelle Heale seems to be based on the presence of the triad, combined with faith that the effects of a serious shaking assault are always immediate. My best guess is that the diagnosis rested largely on the extensive bleeding in the child’s retinas, bleeding that the child abuse experts insist is caused only by abuse. During the trial, pediatric ophthalmologist Dr. Alex Levin was quoted in USA Today as saying, “This is a victim of abusive head trauma. I can’t think of another explanation.”

Josh Burns with his daughter Naomi

Josh Burns with his daughter Naomi

Retinal hemorrhages were also behind the diagnosis in the Joshua Burns case, where the eye exam did not take place until 11 days after the presumed shaking. The Torn Family web site, about the Burns case, offers both prosecution and defense expert opinions, making it possible to unravel some of Naomi’s complex medical history.

Her delivery was prolonged and difficult. Four times, the doctors attached the vacuum-extractor to Naomi’s head and pulled, and four times, the cap popped off. Finally, she was delivered by C-section.

She had difficulty latching onto the breast, and she was gaining weight slowly, so Brenda was pumping breast milk and feeding her daughter with a bottle, which was easier for Naomi to suck on. The girl’s  head circumference was growing at a faster rate than the rest of her body.

Bruising on newborn Naomi from the vacuum-extraction cap

Bruising and abrasions at birth from the vacuum-extraction cap

Then one Saturday afternoon when Naomi was about 11 weeks old, Joshua was at home alone with her, holding her on his lap. Brenda had gone to the hair salon, where the computer asked for a PIN number to go with the credit card. She called her husband, who gave her the number and then, he says, while putting the phone down, almost dropped Naomi, catching her by the head and face before she hit the coffee table.

The scratch on Naomi's left temple, after her near fall

The red mark on the left side of Naomi’s forehead, after her near fall

When Brenda got home, Joshua told her what had happened and showed her the red mark on Naomi’s face. Brenda says she thought it looked like a fingernail scratch, something she’d seen many times in her years as a nurse. (She had quit her job at a local hospital just a few months earlier, in preparation for Naomi’s birth.)

Their daughter seemed fine that night, Joshua and Brenda say, but over the next several days they took her again and again to the doctor and hospital for vomiting, pallor, and uneven breathing, only to be reassured and sent home. On the third day, when she had a seizure during an examination, she was admitted to the hospital. The first reading of the intake MRI identified only “benign enlargement of the subarachnoid spaces” (BESS), which means there was a little more room than usual between the brain and the skull, a not-uncommon condition of infancy that usually resolves on its own. It does, however, predispose to subdural hematoma.

Naomi and Brenda Burns

Naomi and Brenda Burns

Doctors attributed the infant’s seizures to an unidentified gastro-intestinal virus, and after a week in the hospital she was sent home, with anti-seizure medication. Her parents brought her back within hours, though, worried about more vomiting, fussiness, and pallor. At that point, while following up on a possible metabolic disorder, doctors performed a dilated eye exam and were surprised to find what the child abuse report identified as “bilateral multilayer retinal hemorrhages extending to the periphery,” the pattern considered by most child abuse experts to result exclusively from shaking.

“The retinal hemorrhages were an incidental finding,” Brenda says, “but they changed everything.”

Radiologists re-examined the initial MRI and reached a new conclusion:  They still determined that Naomi had BESS, but they also saw old subdural bleeding, possibly dating back to her traumatic birth, and a small amount of fresh subdural blood. Naomi was diagnosed as a shaken baby, and prosecutors targeted Joshua as the abuser.

The defense brought in pediatric ophthalmologist Dr. Khaled A. Tawansy, a retina specialist, who wrote in his report:

The retinal hemorrhages that were seen by the ophthalmologist at University of Michigan and documented by Ret-Cam imaging were predominantly superficial (sub internal limiting membrane or nerve fiber layer or intra-retinal)… [These types of hemorrhages] occur regularly with abrupt elevations of intra-cranial pressure (as in acute subdural hematoma) when the pressure in the cerebrospinal fluid surrounding the optic nerve exceeds the pressure of venous return in the retina as it drains into the optic nerve.

The child abuse doctor in the Burns case asked for advice from the same pediatric ophthalmologist who testified against Michelle Heale, Dr. Alex Levin in Philadelphia. In an email exchange posted on the Torn Family web site, the child abuse doctor summarizes Naomi’s medical history, acknowledging but discounting the traumatic birth. She reports the eye findings in detail and notes that the child has “persistent thrombophilia,” a clotting disorder.

Dr. Levin’s response:

Impressive documentation. Very well done.

Not sure what the question is. I can’t think of another diagnosis other than abuse assuming no obvious coagulopathy or other event.

Apparently Dr. Levin missed the mention of thrombophilia in the original note, because later in the thread, when the pediatrician asks him about it, he writes:

Do you mean thrombocytosis?
Either way we have no idea what this might do re retinal bleeding and could be considered to throw the retinal findings into question. We just don’t know

I don’t know what was said about all of this in court, but it seems to me that retinal hemorrhages are starting to play a very large part in these diagnoses. In this case, the retinal hemorrhages themselves are suspect, and the only other evidence of abuse is subdural hematoma in a child with BESS.

Now the state is trying to terminate Joshua’s parental rights. Those hearings wrapped up in June, and the family is waiting for the judge’s decision.

I don’t understand why the child abuse doctors are so sure Naomi was abused, and I’m even less clear on why the state has decided that her father and not her mother must be guilty. The accident Joshua reported—presumed to be a lie invented to cover up abuse—happened 11 days before doctors ever considered the possibility of head trauma.

I am sorry that another family has been caught up in this tragedy, but I am heartened by the enthusiastic support that Joshua and Brenda Burns are receiving from their community. And I have high hopes that the ongoing coverage will bring more light to the debate about the reliability of a shaken baby diagnosis.

September 2015 update: The court has adopted a treatment plan that allows for reunification of the Burns familly, which is good news if you ignore the irony that the only thing between  the Burns family and reunification is the court.

copyright 2015, Sue Luttner

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

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

The Word Is Out

WashPostTitleAfter 30 years of occasional, isolated coverage, both the national and the local media are starting to take a serious look at the debate about shaken baby theory—even as the accusations and convictions continue.

This past weekend Debbie Cenziper at The Washington Post published what I think qualifies as an exposé of shaking theory, the result of a full year of research that brought together the work of other Post staffers as well as students and teachers at half a dozen universities, including the Medill Justice Project at Northwestern University.

Dr. A. Norman Guthkelch

Dr. A. Norman Guthkelch

Shaken Science: A Disputed Diagnosis Imprisons Parents” offers a thorough but engaging analysis of the issues, including  helpful diagrams and the most accessible press treatment I’ve seen yet of the biomechanics. Cenziper opens, of course, with the story of one accused caregiver and interweaves more cases along the way, so that the piece is not only informative but also readable. She also reports the thoughts of several physicians, including Dr. A. Norman Guthkelch, the first person to propose in print, in the British Medical Journal in 1971, that shaking an infant could cause subdural bleeding.

The National Center on Shaken Baby Syndrome (NCSBS) has released a response to the Post piece, listing the professional organizations that have endorsed shaken baby theory and protesting:

 The Washington Post article portrays a “dispute” in the medical community as to the existence of SBS/AHT. There is a very small minority of proponents for the position that shaking cannot harm an infant, but this position is not supported by the science.

Like the letters protesting the film The Syndrome, the NCSBS response to the Post says that critics of shaking theory think that shaking a baby is not dangerous, although I don’t see anyone in the article making that statement. I think the question is whether the presence of the brain injury proves that a child was violently assaulted.

Cenziper’s article has been picked up in a number of regional newspapers, including the Hamilton Spectator in Ontario, the Daily Herald in Illinois, and the Dallas Morning News in TexaPBSNewsHours.

Then on Monday of this week, PBS NewsHour ran a segment on the shaking debate, a report titled “A disputed diagnosis that sends parents to prison for abuse.” The piece includes a look at the case of Drayton Witt in Arizona, whose appeal drew Dr. Guthkelch back into the arena, as well as interviews with child abuse pediatrician Dr. Lori Frasier—the author of a book on abusive head trauma written “for clinicians, investigators, prosecutors, and social workers”—and Katherine Judson from the Innocence Network.

Josh Burns with his daughter Naomi

Josh Burns with his daughter

Even before these national treatments emerged, regional news outlets had started giving sympathetic coverage to local cases. Last week in Michigan, Heather Catallo of ABC affiliate WXYZ  led off her video report about convicted father Joshua Burns with images of Burns’s supporters proclaiming their faith in his innocence at his sentencing hearing. The prosecutor argued for a harsh sentence, calling Burns a “danger” and objecting, “He’s not admitting that he did it. He’s still maintaining full innocence.” But the judge handed down the minimum sentence, a year in jail. Yesterday, WXYZ reported that prosecutors say they are not moving to terminate Joshua’s parental rights.

Also in early March, the Bennington Banner in Vermont ran a feature story by Keith Whitcomb Jr. about accused father Russell Van Vleck, found innocent by a jury in 2011 after a two-year nightmare for his entire family. Van Vleck’s son Colin, 5 weeks old the evening he quit breathing while lying on the couch next to his father, had been born with a skull malformation that had complicated his delivery.

TheSyndromeAnd the film exposé The Syndrome, which premiered in the fall of 2014, is being accepted at film festivals across the country (coming up: the (In)justice for All Film Festival in Chicago, April 13, and the Arizona International Film Festival in Tucson, April 18), staying in the news and triggering more coverage of the topic.

Outside of the mainstream press, web sites targeted to attorneys are also addressing shaken baby syndrome. On Wednesday of this week, the American Bar Association published an article in its Children’s Rights Litigation section by Katherine Judson at the Innocence Network, titled “What Child Welfare Attorneys Need to Know About Shaken Baby Litigation.” In February, the site LLRX.com, which describes itself as a web journal offering resources for legal professionals, published a valuable review of the debate, “Shaken Baby Syndrome: A Differential Diagnosis of Justice,” featuring live links to court decisions, journal articles, and other resources, by attorney, librarian, and writer Ken Struton, and the National Association of Public Defenders published an essay by public defender Jill Paperno, “Another Step Away From Bad Science – a Review of the  History and Science of Shaken Baby Syndrome in People v. Rene Bailey (December 16, 2014, Monroe County, NY).”

Still, the community of child abuse experts and the justice system remain committed to shaken baby theory. Yesterday in South Carolina, an 18-year police veteran was in court, accused of shaking his 3-month-old son into permanent brain damage. According to the local news report, the prosecutor told the judge that the boy’s injuries “could only have been caused by a violent shaking or by a fall of 20 feet or more.”

oklahomaChildrensIn Oklahoma last week, a step-father was charged with abuse after reporting that the baby fell from a bed. According to the News 9 coverage:

Detectives said they knew [the stepfather] was not being honest about what happened after doctors said the baby’s injuries weren’t consistent with his story. “The baby had to be violently shaken for him to have these injuries,” [Det. David] Thompkins said.

And this week in New York, detectives revisiting an old case charged a mother’s ex-boyfriend with manslaughter for the 2010 death of a 13-month-old boy who suffered injuries “consistent with shaken baby syndrome.” According to the report in The Buffalo News, detectives had acquired a more definitive medical opinion and carried out an additional interview with the suspect:

“In questioning Gonzalez, detectives were able to confirm a few things, though he didn’t confess, but it helped our case,” [Homicide Capt. Joseph] Gramaglia said. “We also obtained a medical opinion that bolstered the case.”

I don’t know what it will take to stop the ongoing tragedy of shaken baby theory in the courtroom. I have taken one small step, though. I’ve signed the Protecting Innocent Families petition, which asks for an objective, scientific review of the evidence behind today’s guidelines for diagnosing child abuse.

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

copyright 2015, Sue Luttner

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Filed under abusive head trauma, National Center on Shaken Baby Syndrome, SBS, shaken baby syndrome