http://www.weeklyblitz.net/461/are-mothers-natural-protectors-or-baby-killers
For many years around the world, doctors, scientists and professors of medicine have been debating as to whether 'Shaken Baby Syndrome' or SBS as it is known, actually exists. For a diagnoses of SBS a baby will need to display a serious acquired brain injury, which is said to be caused when a frustrated or angry adult holds an infant or toddler by the trunk or arms and shakes back and forth in a jerking, whiplash motion. Most cases occur in children under one year of age, although there are documented cases of SBS in older children.
Shaken Baby Syndrome" (SBS) is the term used to describe the collection of signs and symptoms resulting from a child being shaken violently. However, Shaken Baby Syndrome is sometimes difficult to recognize and even more difficult to prove. Which is why many parents claim they have been falsely accused. The doctors say the reason for this is, that many babies who are shaken show no outward signs of abuse, their injuries only become evident when a CT scan or MRI of the head detects subdural haematomas. Another test used in SBS to detect injuries is a simple eye exam, which can detect the presence of retinal haemorrhages. Which doctors claim is another symptom of a shaken baby.
However, common sense tells us, that if a baby was shaken this hard there were be at least some bruising. Sadly it seems that this does not convince doctors as more and more parents are being accused of SBS, which is worrying some doctors, especially as many of these cases are occurring shortly after vaccines and seem to occur particularly in the two to four month age range.
Dr Viera Scheibner in Shaken Baby Syndrome Diagnoses on Shaky Ground said:-
"An epidemic of accusations against parents and baby sitters of Shaken Baby Syndrome is sweeping the developed world. The United States and the United Kingdom are in the forefront of such questionable practise. Brain (mainly subdural, less often subarachnoid) and retinal haemorrhages, retinal detachments and rib and other bone 'fractures' are considered pathognomic. However, the reality of these is very different and well documented: the vast majority occur after the administration of childhood vaccines and a minority of cases are due to the documented birth injuries and pre-eclamptic and eclamptic staes of the mothers."
So why are more parents than ever being falsely accused of shaking their babies? Is it one big cover up, to hide that many of these injuries are being caused by the vaccines?
Dr Buttram believes that all parents accused of Shaken Baby Syndrome are 100% innocent as he believes the syndrome is physiologically impossible.
In an email to me he said:-
"As far as I am concerned, parents accused of shaken baby syndrome are 100 percent innocent, as the syndrome is physiologically impossible, having been totally discredited by the scientific (Ph.D.) speciality known as bio-engineers, which has found that if such violent shaking were actually taking place, it would be fatal in virtually all cases, not from head injury but from a broken neck. The same is true for multiple fractures in infants, the vast majority of which are from metabolic bone disease,.the biggest risk factors being congenital rickets (vitamin D deficiency) and prematurity."
Harold Buttram, MD
In a paper written by him on SBS called Shaken Baby Syndrome and Non-Accidental Injury: Are Parents and Caretakers Being Falsely Accused Dr Buttram proves his theories by using examples of experiments that have been used to dispel the theory. He shows how an experiment on monkeys used to show how babies can have bleeding inside the brain with no sign of any other injury, which has since been used to prove SBS cases, actually falls down because there is no comparison between the head and neck of an adult monkey and the head and neck of a small infant child who is barely able to hold their head up.
Quoted from his paper he says:-
"As pointed out in the Uscinski report,(1) the brain and head of an infant is nearly seven times larger and heavier than that of a monkey. In addition, adult monkeys are known to be incredibly strong, approximately four times stronger than humans. There would be no comparison, therefore, between the neck muscle strength of an adult monkey and that of an infant, barely able to hold up his or her head by age six months, so that if violent shaking were actually taking place, the incidence of neck injuries in the SBS should be exponentially greater than in monkeys. With these facts in mind consider the following:
Most SBS cases in the USA take place during the first six months of life, when there are negligible infant neck muscles. As will be shown further on, the major impact of violent shaking would fall at the junction between the base of the skull and brainstem area and upper cervical spinal cord. In most if not all nstances this would result in instant death or paraplegia from brain stem or cervical spinal cord injuries.
11 of the 19 monkeys (over 50 percent) in the Ommaya experiments had significant neck as well as brain injuries.
Although human brain injuries may occur in rear-end vehicle collisions, whiplash injuries to the neck comprise an overwhelming majority of adult injuries, in which ligaments and muscles are torn, resulting in estabilization of the cervical (neck)vertebral column. Since infants have only rudimentary neck muscles and connective tissues as cushions, the full impact of shaking would fall on the highly vulnerable cervical spinal cord at the base of the brain, which almost certainly would cause death or paraplegia.
In view of these considerations, one would expect a far greater incidence of severe cervical skeletal and spinal cord injuries in infants than took place in the monkeys, and yet this type of injury has not been documented in any SBS case to date. In view of these
facts, the Shaken Baby Syndrome theory defies both reason and common observation. As a simple statement, it is physiologically impossible.
As a final observation concerning "Non accidental Injury," in which it is assumed that there is a head impact in the process of shaking, there must be substantiating evidence in the forms of head/scalp bruising and/or subgaleal (scalp) hematoma in order to justify such an assumption."
Dr Buttrams papers and his evidence has been used in many cases.
Over the years it has been proven that vaccines have been the cause of the death of babies and have caused symptoms seen in cases of SBS. The most famous of those being that of Alan Yurko. The Yurko Project: Triumph Over Tragedy tells the tragic story of baby Alan. Alan died aged 2 months of suspected SBS, his father was accused of his murder and given a life sentence plus 10years. Alan had always been a sickly baby. One should always question whether a baby this sick should be given multiple vaccinations all at one time.
This is from one website and is written by his mother:
"Alan and Francine Yurko's baby boy, Alan, was born on September 16, 1997. Francine's pregnancy was severely compromised with refractory and recurrent E. coli infection, gestational diabetes, group b Streptococcal infection, and an overall weight gain of only two pounds. Labor was induced at 35 weeks because of life-threatening oligohydramnios (loss of amniotic fluid). Baby Alan was born grayish blue with respiratory distress and hypoglycemia. He spent the first week of his life in the Neonatal Intensive Care Unit and Special Nurseries, where his parents spent their days with him until his release. A breathing monitor was sought because Baby Alan was rasping and grunting; however, insurance would not cover it, and the doctors assured that it wasn't necessary.
Over the next six weeks, the family went to weekly pediatrician visits. Baby Alan was seriously jaundiced during his entire neonatal period, and was still rasping and grunting with short periods of apnea. In addition, on November 2, 1997, Alan and Francine rushed the baby to the hospital late in the night because they noticed blood on a burp rag. He was examined by several doctors and nurses, and it was decided that he must have scratched the inside of his nose with his fingernails. Francine pointed out that his fingernails were very trimmed and that, as a preemie, her baby didn't have such muscle control to have scratched himself. However, the doctors disregarded the concerns, and remarks were made about being "overprotective parents."
On November 11, 1997, at his weekly pediatrician visit, baby Alan was still not well: He was congested, rasping and grunting, and he had abnormal bowel movements. Despite this and other concerns, such as prematurity, he was injected with six vaccines. Within 24 hours he became lethargic, feverish, fussy. His feeding and sleeping patterns were markedly reduced and changed. The doctor warned that he could be this way for a week or so, but not to worry because it´s "normal" for some babies after their vaccinations. This desensitized the parents to those reactions.
Over the next ten days, baby Alan's condition did not improve, and he then developed a high-pitched cry. Francine and Alan became concerned, but the doctor said this was normal, and they'd already been chastised for being "overprotective." On November 23, 1997, they decided that if baby Alan did not improve, they would take him to the pediatrician the next day after Francine returned from work. They never got the chance."
Alan his father spent over six years in prison for his murder but eventually was freed on appeal when it was found that a combination of adverse reactions to vaccines and the drug Heparin caused his death and it was not SBS.
Dr Mohammed Ali Al-Bayati PhD, DABT, DABVT had this to say:-
My review of the medical evidence in baby Alan's case clearly shows that he died as result of adverse reactions to vaccines and medications. The tissue bleedings were caused by his treatment of heparin following his respiratory/cardiac arrest. The medical examiner and other physicians who evaluated failed to consider heparin's ability to cause bleeding in tissue. They also overlooked the role of the adverse reactions to vaccines in the baby's health problems. Detailed descriptions of the clinical data and other medical literature explaining the pathogenesis of the baby's illness and supporting my conclusions are presented in this report. Analysis of Causes That Led to the Bleedings in the Subdural Spaces and Other Tissues in Baby Alan Ream Yurko´s Case
In March 2010 another case very similar to the case of baby Alan Yurko goes to court. This is the case of baby T who became ill less than 48 hours after he received a selections of vaccines. His mother Emily says:-
"This story begins August 13th, the day he received his shots. He received his DTaP-IPV-HIB, second dose of Hep B, and oral rotavirus vaccines. Less than 48 hours later, on August 15th, T***** began projectile vomiting. He would not keep much of anything down. I took him in to the local ER, where they rehydrated him and sent him home. He kept vomiting. I took T***** in again on August 18th to the ER. The doctors checked him for pyloric stenosis, which was found to not be ailing him. The doctors suggested switching his formula, that perhaps he was becoming intolerant of the formula he was on. No other explanation was offered as to why he kept vomiting. I followed up with his pediatrician August 21st, and again he could not offer any explanation for his vomiting. I had been feeding him often, and with smaller amounts. He would keep the feeding down for a while, and then sometimes vomit at the next feeding. It was almost always projectile. He was progressively sleeping more and when he was awake, he seemed fussier, almost in pain.
Early morning August 24th, 2009, T***** was at home with his father, Patrick. I work 3rd shift and was at work. T******s older brother and sister were also home sleeping. Patrick called me at work, saying T*******had awoken him with a high-pitched screaming and was acting funny. He said he was pale and crying in a whining fashion. He wasn't sure what was going on with him. He was later holding him when he stiffened up and arched his back, rolled his eyes and then became limp. 911 was called.
When T****** was admitted into the local ER, he was unresponsive. He was not breathing well on his own and was intubated. Once stabilized, he was transferred across the street to the PICU. T****** heart was not functioning properly and an echocardiogram was performed. It showed diminished heart function. A CT scan was also performed, which showed subdural bleeding in his head. T***** was transferred by helicopter to the University of ***** Hospital.
Once at the University Hospitals, T*****'s father and I were questioned by the Department of Human Services and the ********* Police as to the events which led up to his hospitalization. We hadn't even been allowed to see him yet and had no idea what was going on with him, yet we were being questioned as to whether we had shaken him. Patrick was at home with the children at the time of his collapse, so he has been the main target of their investigations.
T****** was in very grave condition. The doctors did not expect him to live. They said there was bleeding in his subdural spaces, both acute and sub-acute, or chronic. The doctors stated that his projectile vomiting was a sign that pressure was building in his head, though during the three trips we had made to the doctor that was never discovered. T***** had also had a stroke.They said he was intentionally hurt. Non-accidental Head Trauma, or Shaken Baby Syndrome."
Like Alan Yurko, baby T was also given Heparin and also became ill within 48 hours of vaccination. Baby T had no bruising, no fractures and no bleeding anywhere else on his body. Baby T survived his injuries and is now in foster care, the older two children were also removed and live with their father.
Emily said in an email:-
"From the first hospital and CT scan he had, they thought SBS, or non-accidental trauma. They never stepped outside of that box. Sure, they tested for bleeding disorders, but that was it. None of the 3 times I took him to the doctor after he began vomiting did they ever think vaccine reaction. I even asked. I had no idea what was going on, only that my other two children had never thrown up like this after their shots. They told me that his vaccines wouldn't cause that. That since he hadn't vomited within the first 24 hours, it wasn't a reaction. I know now how ridiculous that idea is."
Of course she is right this is ridiculous ,as vaccines were found to be the cause of Alan Yurkos death and he had his reaction the day after his vaccinations. The doctor at the hospital in his case had said "The doctor warned that he could be this way for a week or so, but not to worry because it´s "normal" for some babies after their vaccinations"
I am not medically trained but common sense would tell me that vaccines followed by a combination of the huge number of medications listed for me by his mother, is more like feeding him from a witches cauldron than hospital treatments, especially considering this child was only two months old.
This young mother entrusted her beloved son to the care of hospitals who she believed would help her son. Instead they fed him a massive cocktail of drugs that combined with the lethal ingredients in the vaccines, may have contributed to yet further problems. Then when things became so bad that this small baby was fighting for his life ,they ban her from being with him and accuse her and her partner of shaking him so violently that they caused bleeding to the brain.
It really is time for parents to be believed and the medical profession to take on board that vaccines in some cases can and do cause brain damage.
For more information on SBS, Vaccinations and false accusations and papers by Dr Harold Buttram and Dr Michael Innis on Shaken Baby Syndrome go to Profitable Harm SBS.
Showing posts with label subdural hematoma. Show all posts
Showing posts with label subdural hematoma. Show all posts
Wednesday, February 10, 2010
Sunday, October 18, 2009
Shaken Baby Syndrome Misdiagnosed
I had to reprint this to keep the information flowing on the fallacy surrounding Shaken Baby Syndrome.
Regardless of your opinions related to SBS, the profound underlying statement that needs to occur is that anyone convicted of a crime needs to be guilty. To charge someone based on theory and opinion is just as criminal. Whereas no one likes a person to "get away" with murder or abuse of a child, no one should like a person being convicted falsely.
I think my biggest issue aside from flawed science is the fact that some of these children could have an underlying medical condition lurking behind the scene. As a parent, if my child had died unexpectedly, I would want all tests ran to ensure there was no genetic issue at play. What if my other children are a ticking bomb to face the same fate or what if that child passes on that trait to their children? It's easy to charge "the last person with a child" but it's not easy to be the one accused falsely.
We owe it not only to the person accused but we owe it to the child, offspring and parents.
Just imagine if a child would have lived had the doctors accurately diagnosed a child and exhausted all underlying possibilities? This is the biggest question of all. What if? What if the child was treated incorrectly?
It can take weeks or months to run panels of labs and they are expensive to run. I propose someone start collecting the labs ran on alleged SBS victims and determine if there is a consensus on labs ran, why are they not all ran and did anyone ever collect all the results?
Most children don't have but a minimal set of labs ran due to ER doctors already assessing guilt at onset. It's a vicious cycle of injustice for all.
It's not acceptable to take one or more symptoms and mold them into an SBS or blunt force trauma case.
From Radley Balko:
In January 2008, a Wisconsin appeals court granted a new trial to Audrey Edmunds, a 45-year-old woman who had been sentenced in 1995 to 18 years in prison for murdering Natalie Beard, an infant in her care. The ruling was significant, because medical experts said Beard died as a result of Shaken Baby Syndrome (SBS), a diagnosis that grew increasingly common in the late 1980s and early 1990s. The Wisconsin appellate court was the first in the country to recognize increasing doubts about the reliability of SBS diagnoses.
The phrase shaken baby syndrome entered the pop culture lexicon in 1997, when British au pair Louise Woodward was convicted of involuntary manslaughter in the death of Massachusetts infant Matthew Eappen. At the time, the medical community almost universally agreed on the symptoms of SBS. But starting around 1999, a fringe group of SBS skeptics began growing into a powerful reform movement. The Woodward case brought additional attention to the issue, inviting new research into the legitimacy of SBS. Today, as reflected in the Edmunds case, there are significant doubts about both the diagnosis of SBS and how it's being used in court.
In a compelling article published this month in the Washington University Law Review, DePaul University law professor Deborah Teurkheimer argues that the medical research has now shifted to the point where U.S. courts must conduct a major review of most SBS cases from the last 20 years. The problem, Teurkheimer explains, is that the presence of three symptoms in an infant victim—bleeding at the back of the eye, bleeding in the protective area of the brain, and brain swelling—have led doctors and child protective workers to immediately reach a conclusion of SBS. These symptoms have long been considered pathognomic, or exclusive, to SBS. As this line of thinking goes, if those three symptoms are present in the autopsy, then the child could only have been shaken to death.
Moreover, an SBS medical diagnosis has typically served as a legal diagnosis as well. Medical consensus previously held that these symptoms present immediately in the victim. Therefore, a diagnosis of SBS established cause of death (shaking), the identity of the killer (the person who was with the child when it died), and even the intent of the accused (the vigorous nature of the shaking established mens rea). Medical opinion was so uniform that the accused, like Edmunds, often didn't bother questioning the science. Instead, they'd often try to establish the possibility that someone else shook the child.
But now the consensus has shifted. Where the near-unanimous opinion once held that the SBS triad of symptoms could only result from a shaking with the force equivalent of a fall from a three-story to four-story window, or a car moving at 25 mph to 40 mph (depending on the source), research completed in 2003 using lifelike infant dolls suggested that vigorous human shaking produces bleeding similar to that of only a 2-foot to 3-foot fall. Furthermore, the shaking experiments failed to produce symptoms with the severity of those typically seen in SBS deaths.
The research implies that human beings simply cannot shake a baby to death without an accompanying impact to the head. SBS cases, however, frequently show no external injuries. This suggests that other causes are at work. Additional research has shown babies to be lucid up to 72 hours before classic SBS symptoms set in, casting doubt on the long-held theory that the child's caretaker at the time of death (or loss of consciousness) was the likely killer.
Last year, Discover magazine published a provocative article laying out much of this new research. Notably, the magazine found several specialists who have since changed their minds after testifying for the prosecution in multiple SBS cases. (At a post-conviction hearing for Edmunds, all of her defense experts said that when the case was tried in 1995, they would have testified for the prosecution.) One of those specialists is Ronald Uscinski, a student of Ayub Ommaya, the scientist whose research on monkeys in the late 1960s is thought to be the origin of the SBS diagnosis. When Uscinski went back and reexamined the study, he found no support for the way Ommaya’s research is currently being being used in the courtroom.
"When I put all of this together, I said, my God, this is a sham,” Uscinski told Discover. "Somebody made a mistake right at the very beginning, and look at what’s come out of it."
Teurkheimer estimates that "what's come out of it" is about 200 SBS prosecutions per year in America, mostly for murder. She believes there's legitimate reason to review nearly all of these cases, including even those where a suspect admitted to having shaken the baby. As she points out, suggestive or coercive questioning may have elicited such admissions. Moreover, in some cases, a defendant who admitted to shaking a child in order to revive it after it had already been unconscious was seen as having confessed to killing the child.
Whether someone can actually "free shake" an infant to death remains hotly disputed in the medical community. Where there is consensus, however, is that the triad of symptoms traditionally associated with SBS are not exclusive to it. A number of other things can produce these symptoms, including falls, head impacts, infections, birth defects, reaction to vaccinations, and surgical procedures. That's a significant departure from what prosecutors have been telling juries for the past 20 years.
In other words, there are almost certainly a significant number of innocent people in prison today who were wrongly convicted of shaking a baby to death. The problem is that there are also likely a number of guilty people who, nevertheless, shouldn't have been convicted on the basis of science-based testimony we now know to be false. The task will be convincing both the courts and the public to risk freeing actual child killers in order to free the innocent people convicted with flawed medical testimony.
Furthermore, unlike with DNA testing, which came about through rapid scientific breakthroughs, the issue of SBS is tied to a slow shift in the scientific consensus. We simply won’t have the slam-dunk evidence DNA provides when it points to the real culprit. With SBS, the question is usually whether a crime was even committed, or if a child's symptoms were caused by something other than shaking.
This whole controversy speaks to a fundamental tension between science and law. Science moves along a slow trajectory from inquiry toward certainty. While the courts have been eager to embrace new science—particularly forensic science—at the trial level, they're reluctant to revisit those cases when the science changes. One example is the now-discredited specialty of identifying bite mark evidence. But while science is mostly interested in testing, revising, and improving existing theories, once the jury has delivered its verdict, our criminal justice system puts a premium on finality. It takes a major upheaval in the scientific community (like DNA technology) to get courts to consider reopening old cases.
But at the very least the courts should stop prosecutors from making the same mistakes in the future. But even that isn't happening. Tuerkheimer, for example, found literature in current manuals for prosecutors that relies on discredited research from the 1980s and 1990s, still touting the pathognomic nature of SBS symptoms. And the same week Edmunds was given a new trial, an appeals court in Arkansas denied a new trial to a woman convicted under similar circumstances, based on the presence of the same symptoms.
Britain, Canada, and Australia have all initiated major reviews of shaken baby prosecutions in response to new research. Teurkheimer makes a convincing case that it’s time for the U.S. to do the same.
Radley Balko is a senior editor at Reason magazine
Washington University Law Review, DePaul University law professor Deborah Teurkheimer
Regardless of your opinions related to SBS, the profound underlying statement that needs to occur is that anyone convicted of a crime needs to be guilty. To charge someone based on theory and opinion is just as criminal. Whereas no one likes a person to "get away" with murder or abuse of a child, no one should like a person being convicted falsely.
I think my biggest issue aside from flawed science is the fact that some of these children could have an underlying medical condition lurking behind the scene. As a parent, if my child had died unexpectedly, I would want all tests ran to ensure there was no genetic issue at play. What if my other children are a ticking bomb to face the same fate or what if that child passes on that trait to their children? It's easy to charge "the last person with a child" but it's not easy to be the one accused falsely.
We owe it not only to the person accused but we owe it to the child, offspring and parents.
Just imagine if a child would have lived had the doctors accurately diagnosed a child and exhausted all underlying possibilities? This is the biggest question of all. What if? What if the child was treated incorrectly?
It can take weeks or months to run panels of labs and they are expensive to run. I propose someone start collecting the labs ran on alleged SBS victims and determine if there is a consensus on labs ran, why are they not all ran and did anyone ever collect all the results?
Most children don't have but a minimal set of labs ran due to ER doctors already assessing guilt at onset. It's a vicious cycle of injustice for all.
It's not acceptable to take one or more symptoms and mold them into an SBS or blunt force trauma case.
From Radley Balko:
A Shake to the System
New research into "shaken baby syndrome" could put hundreds of convictions in peril.
In January 2008, a Wisconsin appeals court granted a new trial to Audrey Edmunds, a 45-year-old woman who had been sentenced in 1995 to 18 years in prison for murdering Natalie Beard, an infant in her care. The ruling was significant, because medical experts said Beard died as a result of Shaken Baby Syndrome (SBS), a diagnosis that grew increasingly common in the late 1980s and early 1990s. The Wisconsin appellate court was the first in the country to recognize increasing doubts about the reliability of SBS diagnoses.
The phrase shaken baby syndrome entered the pop culture lexicon in 1997, when British au pair Louise Woodward was convicted of involuntary manslaughter in the death of Massachusetts infant Matthew Eappen. At the time, the medical community almost universally agreed on the symptoms of SBS. But starting around 1999, a fringe group of SBS skeptics began growing into a powerful reform movement. The Woodward case brought additional attention to the issue, inviting new research into the legitimacy of SBS. Today, as reflected in the Edmunds case, there are significant doubts about both the diagnosis of SBS and how it's being used in court.
In a compelling article published this month in the Washington University Law Review, DePaul University law professor Deborah Teurkheimer argues that the medical research has now shifted to the point where U.S. courts must conduct a major review of most SBS cases from the last 20 years. The problem, Teurkheimer explains, is that the presence of three symptoms in an infant victim—bleeding at the back of the eye, bleeding in the protective area of the brain, and brain swelling—have led doctors and child protective workers to immediately reach a conclusion of SBS. These symptoms have long been considered pathognomic, or exclusive, to SBS. As this line of thinking goes, if those three symptoms are present in the autopsy, then the child could only have been shaken to death.
Moreover, an SBS medical diagnosis has typically served as a legal diagnosis as well. Medical consensus previously held that these symptoms present immediately in the victim. Therefore, a diagnosis of SBS established cause of death (shaking), the identity of the killer (the person who was with the child when it died), and even the intent of the accused (the vigorous nature of the shaking established mens rea). Medical opinion was so uniform that the accused, like Edmunds, often didn't bother questioning the science. Instead, they'd often try to establish the possibility that someone else shook the child.
But now the consensus has shifted. Where the near-unanimous opinion once held that the SBS triad of symptoms could only result from a shaking with the force equivalent of a fall from a three-story to four-story window, or a car moving at 25 mph to 40 mph (depending on the source), research completed in 2003 using lifelike infant dolls suggested that vigorous human shaking produces bleeding similar to that of only a 2-foot to 3-foot fall. Furthermore, the shaking experiments failed to produce symptoms with the severity of those typically seen in SBS deaths.
The research implies that human beings simply cannot shake a baby to death without an accompanying impact to the head. SBS cases, however, frequently show no external injuries. This suggests that other causes are at work. Additional research has shown babies to be lucid up to 72 hours before classic SBS symptoms set in, casting doubt on the long-held theory that the child's caretaker at the time of death (or loss of consciousness) was the likely killer.
Last year, Discover magazine published a provocative article laying out much of this new research. Notably, the magazine found several specialists who have since changed their minds after testifying for the prosecution in multiple SBS cases. (At a post-conviction hearing for Edmunds, all of her defense experts said that when the case was tried in 1995, they would have testified for the prosecution.) One of those specialists is Ronald Uscinski, a student of Ayub Ommaya, the scientist whose research on monkeys in the late 1960s is thought to be the origin of the SBS diagnosis. When Uscinski went back and reexamined the study, he found no support for the way Ommaya’s research is currently being being used in the courtroom.
"When I put all of this together, I said, my God, this is a sham,” Uscinski told Discover. "Somebody made a mistake right at the very beginning, and look at what’s come out of it."
Teurkheimer estimates that "what's come out of it" is about 200 SBS prosecutions per year in America, mostly for murder. She believes there's legitimate reason to review nearly all of these cases, including even those where a suspect admitted to having shaken the baby. As she points out, suggestive or coercive questioning may have elicited such admissions. Moreover, in some cases, a defendant who admitted to shaking a child in order to revive it after it had already been unconscious was seen as having confessed to killing the child.
Whether someone can actually "free shake" an infant to death remains hotly disputed in the medical community. Where there is consensus, however, is that the triad of symptoms traditionally associated with SBS are not exclusive to it. A number of other things can produce these symptoms, including falls, head impacts, infections, birth defects, reaction to vaccinations, and surgical procedures. That's a significant departure from what prosecutors have been telling juries for the past 20 years.
In other words, there are almost certainly a significant number of innocent people in prison today who were wrongly convicted of shaking a baby to death. The problem is that there are also likely a number of guilty people who, nevertheless, shouldn't have been convicted on the basis of science-based testimony we now know to be false. The task will be convincing both the courts and the public to risk freeing actual child killers in order to free the innocent people convicted with flawed medical testimony.
Furthermore, unlike with DNA testing, which came about through rapid scientific breakthroughs, the issue of SBS is tied to a slow shift in the scientific consensus. We simply won’t have the slam-dunk evidence DNA provides when it points to the real culprit. With SBS, the question is usually whether a crime was even committed, or if a child's symptoms were caused by something other than shaking.
This whole controversy speaks to a fundamental tension between science and law. Science moves along a slow trajectory from inquiry toward certainty. While the courts have been eager to embrace new science—particularly forensic science—at the trial level, they're reluctant to revisit those cases when the science changes. One example is the now-discredited specialty of identifying bite mark evidence. But while science is mostly interested in testing, revising, and improving existing theories, once the jury has delivered its verdict, our criminal justice system puts a premium on finality. It takes a major upheaval in the scientific community (like DNA technology) to get courts to consider reopening old cases.
But at the very least the courts should stop prosecutors from making the same mistakes in the future. But even that isn't happening. Tuerkheimer, for example, found literature in current manuals for prosecutors that relies on discredited research from the 1980s and 1990s, still touting the pathognomic nature of SBS symptoms. And the same week Edmunds was given a new trial, an appeals court in Arkansas denied a new trial to a woman convicted under similar circumstances, based on the presence of the same symptoms.
Britain, Canada, and Australia have all initiated major reviews of shaken baby prosecutions in response to new research. Teurkheimer makes a convincing case that it’s time for the U.S. to do the same.
Radley Balko is a senior editor at Reason magazine
Washington University Law Review, DePaul University law professor Deborah Teurkheimer
Friday, July 31, 2009
Head Trauma outcomes of verifiable falls in newborn babies
Authors:
Caroline Ruddick, Martin Ward Platt, Camille Lazaro
Affiliations:
Ms Caroline Ruddick, Midwifery Manager, Directorate of Women’s ServicesDr Martin Ward Platt, Consultant Paediatrician, Directorate of Women’s ServicesDr Camille Lazaro, Consultant Paediatrician, Department of Child Health
Corresponding author:
Dr Martin Ward PlattWard 35Royal Victoria Infirmary,Newcastle upon Tyne NE1 4LPTele: 0191 282 5197Fax: 0191 282 5038E mail: m.p.ward-platt@ncl.ac.ukJuly 7, 2009 as 10.1136/adc.2008.143131
Head trauma outcomes of verifiable falls in newborn babies
Abstract
Eleven newborn babies of normal weights sustained falls onto a hard surface in hospital. The one baby who fell from over a metre sustained clinical and radiological trauma and encephalopathy, with a skull fracture and cerebral contusion. No other baby demonstrated neurological signs despite the presence of parietal skull fractures in four of six who were X-rayed; only two babies had scalp swelling. The findings suggest that parietal fractures can result from very low level falls and scalp swelling is a poor marker for underlying fracture.
Introduction
The conditions under which very young infants can sustain skull fractures can be contentious, but are clearly important in determining whether an injury might be consistent with the history given.Studies of linear skull fractures and external evidence of skull injury have mostly focused on falls of 3 feet or more1 2, so there is little information on the outcomes of lower level falls. In the context of the accident and emergency department, the prevarication and false histories that are part of thepresentation of child abuse create difficulties for clinicians and researchers alike.
Therefore, we believed it would be useful to present our experience of injuries sustained from falls in newborn babies in the postnatal ward where the fall occurred under verifiable conditions, or was witnessed by someone other than the mother; there was information about the physical environment; immediate medical assessment was available; and many of the falls were from heights as low as 0.5m.
Method
We used our adverse event register, cross checked with the codings for all trauma in newborn babies from the Hospital Episode Statistics, to identify cases where babies fell accidentally to the floor in our maternity unit for the five years January 1999 to December 2003. The records for each child were examined; details of the height to impact, nature of the surface struck, clinical symptoms and the results of any imaging were identified for each child.
Results
The details of the babies are given in the table. 11 babies were identified, seven girls and four boys,all born at term. Birth weights ranged from 2.1 kg to 3.8 kg. Of the 11, seven were totally breast fed, three artificially fed and one mixed fed. Seven of the falls occurred at night, between the hours of 8 p.m. and 8 a.m. Four babies dropped to the floor when their mothers fell asleep following breast feeding.
The estimated distance to impact in most babies was one metre or less. One baby fell about 1.2m. The surface impacted upon in all falls consisted of vinyl tiles laid upon concrete with an intervening solid screed.No clinical findings were identified in eight of the eleven babies. Of the three with clinical findings,one had a bruise over the temporal area, one had a swelling over the parietal area and one had signs of traumatic encephalopathy.
All imaging was at the discretion of the attending physicians. Six of the eleven babies had skull Xrays, one had a CT scan (but no skull X-ray), and two an ultrasound scan. Of the six with X-rays, five had no scalp swelling, but three of these five had a solitary linear parietal skull fracture. Three of the eleven babies had localised scalp swelling, of which two were imaged and each of these had asingle linear parietal fracture. The baby who fell 1.2m had a fronto-parietal contusion beneath the fracture, and had a transiently decreased level of consciousness consistent with a mild traumatic encephalopathy; this baby was born by normal vaginal delivery.
Discussion
Our observations demonstrate that low height falls of under a metre can cause a linear skull fracture, and such skull fractures are not necessarily accompanied by a boggy swelling in the overlying scalp. However not all babies were radiographed so we cannot make any estimate of the rate of fracture among babies who fall.All the fractures, including that caused by the highest fall, were linear and confined to the parietes. Even the baby falling further, and sustaining brain contusion, had a linear fracture, not a more complex one. Although this finding supports the contention that complex, stellate or occipital fractures do not arise from simple domestic falls3 we cannot rule out the possibility that otherkinds of fracture could result from falls such as we have seen.In spite of the fact that hospital floors are particularly hard and unyielding, we found that symptoms suggestive of underlying brain injury (decreased consciousness, feeding problems, irritability,seizures or apnoea) were not found in 10 of 11 babies, even when fractures were found to have occurred. Existing biomechanical evidence suggests that that there is little difference in the effects of falls onto a hard floor or a carpeted domestic floor 4.
We conclude that even very low level falls may produce linear skull fractures, but that such fractures may occur without the scalp swelling traditionally considered suggestive of a fracture.
References
1. Greenes, D. S., Schutzman, S A. Infants with isolated skull fracture: what are their clinicalcharacteristics, and do they require hospitalization? Annals of Emergency Medicine. 1997;30:253-9.
2. Johnson, K., Fischer, T., Chapman, S., Wilson, B. Accidental head injuries in children under 5years of age. Clinical Radiology 2005;60:464-8.
3. Hobbs, C.J. Skull Fracture and the diagnosis of abuse. Archives of Disease in Childhood1984;59:246-52.
4. Coats, B., Margulies, S. S. Potential for head injuries in infants from low-height falls. Journalof Neurosurgery: Pediatrics 2008;2:321-30.
Caroline Ruddick, Martin Ward Platt, Camille Lazaro
Affiliations:
Ms Caroline Ruddick, Midwifery Manager, Directorate of Women’s ServicesDr Martin Ward Platt, Consultant Paediatrician, Directorate of Women’s ServicesDr Camille Lazaro, Consultant Paediatrician, Department of Child Health
Corresponding author:
Dr Martin Ward PlattWard 35Royal Victoria Infirmary,Newcastle upon Tyne NE1 4LPTele: 0191 282 5197Fax: 0191 282 5038E mail: m.p.ward-platt@ncl.ac.ukJuly 7, 2009 as 10.1136/adc.2008.143131
Head trauma outcomes of verifiable falls in newborn babies
Abstract
Eleven newborn babies of normal weights sustained falls onto a hard surface in hospital. The one baby who fell from over a metre sustained clinical and radiological trauma and encephalopathy, with a skull fracture and cerebral contusion. No other baby demonstrated neurological signs despite the presence of parietal skull fractures in four of six who were X-rayed; only two babies had scalp swelling. The findings suggest that parietal fractures can result from very low level falls and scalp swelling is a poor marker for underlying fracture.
Introduction
The conditions under which very young infants can sustain skull fractures can be contentious, but are clearly important in determining whether an injury might be consistent with the history given.Studies of linear skull fractures and external evidence of skull injury have mostly focused on falls of 3 feet or more1 2, so there is little information on the outcomes of lower level falls. In the context of the accident and emergency department, the prevarication and false histories that are part of thepresentation of child abuse create difficulties for clinicians and researchers alike.
Therefore, we believed it would be useful to present our experience of injuries sustained from falls in newborn babies in the postnatal ward where the fall occurred under verifiable conditions, or was witnessed by someone other than the mother; there was information about the physical environment; immediate medical assessment was available; and many of the falls were from heights as low as 0.5m.
Method
We used our adverse event register, cross checked with the codings for all trauma in newborn babies from the Hospital Episode Statistics, to identify cases where babies fell accidentally to the floor in our maternity unit for the five years January 1999 to December 2003. The records for each child were examined; details of the height to impact, nature of the surface struck, clinical symptoms and the results of any imaging were identified for each child.
Results
The details of the babies are given in the table. 11 babies were identified, seven girls and four boys,all born at term. Birth weights ranged from 2.1 kg to 3.8 kg. Of the 11, seven were totally breast fed, three artificially fed and one mixed fed. Seven of the falls occurred at night, between the hours of 8 p.m. and 8 a.m. Four babies dropped to the floor when their mothers fell asleep following breast feeding.
The estimated distance to impact in most babies was one metre or less. One baby fell about 1.2m. The surface impacted upon in all falls consisted of vinyl tiles laid upon concrete with an intervening solid screed.No clinical findings were identified in eight of the eleven babies. Of the three with clinical findings,one had a bruise over the temporal area, one had a swelling over the parietal area and one had signs of traumatic encephalopathy.
All imaging was at the discretion of the attending physicians. Six of the eleven babies had skull Xrays, one had a CT scan (but no skull X-ray), and two an ultrasound scan. Of the six with X-rays, five had no scalp swelling, but three of these five had a solitary linear parietal skull fracture. Three of the eleven babies had localised scalp swelling, of which two were imaged and each of these had asingle linear parietal fracture. The baby who fell 1.2m had a fronto-parietal contusion beneath the fracture, and had a transiently decreased level of consciousness consistent with a mild traumatic encephalopathy; this baby was born by normal vaginal delivery.
Discussion
Our observations demonstrate that low height falls of under a metre can cause a linear skull fracture, and such skull fractures are not necessarily accompanied by a boggy swelling in the overlying scalp. However not all babies were radiographed so we cannot make any estimate of the rate of fracture among babies who fall.All the fractures, including that caused by the highest fall, were linear and confined to the parietes. Even the baby falling further, and sustaining brain contusion, had a linear fracture, not a more complex one. Although this finding supports the contention that complex, stellate or occipital fractures do not arise from simple domestic falls3 we cannot rule out the possibility that otherkinds of fracture could result from falls such as we have seen.In spite of the fact that hospital floors are particularly hard and unyielding, we found that symptoms suggestive of underlying brain injury (decreased consciousness, feeding problems, irritability,seizures or apnoea) were not found in 10 of 11 babies, even when fractures were found to have occurred. Existing biomechanical evidence suggests that that there is little difference in the effects of falls onto a hard floor or a carpeted domestic floor 4.
We conclude that even very low level falls may produce linear skull fractures, but that such fractures may occur without the scalp swelling traditionally considered suggestive of a fracture.
References
1. Greenes, D. S., Schutzman, S A. Infants with isolated skull fracture: what are their clinicalcharacteristics, and do they require hospitalization? Annals of Emergency Medicine. 1997;30:253-9.
2. Johnson, K., Fischer, T., Chapman, S., Wilson, B. Accidental head injuries in children under 5years of age. Clinical Radiology 2005;60:464-8.
3. Hobbs, C.J. Skull Fracture and the diagnosis of abuse. Archives of Disease in Childhood1984;59:246-52.
4. Coats, B., Margulies, S. S. Potential for head injuries in infants from low-height falls. Journalof Neurosurgery: Pediatrics 2008;2:321-30.
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