shaken baby syndrome


What Does Nanny Case Reversal Say About Shaken Baby Syndrome?

In this July 30, 2015 photo, Aisling Brady McCarthy leaves court proceedings at Middlesex Superior Court in Woburn. Middlesex DA Marian Ryan announced Monday that the murder charge against the Irish nanny had been dropped. (Keith Bedford/The Boston Globe via AP)

In this July 30, 2015 photo, Aisling Brady McCarthy leaves court proceedings at Middlesex Superior Court in Woburn. Middlesex District Attorney Marian Ryan announced Monday that the murder charge against the Irish nanny had been dropped. (Keith Bedford/The Boston Globe/Pool)

You read about the striking reversal in the latest Boston nanny case and you wonder: How does this happen? How could a medical examiner first say a baby died of “complications from blunt force head injuries” and then, two years after the baby’s Irish nanny is accused of murder, decide that the cause of death is “undetermined”?

The medical examiner’s report has not been publicly released, but the Middlesex district attorney’s press release does cite a major review process that included “expert witness reports from the defense and prosecution, additional transcripts of police interviews, transcripts of grand jury testimony, additional medical records, DCF reports, and additional laboratory testing.”

On Radio Boston today, co-host Anthony Brooks spoke with Dr. Robert Sege, a member of the American Academy of Pediatrics’ committee on child abuse and neglect, and vice president at Health Resources in Action, a public health policy organization. Here’s an excerpt of that conversation, lightly edited:

Anthony Brooks: This is the second time in a year that the Massachusetts medical examiner has reversed its finding in a baby’s death, and we’ve been reading that in the United States, 16 convictions have been overturned since 2001, including three last year. So does this raise questions about the diagnosis of shaken baby syndrome? What are your thoughts on that?

Dr. Robert Sege: To me, it doesn’t raise the question at all. If you think about it, there are people who are falsely accused of murder, robberies, all kinds of things and the justice system is not perfect. So in a situation where we have hundreds and perhaps a thousand infants a year who experience shaken baby syndrome, the fact that 16 convictions over a multi-year period were overturned lets me know that the justice system worked, and that people get a fair shot at getting their story told…

I’m very happy that we live in a country with a judicial system that looks at things skeptically and tries to make sure that justice is done. It doesn’t change anything about whether or not shaken baby syndrome or abusive head trauma exists. Sadly, it does.

I want to read you one quote from Gregory Davis, the chief medical examiner in Birmingham, Alabama, and board chair of the National Association of Medical Examiners. He told the Washington Post:

“You can’t necessarily prove [shaken baby syndrome] one way or another … Neither side can point to compelling evidence and say, ‘We’re right and the other side is wrong.’ So instead, it goes to trial.”

Do you disagree with that?

I actually do, and I think part of the issue is that many cases of abusive head trauma never make it to trial, sometimes because the police and the prosecutors can’t figure out who the perpetrator was, but often — and I’ve certainly seen this — because someone confesses. It’s a very sad situation, but frequently a person just reaches the end of their rope. They’re frustrated, the infant won’t shut up, they don’t mean to cause harm or death but they just can’t stand it anymore. Continue reading


Boston Medical Center Doc: Abusive Head Trauma All Too Real

Loyal readers of CommonHealth know that we’ve been closely covering the emerging debate on shaken baby syndrome and that numerous posts by medical and legal experts have formed a pretty solid consensus that the science behind the syndrome remains sound.

So we were interested in the NPR story this week called “Rethinking Shaken Baby Syndrome,” which suggests that medical experts are reconsidering whether the phenomenon is being legitimately used in legal cases.

Here, Dr. Robert Sege, a professor of pediatrics at Boston University School of Medicine and the director of the division of ambulatory pediatricss at Boston Medical Center makes the point that just because convictions have been overturned in such cases, it doesn’t mean that children can’t be shaken so fiercely that their head traumas ultimately cause their death:

The recent NPR series on the legal aspects of infant deaths due to abusive head trauma may have left listeners with the misleading impression that there is controversy concerning the existence of abusive head trauma and infants. While there are a number of important issues regarding the identification of infant homicide victims, and their murderers, the sad fact is that this condition still occurs far too frequently in the United States. According to the Centers for Disease Control, over 500 infants are murdered in the United States each year. The majority of these infants die of abusive head trauma. In fact, according to government statistics, two thirds of all child abuse related fatalities occur in the first year of life. Infants, of course, cannot speak for themselves. Physicians carefully examine infants with signs of trauma. Through medical and epidemiologic research, confessions, and animal research, a picture of abusive head trauma has emerged. Infants with abusive head trauma may die as a result of bleeding inside the skull or of direct brain damage from the injury. They may have bleeding behind the eyes, and other signs of trauma. As we constantly work to better understand-and prevent-this sad situation, we should not allow controversies that arise during judicial proceedings cloud the picture of the tragic deaths of American infants.

When Child Death Cases Are Mishandled

An investigation into the death of Isis Vas (above) raises questions about how the case was handled

A joint investigation between NPR, ProPublica and Frontline finds a troubling number of botched cases in which caretakers may have been wrongly charged and convicted of killing or assaulting children.

The piece on NPR today, The Child Cases: Guilty Until Proved Innocent, begins with the heartbreaking story of a little girl from Texas:

Her name was Isis Charm Vas and at 6 months old she was a slight child – fifth percentile in height and weight.

Isis Vas was just six months old when she died.

When the ambulance sped her to Northwest Texas Hospital in Amarillo on a Saturday morning in October 2000, doctors and nurses feared that someone had done something awful to her.

A constellation of bruises stretched across her pale skin. CT scans showed blood pooling on her brain and swelling. Blood was found in her vagina. The damage was so severe that her body’s vital organs were shutting down.

Less than 24 hours later, Isis died.

An autopsy bolstered the initial suspicions that she’d been abused. Joni McClain, a forensic pathologist, ruled Isis’ death a homicide and said the baby had been sexually violated. McClain would later describe it as a “classic” case of blunt force trauma, the type of damage often done by a beating.

The police investigation that followed was constructed almost entirely from medical evidence. In the end, prosecutors indicted one of the child’s babysitters: Ernie Lopez.

Today, Lopez is serving a 60-year prison term for sexual assault and is still facing capital murder charges.

The problem with the case again Lopez, the story reveals, is that it may have been terribly mishandled.

…a growing body of evidence has emerged suggesting that McClain and the hospital staffers were wrong about what happened to Isis — and that her death was not the result of a criminal attack.

If Lopez is ultimately exonerated, his case will not be unique. An investigation by NPR, ProPublica and PBS Frontline has found that medical examiners and coroners have repeatedly mishandled cases of infant and child deaths, helping to put innocent people behind bars.

The piece raises hard questions about the way some of these horrific cases were investigated. But in many ways, it feels like a recap of a recent magazine piece in The New York Times, which posed doubts about the diagnosis and science behind shaken baby syndrome. (The NYT piece mentions CommonHealth, by the way, and when we posted about shaken baby syndrome, we had an overwhelming response from a number of medical and legal experts who asserted, powerfully, that the science behind the syndrome remains sound.

Shaken Baby Syndrome In The NYT Magazine

Nanny Louise Woodward after her 1998 conviction in a famous shaken-baby case

Coming in The New York Times magazine this weekend, and already available online: a lengthy piece by the writer Emily Bazelon, who tends to cover legal topics, on the complex issue of Shaken Baby Syndrome. It’s here, and warning: it’s long.

This magazine article is much more balanced than the Op-Ed contribution by law professor Deborah Tuerkheimer that the Times ran last September, saying that experts were questioning the scientific basis of the syndrome. That piece raised an outpouring of objections from medical and legal experts here on CommonHealth. But this new article will surely still prompt some powerful reactions. I particularly liked this summing-up of why the issue is so fraught:

Normally, of course, this is how science progresses: One researcher comes up with a hypothesis, which others question and test. But shaken-baby cases are haunted by the enormous repercussions of getting it wrong — the conviction of innocent adults, on the one hand, and on the other, the danger to children of missing serious abuse.

And just a narcissistic footnote — Emily Bazelon mentions CommonHealth here:

Last September, the fight among the doctors broke out in public on the Web, after Deborah Tuerkheimer, a former prosecutor and a law professor at DePaul, wrote a New York Times Op-Ed warning of wrongful convictions and calling on the National Academy of Sciences to referee the shaken- baby-syndrome dispute. On the Web site CommonHealth, about 20 doctors commented, mostly to express outrage. One of them was Block. He wrote that Tuerkheimer had “been beguiled by a group of physicians who are using the courtroom to distort science, facts and reality.” And he denounced her for “furthering the cause of the so-called innocence project.”

NY Times Public Editor On ‘Shaken Baby Syndrome’

Deepest thanks to the public editor of The New York Times, Arthur S. Brisbane, for calling attention to CommonHealth’s posts on “shaken baby syndrome.”

See his new post, titled “Shaken Baby Syndrome Debate Moves Offshore,” here.

I promise not to belabor this any further, but I did want to emphasize what, to me, is the central journalistic point in all this: The debate over the science of abusive head trauma in babies is not a simple 50-50 split. The great majority of medical experts are on one side, and coverage should reflect that. As I wrote to the Times: Continue reading

Queens Prosecutors Appalled By ‘Shaken Baby’ Op-Ed

Queens County Courthouse

Comments on this post — The Real Consensus On Shaken Baby Syndrome? — continue to roll in. One of the most eloquent arrived in the form of an email rather than a comment: A letter to The New York Times from Marjory Fisher and Leigh Bishop, Queens prosecutors who handle many “shaken baby” cases. Ms. Bishop told me that after several editing back-and-forths with the Times, an editor told her that it was too late to run the letter.

In it, the prosecutors decry the New York Times op-ed piece in which law professor Deborah Tuerkheimer wrote that “experts are questioning the scientific basis for shaken baby syndrome.”

They accuse her of “a feeble attempt to elevate and equate fringe supposition contrived strictly for use in the courtroom to the level of widely-accepted medical science and research that has been supported by hundreds of studies and millions of hours of clinical experience around the world.”

Here it is:
Continue reading

Pediatrics Academy President-Elect On ‘Shaken Baby Syndrome’

American Academy of Pediatrics President-Elect Robert Block

This CommonHealth post — The Real Consensus On Shaken Baby Syndrome — has brought such a cornucopia of powerful comments that one media-watcher even called it an interesting exploration of Internet journalism. The Knight Science Journalism Tracker, which critiques science media, writes here:

It’s an interesting way of doing journalism in the blog era. Instead of calling sources for comment, open it up to anyone who cares to respond. I’m guessing that even reporters as good as Goldberg and Zimmerman would not have found some of these fascinating responses using the old-fashioned tricks of our trade.

Too true! And we thank you all for allowing us to host your discussion. Our own contributions for today: Rachel Zimmerman heard again from Deborah Tuerkheimer, the law professor whose New York Times op-ed piece triggered this outpouring of response (see below). She also gained some helpful insights from a Children’s Hospital Boston specialist.

And I spoke with Dr. Robert W. Block in his official capacity as the president-elect of the American Academy of Pediatrics, which has 60,000 members. If anyone knows what the consensus really is, I figured, he must.

The debate will surely continue, I said, but if you could post the final word on this, what would it be?
Continue reading

Superior Court Judge On Shaken Baby Syndrome

Informed, impassioned comments continue to pour in at the bottom of this post: The Real Consensus On Shaken Baby Syndrome?

Judge Charles Gill speaking recently at The Gilbert School in Connecticut

Today, we heard, among others, from Connecticut Superior Court Judge Charles Gill, who is known as a longtime children’s advocate. He writes:

Law Professor Deborah Tuerkheimer’s Op-Ed 9/20/10 in the New York Times on The Shaken Baby Syndrome is a criminal defense lawyers dream, but a reality nightmare.

I have lectured at dozens of law and medical schools on child abuse. Her real inexperience in this area shows.

It is disconcerting, if not frightening, when a law professor professes factual, technical, and legal misleading statements in public and professional publications.

Her over-extension of the highly questionable medical minority view on the subject into the legal
world makes me wince. Her beliefs are not medically, scientifically or legally correct. They suggest a legal tilting at her new “innocence project”. We liberals love such pursuits. But her project is guilty of existing pretty much in her own mind. Her sources are scant and wrong.

Let us hope that her efforts do not result in the freeing of people who murder our infants in the most despicable way.

Connecticut Superior Court Judge Charles D. Gill

As we posted here, Professor Tuerkheimer has declined to comment directly on the outpouring of comments on CommonHealth. Most of the comments are critical of her New York Times op-ed piece saying that experts are questioning the science behind shaken baby syndrome. Might Judge Gill’s comment be enough to prompt a more direct response?

Tuerkheimer Responds To Criticism On Shaken Baby Syndrome

CommonHealth asked professor Deborah Tuerkheimer to comment on all of the impassioned responses (mostly negative) we got after linking to her op-ed piece in The New York Times. (The piece, called “Anatomy of a Misdiagnosis,” said that experts are growing wary of the science behind shaken baby syndrome and that innocent people have wrongly been convicted based on this bad science.)

Here is her slightly edited response:

I appreciate the interest and attention being
focused on this important issue. While I am not able to comment on blog
comments, I think it is worthwhile to emphasize – as I’ve done in my
work – the importance of viewing these scientific developments from the
perspective of criminal justice. From this vantage, outstanding areas of
disagreement within the scientific community are dwarfed in importance
by the ground that is shared.

If your blog readers are interested in a more thorough discussion of how
our criminal justice system has responded to SBS, my article can be
accessed here

I am hopeful that the Times Op-Ed can catalyze a productive


Deborah Tuerkheimer
Professor of Law
DePaul University College of Law