"WHAT HAPPENED OVER THE YEARS? HOW COULD ONE PERSON HAVE BEEN RESPONSIBLE FOR SO MANY MISCARRIAGES OF JUSTICE HOW DID DR. SMITH GET TO ENJOY ALL THE POWER THAT HE DEMONSTRATED BOTH INSIDE AND OUTSIDE OF COURT? WHO DO WE BELIEVE? WHO DO WE DISBELIEVE? WHO DO WE TRUST? WHO DON'T WE TRUST? HAVE WE REGAINED CONFIDENCE IN THE CRIMINAL JUSTICE SYSTEM? WILL WE EVER? WHAT HAS TO HAPPEN BEFORE OUR CONFIDENCE IS RESTORED? WHAT CHANGES HAVE TO BE MADE IN OUR COURT SYSTEM TO PREVENT MORE INNOCENT PARENTS AND CAREGIVERS FROM BEING INVESTIGATED AND CHARGED WITH MURDERING CHILDREN? WHAT DID WE LEARN FROM GOUDGE? WAS IT WORTH IT? WHAT SHOULD HAPPEN NOW? HOW CAN WE COMPENSATE DR. SMITH'S WRONGLY CONVICTED VICTIMS? DO WE ACCEPT HIS EXCUSES? JUST ERRORS? JUST MISTAKES? NO INTENT TO HARM ANYONE? NO ONE TAUGHT HIM OTHERWISE? OTHER PATHOLOGISTS WOULD HAVE REACHED THE SAME CONCLUSIONS? THE STATE OF PATHOLOGY WAS AT FAULT - NOT HIM? OTHERS WERE AT FAULT FOR FAILING TO SUPERVISE HIM...
THE LITANY GOES ON...I'M SURE YOU WILL HAVE QUESTIONS OF YOUR OWN ... AND ANSWERS AS WELL."
HAROLD LEVY...THE CHARLES SMITH BLOG;
-------------------------------------------------------------------------------
Dear Readers.
It's mid-June;
Memories of a harsh winter are receding - and I think it's time to pause for a short while, charge the batteries, enjoy the lush summer days and lighten up.
I have had an incredibly intense experience since my first post last September - and have the sense that we are moving towards a crescendo as Commissioner Goudge prepares to release his report this fall.
There are still a few loose ends to tie up, some new areas that I would love to explore and developments in the various on-going cases and investigations involving Dr. Charles Randal Smith.
Above all, I am hoping to present this Blog's own report - based on the Goudge Inquiry - that will call the hard shots and make recommendations. (To precede the release of the Goudge Report by a day or two);
As this is a formidable challenge, I would appreciate receiving our readers own conclusions and recommendations based on the Goudge experience - to help me formulate my own.
The questions abound;
What happened over the years? How could one person have been responsible for so many miscarriages of justice How did Dr. Smith get to enjoy all the power that he demonstrated both inside and outside of court? Who do we believe? Who do we disbelieve? Who do we trust? Who don't we trust? Have we regained confidence in the criminal justice system? Will we ever? What has to happen before our confidence is restored? What changes have to be made in our court system to prevent more innocent parents and caregivers from being investigated and charged with murdering children? What did we learn from Goudge? Was it worth it? What should happen now? How can we compensate Dr. Smith's wrongly convicted victims? Do we accept his excuses? Just errors? Just mistakes? No intent to harm anyone? No one taught him otherwise? Other pathologists would have reached the dame conclusions? The state of pathology was at fault - not him? Others were at fault for failing to supervise him...
The litany goes on...I'm sure you will have questions of your own ... and answers as well.
Please send me your observations and comments by private email at hlevy15@gmail.com...for my guidance only in preparing the report - and not for publication on the Blog. (The message function on the site will be disconnected until we resume postings.)
So meet me back here in September, have a wonderful summer, and enjoy!
Best wishes, Harold Levy;
hlevy15@gmail.com;
Friday, June 13, 2008
Thursday, June 12, 2008
New York Forensic Expert Takes Life: Proper Lab Procedures Not Followed; Another Criminal Justice System On the Alert;
"LISA SCHREIBERSDORF, PRESIDENT OF THE NEW YORK STATE ASSOCIATION OF CRIMINAL DEFENCE LAWYERS, SAID THAT THE NEWS WAS "BEYOND TROUBLING" IN PART BECAUSE JURIES RARELY QUESTION THE CREDIBILITY OF POLICE FORENSIC EXPERTS.
“IT STARTS MAKING YOU THINK ABOUT ALL THE CASES WHERE THE EVIDENCE FROM THE PROSECUTION DIDN'T JIBE WITH WHAT ELSE YOU KNEW ABOUT THE CASE MS. SCHREIBERSDORF SAID.""
NICHOLAS CONFESSORE: NEW YORK TIMES; 12 JUNE, 2008;
---------------------------------------------------------------------------------
A story in today's New York Times sent shivers down my spine.
It's by reporter Nicholas Confessore and appears under the heading, "Police Review Lab Work After Suicide of Scientist."
A good friend sent me the story with a note that said,"Charles Smith Number Two?"
Although, it is far too early to make any comparisons - and no evidence of tainted evidence has been unearthed -I thought it would be useful to draw the story to our readers attention so they can follow developments.
"New York State Police officials are notifying district attorneys across the state that evidence in criminal cases may have been compromised by a forensic scientist who committed suicide last month after auditors discovered that he had not followed proper procedures in some cases, officials said Tuesday<" the story begins.
"The scientist, Garry Veeder, worked at the State Police crime lab for more than 30 years analyzing so-called trace evidence, such as fibers, physical material and impressions left at crime scenes," it continues.
"The agency is reviewing his work going back at least a decade and cannot yet say how many cases could have been compromised.
But police officials and some local prosecutors said that the cases included burglaries, assaults, murders and nearly every other variety of criminal case.
Mr. Veeder, 58, hanged himself in his garage on May 23.
No evidence has emerged so far that Mr. Veeder issued inaccurate findings or that prosecutors relied on false evidence in a criminal trial.
But the district attorneys are being notified so that they can retrieve their own files on the cases and await further information from the agency, officials said.
“None of the evidence in the cases reviewed has been found to be inaccurate or incorrect, but that doesn’t mean that we won’t find something,” said Lt. Glenn Miner, a spokesman for the State Police. “He wasn’t following our procedures, and because he wasn’t following our procedures, we need to let the district attorneys know.”
Lieutenant Miner said that once investigators had identified all of the cases for which Mr. Veeder had provided fiber analysis, the agency would select an outside forensic consultant to perform a technical analysis of each case.
News of Mr. Veeder’s misconduct has spread rapidly through the state’s trial bar, and some lawyers say they have been scouring old case files to see if Mr. Veeder provided evidence against their clients.
Lisa Schreibersdorf, president of the New York State Association of Criminal Defense Lawyers, said that the news was “beyond troubling,” in part because juries rarely question the credibility of police forensics experts.
“It starts making you think about all the cases where the evidence from the prosecution didn’t jibe with what else you knew about the case,” Ms. Schreibersdorf said.
The State Police crime lab handles roughly 10,000 cases a year and provides forensic services to law enforcement officials around the state, chiefly in more rural areas where local police departments do not operate their own crime labs.
The vast majority of that work involves testing illegal drugs seized during raids or arrests, Lieutenant Miner said.
But Mr. Veeder was the lab’s sole expert on fiber evidence, such as threads recovered from clothing at crime scenes.
State Police procedure requires at least two tests on fibers.
The initial test, known as a relative refractive index test, helps scientists narrow the type of fiber being studied.
But a confirming test, known as a Fourier transform infrared spectroscopy test, is required to definitively identify the fiber.
According to Lieutenant Miner, on at least some cases, Mr. Veeder skipped the preliminary test and conducted only the confirming test.
The discrepancies came to light during a routine audit by the American Society of Crime Laboratory Directors, one of several organizations in the United States that accredits crime labs.
Some crime labs view the preliminary test as superfluous and do not require it, Lieutenant Miner said, because the confirming test will identify the type of fiber.
In some cases, Mr. Veeder apparently reported a result for the preliminary test based on what he had learned in the confirming test.
One of the cases under review involves Mr. Veeder’s fiber analysis and testimony in the death of Joseph Corr, a police officer in New Hartford, N.Y., who was shot and killed while pursuing suspects in a jewelry-store robbery in 2006.
That case involved comparing fibers found in a broken display case with a glove linked by prosecutors to a suspect, Toussaint Davis, who was later convicted of second-degree murder.
Scott D. McNamara, the Oneida County district attorney, said that he expected Mr. Davis’s lawyers to request a postconviction hearing, though State Police officials have told Mr. McNamara that there was no indication yet that Mr. Veeder had provided false evidence in the case or had perjured himself.
Prosecutors in Franklin County and Chautauqua County said they received calls from the State Police on Wednesday involving two cases in each county, including one burglary, one assault and a homicide from 1976, a cold case in which no arrests were made.
“I know all my big cases, and I don’t have anything where fibers were a big deal for that,” said Derek P. Champagne, the Franklin County district attorney.
Mr. Veeder also performed work on at least two cases in New York City, where the Police Department normally performs its own forensics work, Mr. Miner said.
One case involved analysis of a 1999 train accident in Staten Island, investigated by the Port Authority of New York and New Jersey; the other involved a 1996 product-tampering case in Manhattan, handled by the state agricultural agency.
Neither involved evidence gleaned from suspects.
Mr. Veeder’s death staggered an agency already reeling from the suicide of a recently retired trooper, Gary A. Berwick, just days before.
Mr. Berwick, 48, who also hanged himself, was said to be distraught over a separate investigation by Attorney General Andrew M. Cuomo into whether the State Police engaged in political espionage against elected officials, though no evidence has emerged that he was a target of the investigation."
Harold Levy...hlevy15@gmail.com;
“IT STARTS MAKING YOU THINK ABOUT ALL THE CASES WHERE THE EVIDENCE FROM THE PROSECUTION DIDN'T JIBE WITH WHAT ELSE YOU KNEW ABOUT THE CASE MS. SCHREIBERSDORF SAID.""
NICHOLAS CONFESSORE: NEW YORK TIMES; 12 JUNE, 2008;
---------------------------------------------------------------------------------
A story in today's New York Times sent shivers down my spine.
It's by reporter Nicholas Confessore and appears under the heading, "Police Review Lab Work After Suicide of Scientist."
A good friend sent me the story with a note that said,"Charles Smith Number Two?"
Although, it is far too early to make any comparisons - and no evidence of tainted evidence has been unearthed -I thought it would be useful to draw the story to our readers attention so they can follow developments.
"New York State Police officials are notifying district attorneys across the state that evidence in criminal cases may have been compromised by a forensic scientist who committed suicide last month after auditors discovered that he had not followed proper procedures in some cases, officials said Tuesday<" the story begins.
"The scientist, Garry Veeder, worked at the State Police crime lab for more than 30 years analyzing so-called trace evidence, such as fibers, physical material and impressions left at crime scenes," it continues.
"The agency is reviewing his work going back at least a decade and cannot yet say how many cases could have been compromised.
But police officials and some local prosecutors said that the cases included burglaries, assaults, murders and nearly every other variety of criminal case.
Mr. Veeder, 58, hanged himself in his garage on May 23.
No evidence has emerged so far that Mr. Veeder issued inaccurate findings or that prosecutors relied on false evidence in a criminal trial.
But the district attorneys are being notified so that they can retrieve their own files on the cases and await further information from the agency, officials said.
“None of the evidence in the cases reviewed has been found to be inaccurate or incorrect, but that doesn’t mean that we won’t find something,” said Lt. Glenn Miner, a spokesman for the State Police. “He wasn’t following our procedures, and because he wasn’t following our procedures, we need to let the district attorneys know.”
Lieutenant Miner said that once investigators had identified all of the cases for which Mr. Veeder had provided fiber analysis, the agency would select an outside forensic consultant to perform a technical analysis of each case.
News of Mr. Veeder’s misconduct has spread rapidly through the state’s trial bar, and some lawyers say they have been scouring old case files to see if Mr. Veeder provided evidence against their clients.
Lisa Schreibersdorf, president of the New York State Association of Criminal Defense Lawyers, said that the news was “beyond troubling,” in part because juries rarely question the credibility of police forensics experts.
“It starts making you think about all the cases where the evidence from the prosecution didn’t jibe with what else you knew about the case,” Ms. Schreibersdorf said.
The State Police crime lab handles roughly 10,000 cases a year and provides forensic services to law enforcement officials around the state, chiefly in more rural areas where local police departments do not operate their own crime labs.
The vast majority of that work involves testing illegal drugs seized during raids or arrests, Lieutenant Miner said.
But Mr. Veeder was the lab’s sole expert on fiber evidence, such as threads recovered from clothing at crime scenes.
State Police procedure requires at least two tests on fibers.
The initial test, known as a relative refractive index test, helps scientists narrow the type of fiber being studied.
But a confirming test, known as a Fourier transform infrared spectroscopy test, is required to definitively identify the fiber.
According to Lieutenant Miner, on at least some cases, Mr. Veeder skipped the preliminary test and conducted only the confirming test.
The discrepancies came to light during a routine audit by the American Society of Crime Laboratory Directors, one of several organizations in the United States that accredits crime labs.
Some crime labs view the preliminary test as superfluous and do not require it, Lieutenant Miner said, because the confirming test will identify the type of fiber.
In some cases, Mr. Veeder apparently reported a result for the preliminary test based on what he had learned in the confirming test.
One of the cases under review involves Mr. Veeder’s fiber analysis and testimony in the death of Joseph Corr, a police officer in New Hartford, N.Y., who was shot and killed while pursuing suspects in a jewelry-store robbery in 2006.
That case involved comparing fibers found in a broken display case with a glove linked by prosecutors to a suspect, Toussaint Davis, who was later convicted of second-degree murder.
Scott D. McNamara, the Oneida County district attorney, said that he expected Mr. Davis’s lawyers to request a postconviction hearing, though State Police officials have told Mr. McNamara that there was no indication yet that Mr. Veeder had provided false evidence in the case or had perjured himself.
Prosecutors in Franklin County and Chautauqua County said they received calls from the State Police on Wednesday involving two cases in each county, including one burglary, one assault and a homicide from 1976, a cold case in which no arrests were made.
“I know all my big cases, and I don’t have anything where fibers were a big deal for that,” said Derek P. Champagne, the Franklin County district attorney.
Mr. Veeder also performed work on at least two cases in New York City, where the Police Department normally performs its own forensics work, Mr. Miner said.
One case involved analysis of a 1999 train accident in Staten Island, investigated by the Port Authority of New York and New Jersey; the other involved a 1996 product-tampering case in Manhattan, handled by the state agricultural agency.
Neither involved evidence gleaned from suspects.
Mr. Veeder’s death staggered an agency already reeling from the suicide of a recently retired trooper, Gary A. Berwick, just days before.
Mr. Berwick, 48, who also hanged himself, was said to be distraught over a separate investigation by Attorney General Andrew M. Cuomo into whether the State Police engaged in political espionage against elected officials, though no evidence has emerged that he was a target of the investigation."
Harold Levy...hlevy15@gmail.com;
Dr. Andrew McCallum: Emergency Specialist; Ontario's New Chief Coroner: Excellent Appointment For Post-Goudge Era;
Ontario's new Chief Coroner is an emergency physician by training who appears to be in an excellent position to help restore public confidence in the Chief Coroner's Office and usher in the Post Goudge era.
He is Dr. Andrew McCallum.
Dr. McCallum was questioned about his background by Counsel for the Ipperwash Inquiry on May 10, 2005:
Here is that testimony:
(VOIR DIRE COMMENCES)
EXAMINATION-IN-CHIEF BY MS. SUSAN VELLA.
"Dr. McCallum...I understand that you are currently the Regional Supervising Coroner for Eastern Ontario?
A: That's correct.
Q: And you have been since September 2003?
A: That's also correct....
Q: And I understand that you obtained your M.D. from McMaster University in 1980?
A: Correct.
Q: You then received -- is it the F.R.C.P.C. in emergency medicine? Perhaps you could just tell us what that is?
A: It's a higher degree in medicine conferred by the Royal College of Physicians and Surgeons of Canada in the specialty of emergency medicine.
Q: And you received that in 1987?
A: Correct.
Q: I understand that you also in 1988 received the diploma of the American Board of Emergency Medicine?
A: Yes.
Q: Since July of 2000 you have been an associate professor with the Department of Medicine at McMaster University?
A: Yes.
Q: And since October 2003, you have also been an associate professor, Department of Emergency Medicine at Queen's University?
A: Correct.
Q: You are a member of a number of professional organizations including the Royal College of Physicians and Surgeons of Canada?
A: Yes.
Q: The American Academy of Forensic Sciences?
A: That's correct.
Q: -- and the Canadian Association of Emergency Physicians and you have held the science -- scientific Co-Chair of that organization since 2002?
A: Actually, that was a -- that was a self-limited appointment for a conference that was -- that I assisted in organizing.
Q: Thank you. From July 2001 to August 2003 you were Chief of Staff at Hamilton Health Sciences Corporation?
A: Yes.
Q: From 1998 to July 2001 you were the Chief of Emergency Medicine at Hamilton Health Sciences Corporation?
A: That's correct
Q: And the Medical Director of the Emergency Program at that organization?
A: That's correct
Q: You were also the Vice-Chair of the Medical Advisory Committee of the Hamilton Health Sciences Corporation?
A: Yes.
Q: From December 2000 to January 2002, you were the Regional Medical Liaison?
A: That's correct.
Q: And from November 2000 to the present you have been a coroner for the Province of Ontario, Ministry of the Solicitor General.
A: That's right.
Q: As well, over the course of your career you have been a consultant in varying capacities with respect to emergency medical services?
A: That's correct.
Q: That includes, for example, having been the Consultant to the Minister of Health in the state of Kerala, India in association with their med and -- sorry, in -- in connection with designing an emergency medical services system for that state?
A: That's right.
Q: In February of 2000 you were a consultant in Mount Sinai Hospital in their utilization of ambulance diversion?
A: Yes.
Q: In February of 2001 you were a consultant to the University Health Network to provide an external review of their Emergency Department?
A: That's correct.
Q: And to provide a review of the University Health Network's emergency services?
A: That's right.
Q: You have conducted numerous reviews of care -- medical care -- conducted for the Chief Coroner for Ontario in -- in various Emergency
Departments?
A: That's right.
Q: From 1993 to 1998 you were the Director for the Department of Emergency Services for Sunnybrook Health -- Health Science Centre?
A: Yes.
Q: You were also a Medical Director for the Advanced Cardiac Life Support Instructional Program at Sunnybrook?
A: That's correct.
Q: Prior to that from 1990 to '93 you were the Chief of Emergency Medicine for St. Joseph's Community Health Centre in Hamilton?
A: That's right.
Q: And prior to that, an emergency physician at St. Joseph's Hospital?
A: Yes.
Q: And before that, an emergency physician for the Toronto General Hospital?
A: That's right.
Q: You've also received various honours from your colleagues from time to time -
A: Yes.
Q: -- as listed at page 6 of your curriculum vitae?
A: That's -- that's correct.
Q: You've also held and been engaged in many professional development activities outlined at pages 7 to 8 of your curriculum vitae, including the Chair of the Board of Examiners in Emergency Medicine of the Royal College of Physicians and Surgeons of Canada from 1994 to 1996?
A: That's right.
Q: A member of the Board of Examiners in Emergency Medicine of the Royal College of Physicians and Surgeons of Canada from 1989 to 1984 -- to '94?
A: Yes.
Q: And a member of the Specialty Committee in Emergency Medicine for the Royal College of Physicians and Surgeons in Canada from 2001 to the present?
A: Actually, that terminated in 2003; that's -- that's -- yes.
Q: Thank you -- thank you very much. As well, you have been a member from time to time of various university committees?
A: Yes.
Q: That's listed at page 8 of your Curriculum vitae and that would include from 1990 to 1993 being a member of the Emergency Medicine Post Graduate Education Committee for McMaster University?
A: That's right.
Q: And as well, you've been on a number of hospital committees listed at pages 8 through 10 of your curriculum vitae including from 2001 to 2003 the Chair of the Medical Advisory Committee for Hamilton Health Services?
A: That's correct
Q: From 1993 to 1998 you were a member of the Trauma Physician Management Group for Sunnybrook?
A: Yes.
Q: And from 1988 to 1993 you were a member of the Acute Care Committee for St. Joseph's Hospital in Hamilton?
A: Also correct
Q: You are also the recipient of research awards, which are -- are listed at page 10 of your curriculum vitae?
A: Yes.
Q: And you are the author or a co-author of a number of peer reviewed publications listed at pages 10 to 11 of your curriculum vitae?
A: Yes.
Q: That would include, for example, the author of -- of a article in the Canadian Association of Emergency Physicians Review entitled "Negative Diagnostic Lavage in Blunt Abdominal Trauma"?
A: Yes.
Q: And in 19 -- the 1991 Canadian Medical Association Journal, co-author of a comment called "A Survey of resuscitation Training in Canadian Undergraduate Medical Programs"?
A: That's correct.
Q: As well in 1996, you were co-author of an article entitled "Pre Hospital Interventions:
Critical Resuscitation's Number 1"?
A: That's correct.
Q: And also the author of a -- editor of a non-peer reviewed document entitled: "The Road to Survival: A Review and Recommendations for Enhancement of Emergency Medical Services System in the State of Kerala, India"?
A: Correct.
MS. SUSAN VELLA: Commissioner, I would like to at this time, tender Dr. McCallum as an expert in emergency medicine, including emergency procedures and pre-hospital and in-hospital assessment and treatment of
penetrating trauma to the torso.
COMMISSIONER SIDNEY LINDEN: Does anybody have any comment or question? That's fine.
MS. SUSAN VELLA: Thank you."
A government release indicates that Dr. McCallum's appointment is effective June 4, 2008 - and that it followed "an extensive international search."
Dr. McCallum appears to have remained free from the cliques that governed the Chief Coroner's Office throughout the Charles Smith years.
To this Blogster, Dr. McCallum's commitment to emergency medicine work over several decades should serve him well as he sets out to restore confidence in the Chief Coroner's Office and turn things around in the post-Goudge era;
He has had to work closely with patients and their families at times of great stress and consequence - and must surely understand the devastating pressures on families that lose their children.
He is a worthy successor to Dr. Barry McLellan who played such a huge role in fearlessly coming to grips with the harm caused by Dr. Charles Smith - no matter were the chips fell.
This Blog wishes him well.
Harold Levy...hlevy15@gmail.com;
He is Dr. Andrew McCallum.
Dr. McCallum was questioned about his background by Counsel for the Ipperwash Inquiry on May 10, 2005:
Here is that testimony:
(VOIR DIRE COMMENCES)
EXAMINATION-IN-CHIEF BY MS. SUSAN VELLA.
"Dr. McCallum...I understand that you are currently the Regional Supervising Coroner for Eastern Ontario?
A: That's correct.
Q: And you have been since September 2003?
A: That's also correct....
Q: And I understand that you obtained your M.D. from McMaster University in 1980?
A: Correct.
Q: You then received -- is it the F.R.C.P.C. in emergency medicine? Perhaps you could just tell us what that is?
A: It's a higher degree in medicine conferred by the Royal College of Physicians and Surgeons of Canada in the specialty of emergency medicine.
Q: And you received that in 1987?
A: Correct.
Q: I understand that you also in 1988 received the diploma of the American Board of Emergency Medicine?
A: Yes.
Q: Since July of 2000 you have been an associate professor with the Department of Medicine at McMaster University?
A: Yes.
Q: And since October 2003, you have also been an associate professor, Department of Emergency Medicine at Queen's University?
A: Correct.
Q: You are a member of a number of professional organizations including the Royal College of Physicians and Surgeons of Canada?
A: Yes.
Q: The American Academy of Forensic Sciences?
A: That's correct.
Q: -- and the Canadian Association of Emergency Physicians and you have held the science -- scientific Co-Chair of that organization since 2002?
A: Actually, that was a -- that was a self-limited appointment for a conference that was -- that I assisted in organizing.
Q: Thank you. From July 2001 to August 2003 you were Chief of Staff at Hamilton Health Sciences Corporation?
A: Yes.
Q: From 1998 to July 2001 you were the Chief of Emergency Medicine at Hamilton Health Sciences Corporation?
A: That's correct
Q: And the Medical Director of the Emergency Program at that organization?
A: That's correct
Q: You were also the Vice-Chair of the Medical Advisory Committee of the Hamilton Health Sciences Corporation?
A: Yes.
Q: From December 2000 to January 2002, you were the Regional Medical Liaison?
A: That's correct.
Q: And from November 2000 to the present you have been a coroner for the Province of Ontario, Ministry of the Solicitor General.
A: That's right.
Q: As well, over the course of your career you have been a consultant in varying capacities with respect to emergency medical services?
A: That's correct.
Q: That includes, for example, having been the Consultant to the Minister of Health in the state of Kerala, India in association with their med and -- sorry, in -- in connection with designing an emergency medical services system for that state?
A: That's right.
Q: In February of 2000 you were a consultant in Mount Sinai Hospital in their utilization of ambulance diversion?
A: Yes.
Q: In February of 2001 you were a consultant to the University Health Network to provide an external review of their Emergency Department?
A: That's correct.
Q: And to provide a review of the University Health Network's emergency services?
A: That's right.
Q: You have conducted numerous reviews of care -- medical care -- conducted for the Chief Coroner for Ontario in -- in various Emergency
Departments?
A: That's right.
Q: From 1993 to 1998 you were the Director for the Department of Emergency Services for Sunnybrook Health -- Health Science Centre?
A: Yes.
Q: You were also a Medical Director for the Advanced Cardiac Life Support Instructional Program at Sunnybrook?
A: That's correct.
Q: Prior to that from 1990 to '93 you were the Chief of Emergency Medicine for St. Joseph's Community Health Centre in Hamilton?
A: That's right.
Q: And prior to that, an emergency physician at St. Joseph's Hospital?
A: Yes.
Q: And before that, an emergency physician for the Toronto General Hospital?
A: That's right.
Q: You've also received various honours from your colleagues from time to time -
A: Yes.
Q: -- as listed at page 6 of your curriculum vitae?
A: That's -- that's correct.
Q: You've also held and been engaged in many professional development activities outlined at pages 7 to 8 of your curriculum vitae, including the Chair of the Board of Examiners in Emergency Medicine of the Royal College of Physicians and Surgeons of Canada from 1994 to 1996?
A: That's right.
Q: A member of the Board of Examiners in Emergency Medicine of the Royal College of Physicians and Surgeons of Canada from 1989 to 1984 -- to '94?
A: Yes.
Q: And a member of the Specialty Committee in Emergency Medicine for the Royal College of Physicians and Surgeons in Canada from 2001 to the present?
A: Actually, that terminated in 2003; that's -- that's -- yes.
Q: Thank you -- thank you very much. As well, you have been a member from time to time of various university committees?
A: Yes.
Q: That's listed at page 8 of your Curriculum vitae and that would include from 1990 to 1993 being a member of the Emergency Medicine Post Graduate Education Committee for McMaster University?
A: That's right.
Q: And as well, you've been on a number of hospital committees listed at pages 8 through 10 of your curriculum vitae including from 2001 to 2003 the Chair of the Medical Advisory Committee for Hamilton Health Services?
A: That's correct
Q: From 1993 to 1998 you were a member of the Trauma Physician Management Group for Sunnybrook?
A: Yes.
Q: And from 1988 to 1993 you were a member of the Acute Care Committee for St. Joseph's Hospital in Hamilton?
A: Also correct
Q: You are also the recipient of research awards, which are -- are listed at page 10 of your curriculum vitae?
A: Yes.
Q: And you are the author or a co-author of a number of peer reviewed publications listed at pages 10 to 11 of your curriculum vitae?
A: Yes.
Q: That would include, for example, the author of -- of a article in the Canadian Association of Emergency Physicians Review entitled "Negative Diagnostic Lavage in Blunt Abdominal Trauma"?
A: Yes.
Q: And in 19 -- the 1991 Canadian Medical Association Journal, co-author of a comment called "A Survey of resuscitation Training in Canadian Undergraduate Medical Programs"?
A: That's correct.
Q: As well in 1996, you were co-author of an article entitled "Pre Hospital Interventions:
Critical Resuscitation's Number 1"?
A: That's correct.
Q: And also the author of a -- editor of a non-peer reviewed document entitled: "The Road to Survival: A Review and Recommendations for Enhancement of Emergency Medical Services System in the State of Kerala, India"?
A: Correct.
MS. SUSAN VELLA: Commissioner, I would like to at this time, tender Dr. McCallum as an expert in emergency medicine, including emergency procedures and pre-hospital and in-hospital assessment and treatment of
penetrating trauma to the torso.
COMMISSIONER SIDNEY LINDEN: Does anybody have any comment or question? That's fine.
MS. SUSAN VELLA: Thank you."
A government release indicates that Dr. McCallum's appointment is effective June 4, 2008 - and that it followed "an extensive international search."
Dr. McCallum appears to have remained free from the cliques that governed the Chief Coroner's Office throughout the Charles Smith years.
To this Blogster, Dr. McCallum's commitment to emergency medicine work over several decades should serve him well as he sets out to restore confidence in the Chief Coroner's Office and turn things around in the post-Goudge era;
He has had to work closely with patients and their families at times of great stress and consequence - and must surely understand the devastating pressures on families that lose their children.
He is a worthy successor to Dr. Barry McLellan who played such a huge role in fearlessly coming to grips with the harm caused by Dr. Charles Smith - no matter were the chips fell.
This Blog wishes him well.
Harold Levy...hlevy15@gmail.com;
Wednesday, June 11, 2008
Doctor Charles Smith Seen As Part Of A Larger Pathology And Medicare Crisis In Canada In Globe And Mail History: "Much More Than Mere Incidents";
"IN ONTARIO, A PEDIATRIC FORENSIC PATHOLOGIST - SOMEONE WHO TRIES TO DETERMINE THE CAUSE OF DEATH IN CHILDREN - MADE CHRONIC ERRORS DURING THE 13 YEARS HE HEADED UP THE DEPARTMENT FOR THE ONTARIO CHIEF CORONER'S OFFICE."
-------------------------------------------------------------------------------
"CANADIANS HAVE BEEN, BY AND LARGE, WILLING CAPTIVES OF THE PUBLICLY FUNDED MONOPOLY OVER NECESSARY HEALTH CARE.
BUT IF THOSE CAPTIVE CONSUMERS ARE TREATED SO CAVALIERLY, IN A SYSTEM THAT SEEMS NOT TO CARE ABOUT HIGH STANDARDS, THEY WILL GO SOUTH, OR INSIST ON CHOICE AT HOME.
THE CRISIS IN PATHOLOGY IS A WARNING SIGN THAT CANADIAN MEDICARE SHOULD NOT IGNORE.
GLOBE AND MAIL EDITORIAL: JUNE 9, 2008;"
-------------------------------------------------------------------------------
In recent posts, this Blog has made the sorry point that Canada is currently suffering not only a crisis in pathology - but a crisis in our medicare system.
This point is echoed in an editorial published the the Globe and Mail on June 9, 2008, under the heading, "Much more than mere incidents."
"When the president of the Canadian Association of Pathologists raises the alarm about the quality of medical testing in Canada, it's time to worry," the editorial begins.
"Major errors by pathologists in four provinces, some of which continued for more than a decade before being identified, have "occupied the minds of Canadian pathologists for months and eroded public confidence," write Jagdish Butany, the association's president and a University of Toronto professor, and Kathy Chorneyko, an Ontario pathologist, in an editorial in the Canadian Medical Association Journal," it continues.
But even these two authors don't appreciate the potential scale of the disaster.
"Canadian laboratories deliver high-quality pathology results," they say, "and it would be incorrect to generalize from specific incidents to the overall state of pathology in the country."
Specific incidents?
This is an avalanche of incidents.
Canadians would have to be asleep not to feel deep anxiety.
After all, as Sir William Osler said - as quoted by Drs. Butany and Chorneyko - "As is your pathology, so is your medicine."
Canadian pathology is ill, and so, it appears, is Canadian medicine.
The "specific incidents" cut a wide swath.
In Newfoundland and Labrador, crucial laboratory tests on more than 300 breast-cancer patients were misread by the Eastern Health Authority, the province's biggest lab, between 1997 and 2005.
In New Brunswick, a pathologist was found to have an error rate of 6 per cent, which is six times higher than normal, in reading laboratory slides; an Ottawa lab is now reviewing 24,000 of that pathologist's cases from 1995 to 2007.
In Ontario, a pediatric forensic pathologist - someone who tries to determine the cause of death in children - made chronic errors during the 13 years he headed up the department for the Ontario Chief Coroner's Office.
The result was that up to 20 people were charged or convicted of major crimes such as murder that they did not commit.
Also in Ontario, an Owen Sound hospital is probing a pathologist's high error rate.
In Manitoba, a review of cancer tests found errors in 20 per cent of a senior pathologist's cases; seven hundred cases from the past year are under review.
No wonder public confidence is at risk.
The public has every right to wonder how accurate tests are, and not just at the labs with known problems.
The two doctors prescribe a variety of treatments, from the creation of a national quality-assurance system to more money for labs to hire more pathologists and do regular audits of their work and tests of their competency.
But they don't ask a crucial question: Where is the commitment to quality in the system?
Does no one in institutions have the job of doggedly insisting on a high standard of medical professionalism?
Where is the institutional will to be excellent, or even accurate?
As judicial inquiries in Newfoundland and Labrador and Ontario have shown, warning signs were ignored, followed inevitably by excuses.
The excuses threaten to aggravate the damage already done.
Canadians have been, by and large, willing captives of the publicly funded monopoly over necessary health care.
But if those captive consumers are treated so cavalierly, in a system that seems not to care about high standards, they will go south, or insist on choice at home.
The crisis in pathology is a warning sign that Canadian medicare should not ignore.
Harold Levy...hlevy15@gmail.com
-------------------------------------------------------------------------------
"CANADIANS HAVE BEEN, BY AND LARGE, WILLING CAPTIVES OF THE PUBLICLY FUNDED MONOPOLY OVER NECESSARY HEALTH CARE.
BUT IF THOSE CAPTIVE CONSUMERS ARE TREATED SO CAVALIERLY, IN A SYSTEM THAT SEEMS NOT TO CARE ABOUT HIGH STANDARDS, THEY WILL GO SOUTH, OR INSIST ON CHOICE AT HOME.
THE CRISIS IN PATHOLOGY IS A WARNING SIGN THAT CANADIAN MEDICARE SHOULD NOT IGNORE.
GLOBE AND MAIL EDITORIAL: JUNE 9, 2008;"
-------------------------------------------------------------------------------
In recent posts, this Blog has made the sorry point that Canada is currently suffering not only a crisis in pathology - but a crisis in our medicare system.
This point is echoed in an editorial published the the Globe and Mail on June 9, 2008, under the heading, "Much more than mere incidents."
"When the president of the Canadian Association of Pathologists raises the alarm about the quality of medical testing in Canada, it's time to worry," the editorial begins.
"Major errors by pathologists in four provinces, some of which continued for more than a decade before being identified, have "occupied the minds of Canadian pathologists for months and eroded public confidence," write Jagdish Butany, the association's president and a University of Toronto professor, and Kathy Chorneyko, an Ontario pathologist, in an editorial in the Canadian Medical Association Journal," it continues.
But even these two authors don't appreciate the potential scale of the disaster.
"Canadian laboratories deliver high-quality pathology results," they say, "and it would be incorrect to generalize from specific incidents to the overall state of pathology in the country."
Specific incidents?
This is an avalanche of incidents.
Canadians would have to be asleep not to feel deep anxiety.
After all, as Sir William Osler said - as quoted by Drs. Butany and Chorneyko - "As is your pathology, so is your medicine."
Canadian pathology is ill, and so, it appears, is Canadian medicine.
The "specific incidents" cut a wide swath.
In Newfoundland and Labrador, crucial laboratory tests on more than 300 breast-cancer patients were misread by the Eastern Health Authority, the province's biggest lab, between 1997 and 2005.
In New Brunswick, a pathologist was found to have an error rate of 6 per cent, which is six times higher than normal, in reading laboratory slides; an Ottawa lab is now reviewing 24,000 of that pathologist's cases from 1995 to 2007.
In Ontario, a pediatric forensic pathologist - someone who tries to determine the cause of death in children - made chronic errors during the 13 years he headed up the department for the Ontario Chief Coroner's Office.
The result was that up to 20 people were charged or convicted of major crimes such as murder that they did not commit.
Also in Ontario, an Owen Sound hospital is probing a pathologist's high error rate.
In Manitoba, a review of cancer tests found errors in 20 per cent of a senior pathologist's cases; seven hundred cases from the past year are under review.
No wonder public confidence is at risk.
The public has every right to wonder how accurate tests are, and not just at the labs with known problems.
The two doctors prescribe a variety of treatments, from the creation of a national quality-assurance system to more money for labs to hire more pathologists and do regular audits of their work and tests of their competency.
But they don't ask a crucial question: Where is the commitment to quality in the system?
Does no one in institutions have the job of doggedly insisting on a high standard of medical professionalism?
Where is the institutional will to be excellent, or even accurate?
As judicial inquiries in Newfoundland and Labrador and Ontario have shown, warning signs were ignored, followed inevitably by excuses.
The excuses threaten to aggravate the damage already done.
Canadians have been, by and large, willing captives of the publicly funded monopoly over necessary health care.
But if those captive consumers are treated so cavalierly, in a system that seems not to care about high standards, they will go south, or insist on choice at home.
The crisis in pathology is a warning sign that Canadian medicare should not ignore.
Harold Levy...hlevy15@gmail.com
Tuesday, June 10, 2008
Critique Of Le Fanu Article "Why Have Women Been Wrongly Convicted Of Killing Their Children?" - By Dr. Michael Fitzpatrick;
"EMPHASISING THE DECISIVE ROLE OF PROFESSOR MEADOW AND HIS COLLEAGUES IN THE PROSECUTION OF PARENTS, DR LE FANU ARGUES THAT 'THEIR PERSUASIVE EXPERT OPINION, WHEN EXPRESSED IN COURT, WAS GUARANTEED A SYMPATHETIC HEARING, WHILE THEIR CONFIDENCE IN THE SYNDROMES THEY HAD DISCOVERED WAS VIRTUALLY UNCHALLENGEABLE'. NO DOUBT DR LE FANU IS RIGHT TO NOTE THE DOGMATIC ATTACHMENT OF THE CHILD ABUSE EXPERTS TO THEIR OWN THEORIES, A FEATURE FORCEFULLY EXPOSED IN THE CASE OF DR SOUTHALL. YET THIS DOES NOT EXPLAIN WHY THEY WERE GUARANTEED A SYMPATHETIC HEARING IN COURT, NOR WHY THEIR EVIDENCE WAS CONSIDERED SO CONVINCING.
IT IS IMPORTANT TO RECALL THAT THESE PARENTS WERE NOT CONVICTED BY PROFESSOR MEADOW AND DR SOUTHALL, BUT BY A JUDICIAL PROCESS OF WHICH THEIR EXPERT EVIDENCE WAS BUT A SMALL PART. JUDGES ARE NOT KNOWN FOR THEIR DEFERENCE TOWARDS EXPERT WITNESSES AND ARE OFTEN READY AND WILLING TO DISMISS SUCH EVIDENCE OR TO DRAW ATTENTION TO ITS LIMITATIONS. JURIES, TOO, ARE CAPABLE OF COMING TO THEIR OWN CONCLUSIONS ON THE VALUE OF EXPERT TESTIMONY. THE DISTINCTIVE FEATURE OF RECENT CHILD ABUSE PROSECUTIONS HAS BEEN THE EXTENT TO WHICH THE ABUSE OBSESSION HAS ALSO INFLUENCED THE JUDICIAL PROCESS. AS A RESULT, COURTS ARE, LIKE PROFESSIONALS IN THE FIELD OF CHILD PROTECTION, PREDISPOSED TO ACCEPT THE VIEW THAT ABUSIVE RELATIONSHIPS BETWEEN PARENTS AND CHILDREN ARE MUCH MORE WIDESPREAD THAN WAS PREVIOUSLY BELIEVED."
DR. MICHAEL FITZPATRICK; CRITIQUE OF LE FANU ARTICLE;
--------------------------------------------------------------------------------
Although I disagreed with many of the points made by Dr. Michael Fitzpatrick in his critique, I found it well worth reading because it attempted to place Sir Roy Meadow - and people like him such as Dr. Charles Smith and David Southall - in a larger social context.
(I will set out my own views in a future post);
Dr Fitzpatrick, is the author of "The Tyranny of Health: Doctors and the Regulation of Lifestyle," Published by Routledge, in 2000;
Fitzpatrick argues that "Sir Roy Meadow is not single-handedly responsible for a culture that sees child abuse everywhere."
"This is a response to Dr James Le Fanu's piece, Expert witnesses, suspect science and dead babies," Fitzpatrick begins;
"Retired paediatrician Roy Meadow is currently facing charges of gross professional misconduct before the General Medical Council in connection with his evidence against a number of parents wrongfully convicted of killing their children," he continues;
"Over the past two decades he has helped to popularise the view that children are being abused and even killed by their parents much more commonly than was previously believed. But he did not single-handedly create the obsession with abuse that led to these unjust convictions. Nor are these parents the only victims of a climate of opinion that is predisposed to believe the worst about how people behave in intimate relationships.
According to Dr James Le Fanu, 'the medical advocacy of contentious theories of the mechanisms of child abuse is likely to have been responsible for a systematic miscarriage of justice on a scale without precedent in British legal history - with devastating consequences for the parents wrongly convicted'. Though the scale of these injustices remains unclear - in only a handful of cases has a guilty verdict so far been overturned - the consequences of such wrongful convictions are undoubtedly devastating.
Dr Le Fanu traces the origins of the current situation back to the 1980s, when Professor Meadow (and Dr David Southall, the subject of earlier disciplinary proceedings at the GMC) described 'two covert forms of child abuse' - factitious illness (which Meadow labeled Munchausen's Syndrome by Proxy) and smothering (famously exposed by Southall through covert video surveillance).
Individual doctors, no matter how brilliant and charismatic, do not have the power to transform the culture of society in relation to a matter as important as the ill-treatment of children by their parents. A closer look at the new outlook on children that emerged in British society in the 1980s reveals that when Professor Meadow and his colleagues suggested that there was 'a hidden epidemic of child abuse' there was widespread acceptance of this view, among medical - and legal - professionals, the media and the general public.
Children of the risk society;
According to one commentator, the distinctive feature of British society in the 1980s was the 'normalisation of the experience of abuse'. Diverse forces - social fragmentation, political disengagement and ideological exhaustion - combined to create an unprecedented consciousness of risk. In the 'risk society', insecure individuals felt themselves to be under threat, not only from environmental dangers, but also from other people. Risks were identified in the public realm - from criminal and anti-social behaviour in the streets and from bullying and harassment in the workplace. Intimate personal relationships, whether romantic, sexual or familial, were also increasingly regarded as being fraught with danger. The concept of risk was most consistently used in relation to the dangers confronting vulnerable children from adults, in both the private and the public realms.
Whereas the family had once been regarded as a refuge for adults from the cares of the world and a safe haven for children, it now came to be regarded a hidden realm in which abusive relationships thrived. The long-standing feminist focus on domestic violence expanded and diversified, taking in 'recovered memories' of childhood abuse as well as emotional and psychological ill-treatment. In the past, paediatricians had recognised occasional cases of 'battered babies' and 'non-accidental injury'. Now they encountered an epidemic of children suffering a wide range of forms of abuse; rare cases of incest were replaced by relatively common allegations of 'child sexual abuse'. Elder abuse was added to the list of crimes committed furtively behind the net curtains. This obsession with abuse was promoted by therapeutic entrepreneurs in the medical and social work professions and by voluntary organisations in the spheres of domestic violence and child care.
This misanthropic outlook on intimate relationships was not foisted on a sceptical public. Its promoters appeared to find a responsive audience in an increasingly atomised and individuated society. The media also played their part. Themes of child abuse, sexual violence, paedophilia, stalking and serial sex crime became staples of novels, newspaper reports, television features, dramas and soaps (ChildLine was a spin off from Esther Rantzen's late 80s BBC TV show, That's Life). In this climate of opinion, Professor Meadow's theories were guaranteed a popular reception - and it was not surprising that he rapidly came to enjoy celebrity status in the burgeoning world of child protection.
The event that dramatically revealed the ascendancy of the abuse obsession in Britain (while also imposing some limits on it) was the Cleveland child sexual abuse scandal of 1987. In the course of a few months, more than 120 children were removed from their homes in this industrial town in the northeast and taken into local authority care, following allegations that they had been sexually abused, usually by their fathers.
The initiative for this coercive intrusion into family life came from social workers and doctors influenced by radical feminism - in defiance of the local police. A media campaign scapegoated the leading social workers and doctors, who faced a barrage of personal hostility. Though the subsequent inquiry conducted by Lord Justice Butler Sloss criticised the key professionals for their 'certainty and over-confidence', it generally endorsed professional intervention in cases where there were reasonable grounds to suspect abuse.
Miscarriages of justice;
Despite the backlash against the leading figures in the Cleveland case, the bleak presumption underlying their activities - that sexual degradation was a virtually universal feature of family life - and their conviction that coercive state intervention was necessary to deal with it became increasingly influential. Over the next decade these views were influential in a number of cases in which parents and care workers were accused of particularly gross forms of child abuse, generally with a sexual dimension. Whereas the police had been reluctant to play a leading role in the Cleveland cases, they now threw major resources into the pursuit and prosecution of alleged child abusers. The result was a series of grotesque injustices.
....Shieldfield Nursery In 1998 former nursery workers Dawn Read and Christopher Lillie won a libel action against Newcastle council and others who had continued to accuse them of child abuse after they were acquitted in 1994 of charges of serial sexual molestation of children in their care (3). It emerged that these charges were largely the result of suggestive interview techniques used by child protection professionals. Read and Lillie lost their jobs and were obliged to go into hiding to escape the retribution of a mob whipped up by prejudicial media reports. (Paediatrician Camille San Lazaro, whose damning evidence against the nursery workers was described by the judge as 'unbalanced, obsessive and lacking in judgement', was recently exonerated by the GMC.) (4)
....Welsh Children's Homes In March 1992, 40 police officers in Wrexham arrested 16 men and one woman, all but one of whom had formerly worked at Bryn Estyn, a local care home for adolescent boys, which had been closed down in 1984 (5). This home was said to have been a centre for the homosexual abuse of adolescent boys by a paedophile ring, whose members had terrorised their victims and subjected them to a regime of violence and brutality. The ensuing investigation, after trawling former residents of care homes for retrospective claims of abuse, led to allegations against hundreds of care workers in children's homes across north Wales, many of which were revealed to have been of dubious reliability.
....Satanic Abuse rings In a series of cases in the late 1980s and early 1990s, groups of parents were arrested and children taken into care following allegations of ritual sexual abuse by parents involved in paedophile rings (6). Subsequent investigations in Nottingham, Pembroke, Rochdale and the Orkneys failed to confirm any of these allegations, and in 1994 a three-year investigation funded by the UK Department of Health and headed by Professor Jean La Fontaine concluded that there was no evidence that Satanic ritual abuse had taken place anywhere in the UK. Yet children have been traumatised, families disrupted and parents stigmatised in the course of these late twentieth-century witch-hunts.
The scapegoating of Roy Meadow;
It is true, as Dr Le Fanu points out, that many of the features held by Professor Meadow to be diagnostic of different forms of child abuse are contentious and lacking in specificity. (The sign of 'reflex anal dilatation', which the Cleveland inquisitors regarded as diagnostic of anal penetration, is even more unreliable - though Dr Le Fanu has never objected to this.)
It is also the case that many of the alternative explanations of sudden infant death advanced by campaigners against Professor Meadow are at best speculative (such as the genetic mechanisms suggested by Dr Le Fanu). When campaigners suggest organophosphate poisoning or vaccinations, or hypothetical syndromes such as 'temporary brittle bone disease', to explain sudden infant deaths, they enter the realm of junk science. However, Dr Le Fanu is right to insist that parents should not be convicted only on the basis of contentious medical diagnoses, where the causal mechanism between putative assault and subsequent injury remains obscure, in the absence of wider circumstantial evidence.
Emphasising the decisive role of Professor Meadow and his colleagues in the prosecution of parents, Dr Le Fanu argues that 'their persuasive expert opinion, when expressed in court, was guaranteed a sympathetic hearing, while their confidence in the syndromes they had discovered was virtually unchallengeable'. No doubt Dr Le Fanu is right to note the dogmatic attachment of the child abuse experts to their own theories, a feature forcefully exposed in the case of Dr Southall. Yet this does not explain why they were guaranteed a sympathetic hearing in court, nor why their evidence was considered so convincing.
It is important to recall that these parents were not convicted by Professor Meadow and Dr Southall, but by a judicial process of which their expert evidence was but a small part. Judges are not known for their deference towards expert witnesses and are often ready and willing to dismiss such evidence or to draw attention to its limitations. Juries, too, are capable of coming to their own conclusions on the value of expert testimony. The distinctive feature of recent child abuse prosecutions has been the extent to which the abuse obsession has also influenced the judicial process. As a result, courts are, like professionals in the field of child protection, predisposed to accept the view that abusive relationships between parents and children are much more widespread than was previously believed.
As prominent figures in both the medical and legal worlds, Professor Meadow and his colleagues became beneficiaries of the abuse obsession they helped to promote. Now they have become victims of the backlash against it. Both Professor Meadow and Dr Southall have become the targets of a vituperative campaign, involving supporters of accused parents and a number of journalists - who do not seem to have been similarly outraged by the events in Cleveland and the other scandals listed above.
The distinctive feature of the recent cases overturned in the courts is that, unlike the earlier cases, they often involved middle-class families. According to Dr Le Fanu such parents are quite different from typical child abusers, who are 'psychopaths, criminals, opioid abusers, alcoholics, and so on' (the 'and so on' clause appears to invite the addition of further categories of people 'not like us'). In fact, the most recent reference provided by Dr Le Fanu for this abuser profile does not support his interpretation: parents who kill their children are often suffering from mental illness (depression or psychosis) and, though some abuse drugs or alcohol, they often do not have a previous record of child abuse (7). The record suggests that, just as miscarriages of justice can occur in the most respectable families, so also can (genuine) cases of child abuse (even homicide).
While the false conviction of parents on charges of killing their children seems likely to have been a rare occurrence, the prevailing cultural obsession with abuse that proved decisive in securing these convictions has had much wider consequences. It has not only contributed to the series of miscarriages of justice outlined above, but has fostered a widespread belief that all forms of abuse of children are commonplace. Serious child abuse is a terrible thing, but the fact is that it remains a rare occurrence.
The proliferation of codes of conduct and protocols governing all interactions between adults and children reflects prevailing anxieties on this subject and the institutionalisation of distrust between parents and professionals. Parents have become fearful about bringing their children to doctors' surgeries or hospital accident and emergency departments lest their symptoms be interpreted as manifestations of abuse. Many adults have become reluctant to engage in any form of social activity with children - such as sports coaching, music or drama - because of the inevitable suspicion aroused by their involvement. Whatever the outcome of Professor Meadow's appearance before the GMC, the narrow focus on his personal role means that the wider abuse obsession remains unchallenged."
Harold Levy...hlevy@gmail.com;
IT IS IMPORTANT TO RECALL THAT THESE PARENTS WERE NOT CONVICTED BY PROFESSOR MEADOW AND DR SOUTHALL, BUT BY A JUDICIAL PROCESS OF WHICH THEIR EXPERT EVIDENCE WAS BUT A SMALL PART. JUDGES ARE NOT KNOWN FOR THEIR DEFERENCE TOWARDS EXPERT WITNESSES AND ARE OFTEN READY AND WILLING TO DISMISS SUCH EVIDENCE OR TO DRAW ATTENTION TO ITS LIMITATIONS. JURIES, TOO, ARE CAPABLE OF COMING TO THEIR OWN CONCLUSIONS ON THE VALUE OF EXPERT TESTIMONY. THE DISTINCTIVE FEATURE OF RECENT CHILD ABUSE PROSECUTIONS HAS BEEN THE EXTENT TO WHICH THE ABUSE OBSESSION HAS ALSO INFLUENCED THE JUDICIAL PROCESS. AS A RESULT, COURTS ARE, LIKE PROFESSIONALS IN THE FIELD OF CHILD PROTECTION, PREDISPOSED TO ACCEPT THE VIEW THAT ABUSIVE RELATIONSHIPS BETWEEN PARENTS AND CHILDREN ARE MUCH MORE WIDESPREAD THAN WAS PREVIOUSLY BELIEVED."
DR. MICHAEL FITZPATRICK; CRITIQUE OF LE FANU ARTICLE;
--------------------------------------------------------------------------------
Although I disagreed with many of the points made by Dr. Michael Fitzpatrick in his critique, I found it well worth reading because it attempted to place Sir Roy Meadow - and people like him such as Dr. Charles Smith and David Southall - in a larger social context.
(I will set out my own views in a future post);
Dr Fitzpatrick, is the author of "The Tyranny of Health: Doctors and the Regulation of Lifestyle," Published by Routledge, in 2000;
Fitzpatrick argues that "Sir Roy Meadow is not single-handedly responsible for a culture that sees child abuse everywhere."
"This is a response to Dr James Le Fanu's piece, Expert witnesses, suspect science and dead babies," Fitzpatrick begins;
"Retired paediatrician Roy Meadow is currently facing charges of gross professional misconduct before the General Medical Council in connection with his evidence against a number of parents wrongfully convicted of killing their children," he continues;
"Over the past two decades he has helped to popularise the view that children are being abused and even killed by their parents much more commonly than was previously believed. But he did not single-handedly create the obsession with abuse that led to these unjust convictions. Nor are these parents the only victims of a climate of opinion that is predisposed to believe the worst about how people behave in intimate relationships.
According to Dr James Le Fanu, 'the medical advocacy of contentious theories of the mechanisms of child abuse is likely to have been responsible for a systematic miscarriage of justice on a scale without precedent in British legal history - with devastating consequences for the parents wrongly convicted'. Though the scale of these injustices remains unclear - in only a handful of cases has a guilty verdict so far been overturned - the consequences of such wrongful convictions are undoubtedly devastating.
Dr Le Fanu traces the origins of the current situation back to the 1980s, when Professor Meadow (and Dr David Southall, the subject of earlier disciplinary proceedings at the GMC) described 'two covert forms of child abuse' - factitious illness (which Meadow labeled Munchausen's Syndrome by Proxy) and smothering (famously exposed by Southall through covert video surveillance).
Individual doctors, no matter how brilliant and charismatic, do not have the power to transform the culture of society in relation to a matter as important as the ill-treatment of children by their parents. A closer look at the new outlook on children that emerged in British society in the 1980s reveals that when Professor Meadow and his colleagues suggested that there was 'a hidden epidemic of child abuse' there was widespread acceptance of this view, among medical - and legal - professionals, the media and the general public.
Children of the risk society;
According to one commentator, the distinctive feature of British society in the 1980s was the 'normalisation of the experience of abuse'. Diverse forces - social fragmentation, political disengagement and ideological exhaustion - combined to create an unprecedented consciousness of risk. In the 'risk society', insecure individuals felt themselves to be under threat, not only from environmental dangers, but also from other people. Risks were identified in the public realm - from criminal and anti-social behaviour in the streets and from bullying and harassment in the workplace. Intimate personal relationships, whether romantic, sexual or familial, were also increasingly regarded as being fraught with danger. The concept of risk was most consistently used in relation to the dangers confronting vulnerable children from adults, in both the private and the public realms.
Whereas the family had once been regarded as a refuge for adults from the cares of the world and a safe haven for children, it now came to be regarded a hidden realm in which abusive relationships thrived. The long-standing feminist focus on domestic violence expanded and diversified, taking in 'recovered memories' of childhood abuse as well as emotional and psychological ill-treatment. In the past, paediatricians had recognised occasional cases of 'battered babies' and 'non-accidental injury'. Now they encountered an epidemic of children suffering a wide range of forms of abuse; rare cases of incest were replaced by relatively common allegations of 'child sexual abuse'. Elder abuse was added to the list of crimes committed furtively behind the net curtains. This obsession with abuse was promoted by therapeutic entrepreneurs in the medical and social work professions and by voluntary organisations in the spheres of domestic violence and child care.
This misanthropic outlook on intimate relationships was not foisted on a sceptical public. Its promoters appeared to find a responsive audience in an increasingly atomised and individuated society. The media also played their part. Themes of child abuse, sexual violence, paedophilia, stalking and serial sex crime became staples of novels, newspaper reports, television features, dramas and soaps (ChildLine was a spin off from Esther Rantzen's late 80s BBC TV show, That's Life). In this climate of opinion, Professor Meadow's theories were guaranteed a popular reception - and it was not surprising that he rapidly came to enjoy celebrity status in the burgeoning world of child protection.
The event that dramatically revealed the ascendancy of the abuse obsession in Britain (while also imposing some limits on it) was the Cleveland child sexual abuse scandal of 1987. In the course of a few months, more than 120 children were removed from their homes in this industrial town in the northeast and taken into local authority care, following allegations that they had been sexually abused, usually by their fathers.
The initiative for this coercive intrusion into family life came from social workers and doctors influenced by radical feminism - in defiance of the local police. A media campaign scapegoated the leading social workers and doctors, who faced a barrage of personal hostility. Though the subsequent inquiry conducted by Lord Justice Butler Sloss criticised the key professionals for their 'certainty and over-confidence', it generally endorsed professional intervention in cases where there were reasonable grounds to suspect abuse.
Miscarriages of justice;
Despite the backlash against the leading figures in the Cleveland case, the bleak presumption underlying their activities - that sexual degradation was a virtually universal feature of family life - and their conviction that coercive state intervention was necessary to deal with it became increasingly influential. Over the next decade these views were influential in a number of cases in which parents and care workers were accused of particularly gross forms of child abuse, generally with a sexual dimension. Whereas the police had been reluctant to play a leading role in the Cleveland cases, they now threw major resources into the pursuit and prosecution of alleged child abusers. The result was a series of grotesque injustices.
....Shieldfield Nursery In 1998 former nursery workers Dawn Read and Christopher Lillie won a libel action against Newcastle council and others who had continued to accuse them of child abuse after they were acquitted in 1994 of charges of serial sexual molestation of children in their care (3). It emerged that these charges were largely the result of suggestive interview techniques used by child protection professionals. Read and Lillie lost their jobs and were obliged to go into hiding to escape the retribution of a mob whipped up by prejudicial media reports. (Paediatrician Camille San Lazaro, whose damning evidence against the nursery workers was described by the judge as 'unbalanced, obsessive and lacking in judgement', was recently exonerated by the GMC.) (4)
....Welsh Children's Homes In March 1992, 40 police officers in Wrexham arrested 16 men and one woman, all but one of whom had formerly worked at Bryn Estyn, a local care home for adolescent boys, which had been closed down in 1984 (5). This home was said to have been a centre for the homosexual abuse of adolescent boys by a paedophile ring, whose members had terrorised their victims and subjected them to a regime of violence and brutality. The ensuing investigation, after trawling former residents of care homes for retrospective claims of abuse, led to allegations against hundreds of care workers in children's homes across north Wales, many of which were revealed to have been of dubious reliability.
....Satanic Abuse rings In a series of cases in the late 1980s and early 1990s, groups of parents were arrested and children taken into care following allegations of ritual sexual abuse by parents involved in paedophile rings (6). Subsequent investigations in Nottingham, Pembroke, Rochdale and the Orkneys failed to confirm any of these allegations, and in 1994 a three-year investigation funded by the UK Department of Health and headed by Professor Jean La Fontaine concluded that there was no evidence that Satanic ritual abuse had taken place anywhere in the UK. Yet children have been traumatised, families disrupted and parents stigmatised in the course of these late twentieth-century witch-hunts.
The scapegoating of Roy Meadow;
It is true, as Dr Le Fanu points out, that many of the features held by Professor Meadow to be diagnostic of different forms of child abuse are contentious and lacking in specificity. (The sign of 'reflex anal dilatation', which the Cleveland inquisitors regarded as diagnostic of anal penetration, is even more unreliable - though Dr Le Fanu has never objected to this.)
It is also the case that many of the alternative explanations of sudden infant death advanced by campaigners against Professor Meadow are at best speculative (such as the genetic mechanisms suggested by Dr Le Fanu). When campaigners suggest organophosphate poisoning or vaccinations, or hypothetical syndromes such as 'temporary brittle bone disease', to explain sudden infant deaths, they enter the realm of junk science. However, Dr Le Fanu is right to insist that parents should not be convicted only on the basis of contentious medical diagnoses, where the causal mechanism between putative assault and subsequent injury remains obscure, in the absence of wider circumstantial evidence.
Emphasising the decisive role of Professor Meadow and his colleagues in the prosecution of parents, Dr Le Fanu argues that 'their persuasive expert opinion, when expressed in court, was guaranteed a sympathetic hearing, while their confidence in the syndromes they had discovered was virtually unchallengeable'. No doubt Dr Le Fanu is right to note the dogmatic attachment of the child abuse experts to their own theories, a feature forcefully exposed in the case of Dr Southall. Yet this does not explain why they were guaranteed a sympathetic hearing in court, nor why their evidence was considered so convincing.
It is important to recall that these parents were not convicted by Professor Meadow and Dr Southall, but by a judicial process of which their expert evidence was but a small part. Judges are not known for their deference towards expert witnesses and are often ready and willing to dismiss such evidence or to draw attention to its limitations. Juries, too, are capable of coming to their own conclusions on the value of expert testimony. The distinctive feature of recent child abuse prosecutions has been the extent to which the abuse obsession has also influenced the judicial process. As a result, courts are, like professionals in the field of child protection, predisposed to accept the view that abusive relationships between parents and children are much more widespread than was previously believed.
As prominent figures in both the medical and legal worlds, Professor Meadow and his colleagues became beneficiaries of the abuse obsession they helped to promote. Now they have become victims of the backlash against it. Both Professor Meadow and Dr Southall have become the targets of a vituperative campaign, involving supporters of accused parents and a number of journalists - who do not seem to have been similarly outraged by the events in Cleveland and the other scandals listed above.
The distinctive feature of the recent cases overturned in the courts is that, unlike the earlier cases, they often involved middle-class families. According to Dr Le Fanu such parents are quite different from typical child abusers, who are 'psychopaths, criminals, opioid abusers, alcoholics, and so on' (the 'and so on' clause appears to invite the addition of further categories of people 'not like us'). In fact, the most recent reference provided by Dr Le Fanu for this abuser profile does not support his interpretation: parents who kill their children are often suffering from mental illness (depression or psychosis) and, though some abuse drugs or alcohol, they often do not have a previous record of child abuse (7). The record suggests that, just as miscarriages of justice can occur in the most respectable families, so also can (genuine) cases of child abuse (even homicide).
While the false conviction of parents on charges of killing their children seems likely to have been a rare occurrence, the prevailing cultural obsession with abuse that proved decisive in securing these convictions has had much wider consequences. It has not only contributed to the series of miscarriages of justice outlined above, but has fostered a widespread belief that all forms of abuse of children are commonplace. Serious child abuse is a terrible thing, but the fact is that it remains a rare occurrence.
The proliferation of codes of conduct and protocols governing all interactions between adults and children reflects prevailing anxieties on this subject and the institutionalisation of distrust between parents and professionals. Parents have become fearful about bringing their children to doctors' surgeries or hospital accident and emergency departments lest their symptoms be interpreted as manifestations of abuse. Many adults have become reluctant to engage in any form of social activity with children - such as sports coaching, music or drama - because of the inevitable suspicion aroused by their involvement. Whatever the outcome of Professor Meadow's appearance before the GMC, the narrow focus on his personal role means that the wider abuse obsession remains unchallenged."
Harold Levy...hlevy@gmail.com;
Monday, June 9, 2008
Extraordinary Article: Dr. James Le Fanu: Why Have Women Been Wrongly Convicted Of Killing Their Children?
My attention was recently drawn to an extraordinary article entitled: "Expert witnesses, suspect science and dead babies: Why have women been wrongly convicted of killing their children?"
The author is Dr. James Le Fanu - a medical columnist for London's Daily and Sunday Telegraph and winner of the Los Angeles Times Book Prize for "The Rise and Fall of Modern Medicine" published by Diane Publishing Company in 2001;
The article was published in a feisty medical publication called "Spiked Health" on June 27, 2005.
As a practicing physician, Le Fanu saw first hand the emergence of the dubious proposition that there might be a hidden epidemic of abusive injury of children emerged in the 1980s with the description by British paediatricians of two covert forms of child abuse - factitious illness and smothering - and its tragic results.
Le Fanu's insightful article is preceded by the following quotes:
'PLEASE, IF THERE IS ANY WAY YOU COULD HELP WITH OUR SITUATION, BY YOURSELF OR ANYONE YOU KNOW, COULD YOU PLEASE GET IN TOUCH. WE CAN HONESTLY SAY, HAND ON HEART, WE HAVEN'T DONE ANYTHING TO HURT OUR BABY. WE ARE NOW BEEN [SIC] ASSESSED AND WE GOT TOLD [SIC] THAT WHEN WE GO TO THE FINDING OF FACTS HEARING AND WE STILL INSIST WE HAVEN'T DONE ANYTHING, OUR TWINS WILL GO UP FOR ADOPTION.';
LETTER FROM PARENT
-------------------------------------------------------------------------------
'FOR ME, THE UNUSUAL FEATURE IS DEATH SO SOON AFTER BEING SEEN WELL, THE FACT THAT THERE HAVE BEEN PREVIOUS DEATHS IN THE FAMILY AND THE FACT THAT HE HAD HAD AN EPISODE OF SOME SORT ONLY NINE DAYS BEFORE HE DIED THAT CAUSED HIM TO BE ASSESSED IN HOSPITAL, BECAUSE THOSE FEATURES ARE ONES THAT ARE FOUND REALLY QUITE COMMONLY IN CHILDREN WHO HAVE BEEN SMOTHERED BY THEIR MOTHERS. SO THE DIAGNOSIS FOR ME, THE CLINICAL DIAGNOSIS, WOULD BE THIS WAS CHARACTERISTIC OF SMOTHERING.';
TESTIMONY OF PROFESSOR SIR ROY MEADOW, R V CANNINGS, MARCH 2002;
-------------------------------------------------------------------------------
THE AUTHORITY OF MEDICINE DERIVES FROM ITS SCIENCE BASE, SO IT WOULD BE REASONABLE TO ASSUME THAT DOCTORS WHEN CALLED ON TO GIVE THEIR EXPERT OPINION IN COURT WOULD HAVE A THOROUGH BALANCED GRASP OF THE RELEVANT SCIENTIFIC EVIDENCE. THE SUCCESSFUL APPEALS OF SALLY CLARK AND ANGELA CANNINGS AGAINST THEIR CONVICTIONS FOR CHILD MURDER WOULD SUGGEST OTHERWISE, AS DOES THE RECENT RULING OF THE ATTORNEY GENERAL THAT A FURTHER 28 CASES OF PARENTS CONVICTED OF SMOTHERING OR SHAKING THEIR CHILDREN ARE 'POTENTIALLY UNSAFE';
NOR CAN THAT BE ALL, FOR THE ATTORNEY GENERAL'S REVIEW WAS RESTRICTED TO THE CRIMINAL COURTS, AND THUS DOES NOT TAKE INTO ACCOUNT THE SEVERAL HUNDRED CASES A YEAR HEARD IN THE FAMILY COURTS WHOSE LESS STRINGENT STANDARDS OF PROOF ('BALANCE OF PROBABILITY' RATHER THAN 'BEYOND REASONABLE DOUBT') WOULD FURTHER INCREASE THE RISK OF UNSAFE CONVICTIONS. THUS THE MEDICAL ADVOCACY OF CONTENTIOUS THEORIES OF THE MECHANISMS OF CHILD ABUSE IS LIKELY TO HAVE BEEN RESPONSIBLE FOR A SYSTEMATIC MISCARRIAGE OF JUSTICE ON A SCALE WITHOUT PRECEDENT IN BRITISH LEGAL HISTORY - WITH DEVASTATING CONSEQUENCES FOR THE PARENTS WRONGLY CONVICTED. HERE I OFFER A 'MASTER THEORY' TO EXPLAIN HOW THIS EXTRAORDINARY SITUATION HAS COME ABOUT.
-------------------------------------------------------------------------------
The article proceeds as follows:
The hidden epidemic of child abuse;
Since Kempe's description of the 'battered-child syndrome' in 1962, paediatricians have become only too familiar with the burns, bruises, fractures and neglect of the child victim of abusive physical assault. The current concerns about the wrongful diagnosis of child abuse, however, centre on a trio of very different clinical situations whose defining characteristic might be described rather as one of uncertainty or ambiguity.
-- Sudden infant death syndrome (SIDS) - SIDS remains much the commonest cause of unexpected death in childhood, whose primary aetiology, despite much research, has proved elusive.
-- Childhood injuries - children are by nature accident-prone but sometimes the severity of their injuries might seem disproportionate to the explanation provided.
-- Medically unexplained symptoms - all doctors have patients whose signs and symptoms are difficult to explain.
Doctors are no different from anyone else in being reluctant to admit they 'do not know'. Why, for example, might SIDS affect two or more children in the same family, or how might a seemingly trivial accident cause an acute intracranial injury? Some might thus be unduly susceptible to the notion that the uncertainties arise not from their lack of knowledge or clinical skills but from parental concealment - that each of these ambiguous clinical situations is potentially a form of hidden or covert abuse inflicted by parents in such a way as to hide their intentions from external scrutiny. Further, these clinically ambiguous situations are not uncommon, which would suggest that child abuse is both more prevalent than is widely appreciated and perpetrated by even the most apparently respectable of parents. Paediatricians clearly have a major responsibility in identifying these concealed forms of abuse if they are to protect children from further injury or death.
The evidence for a hidden epidemic of child abuse;
The proposition that there might be a hidden epidemic of abusive injury of children emerged in the 1980s with the description by British paediatricians of two covert forms of child abuse - factitious illness and smothering. Roy Meadow, in his pioneering paper on Munchausen's syndrome by proxy, described two cases illustrating a phenomenon, familiar now but puzzling at the time, where mothers sought the sympathy of doctors and nursing staff by fabricating the symptoms of a perplexing illness in their child that warranted repeated hospital admissions and investigative procedures. In the first case the mother contaminated her six-year-old daughter's urine specimens to simulate recurrent urinary tract infections, while in the second the mother fed her six-week-old son high doses of salt, causing him to be admitted to hospital several times with 'unexplained' hypernatraemia. Four years later Meadow reported a further series of 19 cases in which 'fraudulent clinical histories and fabricated signs' encompassed the entire spectrum of paediatric illness - bleeding from every orifice, neurological symptoms of drowsiness, seizures and unsteadiness, rashes, glycosuria, fevers and 'biochemical chaos'.
The implications of Munchausen's syndrome by proxy were twofold: it alerted doctors to the possibility of fabricated illness as a potential differential diagnosis in children with unexplained symptoms. But it also demonstrated how the seemingly most devoted of parents might, in reality, be potential child abusers. Meadow himself, commenting on the mothers in the cases he described, observed how they were 'very pleasant to deal with, cooperative and appreciative of good medical care'.
David Southall's innovative technique of covert video surveillance for investigating apnoeic episodes in children vividly confirmed the sinister reality of hidden abuse. Now paediatricians attending meetings and conferences could see for themselves the blurry black and white images of mothers caught in the act of smothering or choking their babies. Southall's study widened the spectrum of child abuse in two significant directions. It offered, in smothering, a plausible explanation for why a child might experience recurrent acute life-threatening events necessitating urgent admission to hospital. And it emphasised, once again, the possibility that some at least of those children whose deaths were labelled as SIDS might have been the victims of smothering. Southall in a further report of 30 children undergoing covert video surveillance identified 12 siblings who had died unexpectedly, eight of whom the parents subsequently confessed to having smothered. Thus parental smothering must be a clear possibility in any child with recurrent acute life-threatening events where there has been more than one unexplained childhood death in the family;
The hidden epidemic revealed;
There could be no doubt following Meadow and Southall's findings that paediatricians must have been missing a substantial number of cases of child abuse and would in future need to be much more alert to the possibility of parental harm where the diagnosis was not clear. Frequently, however, such suspicions could not be confirmed with the sort of direct evidence provided by techniques such as covert video surveillance. So how could doctors be confident that covert abuse was the cause - and convince others to take the necessary steps to protect the child from further danger?
Significantly, there were certain similarities in the signs and symptoms of children with these clinically ambiguous situations and those recorded in well-authenticated forms of abuse such as smothering, poisoning and abusive head injury. Thus it seemed reasonable to infer, by extrapolation, that these presentations were 'characteristic' of covert forms of abuse which could then be confidently diagnosed - even in the absence of any other circumstantial evidence such as bruises, signs of neglect or parental history of violence. During the 1980s the trio of clinically ambiguous situations would become redesignated as 'child abuse syndromes'. A key influence was 'Meadow's rule' regarding SIDS. While the absence of reliable pathological findings made it difficult to distinguish SIDS from smothering, Meadow argued that two or more childhood deaths in the same family, along with a recognisable 'pattern' of events (such as previous acute life-threatening episodes) was strongly suggestive of infanticide: 'two is suspicious and three murder unless proved otherwise...';
Another was the proposal that two specific presentations of childhood injury were 'characteristic' of abusive assault. Caffey's original description of shaken baby syndrome suggested that the whiplash effect of vigorous shaking offered a 'reasonable explanation' for the presence of subdural and retinal haemorrhages in severely abused children. The imagery of how the violent to-and-fro movement of the baby's head could cause bleeding of the vessels of the eye and brain proved very persuasive, and it seemed logical to infer that any child presenting with retinal and subdural haemorrhages must have been shaken - despite the absence of other circumstantial evidence of abuse;
Similarly, Caffey attributed a radiological 'bucket handle' appearance of the metaphyses of the long bones in severely abused children as being due to a 'twisting and wrenching' of the child's limbs by the parents. Subsequently, it was suggested that those children in whom abuse was suspected should have a skeletal survey for similar 'suspicious' metaphyseal lesions that were interpreted as being characteristic of abusive assault - again, despite the absence of clinical signs of fracture or subsequent radiological evidence of healing. A third was a widened case definition for Munchausen's syndrome by proxy. Meadow, in his initial series, had confirmed the diagnosis either by covert surveillance or by confronting the perpetrator and obtaining a confession. In a widened definition the presence of 'diagnostic pointers' was proposed for use in children with medically unexplained symptoms. They included:
-- Parents unusually calm for the severity of illness;
-- Parents unusually knowledgeable about the illness;
-- Parents fitting in contentedly with ward life and attention from staff;
-- Symptoms and signs inconsistent with known pathophysiology;
-- Treatments ineffective or poorly tolerated;
The hidden epidemic confirmed;
These novel child abuse syndromes, taken together, represented a major conceptual breakthrough in paediatrics. The uncertainty of clinically ambiguous situations had given place to the certainty of the single unifying and plausible diagnosis of covert abuse. The scale of the hidden epidemic then turned out to be substantially greater than had been expected, with a fourfold increase in the number of child abuse cases in the 10 years from 1978 to 1988. This was reflected regionally in an increase from 40 to over 200 cases a year in the City of Leeds while, by the end of the decade, an extra 7,500 children every year were being placed on the child protection register on the grounds of physical abuse;
Nonetheless, the facility with which the syndromes could bring to light covert abuse concealed from view their poor evidential basis. The causal link between the putative mechanism of assault and subsequent injury could be neither independently confirmed nor experimentally investigated. It might seem reasonable to extrapolate from the presence of retinal and subdural haemorrhages in the battered child that these features had the same significance in a child with no other circumstantial evidence of injury. Certainly the powerful imagery of violent shearing forces disrupting the blood vessels was persuasive, but shaking has never been directly observed or proven to cause such injuries; the supposition that they do is based on (contested) theories of biomechanics;
Rather, the legitimacy of the syndromes was predicated on two related and highly improbable assumptions, scientific and legal. The scientific assumption was that there could be no other explanation, either known or that might be discovered at some time in the future, that might explain these 'characteristic' presentations. Meadow's 'rule', for example, precluded the possibility that there might be some unknown genetic explanation for multiple unexpected childhood deaths in the same family, while the 'characteristic' pattern of shaken baby syndrome precluded the possibility of some alternative explanation for the retinal and subdural haemorrhages - such as an acute increase in retinal venous pressure from intracranial bleeding caused by accidental head injury. The legal assumption presupposed that these presentations were so specific for abuse that they were by themselves sufficient to secure a conviction - even in the absence of the sort of circumstantial evidence of violence or neglect that would normally be required to return a guilty verdict in a court of law.
Put another way, the 'characteristic' presentations of the syndromes could not sustain the interpretation placed upon them: they might be 'consistent with' but could not, by themselves, be 'diagnostic of' child abuse. Thus some at least of the parents contributing to the statistics of the fourfold rise in child abuse were likely to be innocent. Three additional factors, in particular, bolstered the credibility of the syndromes in the family and criminal courts.
The authority of the child abuse expert;
By the close of the 1980s, the leading experts in child abuse had acquired an international reputation and were thus called on to instruct and educate not just their fellow paediatricians but also the police, lawyers, social workers and judges in the child abuse syndromes. Their persuasive expert opinion, when expressed in court, was guaranteed a sympathetic hearing, while their confidence in the syndromes they had discovered was virtually unchallengeable. Further, they could scarcely accept the force of contrary evidence since to do so would require them to concede that their expert testimonies might, in similar cases, have resulted in wrongful conviction. Meanwhile the costs of the process of investigating allegations arising out of the child abuse syndromes rose to an estimated £1billion per year, with the more prominent experts receiving fees for the preparation of their reports and appearances in court in excess of £100,000 a year;
The circular argument of successful convictions;
The validity of the child abuse syndromes would appear to be confirmed by the high proportion of successful convictions that followed the courts' careful scrutiny of the allegations against parents. These convictions, however, came to rely increasingly on a circular argument - whereby the main evidence for the child abuse syndrome of which the parents were accused was that parents had been convicted of it in the past. Thus parents whose child presents with subdural and retinal haemorrhages are accused of inflicting shaken baby syndrome because, in the vast majority of cases, parents of children with subdural and retinal haemorrhages are convicted of causing shaken baby syndrome. Similarly, Meadow argued that 'the likelihood that the court verdicts about parental responsibility for [causing their children's death] were correct was very high indeed', without making clear that it was his expert testimony that repetitive SIDS was 'murder unless proved otherwise' that had been a major factor in securing those convictions;
There is a further element of circularity in the presumed pathogenesis of the syndrome of which the parents are accused. The theory of shaken baby syndrome presupposes that violent, abusive force (comparable, it is claimed, to that sustained in a high-speed road traffic accident or a fall from a second storey window) is necessary to cause retinal and subdural haemorrhages. The parents are then caught in the catch-22 of either confessing to the alleged assault (for which they might be offered the inducement 'if you say you did it we will let you have your child back') or denying it, in which case their denial is evidence they must be lying about the events surrounding their child's injury, which is then further evidence of their guilt;
The silencing of parents;
The forces of expertise ranged against the parents were formidable enough, but it is apparent too from their personal accounts that they were subjected to a series of intimidatory tactics to silence their protestations of innocence and deny the validity of their testimony as the only witnesses of the circumstances surrounding their child's injury or death. Thus parents describe how, when summoned to see the consultant to learn (they presume) about their child's progress, they were 'ambushed' with the diagnosis of, for example, shaken baby syndrome, presented to them as irrefutable fact ('your son must have been violently shaken for several minutes to cause these injuries') without any suggestion that there could be some alternative explanation.
The prompt involvement of the police and social workers would lead to further accusatory interrogations that begin from the principle that the parents must be guilty - as the doctors would not have made such serious accusations if they were not convinced they were true. The transcript of these interrogations would subsequently be turned against them in court so that any inconsistencies in their explanations of how their child's injuries might have occurred were then presented as evidence of their efforts to conceal their guilt. Parents describe the same pattern of events where they would only be informed late on a Friday evening that a preliminary court hearing had been arranged for the following Monday morning - thus leaving them the weekend to find a lawyer (who was unlikely to have any expertise in this field) to contest their child being taken into foster care;
These psychological tactics were a prelude to the yet more powerful intimidatory weapon of technical obscurantism - the description of their child's injuries and couching of the charges against them in a language in which the professionals were fluent but the bewildered parents were not. How could they hope to dispute the allegations when they did not know what was being talked about? Parents are of course entitled to seek their own expert opinion, but soon discovered that the overwhelming consensus about the validity of the child abuse syndromes meant it was very difficult to find anyone to argue in their defence; or worse, the expert reports they requested were actively detrimental to their case;
This silencing of parents was made more effective still by the rules of confidentiality that wrap the proceedings of the family courts in a cocoon of secrecy, making parents liable to a charge of contempt of court if they sought advice or support from anyone not directly involved in their case. This secrecy in turn protected the proceedings of the court, and in particular the testimony of expert witnesses, from external scrutiny while concealing from public view the spectacle of so many apparently respectable parents being convicted of inflicting these terrible injuries on their children - without any circumstantial evidence that they had done so.
For parents there was no escaping their fate. From the moment of the initial allegation against them, the alliance of medical experts, police, social workers and an unsympathetic judiciary - well organised, experienced and well financed - meant that their eventual conviction was almost a foregone conclusion. Nonetheless, the two assumptions, scientific and legal, of the specificity of the syndromes as being diagnostic of abuse remained as insecure as ever, with the courts' willingness to convict parents in the absence of circumstantial evidence of abuse resting almost entirely on their faith in the reliability and trustworthiness of medical expert opinion.
The first sign that such faith might be misplaced came in 2003 during Sally Clark's successful appeal, with the revelation of 'fundamental errors' in the testimony of Meadow and other prominent experts that had resulted in her original conviction. Their credibility was further undermined by Justice Judge's Appeal Court ruling exonerating Angela Cannings of murdering her two children. Justice Judge dismissed the central plank of the prosecution case, Meadow's claim that there had been a 'pattern of events' leading up to the deaths of children that was 'characteristic' of smothering: 'We doubt the aptness of the description "pattern"...the history of each child was different from every other child.' Further research would refute Meadow's claim (as reflected in his 'rule') that recurrent SIDS in the same family was 'extremely rare' - in other words, that in such cases the cause was likely to be unnatural. On the contrary, a follow-up study of SIDS families found two or more deaths in the same family to be 'not uncommon' with the overwhelming majority (80-90 per cent) due to natural causes. There are, it has subsequently emerged, several genetic mechanisms that could account for recurrent SIDS including congenital visceroautonomic dysfunction and cardiac dysrhythmias;
Similarly, further research has undermined the validity of retinal and subdural haemorrhages as being characteristic of shaken baby syndrome, with an evidence-based review finding 'serious data gaps, flaws of logic and inconsistency of case definition' in the relevant scientific work. Shaken baby syndrome was not, as its name implied, a 'syndrome', but rather encompassed several different forms of brain injury, with different clinical history and neuropathology, involving some mechanism other than shaking to account for the presence of retinal haemorrhages. Thus a series of independently witnessed accidents confirmed that, as parents had maintained, minor falls could cause an acute subdural bleed with the retinal haemorrhages being due to a sudden rise in retinal venous pressure (44). Further, parental histories of a preceding episode of respiratory collapse were compatible with the very different pathological findings of anoxic brain damage, with disturbance of the microcirculation causing thin subdural and retinal haemorrhages;
Meanwhile, the widened definition of Munchausen's syndrome by proxy based on 'diagnostic pointers' has also resulted in wrongful convictions, with the child's unexplained symptoms proving to be due to some rare or unusual medical condition with which the doctor was not familiar. Subsequently the syndrome would be renamed 'factitious illness' in recognition of the fact that, while some parents may fabricate the symptoms of their child's illness, the combination of unexplained symptoms and the mother's personality profile did not constitute a syndrome of abuse. Finally, radiologists' misinterpretation of normal variants of ossification in the first year of life as being metaphyseal fractures accounts for the obvious discrepancy between the findings of multiple fractures on skeletal survey and the absence of any clinical signs of abusive injury;
This serial collapse of the improbable scientific assumption that there could be no explanation other than abuse for the characteristic presentation of these syndromes has exposed in turn the equally improbable legal assumption that, contrary to sound judicial practice, it is possible to convict parents without there being additional circumstantial evidence or reasonable motive for their abusive intentions. Thus Justice Judge would, in his exoneration of Angela Cannings, draw attention to 'the absence of the slightest evidence of physical interference which might support the allegation she had deliberately harmed them'. And, again, he emphasised how 'the absence of any indication of ill temper or ill treatment of any child at any time' and 'the evidence of both her family and outsiders about the love and care she bestowed on her children' made it extraordinarily unlikely that she might have smothered them. Justice Judge's exoneration of Angela Cannings' character as a loving mother focuses attention on the moral and judgmental dimension of the child abuse syndromes, arising from extrapolation from Meadow's original description of Munchausen syndrome by proxy, that all parents are potential child abusers. Is this extrapolation plausible? The psychological profile of those who unambiguously have harmed their children reveals, as would be expected, them to be psychopaths, criminals, opioid abusers, alcoholics and so on. So when parents such as Angela Cannings, with no blemish on their character, appear as loving, concerned parents, the likelihood must be that it is because they are loving concerned parents - and very powerful evidence is required to argue otherwise.
Meadow and the proponents of the child abuse syndromes necessarily take the contrary view, and in so doing are required to portray parents' protestations of innocence as deceitful. That moral judgment, together with the failure to recognise that medical knowledge may be incomplete, meant that Angela Cannings' wrongful conviction for infanticide was almost inevitable. The question remains how many other parents have similarly been wrongly convicted of the terrible crime of injuring their children, and been robbed of their families, livelihoods and good name.
Next Post: A critique of this article by Dr Michael Fitzpatrick as published in "Spiked Health."
Harold Levy...hlevy15@gmail.com...hlevy15@gmail.com;
The author is Dr. James Le Fanu - a medical columnist for London's Daily and Sunday Telegraph and winner of the Los Angeles Times Book Prize for "The Rise and Fall of Modern Medicine" published by Diane Publishing Company in 2001;
The article was published in a feisty medical publication called "Spiked Health" on June 27, 2005.
As a practicing physician, Le Fanu saw first hand the emergence of the dubious proposition that there might be a hidden epidemic of abusive injury of children emerged in the 1980s with the description by British paediatricians of two covert forms of child abuse - factitious illness and smothering - and its tragic results.
Le Fanu's insightful article is preceded by the following quotes:
'PLEASE, IF THERE IS ANY WAY YOU COULD HELP WITH OUR SITUATION, BY YOURSELF OR ANYONE YOU KNOW, COULD YOU PLEASE GET IN TOUCH. WE CAN HONESTLY SAY, HAND ON HEART, WE HAVEN'T DONE ANYTHING TO HURT OUR BABY. WE ARE NOW BEEN [SIC] ASSESSED AND WE GOT TOLD [SIC] THAT WHEN WE GO TO THE FINDING OF FACTS HEARING AND WE STILL INSIST WE HAVEN'T DONE ANYTHING, OUR TWINS WILL GO UP FOR ADOPTION.';
LETTER FROM PARENT
-------------------------------------------------------------------------------
'FOR ME, THE UNUSUAL FEATURE IS DEATH SO SOON AFTER BEING SEEN WELL, THE FACT THAT THERE HAVE BEEN PREVIOUS DEATHS IN THE FAMILY AND THE FACT THAT HE HAD HAD AN EPISODE OF SOME SORT ONLY NINE DAYS BEFORE HE DIED THAT CAUSED HIM TO BE ASSESSED IN HOSPITAL, BECAUSE THOSE FEATURES ARE ONES THAT ARE FOUND REALLY QUITE COMMONLY IN CHILDREN WHO HAVE BEEN SMOTHERED BY THEIR MOTHERS. SO THE DIAGNOSIS FOR ME, THE CLINICAL DIAGNOSIS, WOULD BE THIS WAS CHARACTERISTIC OF SMOTHERING.';
TESTIMONY OF PROFESSOR SIR ROY MEADOW, R V CANNINGS, MARCH 2002;
-------------------------------------------------------------------------------
THE AUTHORITY OF MEDICINE DERIVES FROM ITS SCIENCE BASE, SO IT WOULD BE REASONABLE TO ASSUME THAT DOCTORS WHEN CALLED ON TO GIVE THEIR EXPERT OPINION IN COURT WOULD HAVE A THOROUGH BALANCED GRASP OF THE RELEVANT SCIENTIFIC EVIDENCE. THE SUCCESSFUL APPEALS OF SALLY CLARK AND ANGELA CANNINGS AGAINST THEIR CONVICTIONS FOR CHILD MURDER WOULD SUGGEST OTHERWISE, AS DOES THE RECENT RULING OF THE ATTORNEY GENERAL THAT A FURTHER 28 CASES OF PARENTS CONVICTED OF SMOTHERING OR SHAKING THEIR CHILDREN ARE 'POTENTIALLY UNSAFE';
NOR CAN THAT BE ALL, FOR THE ATTORNEY GENERAL'S REVIEW WAS RESTRICTED TO THE CRIMINAL COURTS, AND THUS DOES NOT TAKE INTO ACCOUNT THE SEVERAL HUNDRED CASES A YEAR HEARD IN THE FAMILY COURTS WHOSE LESS STRINGENT STANDARDS OF PROOF ('BALANCE OF PROBABILITY' RATHER THAN 'BEYOND REASONABLE DOUBT') WOULD FURTHER INCREASE THE RISK OF UNSAFE CONVICTIONS. THUS THE MEDICAL ADVOCACY OF CONTENTIOUS THEORIES OF THE MECHANISMS OF CHILD ABUSE IS LIKELY TO HAVE BEEN RESPONSIBLE FOR A SYSTEMATIC MISCARRIAGE OF JUSTICE ON A SCALE WITHOUT PRECEDENT IN BRITISH LEGAL HISTORY - WITH DEVASTATING CONSEQUENCES FOR THE PARENTS WRONGLY CONVICTED. HERE I OFFER A 'MASTER THEORY' TO EXPLAIN HOW THIS EXTRAORDINARY SITUATION HAS COME ABOUT.
-------------------------------------------------------------------------------
The article proceeds as follows:
The hidden epidemic of child abuse;
Since Kempe's description of the 'battered-child syndrome' in 1962, paediatricians have become only too familiar with the burns, bruises, fractures and neglect of the child victim of abusive physical assault. The current concerns about the wrongful diagnosis of child abuse, however, centre on a trio of very different clinical situations whose defining characteristic might be described rather as one of uncertainty or ambiguity.
-- Sudden infant death syndrome (SIDS) - SIDS remains much the commonest cause of unexpected death in childhood, whose primary aetiology, despite much research, has proved elusive.
-- Childhood injuries - children are by nature accident-prone but sometimes the severity of their injuries might seem disproportionate to the explanation provided.
-- Medically unexplained symptoms - all doctors have patients whose signs and symptoms are difficult to explain.
Doctors are no different from anyone else in being reluctant to admit they 'do not know'. Why, for example, might SIDS affect two or more children in the same family, or how might a seemingly trivial accident cause an acute intracranial injury? Some might thus be unduly susceptible to the notion that the uncertainties arise not from their lack of knowledge or clinical skills but from parental concealment - that each of these ambiguous clinical situations is potentially a form of hidden or covert abuse inflicted by parents in such a way as to hide their intentions from external scrutiny. Further, these clinically ambiguous situations are not uncommon, which would suggest that child abuse is both more prevalent than is widely appreciated and perpetrated by even the most apparently respectable of parents. Paediatricians clearly have a major responsibility in identifying these concealed forms of abuse if they are to protect children from further injury or death.
The evidence for a hidden epidemic of child abuse;
The proposition that there might be a hidden epidemic of abusive injury of children emerged in the 1980s with the description by British paediatricians of two covert forms of child abuse - factitious illness and smothering. Roy Meadow, in his pioneering paper on Munchausen's syndrome by proxy, described two cases illustrating a phenomenon, familiar now but puzzling at the time, where mothers sought the sympathy of doctors and nursing staff by fabricating the symptoms of a perplexing illness in their child that warranted repeated hospital admissions and investigative procedures. In the first case the mother contaminated her six-year-old daughter's urine specimens to simulate recurrent urinary tract infections, while in the second the mother fed her six-week-old son high doses of salt, causing him to be admitted to hospital several times with 'unexplained' hypernatraemia. Four years later Meadow reported a further series of 19 cases in which 'fraudulent clinical histories and fabricated signs' encompassed the entire spectrum of paediatric illness - bleeding from every orifice, neurological symptoms of drowsiness, seizures and unsteadiness, rashes, glycosuria, fevers and 'biochemical chaos'.
The implications of Munchausen's syndrome by proxy were twofold: it alerted doctors to the possibility of fabricated illness as a potential differential diagnosis in children with unexplained symptoms. But it also demonstrated how the seemingly most devoted of parents might, in reality, be potential child abusers. Meadow himself, commenting on the mothers in the cases he described, observed how they were 'very pleasant to deal with, cooperative and appreciative of good medical care'.
David Southall's innovative technique of covert video surveillance for investigating apnoeic episodes in children vividly confirmed the sinister reality of hidden abuse. Now paediatricians attending meetings and conferences could see for themselves the blurry black and white images of mothers caught in the act of smothering or choking their babies. Southall's study widened the spectrum of child abuse in two significant directions. It offered, in smothering, a plausible explanation for why a child might experience recurrent acute life-threatening events necessitating urgent admission to hospital. And it emphasised, once again, the possibility that some at least of those children whose deaths were labelled as SIDS might have been the victims of smothering. Southall in a further report of 30 children undergoing covert video surveillance identified 12 siblings who had died unexpectedly, eight of whom the parents subsequently confessed to having smothered. Thus parental smothering must be a clear possibility in any child with recurrent acute life-threatening events where there has been more than one unexplained childhood death in the family;
The hidden epidemic revealed;
There could be no doubt following Meadow and Southall's findings that paediatricians must have been missing a substantial number of cases of child abuse and would in future need to be much more alert to the possibility of parental harm where the diagnosis was not clear. Frequently, however, such suspicions could not be confirmed with the sort of direct evidence provided by techniques such as covert video surveillance. So how could doctors be confident that covert abuse was the cause - and convince others to take the necessary steps to protect the child from further danger?
Significantly, there were certain similarities in the signs and symptoms of children with these clinically ambiguous situations and those recorded in well-authenticated forms of abuse such as smothering, poisoning and abusive head injury. Thus it seemed reasonable to infer, by extrapolation, that these presentations were 'characteristic' of covert forms of abuse which could then be confidently diagnosed - even in the absence of any other circumstantial evidence such as bruises, signs of neglect or parental history of violence. During the 1980s the trio of clinically ambiguous situations would become redesignated as 'child abuse syndromes'. A key influence was 'Meadow's rule' regarding SIDS. While the absence of reliable pathological findings made it difficult to distinguish SIDS from smothering, Meadow argued that two or more childhood deaths in the same family, along with a recognisable 'pattern' of events (such as previous acute life-threatening episodes) was strongly suggestive of infanticide: 'two is suspicious and three murder unless proved otherwise...';
Another was the proposal that two specific presentations of childhood injury were 'characteristic' of abusive assault. Caffey's original description of shaken baby syndrome suggested that the whiplash effect of vigorous shaking offered a 'reasonable explanation' for the presence of subdural and retinal haemorrhages in severely abused children. The imagery of how the violent to-and-fro movement of the baby's head could cause bleeding of the vessels of the eye and brain proved very persuasive, and it seemed logical to infer that any child presenting with retinal and subdural haemorrhages must have been shaken - despite the absence of other circumstantial evidence of abuse;
Similarly, Caffey attributed a radiological 'bucket handle' appearance of the metaphyses of the long bones in severely abused children as being due to a 'twisting and wrenching' of the child's limbs by the parents. Subsequently, it was suggested that those children in whom abuse was suspected should have a skeletal survey for similar 'suspicious' metaphyseal lesions that were interpreted as being characteristic of abusive assault - again, despite the absence of clinical signs of fracture or subsequent radiological evidence of healing. A third was a widened case definition for Munchausen's syndrome by proxy. Meadow, in his initial series, had confirmed the diagnosis either by covert surveillance or by confronting the perpetrator and obtaining a confession. In a widened definition the presence of 'diagnostic pointers' was proposed for use in children with medically unexplained symptoms. They included:
-- Parents unusually calm for the severity of illness;
-- Parents unusually knowledgeable about the illness;
-- Parents fitting in contentedly with ward life and attention from staff;
-- Symptoms and signs inconsistent with known pathophysiology;
-- Treatments ineffective or poorly tolerated;
The hidden epidemic confirmed;
These novel child abuse syndromes, taken together, represented a major conceptual breakthrough in paediatrics. The uncertainty of clinically ambiguous situations had given place to the certainty of the single unifying and plausible diagnosis of covert abuse. The scale of the hidden epidemic then turned out to be substantially greater than had been expected, with a fourfold increase in the number of child abuse cases in the 10 years from 1978 to 1988. This was reflected regionally in an increase from 40 to over 200 cases a year in the City of Leeds while, by the end of the decade, an extra 7,500 children every year were being placed on the child protection register on the grounds of physical abuse;
Nonetheless, the facility with which the syndromes could bring to light covert abuse concealed from view their poor evidential basis. The causal link between the putative mechanism of assault and subsequent injury could be neither independently confirmed nor experimentally investigated. It might seem reasonable to extrapolate from the presence of retinal and subdural haemorrhages in the battered child that these features had the same significance in a child with no other circumstantial evidence of injury. Certainly the powerful imagery of violent shearing forces disrupting the blood vessels was persuasive, but shaking has never been directly observed or proven to cause such injuries; the supposition that they do is based on (contested) theories of biomechanics;
Rather, the legitimacy of the syndromes was predicated on two related and highly improbable assumptions, scientific and legal. The scientific assumption was that there could be no other explanation, either known or that might be discovered at some time in the future, that might explain these 'characteristic' presentations. Meadow's 'rule', for example, precluded the possibility that there might be some unknown genetic explanation for multiple unexpected childhood deaths in the same family, while the 'characteristic' pattern of shaken baby syndrome precluded the possibility of some alternative explanation for the retinal and subdural haemorrhages - such as an acute increase in retinal venous pressure from intracranial bleeding caused by accidental head injury. The legal assumption presupposed that these presentations were so specific for abuse that they were by themselves sufficient to secure a conviction - even in the absence of the sort of circumstantial evidence of violence or neglect that would normally be required to return a guilty verdict in a court of law.
Put another way, the 'characteristic' presentations of the syndromes could not sustain the interpretation placed upon them: they might be 'consistent with' but could not, by themselves, be 'diagnostic of' child abuse. Thus some at least of the parents contributing to the statistics of the fourfold rise in child abuse were likely to be innocent. Three additional factors, in particular, bolstered the credibility of the syndromes in the family and criminal courts.
The authority of the child abuse expert;
By the close of the 1980s, the leading experts in child abuse had acquired an international reputation and were thus called on to instruct and educate not just their fellow paediatricians but also the police, lawyers, social workers and judges in the child abuse syndromes. Their persuasive expert opinion, when expressed in court, was guaranteed a sympathetic hearing, while their confidence in the syndromes they had discovered was virtually unchallengeable. Further, they could scarcely accept the force of contrary evidence since to do so would require them to concede that their expert testimonies might, in similar cases, have resulted in wrongful conviction. Meanwhile the costs of the process of investigating allegations arising out of the child abuse syndromes rose to an estimated £1billion per year, with the more prominent experts receiving fees for the preparation of their reports and appearances in court in excess of £100,000 a year;
The circular argument of successful convictions;
The validity of the child abuse syndromes would appear to be confirmed by the high proportion of successful convictions that followed the courts' careful scrutiny of the allegations against parents. These convictions, however, came to rely increasingly on a circular argument - whereby the main evidence for the child abuse syndrome of which the parents were accused was that parents had been convicted of it in the past. Thus parents whose child presents with subdural and retinal haemorrhages are accused of inflicting shaken baby syndrome because, in the vast majority of cases, parents of children with subdural and retinal haemorrhages are convicted of causing shaken baby syndrome. Similarly, Meadow argued that 'the likelihood that the court verdicts about parental responsibility for [causing their children's death] were correct was very high indeed', without making clear that it was his expert testimony that repetitive SIDS was 'murder unless proved otherwise' that had been a major factor in securing those convictions;
There is a further element of circularity in the presumed pathogenesis of the syndrome of which the parents are accused. The theory of shaken baby syndrome presupposes that violent, abusive force (comparable, it is claimed, to that sustained in a high-speed road traffic accident or a fall from a second storey window) is necessary to cause retinal and subdural haemorrhages. The parents are then caught in the catch-22 of either confessing to the alleged assault (for which they might be offered the inducement 'if you say you did it we will let you have your child back') or denying it, in which case their denial is evidence they must be lying about the events surrounding their child's injury, which is then further evidence of their guilt;
The silencing of parents;
The forces of expertise ranged against the parents were formidable enough, but it is apparent too from their personal accounts that they were subjected to a series of intimidatory tactics to silence their protestations of innocence and deny the validity of their testimony as the only witnesses of the circumstances surrounding their child's injury or death. Thus parents describe how, when summoned to see the consultant to learn (they presume) about their child's progress, they were 'ambushed' with the diagnosis of, for example, shaken baby syndrome, presented to them as irrefutable fact ('your son must have been violently shaken for several minutes to cause these injuries') without any suggestion that there could be some alternative explanation.
The prompt involvement of the police and social workers would lead to further accusatory interrogations that begin from the principle that the parents must be guilty - as the doctors would not have made such serious accusations if they were not convinced they were true. The transcript of these interrogations would subsequently be turned against them in court so that any inconsistencies in their explanations of how their child's injuries might have occurred were then presented as evidence of their efforts to conceal their guilt. Parents describe the same pattern of events where they would only be informed late on a Friday evening that a preliminary court hearing had been arranged for the following Monday morning - thus leaving them the weekend to find a lawyer (who was unlikely to have any expertise in this field) to contest their child being taken into foster care;
These psychological tactics were a prelude to the yet more powerful intimidatory weapon of technical obscurantism - the description of their child's injuries and couching of the charges against them in a language in which the professionals were fluent but the bewildered parents were not. How could they hope to dispute the allegations when they did not know what was being talked about? Parents are of course entitled to seek their own expert opinion, but soon discovered that the overwhelming consensus about the validity of the child abuse syndromes meant it was very difficult to find anyone to argue in their defence; or worse, the expert reports they requested were actively detrimental to their case;
This silencing of parents was made more effective still by the rules of confidentiality that wrap the proceedings of the family courts in a cocoon of secrecy, making parents liable to a charge of contempt of court if they sought advice or support from anyone not directly involved in their case. This secrecy in turn protected the proceedings of the court, and in particular the testimony of expert witnesses, from external scrutiny while concealing from public view the spectacle of so many apparently respectable parents being convicted of inflicting these terrible injuries on their children - without any circumstantial evidence that they had done so.
For parents there was no escaping their fate. From the moment of the initial allegation against them, the alliance of medical experts, police, social workers and an unsympathetic judiciary - well organised, experienced and well financed - meant that their eventual conviction was almost a foregone conclusion. Nonetheless, the two assumptions, scientific and legal, of the specificity of the syndromes as being diagnostic of abuse remained as insecure as ever, with the courts' willingness to convict parents in the absence of circumstantial evidence of abuse resting almost entirely on their faith in the reliability and trustworthiness of medical expert opinion.
The first sign that such faith might be misplaced came in 2003 during Sally Clark's successful appeal, with the revelation of 'fundamental errors' in the testimony of Meadow and other prominent experts that had resulted in her original conviction. Their credibility was further undermined by Justice Judge's Appeal Court ruling exonerating Angela Cannings of murdering her two children. Justice Judge dismissed the central plank of the prosecution case, Meadow's claim that there had been a 'pattern of events' leading up to the deaths of children that was 'characteristic' of smothering: 'We doubt the aptness of the description "pattern"...the history of each child was different from every other child.' Further research would refute Meadow's claim (as reflected in his 'rule') that recurrent SIDS in the same family was 'extremely rare' - in other words, that in such cases the cause was likely to be unnatural. On the contrary, a follow-up study of SIDS families found two or more deaths in the same family to be 'not uncommon' with the overwhelming majority (80-90 per cent) due to natural causes. There are, it has subsequently emerged, several genetic mechanisms that could account for recurrent SIDS including congenital visceroautonomic dysfunction and cardiac dysrhythmias;
Similarly, further research has undermined the validity of retinal and subdural haemorrhages as being characteristic of shaken baby syndrome, with an evidence-based review finding 'serious data gaps, flaws of logic and inconsistency of case definition' in the relevant scientific work. Shaken baby syndrome was not, as its name implied, a 'syndrome', but rather encompassed several different forms of brain injury, with different clinical history and neuropathology, involving some mechanism other than shaking to account for the presence of retinal haemorrhages. Thus a series of independently witnessed accidents confirmed that, as parents had maintained, minor falls could cause an acute subdural bleed with the retinal haemorrhages being due to a sudden rise in retinal venous pressure (44). Further, parental histories of a preceding episode of respiratory collapse were compatible with the very different pathological findings of anoxic brain damage, with disturbance of the microcirculation causing thin subdural and retinal haemorrhages;
Meanwhile, the widened definition of Munchausen's syndrome by proxy based on 'diagnostic pointers' has also resulted in wrongful convictions, with the child's unexplained symptoms proving to be due to some rare or unusual medical condition with which the doctor was not familiar. Subsequently the syndrome would be renamed 'factitious illness' in recognition of the fact that, while some parents may fabricate the symptoms of their child's illness, the combination of unexplained symptoms and the mother's personality profile did not constitute a syndrome of abuse. Finally, radiologists' misinterpretation of normal variants of ossification in the first year of life as being metaphyseal fractures accounts for the obvious discrepancy between the findings of multiple fractures on skeletal survey and the absence of any clinical signs of abusive injury;
This serial collapse of the improbable scientific assumption that there could be no explanation other than abuse for the characteristic presentation of these syndromes has exposed in turn the equally improbable legal assumption that, contrary to sound judicial practice, it is possible to convict parents without there being additional circumstantial evidence or reasonable motive for their abusive intentions. Thus Justice Judge would, in his exoneration of Angela Cannings, draw attention to 'the absence of the slightest evidence of physical interference which might support the allegation she had deliberately harmed them'. And, again, he emphasised how 'the absence of any indication of ill temper or ill treatment of any child at any time' and 'the evidence of both her family and outsiders about the love and care she bestowed on her children' made it extraordinarily unlikely that she might have smothered them. Justice Judge's exoneration of Angela Cannings' character as a loving mother focuses attention on the moral and judgmental dimension of the child abuse syndromes, arising from extrapolation from Meadow's original description of Munchausen syndrome by proxy, that all parents are potential child abusers. Is this extrapolation plausible? The psychological profile of those who unambiguously have harmed their children reveals, as would be expected, them to be psychopaths, criminals, opioid abusers, alcoholics and so on. So when parents such as Angela Cannings, with no blemish on their character, appear as loving, concerned parents, the likelihood must be that it is because they are loving concerned parents - and very powerful evidence is required to argue otherwise.
Meadow and the proponents of the child abuse syndromes necessarily take the contrary view, and in so doing are required to portray parents' protestations of innocence as deceitful. That moral judgment, together with the failure to recognise that medical knowledge may be incomplete, meant that Angela Cannings' wrongful conviction for infanticide was almost inevitable. The question remains how many other parents have similarly been wrongly convicted of the terrible crime of injuring their children, and been robbed of their families, livelihoods and good name.
Next Post: A critique of this article by Dr Michael Fitzpatrick as published in "Spiked Health."
Harold Levy...hlevy15@gmail.com...hlevy15@gmail.com;
Sunday, June 8, 2008
Part Nine: Eight: Gaurov's Father; A Third Shocking Revelation From Inquiry; Brother collapsed Shortly Before Gaurov's Death: Hereditory Factor?
"THE HISTORY STATES THAT HE (GAUROV'S BROTHER SAUROB)WAS PLAYING WHEN HE SUDDENLY FELL ON THE GROUND - APPARENTLY THE FATHER GAVE HIM SOMETHING, AND COMPRESSIONS AND MOUTH TO MOUTH. AND THEN THERE'S A SUGGESTION THERE MAY HAVE BEEN A SIMILAR EPISODE LAST YEAR;"
LAWYER JAMES LOCKYER TO COMMISSIONER STEPHEN GOUDGE DURING CROSS-EXAMINATION OF PROFESSOR HELEN WHITWELL;
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"BUT IF WE ASSUME FOR A MOMENT THAT JUST DAYS BEFORE GAUROV DIED HIS ONE (1) YEAR OLD BROTHER, SAUROB HAD BEEN THROUGH, WHAT COULD BE DESCRIBED AS A SIMILAR EXPERIENCE TO GAUROV, WOULD THAT SUGGEST THAT THERE MIGHT BE ANY KIND OF -- OF HEREDITARY PROBLEM WITHIN FAMILY?
DR. HELEN WHITWELL: "I DON'T THINK I CAN REALLY ANSWER THAT. IT MAY OR MAY NOT. I MEAN, WE -- WE JUST DON'T KNOW."
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LAWYER JAMES LOCKYER AND PROFESSOR HELEN WHITWELL;
-------------------------------------------------------------------------------
In an earlier posting I referred to the shocking disclosure from the Goudge Inquiry that Dinesh Kumar's lawyer's testified that he had not been informed by prosecutors about a disturbing decision from Ontario Court Justice Patrick Dunn in the Amber case.
That decision was was highly critical of the opinions of Dr. Charles Smith and the Hospital for Sick Children SCAN (Suspected Child Abuse And Neglect) team.
Two other shocking disclosures relating to Gaurov's case also emanated from the Inquiry;
The second - the subject of this post - was that Dr. Charles Smith had informed homicide investigators that both he, and Dr. Dirk Huyer, the head of the SCAN team at the Hospital for Sick Children In Toronto were both "struggling" to find criminality in the case - a far cry from the language in their official reports;
Now the third: It has been disclosed during the Goudge Inquiry that in March 1992, just a few days before Gaurov's death his brother Saurob, was seen at a walk-in clinic at the Hospital for Children for spells.
Lawyer James Lockyer told the Inquiry that he had "just obtained" Saurob's medical records through a request.
Lockyer said the the history states that he was playing when he suddenly fell on the ground - - and we don't quite know what -- and was cyanosed. Apparently the father gave him something, andC compressions and mouth to mouth. And then there's a suggestion there may have been a similar episode last year.
Lockyer began this portion of his cross-examination of Professor Helen Whitwell - the independent reviewer of Gaurov's case - by informing Commissioner Steven Goudge that, "Another document that we just obtained through a request is the medical records, or -- the medical records of Dinash's (phonetic) brother, Saurob.
And if we go to PFP302210 -- now it's -- it's the best we have so far, and we're trying to get a better copy of this document -- but if you look at this document, it's addressed to Dr. Rana, who was Saurob's -- and indeed still is -- Saurob's physician.
Saurob is now -- I think I'm right in saying -- seventeen (17) years old and, Mr. Commissioner, he -- he is with his parents, I'm glad to say.
Any event, it's a report from the Hospital for Sick Children.
If we go to the second page, you'll see this document.
I'm afraid you -- we don't know who it's from because you can't quite read it.
But if you look at this document on page 1 -- if you could show us page 1 again? There might a Dr. Bard, if there is such a doctor at the Hospital for Sick Children.
And you'll see -- and this is a matter of days before Gaurov's death.
If you could raise the page, give us the bottom of the page.
COMMISSIONER STEPHEN GOUDGE: Is there a date on it somewhere?
JAMES LOCKYER: Well, it's -- I think it's mark -- I'm right in saying we've worked it out as being March 1st, 1992. It might be March 11th or 21st.
it's -- it's -- there's a one (1) and we have reason to think it's March. And I think that becomes apparent.
CONTINUED BY MR. JAMES LOCKYER:
MR. JAMES LOCKYER: If you could give us the -- the -- to the bottom of this page, please.
Thank you. You'll see here that Saurob, in what's really just a matter of days before Gaurov's death, was seen in the walk-in clinic at the Hospital for Sick Children for these spells.
you see where I'm looking?
DR. HELEN WHITWELL: Yes.
MR. JAMES LOCKYER: The history states -- and -- and we can probably invent some of the lines -- some of the words that are missing -- the history states that he was playing when he suddenly fell on the ground - - and we don't quite know what -- and was cyanosed.
Apparently the father gave him something, and compressions and mouth to mouth.
And then there's a suggestion there may have been a similar episode last year.
And then if we go to the -- over the page, and there's -- you'll see in the last paragraph: "Difficult to elicit exactly what the problem is. In a consideration of the description of this spell, we feel it's worthwhile to do..." And I'm -- I'm sort of translating, Mr. Commissioner, to some extent. "...a reassessment of the patient after an EEG has been done."
We also -- I can also tell you that Gaurov's father used to be an ambulance attendant back in his home country.
DR. HELEN WHITWELL: Right.
MR. JAMES LOCKYER: And so had familiarity with resuscitation and mouth-to-mouth techniques.
DR. HELEN WHITWELL: Yes.
MR. JAMES LOCKYER: So if we -- and I appreciate this is a dreadful document, but it's all we've got at the moment, and as I say, we're trying to get a better copy of it.
But if we assume for a moment that just days before Gaurov died his one (1) year old brother, Saurob had been through, what could be described as a similar experience to Gaurov, would that suggest that there might be any kind of -- of hereditary problem within family?
DR. HELEN WHITWELL: I don't think I can really answer that. It may or may not. I mean, we -- we just don't know.
This Blogster has no doubt that there is no way - at this point of time - that Professor Whitwell, or anyone else could give a definitive answer to this question.
I am however troubled by the fact that the shocking disclosure appears to have merged for the first time almost two decades after Mr. Kumar pleaded guilty to criminal negligence in connection with Gaurov's death.
This is an important investigative fact which should have been discovered by both the corner and police investigators, relayed to the police, and then disclosed to defence counsel - if at that point of time the prosecution was determined to expose Mr. Kumar to criminal proceedings.
It is crucial to recollect that Mr. Kumar felt pressured to enter a plea to criminal negligence causing Gaurov's death shortly after it was offered by prosecutors in order to avoid the oppressive murder charge - while the family was still deeply in mourning.
His lawyers therefore never got down to the type of investigation which would have revealed this kind of information which may have offered a medical defence which indicated that Gaurov, like so many other infants in Dr. Charles Smith's cases, had died a tragic, but natural death.
Harold Levy...hlevy15@gmail.com;
LAWYER JAMES LOCKYER TO COMMISSIONER STEPHEN GOUDGE DURING CROSS-EXAMINATION OF PROFESSOR HELEN WHITWELL;
-------------------------------------------------------------------------------
"BUT IF WE ASSUME FOR A MOMENT THAT JUST DAYS BEFORE GAUROV DIED HIS ONE (1) YEAR OLD BROTHER, SAUROB HAD BEEN THROUGH, WHAT COULD BE DESCRIBED AS A SIMILAR EXPERIENCE TO GAUROV, WOULD THAT SUGGEST THAT THERE MIGHT BE ANY KIND OF -- OF HEREDITARY PROBLEM WITHIN FAMILY?
DR. HELEN WHITWELL: "I DON'T THINK I CAN REALLY ANSWER THAT. IT MAY OR MAY NOT. I MEAN, WE -- WE JUST DON'T KNOW."
-------------------------------------------------------------------------------
LAWYER JAMES LOCKYER AND PROFESSOR HELEN WHITWELL;
-------------------------------------------------------------------------------
In an earlier posting I referred to the shocking disclosure from the Goudge Inquiry that Dinesh Kumar's lawyer's testified that he had not been informed by prosecutors about a disturbing decision from Ontario Court Justice Patrick Dunn in the Amber case.
That decision was was highly critical of the opinions of Dr. Charles Smith and the Hospital for Sick Children SCAN (Suspected Child Abuse And Neglect) team.
Two other shocking disclosures relating to Gaurov's case also emanated from the Inquiry;
The second - the subject of this post - was that Dr. Charles Smith had informed homicide investigators that both he, and Dr. Dirk Huyer, the head of the SCAN team at the Hospital for Sick Children In Toronto were both "struggling" to find criminality in the case - a far cry from the language in their official reports;
Now the third: It has been disclosed during the Goudge Inquiry that in March 1992, just a few days before Gaurov's death his brother Saurob, was seen at a walk-in clinic at the Hospital for Children for spells.
Lawyer James Lockyer told the Inquiry that he had "just obtained" Saurob's medical records through a request.
Lockyer said the the history states that he was playing when he suddenly fell on the ground - - and we don't quite know what -- and was cyanosed. Apparently the father gave him something, andC compressions and mouth to mouth. And then there's a suggestion there may have been a similar episode last year.
Lockyer began this portion of his cross-examination of Professor Helen Whitwell - the independent reviewer of Gaurov's case - by informing Commissioner Steven Goudge that, "Another document that we just obtained through a request is the medical records, or -- the medical records of Dinash's (phonetic) brother, Saurob.
And if we go to PFP302210 -- now it's -- it's the best we have so far, and we're trying to get a better copy of this document -- but if you look at this document, it's addressed to Dr. Rana, who was Saurob's -- and indeed still is -- Saurob's physician.
Saurob is now -- I think I'm right in saying -- seventeen (17) years old and, Mr. Commissioner, he -- he is with his parents, I'm glad to say.
Any event, it's a report from the Hospital for Sick Children.
If we go to the second page, you'll see this document.
I'm afraid you -- we don't know who it's from because you can't quite read it.
But if you look at this document on page 1 -- if you could show us page 1 again? There might a Dr. Bard, if there is such a doctor at the Hospital for Sick Children.
And you'll see -- and this is a matter of days before Gaurov's death.
If you could raise the page, give us the bottom of the page.
COMMISSIONER STEPHEN GOUDGE: Is there a date on it somewhere?
JAMES LOCKYER: Well, it's -- I think it's mark -- I'm right in saying we've worked it out as being March 1st, 1992. It might be March 11th or 21st.
it's -- it's -- there's a one (1) and we have reason to think it's March. And I think that becomes apparent.
CONTINUED BY MR. JAMES LOCKYER:
MR. JAMES LOCKYER: If you could give us the -- the -- to the bottom of this page, please.
Thank you. You'll see here that Saurob, in what's really just a matter of days before Gaurov's death, was seen in the walk-in clinic at the Hospital for Sick Children for these spells.
you see where I'm looking?
DR. HELEN WHITWELL: Yes.
MR. JAMES LOCKYER: The history states -- and -- and we can probably invent some of the lines -- some of the words that are missing -- the history states that he was playing when he suddenly fell on the ground - - and we don't quite know what -- and was cyanosed.
Apparently the father gave him something, and compressions and mouth to mouth.
And then there's a suggestion there may have been a similar episode last year.
And then if we go to the -- over the page, and there's -- you'll see in the last paragraph: "Difficult to elicit exactly what the problem is. In a consideration of the description of this spell, we feel it's worthwhile to do..." And I'm -- I'm sort of translating, Mr. Commissioner, to some extent. "...a reassessment of the patient after an EEG has been done."
We also -- I can also tell you that Gaurov's father used to be an ambulance attendant back in his home country.
DR. HELEN WHITWELL: Right.
MR. JAMES LOCKYER: And so had familiarity with resuscitation and mouth-to-mouth techniques.
DR. HELEN WHITWELL: Yes.
MR. JAMES LOCKYER: So if we -- and I appreciate this is a dreadful document, but it's all we've got at the moment, and as I say, we're trying to get a better copy of it.
But if we assume for a moment that just days before Gaurov died his one (1) year old brother, Saurob had been through, what could be described as a similar experience to Gaurov, would that suggest that there might be any kind of -- of hereditary problem within family?
DR. HELEN WHITWELL: I don't think I can really answer that. It may or may not. I mean, we -- we just don't know.
This Blogster has no doubt that there is no way - at this point of time - that Professor Whitwell, or anyone else could give a definitive answer to this question.
I am however troubled by the fact that the shocking disclosure appears to have merged for the first time almost two decades after Mr. Kumar pleaded guilty to criminal negligence in connection with Gaurov's death.
This is an important investigative fact which should have been discovered by both the corner and police investigators, relayed to the police, and then disclosed to defence counsel - if at that point of time the prosecution was determined to expose Mr. Kumar to criminal proceedings.
It is crucial to recollect that Mr. Kumar felt pressured to enter a plea to criminal negligence causing Gaurov's death shortly after it was offered by prosecutors in order to avoid the oppressive murder charge - while the family was still deeply in mourning.
His lawyers therefore never got down to the type of investigation which would have revealed this kind of information which may have offered a medical defence which indicated that Gaurov, like so many other infants in Dr. Charles Smith's cases, had died a tragic, but natural death.
Harold Levy...hlevy15@gmail.com;
Saturday, June 7, 2008
Part Eight: Gaurov's Father: A Second Shocking Revelation From Goudge Inquiry; Both Smith And Huyer Were "Struggling" With Criminality In the Case;
"SPEAK TO PATHOLOGIST, DR. CHARLES SMITH, OF SICK KIDS HOSPITAL RE. UPDATE. STILL IS OF THE OPINION THAT DEATH WAS FROM EITHER TWO (2) SOURCES: SHAKEN BABY, BLUNT TRAUMA. HE HAS CONSULTED WITH DR. HUYER, SCAN PROGRAM. THEY BOTH HAVE MISGIVINGS ABOUT CRIMINAL ELEMENT. QUOTE, 'HAS STRUGGLED WITH THIS BEING CRIMINAL. AGREES TO MEET WITH MARY HALL ANY TIME.'"
NOTE WRITTEN BY TORONTO HOMICIDE OFFICER DETECTIVE JOHN LINE IN RELATION TO KUMAR INVESTIGATION. DETECTIVE LINE WAS REFERRING TO MARY HALL WHO WAS DESCRIBED BY LAWYER JAMES LOCKYER AS HEAD CROWN ATTORNEY IN THE SCARBOROUGH OFFICE OUT OF WHICH KUMAR WAS PROSECUTED;
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In an earlier posting I referred to the shocking disclosure from the Goudge Inquiry that Dinesh Kumar's lawyer's testified that he had not been informed by prosecutors about a disturbing decision from Ontario Court Justice Patrick Dunn in the Amber case.
That decision was was highly critical of the opinions of Dr. Charles Smith and the Hospital for Sick Children SCAN (Suspected Child Abuse And Neglect) team.
Two other shocking disclosures relating to Gaurov's case also emanated from the Inquiry;
The second - the subject of this post - was that Dr. Charles Smith had informed homicide investigators that both he, and Dr. Dirk Huyer, the head of the SCAN team at the Hospital for Sick Children In Toronto were both "struggling" to find criminality in the case - a far cry from the language in their official reports;
The section of transcript relating to this disclosure is found in lawyer James Lockyer's cross-examination of Dr. Helen Whitwell, the independent examiner who reviewed Gaurov's case at the request of former Chief Coroner, Dr. Barry McLellan;
It reads as follows:
MR. JAMES LOCKYER: And so in Gaurov's case, whilst we have -- the preexisting condition may have been responsible for what ultimately caused Gaurov's death, beyond that, potentially, as Dr. Pollanen has pointed out, we don't even seem to have the triad in the first place.
DR. HELEN WHITWELL: No, you don't.
MR. JAMES LOCKYER: I don't know quite why Dr. Smith said this, but he seems to have had a lot of trouble with the case himself, and we got some notes just a -- a few days ago in this regard. If we could go to PFP302155; And what we're looking at here is the notes of one (1) of the officers in charge of the case, Detective Lines (sic). And if you go -- could you -- I'm sorry, I don't have a page number here. Could you just keep -- keep moving and I'll tell you when to stop through these notes. We're looking for March 23rd, which you'll see at the top of one (1) of the pages. And if you look at the entry for 2:55 on March 23rd -- and if you could raise the page a little so we can go to the bottom of it -- what it says there, and this is Detective Lines, one (1) of the officers in charge, and what he's noted March 23rd of 1992, which is post-autopsy, he's noted: "Speak to pathologist, Dr. Charles Smith, of Sick Kids Hospital re.
update. Still is of the opinion that death was from either two (2) sources: shaken baby, blunt trauma. He has consulted with Dr. Huyer, SCAN program. They both have misgivings about criminal element. Quote, 'Has struggled with this being criminal. Agrees to meet with Mary Hall any time.' And I can just tell you, Dr. Whitwell, that Mary Hall was then a -- the head Crown attorney in the Scarborough office where --
DR. HELEN WHITWELL: Right.
MR. JAMES LOCKYER: -- out of which Mr. Kumar was prosecuted.
So it would seem, at least in the early days -- and this is before Gaurov's father is charged with the second degree murder of his son Gaurov -- that even after the autopsy, Dr. Smith, and indeed Dr. Huyer of the SCAN unit, to use the -- to use the quote, "struggling" with the question of whether any crime had
been committed in Gaurov's death in the first place. I don't think you would have known that. We only got this document about a week ago --
DR. HELEN WHITWELL: Right.
MR. JAMES LOCKYER: -- through -- through the officer himself providing it.
-------------------------------------------------------------------------------
We are told that this note was written before Dinesh Kumar was encouraged by prosecutors to plead guilty to criminal negligence causing his son Gaurov's death in order to avoid being prosecuted for murder.
The existence of such a note - in which both Dr. Smith and the Head of the SCAN team are struggling to find any scientific evidence of criminality in the case - clearly raises the prospect that there was no reasonable possibility of obtaining a conviction.
The last time I looked at a Criminal Code - Criminal Negligence Causing Death was just what it sounded like: a very serious criminal offence.
So we have to wonder why the prosecutors who, as crown attorneys, also hold the function of being officers of the Court, proceeded to take Mr. Kumar to Court on any criminal charge at all - whether they were bound by the law to withdraw all charges against him or not.
A very shocking revelation indeed, which, it seems, only raised its ugly head publicly more than 16-years after Mr. Kumar pleaded guilty to an offence he did not commit, to avoid life in prison for murder on the evidence of the celebrated Dr. Smith's evidence supported by the world famous Hospital for Sick Children, to regain custody of his son, and to avoid deportation from Canada;
How could our Canadian Justice system fall so low?
Next Posting: Part Nine; Gaurov's Father; A Third Shocking Revelation From The Goudge Inquiry;
Harold Levy...hlevy15@gmail.com;
NOTE WRITTEN BY TORONTO HOMICIDE OFFICER DETECTIVE JOHN LINE IN RELATION TO KUMAR INVESTIGATION. DETECTIVE LINE WAS REFERRING TO MARY HALL WHO WAS DESCRIBED BY LAWYER JAMES LOCKYER AS HEAD CROWN ATTORNEY IN THE SCARBOROUGH OFFICE OUT OF WHICH KUMAR WAS PROSECUTED;
-------------------------------------------------------------------------------
In an earlier posting I referred to the shocking disclosure from the Goudge Inquiry that Dinesh Kumar's lawyer's testified that he had not been informed by prosecutors about a disturbing decision from Ontario Court Justice Patrick Dunn in the Amber case.
That decision was was highly critical of the opinions of Dr. Charles Smith and the Hospital for Sick Children SCAN (Suspected Child Abuse And Neglect) team.
Two other shocking disclosures relating to Gaurov's case also emanated from the Inquiry;
The second - the subject of this post - was that Dr. Charles Smith had informed homicide investigators that both he, and Dr. Dirk Huyer, the head of the SCAN team at the Hospital for Sick Children In Toronto were both "struggling" to find criminality in the case - a far cry from the language in their official reports;
The section of transcript relating to this disclosure is found in lawyer James Lockyer's cross-examination of Dr. Helen Whitwell, the independent examiner who reviewed Gaurov's case at the request of former Chief Coroner, Dr. Barry McLellan;
It reads as follows:
MR. JAMES LOCKYER: And so in Gaurov's case, whilst we have -- the preexisting condition may have been responsible for what ultimately caused Gaurov's death, beyond that, potentially, as Dr. Pollanen has pointed out, we don't even seem to have the triad in the first place.
DR. HELEN WHITWELL: No, you don't.
MR. JAMES LOCKYER: I don't know quite why Dr. Smith said this, but he seems to have had a lot of trouble with the case himself, and we got some notes just a -- a few days ago in this regard. If we could go to PFP302155; And what we're looking at here is the notes of one (1) of the officers in charge of the case, Detective Lines (sic). And if you go -- could you -- I'm sorry, I don't have a page number here. Could you just keep -- keep moving and I'll tell you when to stop through these notes. We're looking for March 23rd, which you'll see at the top of one (1) of the pages. And if you look at the entry for 2:55 on March 23rd -- and if you could raise the page a little so we can go to the bottom of it -- what it says there, and this is Detective Lines, one (1) of the officers in charge, and what he's noted March 23rd of 1992, which is post-autopsy, he's noted: "Speak to pathologist, Dr. Charles Smith, of Sick Kids Hospital re.
update. Still is of the opinion that death was from either two (2) sources: shaken baby, blunt trauma. He has consulted with Dr. Huyer, SCAN program. They both have misgivings about criminal element. Quote, 'Has struggled with this being criminal. Agrees to meet with Mary Hall any time.' And I can just tell you, Dr. Whitwell, that Mary Hall was then a -- the head Crown attorney in the Scarborough office where --
DR. HELEN WHITWELL: Right.
MR. JAMES LOCKYER: -- out of which Mr. Kumar was prosecuted.
So it would seem, at least in the early days -- and this is before Gaurov's father is charged with the second degree murder of his son Gaurov -- that even after the autopsy, Dr. Smith, and indeed Dr. Huyer of the SCAN unit, to use the -- to use the quote, "struggling" with the question of whether any crime had
been committed in Gaurov's death in the first place. I don't think you would have known that. We only got this document about a week ago --
DR. HELEN WHITWELL: Right.
MR. JAMES LOCKYER: -- through -- through the officer himself providing it.
-------------------------------------------------------------------------------
We are told that this note was written before Dinesh Kumar was encouraged by prosecutors to plead guilty to criminal negligence causing his son Gaurov's death in order to avoid being prosecuted for murder.
The existence of such a note - in which both Dr. Smith and the Head of the SCAN team are struggling to find any scientific evidence of criminality in the case - clearly raises the prospect that there was no reasonable possibility of obtaining a conviction.
The last time I looked at a Criminal Code - Criminal Negligence Causing Death was just what it sounded like: a very serious criminal offence.
So we have to wonder why the prosecutors who, as crown attorneys, also hold the function of being officers of the Court, proceeded to take Mr. Kumar to Court on any criminal charge at all - whether they were bound by the law to withdraw all charges against him or not.
A very shocking revelation indeed, which, it seems, only raised its ugly head publicly more than 16-years after Mr. Kumar pleaded guilty to an offence he did not commit, to avoid life in prison for murder on the evidence of the celebrated Dr. Smith's evidence supported by the world famous Hospital for Sick Children, to regain custody of his son, and to avoid deportation from Canada;
How could our Canadian Justice system fall so low?
Next Posting: Part Nine; Gaurov's Father; A Third Shocking Revelation From The Goudge Inquiry;
Harold Levy...hlevy15@gmail.com;
Friday, June 6, 2008
Stop The Press: Part Two; Access to Information Request:
This Blog's access to information request appears to confirm that $7,888.00 was paid out of taxpayer's funds to reimburse Dr. Charles Smith for legal expenses he incurred in suing the Canadian Broadcasting Corporation for libel.
I will repeat that: $7,888.20 - almost $8,000.00 out of the taxpayer's pocket to help Dr. Smith sue the CBC - in connection with the CBC Fifth Estate documentary which, we now know, as a result of the evidence called at the Goudge Inquiry, told the truth about Dr. Charles Smith and the Chief Coroner's Office.
In previous posts I have discussed this issue in the context of freedom of expression - and government funds being used to chill the press from performing its watchdog function.
That's a no-brainer.
But I am also troubled by the fact that the government should go to bat to protect Dr. Smith's reputation with taxpayer's dollars - when many of the innocent parents and caregivers affected by Dr. Smith - and their families - had to scrape together funds in order to retain lawyers who were willing to take on the government and its
supreme witness, Dr. Charles Smith.
Some had to borrow heavily.
Others had to use up their hard-earned retirement savings.
All this while trying to cope with the horror of being accused of killing a child - and, in some cases, fighting to fend off the seizure of other children by the Children's Aid Societies.
The thought that Dr. Smith's victims were unknowingly helping pay his legal fees out of the taxes they paid to protect his reputation is also disturbing.
I wonder how they feel.
We learned from the Inquiry that attempts to complain about Dr. Smith to the Chief Coroner's Office came to naught - because there was no political will to receive and consider them - and determine if they were justified.
(That allowed Dr. Smith to continue reaping the damage with impunity);
Since there was no channel within the Chief Coroner's to have complaints seriously probed and acted on, Dr. Smith's victims had only one other recourse - the media - and at the same time the government was helping thwart media scrutiny by supporting Dr. Smith's private lawsuit against the CBC.
I am also troubled by the secrecy with which this appears to have been done.
If it weren't for the Goudge inquiry we might never have discovered that public funds had been used to fund this private law suit.
What now?
Justice Stephen Goudge is set to issue his report on Sept. 30, 2008: Perhaps he could recommend that Dr. Smith return the $8,000 to government coffers.
I would love to see the Canadian Civil Liberties Asociation take on this issue: It goes to the heart of our democracy;
I would also like to see the CBC wake up to this issue that hit them so close to home, follow up with its own stories, and join me on my appeal of the government's refusal to provide several documents relating to this matter on the basis that they are protected ny the "solicitor client privilege."
Harold Levy...hlevy15@gmail.com;
I will repeat that: $7,888.20 - almost $8,000.00 out of the taxpayer's pocket to help Dr. Smith sue the CBC - in connection with the CBC Fifth Estate documentary which, we now know, as a result of the evidence called at the Goudge Inquiry, told the truth about Dr. Charles Smith and the Chief Coroner's Office.
In previous posts I have discussed this issue in the context of freedom of expression - and government funds being used to chill the press from performing its watchdog function.
That's a no-brainer.
But I am also troubled by the fact that the government should go to bat to protect Dr. Smith's reputation with taxpayer's dollars - when many of the innocent parents and caregivers affected by Dr. Smith - and their families - had to scrape together funds in order to retain lawyers who were willing to take on the government and its
supreme witness, Dr. Charles Smith.
Some had to borrow heavily.
Others had to use up their hard-earned retirement savings.
All this while trying to cope with the horror of being accused of killing a child - and, in some cases, fighting to fend off the seizure of other children by the Children's Aid Societies.
The thought that Dr. Smith's victims were unknowingly helping pay his legal fees out of the taxes they paid to protect his reputation is also disturbing.
I wonder how they feel.
We learned from the Inquiry that attempts to complain about Dr. Smith to the Chief Coroner's Office came to naught - because there was no political will to receive and consider them - and determine if they were justified.
(That allowed Dr. Smith to continue reaping the damage with impunity);
Since there was no channel within the Chief Coroner's to have complaints seriously probed and acted on, Dr. Smith's victims had only one other recourse - the media - and at the same time the government was helping thwart media scrutiny by supporting Dr. Smith's private lawsuit against the CBC.
I am also troubled by the secrecy with which this appears to have been done.
If it weren't for the Goudge inquiry we might never have discovered that public funds had been used to fund this private law suit.
What now?
Justice Stephen Goudge is set to issue his report on Sept. 30, 2008: Perhaps he could recommend that Dr. Smith return the $8,000 to government coffers.
I would love to see the Canadian Civil Liberties Asociation take on this issue: It goes to the heart of our democracy;
I would also like to see the CBC wake up to this issue that hit them so close to home, follow up with its own stories, and join me on my appeal of the government's refusal to provide several documents relating to this matter on the basis that they are protected ny the "solicitor client privilege."
Harold Levy...hlevy15@gmail.com;
Part Seven: Gaurov's Father; Shocking Disclosure At Inquiry: Kumar Not Told By Crowns About Recent Decision Blasting Smith And Sick Kids SCAN Team;
"THIS WAS A MAN WITH NO RECORD -- A NEW IMMIGRANT TO THIS COUNTRY, A WIFE WITH A BRAIN TUMOUR, A JOB. HE WAS A CONTRIBUTING MEMBER OF SOCIETY, AND ALL OF THE SUDDEN AN ATOMIC BOMB GOES OFF IN HIS LIFE -- MURDER 2. YOU HAVE TO TELL HIM BECAUSE THEY ALWAYS ASK, WHAT'S THE PENALTY, AND YOU SAY, LIFE WITH A MINIMUM PENALTY OF TEN (10) YEARS -- TEN (10) YEARS. HE WOULD HAVE GOTTEN OUT OF JAIL HAD HE
GOTTEN TEN (10) YEARS, AND IF THE TRIAL HAD TAKEN TWO (2) YEARS, HE'S JUST BE OUT NOW FOR FOUR (4) YEARS, AND HIS WHOLE LIFE WOULD BE SHATTERED. NOW, I -- I SEE IN THESE NOTES THAT I'VE BEEN GIVEN FOR THE FIRST TIME TODAY, THE MEETING JANUARY 30TH OF 1992, THE WORDS "DAMAGE CONTROL" APPEAR DEALING WITH THE CASE FROM MR. JUSTICE DUNN. I CAN'T MAKE A CONNECTION BETWEEN THAT MEETING AND WHAT HAPPENED IN MY CASE, EXCEPT THAT IT HAPPENED JUST A FEW WEEKS LATER OUT OF THE SAME OFFICE. I'M STILL SHOCKED."
-------------------------------------------------------------------------------
LAWYER DAVID GORRELL IN RESPONSE TO QUESTIONS POSED IN CROSS-EXAMINATION BY JAMES LOCKYER;
-------------------------------------------------------------------------------
One of the most shocking revelations from the Goudge Inquiry is Dinesh Kumar's lawyer's evidence that he was not been informed by prosecutors about a disturbing decision from Ontario Court Justice Patrick Dunn in the Amber case.
As we have seen in many previous posts, this decision was was highly critical of the opinions of Dr. Charles Smith and the Hospital for Sick Children SCAN team.
As will be seen towards the end of this post, a lack of access to this decision had dire consequences for Mr. Kumar which he bears to this day.
By was of background information, here is a post I ran on Thursday, January 10, 2008, under the heading "Damage Control And Lost Opportunity: The Hospital For Sick Children Suspected Child Abuse and Neglect (SCAN) Unit;"
It describes how the Hospital for Sick Children resorted to "damage control" rather than to dissecting Dunn's decision in order to see what they could learn from it in order to avoid future debacles.
I did not realize the additional significance of the damage control meeting - the presence of a prosecutor - until I was later exposed to Gaurov's case at the inquiry.
Here is the earlier post as published:
""C.S. FEELS HE WAS MISUNDERSTOOD."
FROM HOSPITAL FOR SICK CHILDREN DAMAGE CONTROL DOCUMENT;
One would like to think of the Hospital For Sick Children as an institution that wants to learn from its mistakes.
This would especially apply to the serious medical errors made by Dr. Charles Smith and the hospital's Suspected Child Abuse and Neglect (SCAN) Unit that led to a 12-year old girl Timmins, Ontario girl being wrongfully charged with manslaughter.
However, a document has emerged at the Goudge inquiry which shows that the SCAN team reacted to Ontario Court Judge Judge Patrick Dunn's scathing criticisms of its work by holding a "damage control" meeting at which Smith defended his work, and Dunn was branded as "strange" and "from the bottom of the heap"
The handwritten document does not evidence any concern on the part of Smith or the members of the SCAN team that Judge Dunn's rejection of the hospital's opinion that baby Amber was a victim of "shaken-baby syndrome," as opposed to a fall down the stairs, may have been well-founded.
Nor does it evidence any desire to figure out what went wrong so that the risk of future wrongful prosecutions can be minimized.
Instead, after noting that the meeting was attended by the members of the SCAN team and several prosecutors, it goes on to describe Dunn as "strange" a member of the "family court" and "not used to criminal standards."
It goes on to express a concern that, "the judgment is likely to be passed around and (symbol for "therefore") damage control)";
(In retrospect, this prediction was right on the mark as Dunn's carefully structured judgement is resonating today at the core of the Goudge inquiry as one of the first alarm bells to sound over Smith's competence.)
But is is evident that the "damage control" ultimately failed as the hospital's failure to accept its responsibility and do something to remedy its mistakes is now available on the public record for all to see.
One of the most disturbing suggestions in the document is the comment that there is "no precedential value re medical evidence. Family court judge at bottom of heap. Error may be brought up in another case."
The reality is that if Dunn's criticisms - as set out in a beautifully structured decision - had been heeded back in 1991, so many other individuals would have been spared the torment of being wrongfully accused of killing their beloved children.
Instead, the consensus of the meeting appears to be that it is, "acceptable to say we disagree with judge's judgment."
The notes indicated that Smith defended his opinion in the case on the basis that "our standard is higher than theirs" - (an apparent reference to the large number of U.S. experts called by the defence) - "but still has to be held up to a higher standard."
He also attempts to deflect criticism from himself by saying that the case involved an "outside opinion" and that he "relied on police photos."
"C.S. feels he was misunderstood," the anonymous minute-taker wrote.
This is typical of Dr. Charles Randal Smith.
Evidence called at the Inquiry indicates that even his defenders at the highest levels of the Chief Coroner's Office observed toward the end of his career at the hospital that he was incapable of accepting responsibility for his actions and tended to blame others for his own mistakes.
During his questioning yesterday of Dr. Dirk Huyer, former head of the SCAN team and Dr. Katy Driver, who played a prominent role for that team in Amber's case, lawyer Louis Sokolov, who represents the Association in Defence of the Wrongly Convicted, (AIDWYC) suggested that the Hospital's damage control meeting represented, "a lost opportunity."
He sure got that right.
(See previous posting: "A glimmer of understanding: Part Three; A dangerous mix; Dr. Charles Smith and the Hospital For Sick Children SCAN team.)
Posted by Harold levy at Thursday, January 10, 2008;"
Goudge Inquiry Counsel Mark Sandler twigged to the fact that the prosecutor who was present at the damage control meeting played an active role in the Kumar investigation - just several weeks later;
Here is Sandler's examination of David Gorrell, Kumar's lawyer, on this connection:
(Bear with me: I prefer to give full stretched of evidence rather than to risk inadvertently distorting the substance through editing);
CONTINUED BY MR. MARK SANDLER:
MR. MARK SANDLER: Thank you. Mr. Gorrell, we know from the materials that have been filed here that -- that Gaurov died in Toronto on March the 20th, 1992, at the age of five (5) weeks. Due to suspicions about his death, his older brother was apprehended by CAS on that same date. We also know that on June the 16th of 1992, the report of post-mortem examination prepared by Dr. Smith was issued. I'm going to take you to the overview report if I may, which is at Tab 1 of your materials. And if you'd go to PFP143828, at paragraph 59, and you'll
see paragraph 59 is at page 32 of the overview report.
MR. DAVID GORRELL: Thank you.
MR. MARK SANDLER: And you'll see that on June the 26th of 1992, there was a meeting involving Dr. Smith, Constable Line, Detective Rolf Prisor, and -- Prisor, and Crown counsel, Mary Hall and Sandra Kingston. Just stopping there for a -- for a moment. First of all, what was Ms. Hall's position back in June
of 1992, as you understand it?
MR. DAVID GORRELL: I believe she was the -- either a Bureau Chief, or a Crown attorney, an independent Crown attorney. I'm not sure if Scarborough had been hived off yet, and made into a -- a jurisdiction for a separate Crown. But she was the head person. (Blogster's Note: Prosecutor Hall did not testify at the Inquiry. Her side of the story is not represented in this post.)
MR. MARK SANDLER: And were you aware of what, if any, role she played in the Gaurov case?
MR. DAVID GORRELL: Well, she would obviously supervise. She did participate in the -- in a judicial pretrial that we had on October 22nd of 1992, but that was simply because the assigned Crown, I believe, was not available.
MR. MARK SANDLER: And that was Ms. Koehl?
MR. DAVID GORRELL: Ms. Koehl, yes.
MR. MARK SANDLER: And you see from the overview report that that meeting involving the police and Crown counsel and Dr. Smith took place on June the 26th, and the overview report reflects that, according to a police report, Dr. Smith confirmed his diagnosis of Shaken Baby Syndrome, and added that the injuries probably resulted from continuous shaking as opposed to a single violent shake. We also know, Mr. Gorrell, that on June the 29th of 1992, Gaurov's father was arrested for second degree murder, some three (3) days later.
MR. DAVID GORRELL: Yes.
MR. MARK SANDLER: And the bail hearing took place on July the 10th -
MR. DAVID GORRELL: Yes.
MR. MARK SANDLER: -- and were you involved in the bail hearing?
MR. DAVID GORRELL: I became involved on July 2nd. The case first went to Dhamen Kissoon -- K-I- S-S-O-O-N, who had gone to the bar in 1989, and he retained me to lead on the defence. And I became involved on June 30th. And we worked on preparing the necessary affidavits and so on for the bail hearing from June 30th on.
MR. MARK SANDLER: All right.
MR. DAVID GORRELL: Until July 10th.
MR. MARK SANDLER: And we know from the materials that have been filed that the Crown consented to the release of your client on bail, pending trial. Am I right?
MR. DAVID GORRELL: Yes.
MR. MARK SANDLER: And I want to ask you about a conversation that your dockets reflect took place with Rita Koehl on the same date of the bail hearing, June -- July the 10th.
MR. DAVID GORRELL: Yes.
MR. MARK SANDLER: Tell us what transpired.
MR. DAVID GORRELL: This is a -- a case that's sixteen (16) years ago, and therefore, I'm relying heavily on the notes that were found in Mr. Kissoon's file. My own file isn't -- is no longer available. According to the dockets and the notes that I have here, on the day of the bail hearing, Ms.
Koehl, with Sergeant Prisor, I think, present, discussed with me the possibility of a resolution by way of plea to something possibly for no time.
MR. MARK SANDLER: All right. And how did you react to the fact that on a murder case, the Crown had initiated a discussion with you that involved a
potential plea for -- for no time?
MR. DAVID GORRELL: I was surprised.
MR. MARK SANDLER: And did you have any explana -- or was any explanation given to you as to why the Crown was taking that position as -- that early and at that stage in the proceedings?
MR. DAVID GORRELL: Not that I recall, and I would not have asked. You don't look a gift horse in the mouth.
MR. MARK SANDLER: All right. And similarly, I see that, as you've indicated, there was a consent to your client's release on bail, pending trial.
MR. DAVID GORRELL: Yes.
MR. MARK SANDLER: Was that in your experience usual for a murder case?
MR. DAVID GORRELL: John would be better to ask. I haven't done nearly as many as he has, but you can get consent releases on murders, and I think this would have been a case where you could have.
MR. MARK SANDLER: All right. Now, just seeing what, if anything, we can figure out about -- about why the Crown was motivated to proceed in the way it did. I want to ask you about something that you may or may not know about, and that is, we've heard some evidence here, Mr. Gorrell, that on January -- in January of 1992, that same year -- a conference -- a case conference was conducted at the Hospital for Sick Children in connection with the Amber case, and it arose out of the comments that Justice Dunn had made about the Hospital for Sick Children witnesses, including Dr. Smith, at -- at that trial, and we also know that in January of 1992, Ms. Hall and Ms. Kingston participated in that conference.
Two (2) questions arising out of that. Did either Ms. Hall or Ms. Kingston, or anyone else from the Crown's office have any discussions with you about the Amber case and its impact upon the Gaurov case?
MR. DAVID GORRELL: No.
MR. MARK SANDLER: Were you aware that -- that the Crowns, including Ms. Hall, had participated in a case conference in connection with the Amber case before the Gaurov case had taken place?
MR. DAVID GORRELL: No.
MR. MARK SANDLER: All right.
MR. DAVID GORRELL: All right, let me rephrase that. I know that they met again, I think, on June the 26th about this case, about the -- the Gaurov case, but I was unaware of this meeting. I have the notes in front of me here. I've seen them today for the first time. I was unaware of this meeting on January 30th, 1992.
MR. MARK SANDLER: All right. And you've made reference to -- to the meeting that took place here and -- and I've made reference to the Crown, so just taking you to page 32, paragraph 59, that's the reference that I took you to a little bit earlier of the meeting that took place involving Dr. Smith, the police, Ms. Hall, and Ms. Kingston. Am I right?
MR. DAVID GORRELL: Yes.
MR. MARK SANDLER: And were you aware that -- that that conference had taken place prior to the laying of the charges?
MR. DAVID GORRELL: I don't think so. It's been a long time ago, but I don't think I was aware of that meeting, and I don't think I had the police notes of it. I do have the original disclosure here from 1992, and the summary that is -- is available in these materials is not in that disclosure.
MR. MARK SANDLER: Okay, and leaving aside your awareness of the June 26th, 1992 meeting, you earlier indicated that you were the one that actually
gave Mr. Struthers a copy of the Amber decision, and this would be sometime later on.
MR. DAVID GORRELL: Yes.
MR. MARK SANDLER: Were you even aware of the Amber decision back in June of 1992 or during the currency of your involvement in the Gaurov file?
MR. DAVID GORRELL: No, I was not.
MR. MARK SANDLER: Was it something that you would have been like -- that you would have liked to have been aware of?
MR. DAVID GORRELL: Oh, yes;"
As the following transcript indicates, lawyer James Lockyer, who represents William Mullins-Johnson, Sherry Sherret-Robinson and at least seven unnamed persons at the Inquiry, was quick to zoom into this connection in his cross-examination of Gorrell;
MR. DAVID GORRELL: This was a man with no record -- a new immigrant to this country, a wife with a brain tumour, a job," Gorrell told Lockyer;
"He was a contributing member of society, and all of the sudden an atomic bomb goes off in his life -- murder 2. You have to tell him because they always ask, What's the penalty, and you say, Life with a minimum penalty of ten (10) years -- ten (10) years. He would have gotten out of jail had he gotten ten (10) years, and if the trial had taken two (2) years, he's just be out now for four (4) years, and his
whole life would be shattered. Now, I -- I see in these notes that I've been given for the first time today, the meeting January 30th of 1992, the words "damage control" appear dealing with the case from Mr. Justice Dunn. I can't make a connection between that meeting and what happened in my case, except that it
happened just a few weeks later out of the same office. I'm still shocked.
MR. JAMES LOCKYER: The same Crown, as a matter of fact --
MR. DAVID GORRELL: Well, no, -- well, no, Ms. Koehl wasn't on this case, but Mary --
MR. JAMES LOCKYER: Mary Hall --
MR. DAVID GORRELL: Mary Hall, the same Crown attorney.
MR. JAMES LOCKYER: -- was the common denominator to your case and their case, is that right?
MR. DAVID GORRELL: Yes, and the Scarborough courthouse --
MR. JAMES LOCKYER: Mm-hm.
MR. DAVID GORRELL: -- and Charles Smith, Of course. But --
MR. JAMES LOCKYER: I think Mary Hall was actually the Crown when you did the pretrial in October--
MR. DAVID GORRELL: Yes, she did.
MR. JAMES LOCKYER: -- on the Gaurov case, is that right?
MR. DAVID GORRELL: She was there. I think Ms. Koehl was unavailable for some reason, but...
MR. JAMES LOCKYER: Yes. And I -- as I recall, Mr. Koehl also said that any plea arrangement would be subject to the approval of Ms. Hall.
MR. DAVID GORRELL: That I don't remember, but I -- I wouldn't be surprised in any case.
MR. JAMES LOCKYER: It's in one (1) of the documents in the file you arrived with today.
MR. DAVID GORRELL: Really?
MR. JAMES LOCKYER: Yes.
MR. DAVID GORRELL: Fine, then I accept
that.
MR. JOHN STRUTHERS: It was the practice
at the time.
MR. JAMES LOCKYER: Yes.
MR. DAVID GORRELL: But the -- just -- just to continue with this, what -- I said, my heart went out to Gaurov's father. I don't know how I'd -- I'd act in this situation if I had someone like Mr. Struthers saying, Well, you can get ninety (90) days on weekends. After emission, that's sixty (60) days. That's a maximum of fifteen (15) weekends. The Mimico is jammed, so you'll wind up doing only three (3), or four (4), or five (5). You can do that, or you can sit in the courtroom and be judged by everybody with a risk, with Charles Smith up there with a mantle of Sick Kids on his shoulder. You can go to jail. You can go to jail on a
manslaughter. I really didn't think a murder was in the cards, but you can go to jail on a manslaughter. What decision would I make? I'm pretty sure I'd make the
decision he made even if I were not guilty. But as his lawyer, I'm the only person in the whole scenario that Doesn't judge him. The police judge him when they charge him. The Crown judges him when they prosecute him. The Judge judges him, the jury judges him, the press judges him. When he says, I want to plead guilty, and
I will sign on the dotted line, and I did it, I'm not going to tell him, No, sir, you're going to face the trial and if you get eight (8) years, that's for the
greater good of the justice. I took his instructions and I -- I would not be at all surprised, with the stress that man was under at the time, if he was doing it out of expediency.
MR. JAMES LOCKYER: And the instructions that you received from him by way of the form that you prepared, obviously the way it's typed up, it was -- the words were your words in that document, is that fair?
MR. DAVID GORRELL: Yes, they were my words.
MR. JAMES LOCKYER: And they were words designed to fit the notion of criminal negligence. Reckless is hardly a word an east Indian that doesn't
speak English is going to come up with.
MR. DAVID GORRELL: No, the -- this -- these were my words.
MR. JAMES LOCKYER: Yes. And, as Mr. Struthers was just saying, it was more a document for your protection than a document to assist Gaurov's
father, is that fair?
MR. DAVID GORRELL: I think that's probably fair. It's also a document that you would use to fix his mind as to what he's doing, so that he can't
come back and -- I guess to protect counsel, that's right. I(t) was thirteen (13) pages;"
Dear readers:
Imagine how the prosecutors must have felt to learn about Justice Dunn's troubling criticisms of the work performed by Dr. Charles Smith and the Hospital for Sick Children SCAN-TEAM in the then recent Amber case;
Would that not have raised serious questions as to whether or not there was a reasonable possibility of obtaining a conviction in the case?
At the very least, shouldn't the existence of the decision - which was not likely publicly available at that time - have been made to the defence lawyers?
At least, that way they could assess the strength of the Crown's case before putting the plea to criminal negligence causing his son Gaurov's death to his client whether or not the law relating to disclosure at the time required them to do so?
As a criminal lawyer, I suspect that after reading the Dunn decision I would have been in a position to more confidently advise the client to contest the murder charge - instead of having to go through the contortions involved in a criminal negligence plea where I would have so much doubt about my client's guilt?
Just imagine how much pain this mourning family would have been spared - let alone the need to bear the load of sixteen years of stigma in their tiny community - and having to fight for ultimate exoneration after sixteen years in the Ontario Court of Appeal;
Next: Part Seven; Gaurov's father: Another shocking revelation;
Harold Levy: hlevy15@gmail.com;
GOTTEN TEN (10) YEARS, AND IF THE TRIAL HAD TAKEN TWO (2) YEARS, HE'S JUST BE OUT NOW FOR FOUR (4) YEARS, AND HIS WHOLE LIFE WOULD BE SHATTERED. NOW, I -- I SEE IN THESE NOTES THAT I'VE BEEN GIVEN FOR THE FIRST TIME TODAY, THE MEETING JANUARY 30TH OF 1992, THE WORDS "DAMAGE CONTROL" APPEAR DEALING WITH THE CASE FROM MR. JUSTICE DUNN. I CAN'T MAKE A CONNECTION BETWEEN THAT MEETING AND WHAT HAPPENED IN MY CASE, EXCEPT THAT IT HAPPENED JUST A FEW WEEKS LATER OUT OF THE SAME OFFICE. I'M STILL SHOCKED."
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LAWYER DAVID GORRELL IN RESPONSE TO QUESTIONS POSED IN CROSS-EXAMINATION BY JAMES LOCKYER;
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One of the most shocking revelations from the Goudge Inquiry is Dinesh Kumar's lawyer's evidence that he was not been informed by prosecutors about a disturbing decision from Ontario Court Justice Patrick Dunn in the Amber case.
As we have seen in many previous posts, this decision was was highly critical of the opinions of Dr. Charles Smith and the Hospital for Sick Children SCAN team.
As will be seen towards the end of this post, a lack of access to this decision had dire consequences for Mr. Kumar which he bears to this day.
By was of background information, here is a post I ran on Thursday, January 10, 2008, under the heading "Damage Control And Lost Opportunity: The Hospital For Sick Children Suspected Child Abuse and Neglect (SCAN) Unit;"
It describes how the Hospital for Sick Children resorted to "damage control" rather than to dissecting Dunn's decision in order to see what they could learn from it in order to avoid future debacles.
I did not realize the additional significance of the damage control meeting - the presence of a prosecutor - until I was later exposed to Gaurov's case at the inquiry.
Here is the earlier post as published:
""C.S. FEELS HE WAS MISUNDERSTOOD."
FROM HOSPITAL FOR SICK CHILDREN DAMAGE CONTROL DOCUMENT;
One would like to think of the Hospital For Sick Children as an institution that wants to learn from its mistakes.
This would especially apply to the serious medical errors made by Dr. Charles Smith and the hospital's Suspected Child Abuse and Neglect (SCAN) Unit that led to a 12-year old girl Timmins, Ontario girl being wrongfully charged with manslaughter.
However, a document has emerged at the Goudge inquiry which shows that the SCAN team reacted to Ontario Court Judge Judge Patrick Dunn's scathing criticisms of its work by holding a "damage control" meeting at which Smith defended his work, and Dunn was branded as "strange" and "from the bottom of the heap"
The handwritten document does not evidence any concern on the part of Smith or the members of the SCAN team that Judge Dunn's rejection of the hospital's opinion that baby Amber was a victim of "shaken-baby syndrome," as opposed to a fall down the stairs, may have been well-founded.
Nor does it evidence any desire to figure out what went wrong so that the risk of future wrongful prosecutions can be minimized.
Instead, after noting that the meeting was attended by the members of the SCAN team and several prosecutors, it goes on to describe Dunn as "strange" a member of the "family court" and "not used to criminal standards."
It goes on to express a concern that, "the judgment is likely to be passed around and (symbol for "therefore") damage control)";
(In retrospect, this prediction was right on the mark as Dunn's carefully structured judgement is resonating today at the core of the Goudge inquiry as one of the first alarm bells to sound over Smith's competence.)
But is is evident that the "damage control" ultimately failed as the hospital's failure to accept its responsibility and do something to remedy its mistakes is now available on the public record for all to see.
One of the most disturbing suggestions in the document is the comment that there is "no precedential value re medical evidence. Family court judge at bottom of heap. Error may be brought up in another case."
The reality is that if Dunn's criticisms - as set out in a beautifully structured decision - had been heeded back in 1991, so many other individuals would have been spared the torment of being wrongfully accused of killing their beloved children.
Instead, the consensus of the meeting appears to be that it is, "acceptable to say we disagree with judge's judgment."
The notes indicated that Smith defended his opinion in the case on the basis that "our standard is higher than theirs" - (an apparent reference to the large number of U.S. experts called by the defence) - "but still has to be held up to a higher standard."
He also attempts to deflect criticism from himself by saying that the case involved an "outside opinion" and that he "relied on police photos."
"C.S. feels he was misunderstood," the anonymous minute-taker wrote.
This is typical of Dr. Charles Randal Smith.
Evidence called at the Inquiry indicates that even his defenders at the highest levels of the Chief Coroner's Office observed toward the end of his career at the hospital that he was incapable of accepting responsibility for his actions and tended to blame others for his own mistakes.
During his questioning yesterday of Dr. Dirk Huyer, former head of the SCAN team and Dr. Katy Driver, who played a prominent role for that team in Amber's case, lawyer Louis Sokolov, who represents the Association in Defence of the Wrongly Convicted, (AIDWYC) suggested that the Hospital's damage control meeting represented, "a lost opportunity."
He sure got that right.
(See previous posting: "A glimmer of understanding: Part Three; A dangerous mix; Dr. Charles Smith and the Hospital For Sick Children SCAN team.)
Posted by Harold levy at Thursday, January 10, 2008;"
Goudge Inquiry Counsel Mark Sandler twigged to the fact that the prosecutor who was present at the damage control meeting played an active role in the Kumar investigation - just several weeks later;
Here is Sandler's examination of David Gorrell, Kumar's lawyer, on this connection:
(Bear with me: I prefer to give full stretched of evidence rather than to risk inadvertently distorting the substance through editing);
CONTINUED BY MR. MARK SANDLER:
MR. MARK SANDLER: Thank you. Mr. Gorrell, we know from the materials that have been filed here that -- that Gaurov died in Toronto on March the 20th, 1992, at the age of five (5) weeks. Due to suspicions about his death, his older brother was apprehended by CAS on that same date. We also know that on June the 16th of 1992, the report of post-mortem examination prepared by Dr. Smith was issued. I'm going to take you to the overview report if I may, which is at Tab 1 of your materials. And if you'd go to PFP143828, at paragraph 59, and you'll
see paragraph 59 is at page 32 of the overview report.
MR. DAVID GORRELL: Thank you.
MR. MARK SANDLER: And you'll see that on June the 26th of 1992, there was a meeting involving Dr. Smith, Constable Line, Detective Rolf Prisor, and -- Prisor, and Crown counsel, Mary Hall and Sandra Kingston. Just stopping there for a -- for a moment. First of all, what was Ms. Hall's position back in June
of 1992, as you understand it?
MR. DAVID GORRELL: I believe she was the -- either a Bureau Chief, or a Crown attorney, an independent Crown attorney. I'm not sure if Scarborough had been hived off yet, and made into a -- a jurisdiction for a separate Crown. But she was the head person. (Blogster's Note: Prosecutor Hall did not testify at the Inquiry. Her side of the story is not represented in this post.)
MR. MARK SANDLER: And were you aware of what, if any, role she played in the Gaurov case?
MR. DAVID GORRELL: Well, she would obviously supervise. She did participate in the -- in a judicial pretrial that we had on October 22nd of 1992, but that was simply because the assigned Crown, I believe, was not available.
MR. MARK SANDLER: And that was Ms. Koehl?
MR. DAVID GORRELL: Ms. Koehl, yes.
MR. MARK SANDLER: And you see from the overview report that that meeting involving the police and Crown counsel and Dr. Smith took place on June the 26th, and the overview report reflects that, according to a police report, Dr. Smith confirmed his diagnosis of Shaken Baby Syndrome, and added that the injuries probably resulted from continuous shaking as opposed to a single violent shake. We also know, Mr. Gorrell, that on June the 29th of 1992, Gaurov's father was arrested for second degree murder, some three (3) days later.
MR. DAVID GORRELL: Yes.
MR. MARK SANDLER: And the bail hearing took place on July the 10th -
MR. DAVID GORRELL: Yes.
MR. MARK SANDLER: -- and were you involved in the bail hearing?
MR. DAVID GORRELL: I became involved on July 2nd. The case first went to Dhamen Kissoon -- K-I- S-S-O-O-N, who had gone to the bar in 1989, and he retained me to lead on the defence. And I became involved on June 30th. And we worked on preparing the necessary affidavits and so on for the bail hearing from June 30th on.
MR. MARK SANDLER: All right.
MR. DAVID GORRELL: Until July 10th.
MR. MARK SANDLER: And we know from the materials that have been filed that the Crown consented to the release of your client on bail, pending trial. Am I right?
MR. DAVID GORRELL: Yes.
MR. MARK SANDLER: And I want to ask you about a conversation that your dockets reflect took place with Rita Koehl on the same date of the bail hearing, June -- July the 10th.
MR. DAVID GORRELL: Yes.
MR. MARK SANDLER: Tell us what transpired.
MR. DAVID GORRELL: This is a -- a case that's sixteen (16) years ago, and therefore, I'm relying heavily on the notes that were found in Mr. Kissoon's file. My own file isn't -- is no longer available. According to the dockets and the notes that I have here, on the day of the bail hearing, Ms.
Koehl, with Sergeant Prisor, I think, present, discussed with me the possibility of a resolution by way of plea to something possibly for no time.
MR. MARK SANDLER: All right. And how did you react to the fact that on a murder case, the Crown had initiated a discussion with you that involved a
potential plea for -- for no time?
MR. DAVID GORRELL: I was surprised.
MR. MARK SANDLER: And did you have any explana -- or was any explanation given to you as to why the Crown was taking that position as -- that early and at that stage in the proceedings?
MR. DAVID GORRELL: Not that I recall, and I would not have asked. You don't look a gift horse in the mouth.
MR. MARK SANDLER: All right. And similarly, I see that, as you've indicated, there was a consent to your client's release on bail, pending trial.
MR. DAVID GORRELL: Yes.
MR. MARK SANDLER: Was that in your experience usual for a murder case?
MR. DAVID GORRELL: John would be better to ask. I haven't done nearly as many as he has, but you can get consent releases on murders, and I think this would have been a case where you could have.
MR. MARK SANDLER: All right. Now, just seeing what, if anything, we can figure out about -- about why the Crown was motivated to proceed in the way it did. I want to ask you about something that you may or may not know about, and that is, we've heard some evidence here, Mr. Gorrell, that on January -- in January of 1992, that same year -- a conference -- a case conference was conducted at the Hospital for Sick Children in connection with the Amber case, and it arose out of the comments that Justice Dunn had made about the Hospital for Sick Children witnesses, including Dr. Smith, at -- at that trial, and we also know that in January of 1992, Ms. Hall and Ms. Kingston participated in that conference.
Two (2) questions arising out of that. Did either Ms. Hall or Ms. Kingston, or anyone else from the Crown's office have any discussions with you about the Amber case and its impact upon the Gaurov case?
MR. DAVID GORRELL: No.
MR. MARK SANDLER: Were you aware that -- that the Crowns, including Ms. Hall, had participated in a case conference in connection with the Amber case before the Gaurov case had taken place?
MR. DAVID GORRELL: No.
MR. MARK SANDLER: All right.
MR. DAVID GORRELL: All right, let me rephrase that. I know that they met again, I think, on June the 26th about this case, about the -- the Gaurov case, but I was unaware of this meeting. I have the notes in front of me here. I've seen them today for the first time. I was unaware of this meeting on January 30th, 1992.
MR. MARK SANDLER: All right. And you've made reference to -- to the meeting that took place here and -- and I've made reference to the Crown, so just taking you to page 32, paragraph 59, that's the reference that I took you to a little bit earlier of the meeting that took place involving Dr. Smith, the police, Ms. Hall, and Ms. Kingston. Am I right?
MR. DAVID GORRELL: Yes.
MR. MARK SANDLER: And were you aware that -- that that conference had taken place prior to the laying of the charges?
MR. DAVID GORRELL: I don't think so. It's been a long time ago, but I don't think I was aware of that meeting, and I don't think I had the police notes of it. I do have the original disclosure here from 1992, and the summary that is -- is available in these materials is not in that disclosure.
MR. MARK SANDLER: Okay, and leaving aside your awareness of the June 26th, 1992 meeting, you earlier indicated that you were the one that actually
gave Mr. Struthers a copy of the Amber decision, and this would be sometime later on.
MR. DAVID GORRELL: Yes.
MR. MARK SANDLER: Were you even aware of the Amber decision back in June of 1992 or during the currency of your involvement in the Gaurov file?
MR. DAVID GORRELL: No, I was not.
MR. MARK SANDLER: Was it something that you would have been like -- that you would have liked to have been aware of?
MR. DAVID GORRELL: Oh, yes;"
As the following transcript indicates, lawyer James Lockyer, who represents William Mullins-Johnson, Sherry Sherret-Robinson and at least seven unnamed persons at the Inquiry, was quick to zoom into this connection in his cross-examination of Gorrell;
MR. DAVID GORRELL: This was a man with no record -- a new immigrant to this country, a wife with a brain tumour, a job," Gorrell told Lockyer;
"He was a contributing member of society, and all of the sudden an atomic bomb goes off in his life -- murder 2. You have to tell him because they always ask, What's the penalty, and you say, Life with a minimum penalty of ten (10) years -- ten (10) years. He would have gotten out of jail had he gotten ten (10) years, and if the trial had taken two (2) years, he's just be out now for four (4) years, and his
whole life would be shattered. Now, I -- I see in these notes that I've been given for the first time today, the meeting January 30th of 1992, the words "damage control" appear dealing with the case from Mr. Justice Dunn. I can't make a connection between that meeting and what happened in my case, except that it
happened just a few weeks later out of the same office. I'm still shocked.
MR. JAMES LOCKYER: The same Crown, as a matter of fact --
MR. DAVID GORRELL: Well, no, -- well, no, Ms. Koehl wasn't on this case, but Mary --
MR. JAMES LOCKYER: Mary Hall --
MR. DAVID GORRELL: Mary Hall, the same Crown attorney.
MR. JAMES LOCKYER: -- was the common denominator to your case and their case, is that right?
MR. DAVID GORRELL: Yes, and the Scarborough courthouse --
MR. JAMES LOCKYER: Mm-hm.
MR. DAVID GORRELL: -- and Charles Smith, Of course. But --
MR. JAMES LOCKYER: I think Mary Hall was actually the Crown when you did the pretrial in October--
MR. DAVID GORRELL: Yes, she did.
MR. JAMES LOCKYER: -- on the Gaurov case, is that right?
MR. DAVID GORRELL: She was there. I think Ms. Koehl was unavailable for some reason, but...
MR. JAMES LOCKYER: Yes. And I -- as I recall, Mr. Koehl also said that any plea arrangement would be subject to the approval of Ms. Hall.
MR. DAVID GORRELL: That I don't remember, but I -- I wouldn't be surprised in any case.
MR. JAMES LOCKYER: It's in one (1) of the documents in the file you arrived with today.
MR. DAVID GORRELL: Really?
MR. JAMES LOCKYER: Yes.
MR. DAVID GORRELL: Fine, then I accept
that.
MR. JOHN STRUTHERS: It was the practice
at the time.
MR. JAMES LOCKYER: Yes.
MR. DAVID GORRELL: But the -- just -- just to continue with this, what -- I said, my heart went out to Gaurov's father. I don't know how I'd -- I'd act in this situation if I had someone like Mr. Struthers saying, Well, you can get ninety (90) days on weekends. After emission, that's sixty (60) days. That's a maximum of fifteen (15) weekends. The Mimico is jammed, so you'll wind up doing only three (3), or four (4), or five (5). You can do that, or you can sit in the courtroom and be judged by everybody with a risk, with Charles Smith up there with a mantle of Sick Kids on his shoulder. You can go to jail. You can go to jail on a
manslaughter. I really didn't think a murder was in the cards, but you can go to jail on a manslaughter. What decision would I make? I'm pretty sure I'd make the
decision he made even if I were not guilty. But as his lawyer, I'm the only person in the whole scenario that Doesn't judge him. The police judge him when they charge him. The Crown judges him when they prosecute him. The Judge judges him, the jury judges him, the press judges him. When he says, I want to plead guilty, and
I will sign on the dotted line, and I did it, I'm not going to tell him, No, sir, you're going to face the trial and if you get eight (8) years, that's for the
greater good of the justice. I took his instructions and I -- I would not be at all surprised, with the stress that man was under at the time, if he was doing it out of expediency.
MR. JAMES LOCKYER: And the instructions that you received from him by way of the form that you prepared, obviously the way it's typed up, it was -- the words were your words in that document, is that fair?
MR. DAVID GORRELL: Yes, they were my words.
MR. JAMES LOCKYER: And they were words designed to fit the notion of criminal negligence. Reckless is hardly a word an east Indian that doesn't
speak English is going to come up with.
MR. DAVID GORRELL: No, the -- this -- these were my words.
MR. JAMES LOCKYER: Yes. And, as Mr. Struthers was just saying, it was more a document for your protection than a document to assist Gaurov's
father, is that fair?
MR. DAVID GORRELL: I think that's probably fair. It's also a document that you would use to fix his mind as to what he's doing, so that he can't
come back and -- I guess to protect counsel, that's right. I(t) was thirteen (13) pages;"
Dear readers:
Imagine how the prosecutors must have felt to learn about Justice Dunn's troubling criticisms of the work performed by Dr. Charles Smith and the Hospital for Sick Children SCAN-TEAM in the then recent Amber case;
Would that not have raised serious questions as to whether or not there was a reasonable possibility of obtaining a conviction in the case?
At the very least, shouldn't the existence of the decision - which was not likely publicly available at that time - have been made to the defence lawyers?
At least, that way they could assess the strength of the Crown's case before putting the plea to criminal negligence causing his son Gaurov's death to his client whether or not the law relating to disclosure at the time required them to do so?
As a criminal lawyer, I suspect that after reading the Dunn decision I would have been in a position to more confidently advise the client to contest the murder charge - instead of having to go through the contortions involved in a criminal negligence plea where I would have so much doubt about my client's guilt?
Just imagine how much pain this mourning family would have been spared - let alone the need to bear the load of sixteen years of stigma in their tiny community - and having to fight for ultimate exoneration after sixteen years in the Ontario Court of Appeal;
Next: Part Seven; Gaurov's father: Another shocking revelation;
Harold Levy: hlevy15@gmail.com;