SHAKEN-BABY SYNDROME; (PART 2); ROBERT LANGRETH REACTS (STRONGLY) TO EMILY BAZELON'S NYT MAGAZINE FEATURE; REALLY GOOD READ;

"Bazelon writes about one woman in jail today for supposedly shaking a baby-Trudy Eliana Munoz Rueda–who may be innocent. I would vote to acquit her based on what I read in the article. You can’t come close to saying she is guilty beyond a reasonable doubt when there are doubts galore about the whole diagnosis.

You can just see how shaken baby concept proved irresistible in this case. Top pediatric researchers intent on making their come up with an unproven theory. It gains momentum and public attention. When a baby under Rueda’s care stops breathing and suffers brain damage, local doctors in Virginia can’t figure out the cause and are quick to suggest shaken baby syndrome. That leads to a prosecution and a conviction by jurors swayed by impressive sounding experts who spin a good tale, offering expert opinion dressed up as proven science."


ROBERT LANGRETH: FORBES; Robert Langreth is a senior editor at Forbes in charge of health coverage.

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"The medical profession likes to dress up what it does as rigorous science. Doctors publish papers in fancy journals using fancy jargon and fancy statistics," Robert Langreth's Forbes column published on February 5, 2011 begins under the heading, "The Dubious Science Of Shaken-Baby Syndrome."

"Too often there is hardly any solid science supporting their impressive-sounding conclusions," the column continues.

"An amazing article by Slate’s Emily Bazelon in the New York Times magazine finds that this may be the case with shaken baby syndrome. This is the diagnosis whereby caregivers are convicted of child abuse after babies die of sudden subdural brain bleeding and swelling with no evidence of external injury. The theory is that shaking the baby is the only thing that could possibly have caused this.

The medical community has been hyping this for years as if it had convincing evidence behind the diagnosis. There have been public education campaigns about the problem. Caregivers have gone to jail–with little other evidence of abuse–based on medical expert testimony that nothing besides shaking could have caused the baby’s unexplained brain bleeding.

Surely doctors touting this theory have rock solid evidence behind it, right? They’ve at least done basic physics experiments with animals or testing dummies showing that shaking a baby could produce the kinds of high accelerations known to produce cerebral bleeding?

No and no, according to Bazelon’s article.

It turns out, she writes, that the whole diagnosis is based on one experiment from the 1960s in which doctors strapped 50 monkeys onto a track and slammed them into a wall at high speed. Fifteen developed cerebral hemorrhages. As Bazelon puts it (emphasis mine):

Ommaya’s experiment involved neither shaking nor infants. Still, two pediatric specialists, John Caffey and A. Norma Guthkelch, each wrote a paper that pointed to the work as evidence that unexplained subdural bleeding in babies could occur without direct impact to the head and with or without a visible neck injury. In the 1980s, the term “shaken-baby syndrome” came into broad use, and a national prevention and awareness campaign was set in motion.

As the diagnosis of shaken-baby syndrome took hold in medicine, and prosecutors began to bring charges based on it, doctors testified that shaking could generate the same terrible force as throwing a child from a second-­story window. It turned out they were wrong. In 1987, a neurosurgeon named Ann-Christine Duhaime published a paper that included the autopsy results of 13 babies with symptoms associated with shaken-baby syndrome. In all of them she found evidence of trauma that was actually caused by impact. She teamed up with biomechanical engineers to create infant-sized dummies equipped with sensors to measure acceleration.“We shook them as hard as we could, and we thought something was wrong, because the accelerations we measured were unexpectedly low,” Duhaime says. Instead, the force level shot up when the testers released the dummies after shaking them, even if they hit a soft surface like a bed or a couch.

In other words, she writes, not only are there few basic lab experiments supporting to shaken-baby diagnosis, there is actually counter-evidence against it: counter to popular impression, shaking does not produce as much acceleration as colliding with a soft couch.

All this is not to say that everyone convicted of killing babies by shaking them is innocent, but many of them probably are. Obviously, when a baby dies of unexplained brain bleeding, abuse has to be at least considered. According to Bazelon, there many other possible causes of brain bleeding, few of which have been carefully explored by the medication profession fixated on the shaken baby diagnosis. Others could include unnoticed impacts or falls a few days earlier that build up symptoms slowly before resulting in a sudden bleed; infections; and bleeding disorders.

Bazelon writes about one woman in jail today for supposedly shaking a baby-Trudy Eliana Munoz Rueda–who may be innocent. I would vote to acquit her based on what I read in the article. You can’t come close to saying she is guilty beyond a reasonable doubt when there are doubts galore about the whole diagnosis.

You can just see how shaken baby concept proved irresistible in this case. Top pediatric researchers intent on making their come up with an unproven theory. It gains momentum and public attention. When a baby under Rueda’s care stops breathing and suffers brain damage, local doctors in Virginia can’t figure out the cause and are quick to suggest shaken baby syndrome. That leads to a prosecution and a conviction by jurors swayed by impressive sounding experts who spin a good tale, offering expert opinion dressed up as proven science.

Even the most damming evidence against Rueda–that she apparently admitted to a social worker in Spanish that she might have shaken the baby–is not as bad as it sounds in my mind. There are lots of examples of false confessions by innocent people under pressure. Imagine you are an honest caregiver. A baby suddenly suffers permanent brain damage under your care for unexplained reasons. All the “experts” say it must have been something you did. You are wracking your mind wondering, “Could something I did have caused this? Did I do anything remotely rough?” Under great pressure from a social worker, who herself may be biased because she knows that doctors believe abuse has occurred, (and with no lawyer present) you admit to what they want to hear.

Is shaken baby syndrome is an example of how doctors–in their rush to find causes for horrible child injuries before all the evidence is in–may have ended up harming some people? The National Academy of Sciences needs to investigate right now to what extent this syndrome really exists, how often it happens, and how often cases blamed on baby shaking may actually have other causes. It needs to include smart, truly independent experts- and exclude people who have built their careers by touting shaken baby syndrome as a proven common phenomenon. As Emily’s article proves, it is anything but."

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The column can be found at:

http://blogs.forbes.com/robertlangreth/2011/02/05/the-bogus-science-of-shaken-baby-syndrome/

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PUBLISHER'S NOTE: The Toronto Star, my previous employer for more than twenty incredible years, has put considerable effort into exposing the harm caused by Dr. Charles Smith and his protectors - and into pushing for reform of Ontario's forensic pediatric pathology system. The Star has a "topic" section which focuses on recent stories related to Dr. Charles Smith. It can be accessed at:

http://www.thestar.com/topic/charlessmith

For a breakdown of some of the cases, issues and controversies this Blog is currently following, please turn to:

http://www.blogger.com/post-edit.g?blogID=120008354894645705&postID=8369513443994476774

Harold Levy: Publisher; The Charles Smith Blog; hlevy15@gmail.com;