Saturday, July 2, 2011

SHAKEN-BABY SYNDROME; RESEARCHERS HEADED BY DR. EVAN MATSHES (CALGARY) REACH SURPRISING CONCLUSION; COULD ALTER SBS DEBATE; JOSEPH SHAPIRO; NPR;


"The research got an endorsement from the man who is considered the discoverer of shaken baby syndrome. Pediatric neurosurgeon Norman Guthkelch was the first — forty years ago — to connect head injuries in young children to violent shaking. Guthkelch told NPR in an email that the new research is a "most important contribution to understanding" of shaken baby syndrome, adding:

I have little doubt that it will be confirmed by other workers in due course. It will then be possible to say with confidence that if the lesion they described is present, significant shaking occurred--and if not, not. It also explains why in SBS cases a fatal loss of vital functions may not be associated with the degree of traumatic brain damage that one would expect.

In an interview earlier this week with NPR, Guthkelch spoke out for the first time about his worries that doctors and other medical experts are too quick to diagnose shaken baby syndrome when there's suspicion of child abuse, without considering other possibilities."

REPORTER JOSEPH SHAPIRO; NATIONAL PUBLIC RADIO;

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PUBLISHER'S NOTE: Once again, a study has been published which could affect what is referred to as the shaken baby syndrome debate. Without question there have been others and there will undoubtedly be more. This raises the troubling prospect that people who are being charged with killing a child on nothing more than the so-called "shaken baby syndrome" are exposed to horrifying consequences - including loss of freedom, seizure of their other children, and stigmatization as child killers - on nothing more than a controversial medical theory. (Prosecutors in the United Kingdom have begun to insist on the presence of more than the core elements of the syndrome before laying a criminal charge); This is cruel and unjust and an abdication of the safeguards that are supposed to be present in civilized criminal justice systems. The story is a fitting complement to the recent NPR/Frontline/Propublica investigation on "The Child Cases," a recipient of "The Charles Smith Blog Award."

HAROLD LEVY; PUBLISHER; THE CHARLES SMITH BLOG;

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"Findings from a series of autopsies could alter the debate over the controversial diagnosis of shaken baby syndrome,"
the NPR story by reporter Joseph Shapiro published on July 1, 2011 begins, under the heading, "Autopsy Study Provides New Theory On Shaken Baby Syndrome."

"A new study suggests that babies can die by violent shaking alone — but not in the way doctors have previously thought,"
the story continues.

"A team of researchers who conducted autopsies on 35 babies in Miami, Dallas and Calgary, Alberta, report that when children die after being violently shaken, they die of neck injuries and not from brain trauma.

The findings were just published in Academic Forensic Pathology, the journal of the National Association of Medical Examiners.

Shaken baby syndrome is commonly invoked to prosecute child abuse. But growing numbers of medical experts — particularly forensic pathologists — have raised doubts about the diagnosis.

Skeptics question whether it's possible to shake a baby so violently that the child dies from brain injury but without other visible marks or trauma to the neck and spine.

The confusion over the science sometimes results in the conviction of innocent parents and prison. A series of investigative reports called Post Mortem: Child Cases, this week by NPR, PBS Frontline and ProPublica told the stories of the wrongly convicted and looked at the case of Ernie Lopez, who is serving a 60-year prison sentence in Texas.

The authors of the new research did something novel. They looked at a baby's nerve roots. Those are hard to observe, because they are protected by the bone and spine. But by looking, the scientists say they found injuries that no one had observed before. "We contend that up until now, 'neck injuries' have not been seen, not because they were not present, but rather because the appropriate anatomical structures were not dissected," writes lead author Dr. Evan Matshes, a medical examiner in Calgary.

Babies breathe primarily by expanding their bellies. To do this, the diaphragm, the muscle at the base of the lungs, moves to create more room for the lungs to expand. (Adults have an additional way to support breathing: By using chest muscles to to move the rib cage.)

The researchers found that when babies are shaken, the nerve roots get injured and that knocks out the diaphragm. That leads to the brain injuries that are seen in children who are shaken — but it's original injury to those nerves in the neck that caused the death, not the brain injury, according to the new research.

The new findings split a lot of the difference between the warring camps on shaken baby syndrome. For supporters, there's evidence that shaking alone can lead to a baby's death. But it also says skeptics were right to suggest it's not the head injury that causes death and that shaking deaths are likely rare.

The research got an endorsement from the man who is considered the discoverer of shaken baby syndrome. Pediatric neurosurgeon Norman Guthkelch was the first — forty years ago — to connect head injuries in young children to violent shaking. Guthkelch told NPR in an email that the new research is a "most important contribution to understanding" of shaken baby syndrome, adding:

I have little doubt that it will be confirmed by other workers in due course. It will then be possible to say with confidence that if the lesion they described is present, significant shaking occurred--and if not, not. It also explains why in SBS cases a fatal loss of vital functions may not be associated with the degree of traumatic brain damage that one would expect.

In an interview earlier this week with NPR, Guthkelch spoke out for the first time about his worries that doctors and other medical experts are too quick to diagnose shaken baby syndrome when there's suspicion of child abuse, without considering other possibilities.

It's not clear whether forensic pathologists will embrace the findings. For one thing, it's hard work to get at those nerve roots as Matshes and his colleagues did in their small study.

There are extra, time-consuming steps that have to be taken at an autopsy. The spinal column has to be placed in formaldehyde for up to a month in order for the bone to soften before the pathologist can even get at those roots. But the new paper says that's an commitment of time can help pathologist get at the truth of how a baby died."

The story can be found at:

http://www.vpr.net/npr/137553701/

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 found at:

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

Information on "The Charles Smith Blog Award"- and its nomination process - can be found at:

http://smithforensic.blogspot.com/2011/05/charles-smith-blog-award-nominations.html

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