Saturday, July 11, 2015

Shaken Baby Syndrome: Sue Luttner examines the increasing role that retinal hemorrhages are playing in shaken baby syndrome diagnosis, as she asks "Does the brain injury prove abuse or not?" - and notes the role being played as an expert witness for the prosecution by Philadelphia pediatric opthalmologist Dr. Alex Levin; ON SBS;

POST: Does the brain injury prove abuse or not? by Sue Luttner,  published by On SBS.

GIST:  "The two shaking convictions in the news this season, ironically, are both based on brain findings, with no bruising, bone injuries, or other signs of assault—at least five years after the experts started saying that they never diagnose shaken baby based on the triad alone. In the widely reported case of Joshua Burns in Michigan, in fact, the diagnosis was based on only two of the three markers, retinal hemorrhages and subdural  hematoma. A commercial airline pilot active in his local church and community, Joshua Burns was convicted of child abuse in December of 2014. Supporters immediately launched a web site and media campaign protesting his innocence, and now the Michigan Innocence Clinic is appealing his conviction.  Naomi Burns, now 18 months old, seems to have recovered fully. Her mother Brenda Burns has regained custody, but Joshua has been denied any contact with his daughter since April of 2014. In New Jersey, meanwhile, child care provider Michelle Heale has been sentenced to 15 years in prison, with the requirement that she serve at least 85% of her sentence. She was convicted of aggravated manslaughter and child endangerment in April. Michelle said 14-month-old Mason Hess choked while eating a tube of applesauce, but doctors concluded from the brain findings that he had been shaken to death. The only visible evidence of trauma was a bruise on his forehead, suffered the previous week in a fall in his home. He had been sick with coughing and copious mucous, and had just started taking medication the day before..........The child abuse doctor in the Burns case asked for advice from the same pediatric ophthalmologist who testified against Michelle Heale, Dr. Alex Levin in Philadelphia. In an email exchange posted on the Torn Family web site, the child abuse doctor summarizes Naomi’s medical history, acknowledging but discounting the traumatic birth. She reports the eye findings in detail and notes that the child has “persistent thrombophilia,” a clotting disorder. Dr. Levin’s response: Impressive documentation. Very well done. Not sure what the question is. I can’t think of another diagnosis other than abuse assuming no obvious coagulopathy or other event. I’m not sure if Dr. Levin missed the mention of thrombophilia in the original note, or if I’m misunderstanding the situation, but I would expect thrombophilia to count as a coagulopathy. And I don’t know what was said about all of this in court, but it seems to me that retinal hemorrhages are starting to play a very large part in these diagnoses.........Now the state is trying to terminate Joshua’s parental rights. Those hearings wrapped up in June, and the family is waiting for the judge’s decision. I don’t understand why the child abuse doctors are so sure Naomi was abused, and I’m even less clear on why the state has decided that her father and not her mother must be guilty. The accident Joshua reported—presumed to be a lie invented to cover up abuse—happened 11 days before doctors ever considered the possibility of head trauma. I am sorry that another family has been caught up in this tragedy, but I am heartened by the enthusiastic support that Joshua and Brenda Burns are receiving from their community. And I have high hopes that the ongoing coverage will bring more light to the debate about the reliability of a shaken baby diagnosis."
The entire post can be found at:

See story on research conducted by Michigan State University on  how skulls fracture could impact in child abuse cases; "The years that Todd Fenton, Roger Haut and their research team spent smashing infant pig skulls in a lab at Michigan State University could change the way forensic scientists interpret skull fractures in children and the way they determine what's child abuse and what's not. What they found was that multiple skull fractures and fractures that aren't connected can come from a single impact. They found that the greater the impact force the more fractures there were, and that the direction — or line of the actual fracture — pointed back to the location of impact. Currently, when medical examiners or doctors see a child's skull with multiple fractures, it's an immediate red flag for child abuse, said Fenton, director of the MSU's Forensic Anthropology Laboratory; "It might have happened that way. But it also might have been from one blow," he said. "Knowing what we know now, our fear is that there may be people that have been wrongly accused of child abuse based upon those protocols."


Dear Reader. Keep your eye on the Charles Smith Blog. We are following this case.

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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:

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