Sunday, March 17, 2019

Kathleen Folbigg: Australia: Spotlight on SIDS - Sudden Infant Death Syndrome: ABC news provides excellent backgrounder for Judicial Inquiry set to begin Monday, under the heading, "Kathleen Folbigg wrongful conviction argument supported by fresh evidence." (Reporter Quentin McDermott)..."Today's hearing will focus on recent research into SIDS (Sudden Infant Death Syndrome) and SUDI (Sudden Unexpected Death in Infants), and the incidence of reported deaths of three or more infants in the same family, from natural causes. Following an opening statement from Counsel Assisting the Inquiry, Gail Furness SC, evidence will be given by two sleep specialists. The first, Rosemary Horne, is a deputy director of the Hudson Institute's Ritchie Centre at Monash University, while the second, Dawn Elder, is head of the Department of Paediatrics at the University of Otago. Allan Cala, who was the chief medical expert at Folbigg's trial, is expected to give evidence on Tuesday, as will Stephen Cordner, who did not give evidence at the trial, but who wrote a lengthy report which was attached to the petition, and John Hilton, who conducted the autopsy of Folbigg's third child Sarah, and gave evidence at the trial. The ABC understands that Dr Cala stands by the opinion he expressed at Folbigg's trial, that she smothered all four of her children. But, both Professor Cordner and Professor Hilton disagree."


PASSAGE OF THE DAY: " Folbigg was found guilty by a jury in 2003 of three counts of murder, one count of manslaughter, and one count of maliciously inflicting grievous bodily harm in respect of her four children between February 20, 1989 and March 1, 1999.She is currently serving a minimum 25-year sentence for these convictions. The inquiry was announced in August last year, more than three years after Folbigg's legal team submitted a petition on her behalf to the Governor of New South Wales. Former chief judge of the District Court, the Honourable Reginald Blanch AM QC, will preside at the inquiry, and counsel assisting the inquiry is Gail Furness SC. Speaking nine days after an investigation into Folbigg's case was broadcast by the ABC's Australian Story, Mark Speakman, the New South Wales Attorney-General, announced: "I have formed the view that an inquiry into Ms Folbigg's convictions is necessary to ensure public confidence in the administration of justice. Today's decision is not based on any assessment of Ms Folbigg's guilt. "The petition appears to raise a doubt or question concerning evidence as to the incidence of reported deaths of three or more infants in the same family attributed to unidentified natural causes in the proceedings leading to Ms Folbigg's convictions."

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 KEY POINTS: "
  • In 2003, Folbigg was found guilty of killing all four of her children
  • There is growing expert medical opinion that there are plausible natural causes for the children's deaths
  • After genetic evidence is presented next month, Folbigg will give evidence herself.
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STORY: ""Kathleen Folbigg wrongful conviction argument supported by fresh evidence," by reporter Quentin McDermott, published by ABC News on March 17, 2019.

GIST: "Fresh evidence will be presented to an inquiry starting today, suggesting that — on medical grounds at least — there is a strong case that Kathleen Folbigg was wrongly convicted of killing all four of her children. The new evidence adds to a growing body of expert medical opinion that there are plausible natural causes of death for all four children. Folbigg was found guilty by a jury in 2003 of three counts of murder, one count of manslaughter, and one count of maliciously inflicting grievous bodily harm in respect of her four children between February 20, 1989 and March 1, 1999.
She is currently serving a minimum 25-year sentence for these convictions. The inquiry was announced in August last year, more than three years after Folbigg's legal team submitted a petition on her behalf to the Governor of New South Wales. Former chief judge of the District Court, the Honourable Reginald Blanch AM QC, will preside at the inquiry, and counsel assisting the inquiry is Gail Furness SC. Speaking nine days after an investigation into Folbigg's case was broadcast by the ABC's Australian Story, Mark Speakman, the New South Wales Attorney-General, announced: "I have formed the view that an inquiry into Ms Folbigg's convictions is necessary to ensure public confidence in the administration of justice. Today's decision is not based on any assessment of Ms Folbigg's guilt. "The petition appears to raise a doubt or question concerning evidence as to the incidence of reported deaths of three or more infants in the same family attributed to unidentified natural causes in the proceedings leading to Ms Folbigg's convictions. "The direction establishing the inquiry requires Mr Blanch to have particular regard to this evidence in conducting the inquiry." Mr Speakman added: "At the conclusion of the inquiry, Mr Blanch will prepare a report. "If of the opinion that there is a reasonable doubt as to the guilt of Ms Folbigg, Mr Blanch may refer the matter to the Court of Criminal Appeal for further consideration." Sarah Folbigg may have died earlier than thought: One key piece of fresh evidence that has been submitted to the inquiry is the observation that Folbigg's third child Sarah may have died earlier in the night than previously thought, in August 1993. Consulting forensic pathologist Johan Duflou said in his view, taking into account the temperature of the body and the stomach contents, "this would suggest that Sarah died closer to the time she was put to bed by [Folbigg's husband] Craig at around 21:00 hours, rather than when found by Folbigg at around 01:30 hours." Professor Duflou's view challenges the argument presented by the prosecution at Folbigg's trial, that she was present with all four of her children when they died. Key concerns with Kathleen Folbigg's case:
  • Three senior forensic pathologists who will give their opinions this week are expected to agree that the most likely cause of death for Folbigg's fourth child, Laura, was myocarditis — an inflammation of the heart muscles
  • A fourth expert who has written a report for the inquiry supports this view
  • Caroline Blackwell, Conjoint Professor at the University of Newcastle School of Biomedical Sciences and Pharmacy, has submitted a statement saying the detective who led the investigation into the deaths of Folbigg's children turned down the opportunity for tests to be conducted into whether infections had played a part in the deaths, because it was "too expensive"
  • Folbigg's third child Sarah may have died several hours earlier than first thought — casting doubt on the allegation that Folbigg smothered her
  • Further expert opinion casts doubt on the allegation that Folbigg tried to smother her second child, Patrick, when he was four months old
  • Folbigg has notified the inquiry that she will give evidence about the diary entries she made, when hearings resume in April
Today's hearing will focus on recent research into SIDS (Sudden Infant Death Syndrome) and SUDI (Sudden Unexpected Death in Infants), and the incidence of reported deaths of three or more infants in the same family, from natural causes. Following an opening statement from Counsel Assisting the Inquiry, Gail Furness SC, evidence will be given by two sleep specialists. The first, Rosemary Horne, is a deputy director of the Hudson Institute's Ritchie Centre at Monash University, while the second, Dawn Elder, is head of the Department of Paediatrics at the University of Otago. Allan Cala, who was the chief medical expert at Folbigg's trial, is expected to give evidence on Tuesday, as will Stephen Cordner, who did not give evidence at the trial, but who wrote a lengthy report which was attached to the petition, and John Hilton, who conducted the autopsy of Folbigg's third child Sarah, and gave evidence at the trial. The ABC understands that Dr Cala stands by the opinion he expressed at Folbigg's trial, that she smothered all four of her children. But, both Professor Cordner and Professor Hilton disagree. No medical basis for concluding homicide: expert: In his report accompanying the petition, Professor Cordner wrote that: "If the convictions in this case are to stand, I want to clearly state there is no pathological or medical basis for concluding homicide. "The findings are perfectly compatible with natural causes. He added: "Put simply, there is no positive forensic pathology support for the contention that any or all of these children have been killed." In his own statement submitted to the inquiry, Professor Hilton said he was "in substantial agreement with the comments, views and opinions" expressed by Professor Cordner in his report. Significantly, Professor Hilton backs Professor Cordner's view that Folbigg's fourth and oldest child, Laura, died from natural causes — in this case the illness known as myocarditis, or inflammation of the heart muscles.
"Laura died with, and highly probably because of, florid myocarditis," Professor Hilton wrote. "There was no medical evidence demonstrable or demonstrated in the report of the post-mortem examination to support another cause for her death." Professor Duflou backed the views of Professor Hilton and Professor Cordner in his statement to the inquiry: "In my opinion, there is without doubt myocarditis of a severity which can readily cause sudden and unexpected death … in this case, no competing cause of death has been identified at autopsy; therefore based purely on the autopsy findings, the cause of death would be given as myocarditis." However, he added: "Acknowledging that there is no other obvious cause of death in Laura, I nevertheless consider it not unreasonable to give the cause of death as undetermined in the alternative, as proffered by Dr Cala. "The reason for this is the knowledge that myocarditis can be incidental to death, and the fact that three siblings died leads one to consider causes of death, where death is not simply due to myocarditis but that the myocarditis may have been a contributor or incidental to death in this case." Dr Cala 'was incorrect' to exclude myocarditis: Professor Cordner noted: "Dr Cala was of the view that Laura died with myocarditis rather than from it, but his reasons for this do not hold water in my view." He said that where Dr Cala described the myocarditis at Laura's autopsy as "patchy and mild; I think it is better described as widespread and at least moderate in degree". "I do think Dr Cala could have justified the cause of death as he gave it: Undetermined," Professor Cordner said. "He was incorrect to argue that there were medical and pathology reasons for excluding myocarditis." Another medical expert, Robert Clancy, submitted a statement backing the notion that there are plausible natural causes of death for Laura and Folbigg's other three children, Caleb, Patrick and Sarah. Professor Clancy, an immunologist and microbiologist, is Emeritus Professor in the School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine at Newcastle University. He wrote: "I agree with the diagnosis made by professors Cordner and Duflou in the case of Laura, as acute myocarditis …
"I am uncertain why the pathologist (Dr Cala) did not identify myocarditis as the cause of death in Laura … "I see no evidence that any child has been mistreated or any evidence of external trauma or internal evidence of suffocating or alternate cause of death other than SIDS or myocarditis. "Any conviction of Folbigg based on medical grounds, in my opinion, would be unsafe." Patrick had no 'obvious evidence of inflicted injury': In the case of Patrick, Folbigg's second child, fresh medical opinion is being submitted to this week's inquiry that challenges the prosecution's view that Folbigg attempted to smother him when he was four months old, in October 1990, and when Folbigg says she found him gasping, blue around the lips, lifeless and floppy. He was revived and lived for a further four months. Monique Ryan, director of the Neurology Department at the Royal Children's Hospital, Melbourne, who reviewed the medical records relating to Patrick, said in her report to the inquiry that: "Patrick was admitted to hospital on multiple occasions. "On no occasion was he reported to have shown any obvious evidence of inflicted injury," Professor Ryan said. "His CT scans and ophthalmological examination did not show the changes often seen in children subjected to non-accidental injuries." Specifically in relation to the acute life-threatening event when his mother found him apparently lifeless, Professor Ryan said: "I am not convinced that Patrick's clinical history is consistent with him having neurologic deficits resulting from a single hypoxic-ischaemic episode occurring on October 18, 1990. "He was … very unwell at the time of presentation. "On the same day, however, a head ultrasound and EEG were normal, and within a few hours of admission he was described in the nursing notes as feeding well. "Had Patrick sustained a severe hypoxic-ischaemic insult on the morning on October 18, 1990 — one sufficiently severe to cause the changes seen on his subsequent imaging and his post-mortem examination — it is difficult to imagine that he would have been able to feed well that day, and that his EEG could have been entirely normal." This week's inquiry will also consider evidence that infections may have played a role in the deaths of one or more of the Folbigg children. Professor Caroline Blackwell, Conjoint Professor at the University of Newcastle's School of Biomedical Sciences and Pharmacy, told the inquiry in her statement that: "Despite some reluctance to consider that minor infections can trigger SUDI or SIDS, there is a growing body of evidence that infection plays a role in these." Dr Cala 'has ignored the evidence': Professor Blackwell, an infectious diseases specialist, wrote that, in her opinion, Dr Cala "has ignored the evidence implicating infection in SUDI published prior to 2003". "Since 2003 there is increasing evidence that these factors need to be considered," she said. "This is not, as Dr Cala implied, a vague theory by microbiologists, or 'junk science'. "The findings have been reported in well-respected, peer-reviewed scientific and medical journals and presented at major national and international meetings." Professor Blackwell said her conclusions, "particularly for Sarah and Laura", agree with the opinion of another forensic pathologist, Roger Byard, from the University of Adelaide, that "potentially significant organic illness was present in these children". The ABC approached Dr Cala for comment, but he had not responded at the time of writing. Professor Clancy also backed the view that infection may have played a role in Sarah's death.  He told the inquiry that: "The bacteria of the type found in Sarah's lung tissue are commonly present in children that die unexpectedly and without any readily identifiable alternate cause of death. "This is not unique, but rather characteristic of any disorder where the protective immune mechanisms in the airways are compromised. "A confident diagnosis of SIDS can be made as the cause of death in Sarah on clinical grounds. "The microbiological report in my opinion adds confidence to this diagnosis by the finding of both streptococcus and staphylococcus species in the lung cultures … the presence of these bacteria acquired prior to death due to a unique abnormality of impaired airways clearance reinforces the probability of SIDS as the cause of death in Sarah." Professor Blackwell also revealed that in 2000 — three years before Folbigg was sent to trial — she was approached by Detective Inspector Bernie Ryan, the officer heading the police investigation into the deaths of Folbigg's four children, who asked for information about sudden infant deaths. She said she advised him that "my research team had screened tissues and body fluids from infants who died of unexplained causes and identified toxins of staphylococcus aureus in over half of the SIDS/SUDI infants tested". Professor Blackwell said that: "More recent findings have indicated that S. aureus is one of the major isolates from infants who die suddenly and unexpectedly." 'Too expensive': Police turn down toxin test: Professor Blackwell said she told Detective Ryan that she could test for the toxins at the University of Edinburgh, and "I suggested that the costs would be modest". But Detective Inspector Ryan, she alleges, "said it was too expensive as there would need to be someone accompanying the samples and to watch each step of the process". Professor Blackwell said that, as a result, the tests did not go ahead. Professor Blackwell is expected to give evidence on Friday. Detective Inspector Ryan has declined to comment. Kathleen Folbigg will answer questions about diaries: Following this week's hearings on the forensic evidence, further genetic evidence will be presented to the inquiry next month. Following that, Folbigg will herself give evidence about the diaries she wrote, and what she meant by some of the diary entries she made. Ms Folbigg did not give evidence at her trial in 2003 and spoke about her diaries last year for the first time, exclusively, on Australian Story. "You've got to understand that those diaries are written from a point of me always blaming myself," Ms Folbigg said in one phone call. "I blamed myself for everything. It's just I took so much of the responsibility, because that's, as mothers, what you do.""

The entire story can be read at: 
https://www.abc.net.au/news/2019-03-18/kathleen-folbigg-new-evidence-suggests-wrongly-convicted-killing/10910200

PUBLISHER'S NOTE: I am monitoring this case/issue. Keep your eye on the Charles Smith Blog for reports on developments. 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 Please send any comments or information on other cases and issues of interest to the readers of this blog to: hlevy15@gmail.com.  Harold Levy: Publisher; The Charles Smith Blog.




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