BACKGROUND: “Dr. John Cox knew as soon as he heard the baby’s cry that he had hurt his 1-month-old adopted daughter. He’d accidentally fallen asleep while cuddling the girl in bed early one morning last May, he said, and must have turned on top of her. Cox, 39, a pediatric emergency room doctor at Children’s Wisconsin hospital, sat up, panicked. His hands shook as he assessed the baby, he said, fearing that he’d smothered her. She wasn’t in distress, but he said he could tell from the way she was moving her left arm that he might have broken her collarbone, a common injury in infants that typically heals on its own without medical treatment. Cox called his wife, Dr. Sadie Dobrozsi, who was out of town with their two older children, and cried as he explained what had happened. Dobrozsi, a pediatric oncologist at the same hospital, said she told him to calm down and asked to video chat. The baby appeared fine to her, but to be safe, Dobrozsi suggested that Cox take her to see her pediatrician. “That’s what normal parents who aren’t doctors would do,” she told him. What followed, according to more than 15 medical experts who later reviewed Cox’s case, was a series of medical mistakes and misstatements by hospital staff members that has devastated Cox’s family and derailed his career. A nurse practitioner on the hospital’s child abuse team confused the baby’s birthmarks for bruises, according to seven dermatologists who have reviewed the case. A child abuse pediatrician misinterpreted a crucial blood test, four hematologists later said. Then, two weeks after the incident, armed with those disputed medical reports, Child Protective Services took the child. “In hindsight,” Cox said in a recent interview, “taking her to our own hospital was the single most harmful decision that we made for our baby.”
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PASSAGE OF THE DAY: "The visit was traumatic. Leo thrashed and screamed while ER staff and Siebold struggled to hold him down to insert a needle into his veins and poke a catheter into his groin. “There was blood all over the table,” Siebold recalled. The following day, staff confronted the Siebolds about bruises found on Leo — bruises that Dr. Barbara Knox, head of the hospital’s Child Protection Program, flagged as possible signs of abuse. The encounter sparked an investigation that threatened to rip apart the Siebold family and ruin their careers. Surgical scars on Leo were listed as bruises. Demonstrably false information was inserted into his medical record. And Knox allegedly misrepresented herself as a specialist in an attempt to convince the family to approve additional medical testing. Police instantly dismissed the abuse allegation. Child welfare officials would clear the couple after two months. But the episode left Brenna Siebold “petrified” of seeking emergency medical care for their children, including twins, Hazelle and Hank, born in December. Now Knox — considered a national expert on child abuse who testifies as an expert for prosecutors around the country — is under the microscope. The University of Wisconsin placed her on paid leave in mid-2019 after colleagues inside and outside of the hospital accused her of intimidation or retaliation, an internal letter shows. Dr. Ellen Wald, chairwoman of the Department of Pediatrics at the UW School of Medicine and Public Health, wrote to Knox on July 5, saying the administrative leave involved concerns about “your workplace behavior, including unprofessional acts that may constitute retaliation against and/or intimidation of internal and external colleagues.”
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STORY: "University of Wisconsin child abuse doctor leaves a trail of accusations of bullying from colleagues, parents," by Dee J. Hall, published by Wisconsin Watch on February 29, 2020. (Dee J. Hall,
a co-founder of the Wisconsin Center for Investigative Journalism,
joined the staff as managing editor in June 2015. She worked at the
Wisconsin State Journal for 24 years as an editor and reporter focusing
on projects and investigations. Previously she was a reporter for eight
years at The Arizona Republic in Phoenix, where she covered city
government, schools and the environment. During her 35-year journalism
career, Hall has won more than three dozen local, state and national
awards for her work, and is a member of Investigative Reporters and
Editors. She is based in Madison, Wisconsin. Wisconsin Watch is a nonprofit newsroom that focuses on government integrity and quality of life issues.)PASSAGE OF THE DAY: "The visit was traumatic. Leo thrashed and screamed while ER staff and Siebold struggled to hold him down to insert a needle into his veins and poke a catheter into his groin. “There was blood all over the table,” Siebold recalled. The following day, staff confronted the Siebolds about bruises found on Leo — bruises that Dr. Barbara Knox, head of the hospital’s Child Protection Program, flagged as possible signs of abuse. The encounter sparked an investigation that threatened to rip apart the Siebold family and ruin their careers. Surgical scars on Leo were listed as bruises. Demonstrably false information was inserted into his medical record. And Knox allegedly misrepresented herself as a specialist in an attempt to convince the family to approve additional medical testing. Police instantly dismissed the abuse allegation. Child welfare officials would clear the couple after two months. But the episode left Brenna Siebold “petrified” of seeking emergency medical care for their children, including twins, Hazelle and Hank, born in December. Now Knox — considered a national expert on child abuse who testifies as an expert for prosecutors around the country — is under the microscope. The University of Wisconsin placed her on paid leave in mid-2019 after colleagues inside and outside of the hospital accused her of intimidation or retaliation, an internal letter shows. Dr. Ellen Wald, chairwoman of the Department of Pediatrics at the UW School of Medicine and Public Health, wrote to Knox on July 5, saying the administrative leave involved concerns about “your workplace behavior, including unprofessional acts that may constitute retaliation against and/or intimidation of internal and external colleagues.”
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SUB-HEADING: "A couple says Dr. Barbara Knox wrongly suspected child abuse. A forensic pathologist testifies Knox pressured him to report an injury he did not see."
PHOTO CAPTION: "Brenna and Joel Siebold are seen with
their son, Leo, 2, at their home in Mount Horeb, Wis., on Feb. 14, 2020.
Leo has heterotaxy syndrome, a condition in which his internal organs
are abnormally arranged, causing frequent hospital visits for the
family. On Sept. 5, 2018, Leo was taken to the American Family
Children's Hospital in Madison, Wis., with a fever. Medical personnel
reported them for possibly abusing the then 9-month-old, citing tiny
bruises on his body. Although they were cleared of the allegations, the
Siebolds say the episode left them with lingering trauma."
PHOTO CAPTION: Leo
Siebold, 2, is seen with his brother Jonah, 5, at their home in Mount
Horeb, Wis., on Feb. 14. Medical personnel at American Family Children’s
Hospital in Madison, Wis., reported their parents, Brenna and Joel
Siebold, of possible abuse to Leo when he was 9 months old. Police and
child welfare officials ruled the allegations unfounded, but Brenna
Siebold says she is now “petrified” to take any of their five children
to the hospital."
PHOTO CAPTION: " Dr.
Barbara Knox was placed on paid leave in mid-2019 while University of
Wisconsin officials investigated “unprofessional acts that may
constitute retaliation against and/or intimidation of internal and
external colleagues.” Knox voluntarily left her position at the medical
school and the American Family Children’s Hospital in October. She now
works for Alaska CARES, a child abuse response and evaluation program in
Anchorage."
PHOTO CAPTION: "Leo
Siebold’s arm is seen on Sept. 8, 2018, one day after he was released
from American Family Children’s Hospital. The hospital reported Brenna
and Joel Siebold to police and child welfare officials after medical
personnel found tiny bruises on Leo, then 9 months old, that they
labeled as possible signs of abuse. The Siebolds say this bruise likely
was sustained during a traumatic trip to the emergency room three days
earlier as ER staff and Brenna Siebold struggled to hold Leo down to
insert a needle and catheter."
PHOTO CAPTION: Jennifer
Hancock glances back at her family in Dane County Circuit Court in
Madison, Wis., on Dec. 19, 2019. Hancock, 49, is seeking a new trial
after being convicted for the death of a 4-month-old child in her care.
The forensic pathologist who testified at trial has since changed his
view of the cause of death from abuse to “undetermined.” Hancock is
serving a 13-year prison sentence for first-degree reckless homicide for
the baby’s 2007 death."
PHOTO CAPTION: "Dr.
Michael Stier, forensic pathologist at the University of Wisconsin
Hospital, testifies in Dane County Circuit Court in Madison, Wis., on
Nov. 21, 2019. Stier’s testimony helped to convict Jennifer Hancock, a
Verona day care provider, in the 2007 death of a 4-month-old baby in her
care. Stier has since changed the interpretation of his findings,
identifying several possible causes of the baby’s death besides abuse."
PHOTO CAPTION: " Dane
County District Attorney Ismael Ozanne is seen in Dane County Circuit
Court in Madison, Wis., on Dec 19, 2019, prior to the start of Jennifer
Hancock’s hearing. Ozanne wrote in an email that he has never had a
reason to doubt the diagnoses of the Child Protection Program."
PHOTO CAPTION: "Brenna
Siebold is seen with her son Leo, 2, and daughter Hazelle, 2 months, at
their home in Mount Horeb, Wis., on Feb. 14. Siebold is speaking out
about the unfounded allegations of possible child abuse leveled against
them by Dr. Barbara Knox and members of the Child Protection Program at
American Family Children’s Hospital in Madison, Wis. Knox has since
voluntarily left the hospital after being investigated for
unprofessional acts toward colleagues."
VIDEO CAPTION: "In this
family video clip, Leo Siebold is seen crawling on the floor of his
Mount Horeb, Wis., home on Sept. 1, 2018. On Sept. 7, 2018, American
Family Children’s Hospital officials reported Joel and Brenna Siebold to
authorities for possible abuse, citing small bruises on Leo, then 9
months old. The Siebolds say they told Dr. Barbara Knox and physician
assistant Amanda Palm that Leo was “Army crawling,” which could explain
the bruises. The hospital reported the bruises as “unexplained.”
PHOTO CAPTION: "Jennifer
Hancock, 49, is seeking a new trial after being convicted of homicide
in 2009 for the death of a 4-month-old boy who was in her care. A
medical expert who testified in the first trial has since changed the
interpretation of his findings. Hancock is currently serving a 13-year
prison sentence for first-degree reckless homicide for the 2007 death of
the infant. Hancock is seen in Dane County Circuit Court in Madison,
Wis., on Dec. 19, 2019."
PHOTO CAPTION: "Leo
Siebold is seen on Sept. 8, 2018, one day after he was released from
American Family Children’s Hospital. The hospital reported Brenna and
Joel Siebold to police and child welfare officials after medical
personnel found tiny bruises on Leo, then 9 months old, that they
labeled as possible signs of abuse. The Siebolds were cleared of the
allegations."
PHOTO CAPTION: "The
Siebolds are seen at their home in Mount Horeb, Wis., on Feb. 14. From
left are: Joel; Jocelyn, 9; Hazelle, 2 months; Hank, 2 months; Jonah, 5;
Brenna and Leo, 2. Brenna Siebold is a teacher and her husband Joel
works as a school custodian. The allegations of possible child abuse
that officials at a Madison, Wis., hospital made against them — later
declared unfounded — threatened to ruin their careers and split up their
family, they say."
PHOTO CAPTION: "In this family video clip, Leo Siebold is seen crawling on the floor of his Mount Horeb, Wis., home on Sept. 1, 2018. On Sept. 7, 2018, American Family Children’s Hospital officials reported Joel and Brenna Siebold to authorities for possible abuse, citing small bruises on Leo, then 9 months old. The Siebolds say they told Dr. Barbara Knox and physician assistant Amanda Palm that Leo was “Army crawling,” which could explain the bruises. The hospital reported the bruises as “unexplained.”
PHOTO CAPTION: "In this family video clip, Leo Siebold is seen crawling on the floor of his Mount Horeb, Wis., home on Sept. 1, 2018. On Sept. 7, 2018, American Family Children’s Hospital officials reported Joel and Brenna Siebold to authorities for possible abuse, citing small bruises on Leo, then 9 months old. The Siebolds say they told Dr. Barbara Knox and physician assistant Amanda Palm that Leo was “Army crawling,” which could explain the bruises. The hospital reported the bruises as “unexplained.”
UW Health spokesman Tom Russell said the hospital took “appropriate action” after investigating the allegations against Knox but declined to specify what that was. Russell also said UW Health hired a consultant in September to evaluate the Child Protection Program — and implemented recommendations for improvement. Among them: a monthly multi-disciplinary conference to review cases. Knox now works as the medical director of Alaska CARES, a child abuse response and evaluation program based at the Children’s Hospital at Providence in Anchorage. President of the nonprofit Academy on Violence and Abuse, Knox also has worked with the FBI. Two email messages with questions about her leave and about the Siebold case were not returned. A voicemail asking Knox to respond to the questions also was not returned. Knox is a prominent member of the growing field of child abuse pediatrics. Board certification for child abuse pediatrics began in 2009. As of 2018, there were 346 such physicians in the United States, including five in Wisconsin. As the specialty has grown, so has outside scrutiny of its work. News investigations and advocacy groups are increasingly questioning some of these doctors’ qualifications to separate the hundreds of thousands of legitimate cases of child abuse from accidents or underlying medical conditions.
In addition to the Siebolds, Wisconsin Watch has heard from two other Madison-area parents who report being cleared of child abuse allegations after American Family Children’s Hospital reported them to authorities. Russell defended the work of the Child Protection Program. Abuse is a leading cause of death and disability in children, and program staff are dealing with “some of the toughest issues imaginable,” he said. The program’s staff and physicians “are committed to approaching each patient and family with empathy, compassion and support during intensely stressful times,” Russell added.
Knox ‘pressured’ colleague to find abuse:
Soon after arriving at the children’s hospital in 2006, Knox drove the prosecution of Jennifer Hancock, a Verona day care provider who was convicted of killing an infant in her care. Hancock, now serving a 13-year prison term, is appealing the conviction in Dane County Circuit Court.Hancock’s attorneys, led by the UW Law School-based Wisconsin Innocence Project, presented three medical experts during testimony in late 2019 and early 2020 who say pre-existing medical problems could have contributed to the 2007 death of the 4-month-old. Among the experts: the UW Hospital forensic pathologist who conducted the baby’s autopsy. Dr. Michael Stier testified that Knox and others at that hospital pressured him to conclude that the child was abused, possibly coloring his testimony at the 2009 trial. During a post-conviction motion hearing in November, Stier said he felt “peer pressure” to conclude that the baby suffered a skull fracture and that it was caused by abuse. Anyone who voiced an objection, he testified, “probably would’ve been laughed out of the room and told to go back to medical school.” “It’s possible, either consciously or subconsciously, the narrative that I provided under oath … is partly based on that,” Stier testified. Stier said he has witnessed brain bleeding similar to that child in other people who died from natural causes, accidents or drug overdoses. The baby also had a heart virus that may have contributed, Stier said. He is sure the infant had no skull fracture. “If I were to testify at trial today, I would not testify that (the baby’s) death was caused by non-accidental inflicted injury,” Stier wrote in a sworn affidavit. “Instead, I would testify that there is no definitive cause of death. In other words, the cause of death is undetermined.” In August, Dane County Deputy District Attorney Matthew Moeser sent a letter informing a defense attorney in another case that the UW had placed Knox on administrative leave while it investigated complaints about her behavior. The move came as Knox was working with Moeser, the prosecutor in the Hancock case, and on two FBI cases, according to the UW. In response to emailed questions, Dane County District Attorney Ismael Ozanne did not address the UW’s decision to place Knox on leave. In his 10 years as district attorney, Ozanne wrote that he has never had a reason to doubt the diagnoses of the Child Protection Program. He said the program, where “necessary or appropriate,” consults other specialists at the hospital in reaching its diagnoses. “I have faith that the members of that program have made assessments and offered opinions based on sound medical science,” he wrote. “The UW Child Protection Program relies upon research that is widely accepted by many entities such as the American Academy of Pediatrics and the Society for Pediatric Radiology.“My office’s goal in any prosecution is to seek the truth and to pursue justice. The UW Child Protection Program has been and remains an invaluable partner in this work.”
