PASSAGE OF THE DAY: "Few consequences for misdiagnosis; Wisconsin law requires doctors to report suspected child maltreatment, and it gives people involved in reporting child abuse or neglect “in good faith” immunity from legal repercussions. That means consequences for a doctor misdiagnosing child abuse remain elusive. Medical experts who often defend caregivers in court told Wisconsin Watch the child abuse pediatrics subspecialty lacks accountability and scientific rigor, a conclusion also reached by Do No Harm, an NBC News/Houston Chronicle investigation, which uncovered hundreds of cases of false allegations leveled by child abuse pediatricians. Other families in Wisconsin who were damaged by Knox’s child abuse diagnoses are left wondering how she was hired in Florida.'
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Brenna and Joel Siebold, who have followed Knox’s moves since their run-in with her in 2018, questioned why the job application did not ask her to disclose why she left her prior jobs. STORY: "Two couples sue former UW (University of Wisconsin) child abuse doctor for alleged misdiagnoses," WI Wisconsin Watch (Reporter Hope Karnopp) reports, published on September 15, 2022.
GIST: Shortly after former University of Wisconsin Dr. Barbara Knox left Alaska in April, two sets of parents filed a federal lawsuit alleging Knox made “false accusations” of child abuse against them.
The suit names Knox, her supervisor and Providence Alaska Medical Center, which houses the statewide forensic child abuse center, Alaska CARES. Knox now practices at the University of Florida. She accepted the job shortly before resigning as the head of Alaska CARES, where she was accused of misdiagnoses and workplace bullying by co-workers.
Parents and caregivers in Alaska and Wisconsin have told Wisconsin Watch that Knox wrongly diagnosed their children as abused. The families — including Emily and Justin Acker, who lost custody of their children for months — say in their lawsuit that the hospital defamed them and harmed their finances and family.
Knox joined the Department of Pediatrics at the University of Florida College of Medicine in Jacksonville in June as a clinical professor at a salary of $280,000. Knox was issued a Florida medical license in early March, just before her resignation in Alaska took effect. Wisconsin Watch found Knox provided answers on her application for a Florida medical license that appear to contradict her work history.
Dan Leveton, a spokesman for UF Health, declined to answer questions about the hiring process or if Knox revealed that she had been placed on administrative leave at her two previous positions.
“Dr. Knox’s long history and expertise in the field is well-documented, and includes many examples of positive feedback from her colleagues in the medical profession and others. Her background and experience will enhance this program,” Leveton said.
PHOTO CAPTION: Izabel Acker is seen with broken blood vessels in her right eye on Dec. 25, 2020, about two and a half weeks after her birth via emergency C-section. Soon after, her parents, Justin and Emily Acker of Fairbanks, Alaska, were erroneously accused of abusing the newborn. Medical experts found the injuries the baby suffered when she was 3 weeks old stemmed from her traumatic birth. (Courtesy of the Acker family)
In her current position, Knox is “working closely” with the Child Protection Team, Leveton said. The program works with law enforcement and the state Department of Children and Families to evaluate child abuse allegations.
Knox’s diagnoses of child abuse have driven investigations into numerous parents and caregivers in two states, some of which have been rejected by the criminal justice system. In other cases, parents lost custody of their children or faced homicide convictions while maintaining their innocence.
Although multiple investigations were dropped due to lack of evidence, the Ackers still owe around $55,000 in medical bills. The family was told the expenses are not covered by military insurance because the hospital considers the injuries to their 3-week-old infant daughter — who suffered lingering effects of a traumatic birth — to be intentional, Emily Acker said.
“It seems like (Knox) goes from corner to corner (across the United States),” Acker said. “She goes furthest away from the last place she was, probably hoping that no one’s going to hear about it.”
Few consequences for misdiagnosis
Wisconsin law requires doctors to report suspected child maltreatment, and it gives people involved in reporting child abuse or neglect “in good faith” immunity from legal repercussions. That means consequences for a doctor misdiagnosing child abuse remain elusive.
Medical experts who often defend caregivers in court told Wisconsin Watch the child abuse pediatrics subspecialty lacks accountability and scientific rigor, a conclusion also reached by Do No Harm, an NBC News/Houston Chronicle investigation, which uncovered hundreds of cases of false allegations leveled by child abuse pediatricians.
Other families in Wisconsin who were damaged by Knox’s child abuse diagnoses are left wondering how she was hired in Florida.
Brenna and Joel Siebold, who have followed Knox’s moves since their run-in with her in 2018, questioned why the job application did not ask her to disclose why she left her prior jobs.
PHOTO CAPTION: Brenna and Joel Siebold are seen with their son, Leo, 2, at their home in Mount Horeb, Wis., on Feb. 14, 2020. In 2018, Brenna drove Leo to American Family Children’s Hospital, where then-University of Wisconsin Dr. Barbara Knox flagged small bruises as possible signs of abuse. Police dismissed abuse allegations, and child-welfare officials cleared the couple. The Siebolds have since followed Knox’s moves after leaving Wisconsin in 2019 and questioned the hiring process in Florida, where she continues to work as a child abuse pediatrician. (Coburn Dukehart / Wisconsin Watch)
Steve Gehde is the father of Josh Gehde, whose conviction was driven by Knox’s determination that he inflicted abusive head trauma — a disputed diagnosis — on his girlfriend’s daughter. He also questioned how she got a medical license following complaints from former colleagues. Josh Gehde has since filed a new petition in federal court to appeal his conviction.
“She’s going to ruin people’s lives down in Florida now,” Steve Gehde said. “And where is she going to go to after that?”
PHOTO CAPTION: Lisa, Benjamin and Steve Gehde visit Josh Gehde at Wisconsin’s Stanley Correctional Institution in 2021. Gehde was convicted in 2017 of killing his girlfriend’s daughter, after Dr. Barbara Knox said the child died from abusive head trauma. Gehde, who has maintained his innocence, is now trying to get his case back in court. (Courtesy of the Gehde family)
Messages left with Knox’s attorney, Allen Grossman, were not returned. The attorney representing Knox in the lawsuit declined to comment on the litigation.
Meanwhile, Knox’s workplace history has surfaced in three appeals cases back in Wisconsin.
Knox’s references also sued
Knox’s application shows she applied for the Florida position in 2019 — shortly after she was placed on administrative leave from her role leading the University of Wisconsin’s Child Protection Program but before she resigned in October.
Her application included three letters of recommendation, all written before her resignation and subsequent work in Alaska.
Physicians who recommended Knox included Milwaukee child abuse pediatrician Dr. Lynn Sheets, who was named in a federal civil rights lawsuit brought in May by Dr. John Cox and his wife, Dr. Sarah Dobrozsi, who both worked at Children’s Wisconsin.
PHOTO CAPTION: Dr. John Cox and his wife, Dr. Sarah Dobrozsi, leave Milwaukee County Circuit Court in 2020. They are suing several of their former colleagues at Children’s Wisconsin over an abuse diagnosis that led to the infant they were adopting being permanently removed from their home. (Mike De Sisti / Milwaukee Journal Sentinel)
The couple sued several former colleagues and the hospital, among other defendants, over an abuse diagnosis that led to the infant they were in the process of adopting being permanently removed from their home.
Cox was criminally charged, ultimately pleading no contest and agreeing to take parenting classes and perform community service.
And then he sued. Cox and Dobrozsi allege the “spurious and unfounded allegation of suspected abuse” tarnished their reputations as parents and medical professionals and “permanently (altered) the growth and development of their family.”
Defense lawyers wrote that the Cox and Dobrozsi complaint is an “apparent public relations ploy” and that the claims should be dismissed “to prevent the chilling effect that litigation has on child-abuse detection.”
In briefs filed in August, attorneys for the defendants cited the Wisconsin law giving immunity to those who who participate in reporting suspected child abuse.
A federal court cited a similar New York law in cases involving Debra Esernio-Jenssen, now a physician in Pennsylvania, who also recommended Knox. Esernio-Jenssen was sued several times in federal court by parents who allege that she falsely made child abuse diagnoses.
Attempts to reach Sheets and Esernio-Jenssen for comment were unsuccessful.
Dr. Bruce McIntosh, then the statewide medical director of the Florida child protection teams, also supported Knox’s application. In 2020, McIntosh defended the work of the teams after a news outlet investigation uncovered parents’ allegations that they were victims of wrongful abuse diagnoses.
Knox denies previous forced leaves
Knox was placed on administrative leave at her two previous jobs — first in June 2019 at UW-Madison and later at Providence in Anchorage in fall 2021. While on leave from UW, she was barred from performing any duties at the medical school or communicating with patients or colleagues.
However, Knox indicated on her Florida medical license application that she had never had any staff privileges “denied, suspended, revoked, modified, restricted, not renewed, or placed on probation” or had never “been asked to resign or take a temporary leave of absence or otherwise acted against by any facility.”
If Knox indicated that she had been subject to such steps, she would have been required to provide a written self-explanation and supporting documents from the facilities.
A letter from Grossman, Knox’s attorney, was attached to the application noting that Knox “has never been the subject of disciplinary or criminal action in any jurisdiction.”
Knox’s resignation from UW, and her departure from the Alaska clinic, were both characterized as voluntary, though the federal lawsuit filed against her alleges she was pressured to resign in Alaska. The UW agreed not to describe her administrative leave as disciplinary.
The Florida Board of Medicine did not respond to questions about whether it would consider Knox’s answer to the section to be accurate or if it was aware of Knox’s resignations or leaves of absence.
A box on the application — which Knox signed — states that providing false information may result in disciplinary action against her license or criminal penalties.
Settlement protects Knox
As part of Knox’s settlement agreement with UW, the university agreed to draft a letter that was meant to shield details of her departure during credentialing processes.
UW agreed to send the letter to the Alaska State Medical Board, which said it did not receive the letter but had “general knowledge” of the reasons Knox was placed on leave.
The Florida Board of Medicine did not say if it received the letter.
PHOTO CAPTION: Former University of Wisconsin Dr. Barbara Knox is now a professor in the Department of Pediatrics at the University of Florida College of Medicine in Jacksonville after being placed on leave from her two previous jobs at the UW and Alaska CARES evaluating children for abuse. In her new role, Knox is “working closely” with a team that evaluates child abuse allegations, a spokesman said.
The complaint filed by the two families in Alaska alleges that the clinic and/or Knox’s supervisor at Providence, Bryant Skinner, “believed she had misrepresented the circumstances of her separation from the University of Wisconsin.”
Knox and the other defendants have not yet responded to the lawsuit. A spokesman for Providence declined to comment on pending litigation.
The lawsuit also alleges that Knox entered into an agreement with Providence to “avoid adverse credentialing action(s),” and Knox and the clinic will release the agreement only under a court order.
Knox’s settlement with UW also had a provision preventing anyone who knew about the agreement from providing any information during credentialing processes except the dates of Knox’s employment and the privileges she held at the hospital.
Attorneys probe Knox’s leave from UW
Knox’s employment history at UW has come into play in a case involving Kevin Welton, a Middleton businessman who in 2019 was found guilty of sexually assaulting two girls, including Knox’s daughter, at a swimming pool, in 2010 and 2018.
Welton admitted to a Middleton Police Department detective that he groped Knox’s daughter, according to the criminal complaint. He is serving four years in prison with six years of extended supervision.
Matthew Pinix, Welton’s attorney, asked a judge in a postconviction motion to order the disclosure of more records from Knox’s time at UW, including personnel files, disciplinary records and investigation files.
Pinix argued in a Dane County Circuit Court motion hearing that if there was information in the files that would support the idea that Knox had “a character to push persons to accept (her allegations of) assault,” prosecutors should have found it and turned it over.
At Welton’s trial in 2019, Knox’s then-8-year-old daughter testified she changed how she described the situation “just a little” after Knox “kind of” coached her about testifying. The girl, who originally described the contact as “an accident,” testified that she no longer believes that but “no one convinced” her to change her mind.
Knox appeared to contradict her daughter, testifying that she “never” coached her about what to say.
During a September 2021 motion hearing, Judge Susan Crawford questioned whether she could order the release of the records, which the prosecution said it did not possess.
“The State can’t suppress what it doesn’t have,” Crawford found. “In this case, it didn’t have an investigation report showing in detail what was investigated and what the findings are. I don’t know what the outcome of that investigation was and neither does anybody else in this room.”
Crawford also questioned whether potential “workplace improprieties” were relevant to the case.
“An accusation that Dr. Knox pressured other medical professionals through aggressive, demeaning, and unbecoming conduct in a work setting is drastically different than coaxing her child to believe that an accidental touch was sexual in nature,” Milwaukee County Deputy District Attorney Matthew Torbenson said in a response.
In the latest court filing, Welton’s attorney argued there should not be a separation between her professional and personal roles and the same subject matter of “false child abuse allegations” is at play.
Lawyers not informed about Knox’s leave
Knox’s employment history at UW also surfaced during an appeal for Jennifer Hancock, a former Verona day care provider who was convicted of killing an infant in her care in 2007. Hancock completed a 13-year prison sentence this spring and remains on extended supervision for seven more years.
Attorneys for Hancock, led by the Wisconsin Innocence Project, said in a 2021 appeal filed with the state Court of Appeals that the prosecution concealed information about Knox’s departure during appeals hearings despite disclosing it in another case.
Hancock’s appeal rested in part on recanted testimony from Dr. Michael Stier, a UW forensic pathologist who performed the baby’s autopsy. He wrote in a sworn affidavit that he has since seen similar patterns of brain bleeding that were not caused by abuse and would now testify that the cause of death is undetermined.
Stier has said that he felt pressured by Knox and others to agree that the infant may have suffered a skull fracture, but wrote in the affidavit that he would now say there was no skull fracture.
At a post-conviction motion hearing in 2019, Stier said that if he or anyone else had objected to the assumption that the death was caused by abuse, they “probably would have been laughed out of the room and told to go back to medical school.”
Hancock’s attorneys argued that disclosing the details of Knox’s departure would have given credibility to Stier’s testimony that he was pressured to find abuse. Hancock’s appeal is pending.
Appeals cases move forward
Josh Gehde, who was convicted in 2017 of killing his girlfriend’s 2-year-old daughter after Knox determined she had suffered abusive head trauma, is again trying to get his case back in court.
Gehde has steadfastly maintained his innocence. His prison sentence is set to end in 2039 with an additional 15 years of extended supervision. Gehde unsuccessfully appealed his case in 2019.
The Federal Defender Services of Wisconsin, a private law firm funded by the federal judiciary, is representing Gehde. His lawyer, Jessica Arden Ettinger, wrote in a letter to the court that he has 10 additional grounds for appeal.
The new claims include that the prosecution team did not tell Gehde’s original trial attorneys that the lead investigator on the case, Madison Police Department detective Maya Krajcinovic, made misrepresentations in a different case while Gehde’s case was pending — which ultimately led to her suspension.
Madison detectives Maya Krajcinovic and Thomas Helgren question Joshua Gehde at the Dane County Sheriff’s Office on April 15, 2016 after his girlfriend’s 2-year-old daughter suffered a brain injury while in his care and later died. Krajcinovic shook a child-sized mannequin, its head rocking back and forth violently, to demonstrate how she believed Gehde had harmed the girl. Gehde responded: “Who does that though?” Editor’s note: Wisconsin Watch has redacted the name of the mother and child from this video. This video contains some profanity.
Another claim is related to a jailhouse informant interviewed by Krajcinovic who recanted his testimony before trial — a fact that was withheld from the defense, Gehde’s petition states.
Gehde also has “other potentially viable claims,” including “newly discovered evidence” concerning Knox, who was the lead expert witness for the state.
Steve Gehde, Josh’s father, said the family is pleased that the new petition brings up issues that were not in his original appeal.
“He’s maintained his innocence,” Gehde said. “We went through the whole entire trial from day one and we didn’t see any evidence, with the exception of Barbara Knox saying that’s the only thing that could have happened.""
The Fund for Investigative Journalism supported reporting for this story. The nonprofit Wisconsin Watch (www.WisconsinWatch.org) collaborates with WPR, PBS Wisconsin, other news media and the University of Wisconsin-Madison School of Journalism and Mass Communication. All works created, published, posted or disseminated by Wisconsin Watch do not necessarily reflect the views or opinions of UW-Madison or any of its affiliates.
Two couples sue former UW child abuse doctor for alleged misdiagnoses is a post from WisconsinWatch.org, a nonprofit investigative news site covering Wisconsin since 2009.
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PUBLISHER'S NOTE: I am monitoring this case/issue/resurce. 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;
