Resembling SBS

So quick to blame, they miss the truth.(Column)

The Evening Standard (London, England); 3/31/2004

Byline: ALLISON PEARSON

IT happens. You leave the baby on the changing table, you turn to get the wipes and the baby chooses that moment to learn how to roll. There's a thump and she's on the floor, yelling. Or not yelling, which is worse, because a silent baby who has hit its head is one of the most terrifying things known to to man.

On the way to hospital, you cut this deal with God - who, in the last few minutes, you've decided you do believe in - that if He would only make your baby all right, then you will never ever look away again, you will hold her close to you forever, so long as she is all right.

There can hardly be a parent, no matter how vigilant, who has not had something like that happen to them.

Most of us are lucky. The baby squawks, one of those cartoon boiled-egg bumps comes up, the squawking stops, the baby grins, and life goes on.

But, according to BBC1's Real Story this week, there are devoted mothers and fathers whose infants suffer a bleed in the brain and retinal damage after quite a minor fall. The baby is immediately deemed to be a victim of Shaken Baby Syndrome. Once that diagnosis is made, someone has to be guilty.

Lorraine Harris was convicted of shaking her son Patrick to death. She was pregnant when she went to jail, but was not allowed to keep the baby because she was now officially a child-killer.

The expert whose evidence helped put her behind bars has read the recent research and no longer believes Lorraine killed her son. Hundreds more innocent people are serving time for killing children they loved.

Meanwhile, as I know from a friend, there are parents whose injured babies did not die from Shaken Baby Syndrome, but who are still treated as potential murderers. My friend's baby fell off the bed while her husband was taking care of him.

My friend believed her husband's version of events: he was, and is, an exceptional carer of their two small children.

A lawyer told my friend it would be better if she was seen to accept her husband's guilt because, that way, they might get to keep the baby. When she protested, her social worker wrote on her record "in denial". The family courts in this country operate like something out of a police state. Any parent who complains about injustice will simply have their child taken away. Terrified, they stay silent. Injustice goes on. My friend blames medical "experts" - the kind who insisted that two cot deaths could not happen in one family by chance. Well, we know how "expert" they were on that one, don't we?

MY friend also says that social services are stupid, incompetent and appear to enjoy exercising draconian powers. "They are meant to be social workers for the whole family, but in Shaken Baby cases they turn into prosecutors.

They never interviewed anyone who could have said positive things about our relationship with our kids."

It's horrible to not be believed. To not be believed when your baby's safety is in question is a nightmare without end.

Common sense tells us that most Shaken Baby cases are twists of what used to be called fate. But the authorities don't believe in misfortune any more; they only believe in victims.

COPYRIGHT 2004 Solo Syndication Limited

This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan.
All inquiries regarding rights should be directed to the Gale Group.

HighBeam™ Research, LLC. © Copyright 2004. All rights reserved

E-mail the reporter:
Liam.McDougall@sundayherald.com

Below is mine:

Dear Mr. McDougall,

I read with extreme interest and a huge sense of foreboding your two recent articles regarding the examination of past cases of alleged abuse.

It is extremely upsetting that Dr. Chadwick, a member of the Helfer Society, and a prosecution witness in countless cases of alleged shaken baby syndrome, would be permitted to review these cases. Shaken Baby Syndrome has come under criticism recently because review of the very literature physicians such as Dr. Chadwick rely upon has found that the literature is not supported by recent or past scientific evidence. The vast majority of the literature are reports involving very small numbers of children picked because they fit the current criteria of alleged abuse. There is no study which cites
actual witnessed cases of abuse which can be confirmed independently and show the injuries that would result from shaking an infant.

Dr. Chadwick certainly has not only a financial interest but also a professional credibility interest in attempting to discredit recent studies which support a possible nontraumatic etiology in some of these cases. Geddes et al published a report in 2003 in which infants who died from nontraumatic etiologies were examined. They found microscopic bleeding in the dura lining of the brain, some which had dissected through the lining (subdural). They hypothesized that
hypoxia might be a factor in the subdural bleeding found in alleged shaken babies in which subdural and retinal bleeding might be the only findings upon examination. This study came on the heels of three other studies in which attempts to document the traumatic brain injury in alleged shaken babies did not reveal such injury. With the
exception of a few with corresponding skull fractures, any injury found was microscopic. There was no sheering of the brain, contusions, concussions, etc., to evidence the brain bouncing back and forth off of the skull.

Duhaime et al have done two studies on the biomechanics of head injury in infants (1987 and 2003). These studies support each other and from the results of these studies it has been shown that shaking is unlikely to cause traumatic subdural hemorrhaging. They admit that it is unknown if shaking can cause these injuries. Similar studies
have been done over the years which also support these findings.

A major pitfall in the study of shaken baby syndrome is that once the diagnosis is made, very little further examination is performed. Perhaps if this was not the case, similarities would be discovered that would aid in determining the cause of these symptoms. Can profound hypoxia lead to a compensation which aids bleeding? Geddes et al hypothesize that the brain's reaction to hypoxia -- swelling -- and the compensation to underperfusion of oxygenated blood -- arterial hypertension -- can lead to compromise of an infant's fragile vascular system. The brain swells which causes congestion as it becomes harder to circulate blood and as the body increases blood pressure to try to push more blood to the brain, the
vascular system becomes compromised. Many infants are found to have disseminated intravascular coagulapathy (DIC). This disorder causes prolonged and profuse bleeding. Hypoxia is certainly linked to DIC.

Hypertension alone has been linked to intracranial hemorrhage and retinal bleeding in adults (hemorrhagic stroke and hypertensive retinopathy).

Studies in this area are indeed lacking. To rely on known self-proclaimed child abuse experts who have done no realistic,
prospective studies on their own and rely on the opinions and interpretations from single case reports and poorly conducted studies is a misjustice to all involoved except those who stand to prosper.

Children are abused every day. I will never claim otherwise. But the increase in the diagnosis of shaken baby syndrome despite the new worldwide educational programs may be the first hint that they have got it wrong. I have never even seen a report of a caregiver or parent presenting with an infant at the emergency department and
stating immediately that the child had been shaken.

The testimony of Dr. Chadwick and his colleagues is challenged in the United States just as medical testimony is challenged in the European countries. Their support of prosecution witnessed in Europe makes that testimony no more credible in light of conflicting evidence than before. A group of 50 other medical professionals could come to
Europe and review Dr.Chadwick and his team's findings and discredit them. There is no solution in this type of review and debate.

Defense experts are in a very unique and difficult position. They rarely have the opportunity to examine the child at the time of admission and hospitalization. They therefore rely on the documented clinical findings of the treating physicians. They review records and images and hold opinion until they have reviewed it and examined etiologies. They look to see if important clinical results have been overlooked in the rush to diagnose abuse. Often they find lab values which are suspicious, evidence of infection, undiagnosed conditions which may be later revealed but by then are downplayed because the charges have already been levied.

The people of Europe should be frightened by the possibility of a "team of child abuse experts" reviewing past cases to determine the credibility of evidence given at trial. Recent debate in the British Medical Journal only touches on the controversy of shaken baby syndrome. The doctors who come forward questioning the etiology of
shaken baby syndrome may have also provided testimony in trials, but unlike the child abuse experts they are attempting to discover and research all etiologies of these symptoms so that one day they will not be asked to testify. My personal experience is that many of these defense witnesses do not charge for their testimony and therefore
have no financial interest in the outcome of the trial. They are trying to help families they believe are innocent and have suffered wrongdoing at the hands of overzealous child abuse experts who stand to gain considerable funding for educational programs, etc.

Sincerely,
Heather Lohr
Pennsylvania, USA

This letter responds to the article titled "Testimony of child abuse experts under new scrutiny," written by Liam McDougall and published by Sunday Herald on May 9, 2004.

We Americans pride ourselves as a nation that operates under the rule of law and regularly proclaim that we provide the fairest system of justice in the world. While this may arguably

be true in certain areas of the law, it strains credulity to extend this notion to the way in which child abuse cases are typically investigated and prosecuted.

I have not reached these conclusions without appropriate experience, extensive research, and relevant expertise. I have served as director of continuing medical education in the department of psychiatry at Harvard Medical School and at The Menninger Clinic. I also served as associate publisher and senior editor of The Psychiatric Times and have published more than one hundred articles including a series of peer-reviewed articles on psychopharmacology. During the past decade I have devoted my energies to serving as a consultant in more than six hundred child abuse cases and have qualified as an expert witness in twelve states and Canada. My ultimate qualification for submitting this letter may well be the fact that I am proud to identify myself as among the experts that would likely be slandered by such eminent physicians as Drs. Marcovitch, Hobbs, Meadow, Southall, and Chadwick.

A certain subset of "eminent paediatricians" and self-proclaimed "child abuse experts" are clearly in the business of manufacturing victims while destroying countless innocent families. The evidence of child abuse hysteria fomented by this cadre of medical polemicists is staggering. In the United States, and I suspect the statistics are not dissimilar in the U.K., media headlines proclaim that more than 3 million reports of child abuse are recorded annually. The fact that 80-85% are not confirmed by ensuing investigations and legal proceedings is typically not reported.

I need not detail the sorry history of child protection efforts in the U.K. While the abuse of many hundreds of children in state-sponsored placements was being overlooked, the child abuse industry devoted itself to wholesale removal of children from their homes based on spectral evidence, phantom disorders, and fanciful modes of purported abuse that have thankfully been assigned to the trashbin labeled "junk science." Among other delusions, these "distinguished experts" have given us "anal wink" as an indicator of child sex abuse, "satanic ritual abuse" as an actually-occurring phenomenon, "facilitated communication" as a valid investigative technique for identifying abuse of autistic children, "munchausen syndrome by proxy" as a legitimate psychiatric disorder, and "repressed-recovered memories" as evidence of early childhood sex abuse.

The convictions of Angela Cannings, Sally Clark, Trupti Patel, and Mark Latta bring shame to the U.K.'s justice system. These cases serve as a paradigm for the many glaring deficiencies of the system and point to the need for fundamental and comprehensive reform. Inviting individuals such as David Chadwick and his ilk to review child abuse cases in the U.K. is the equivalent of imploring the wolf to guard the chicken coop.

One of the more recent concoctions to emanate from the child abuse cabal is "shaken baby syndrome." Over the past decade, many hundreds of peer-reviewed research articles have soundly challenged every criterion that has been proposed for diagnosing this "heinous crime." This is not to deny that parents sometimes commit horrific acts, including "shaking with impact," that can result in profound injury and even death. But it raises definitive questions about the glib assertions and conscious ignoring of alternative hypotheses that too often are admitted by courts as scientifically-sound gospel.

Among the three million plus child abuse cases reported in the U.S. annually, initial screening or investigation results in the classification of approximately 70% as "unfounded" or "unsubstantiated." When the outcomes of further legal proceedings are taken into account, we find an "error rate" of between 80% and 85%. Yet, despite the laws allowing for sanctions to be brought against those who make false accusations, such cases are almost never prosecuted.

Perjury is rampant in child abuse cases. It has become so common in certain types of cases, that a large body of case material known as "SAID (sexual abuse accusations in divorce) literature" has emerged. Here, too, sanctions are rarely brought.

Most upsetting to some of us is the extent and nature of the perjurious testimony that emanates from mental health and medical professionals and the failure of the justice system to hold these miscreants accountable.

My consultation in a "shaken baby" case in the State of Maine is instructive. Having carefully reviewed the case materials, I advised the prosecutor that I intended to testify that the State's medical expert, who had proclaimed himself from the stand as a "world famous specialist," was a fraud who had committed perjury. (In fact, the pediatrician was not board certified, a requisite for being qualified as a specialist). I also advised the prosecutor that I intended to testify that he (the prosecutor) had suborned perjury by virtue of allowing his expert to mislead the court by testifying that the formula "RH + SD = SBS (retinal hemmorhage plus subdural haematoma unequivocally equals shaken baby syndrome)" had scientific merit. The following day a plea bargain was offered: if the parents agreed to "assure the health of their infant son by allowing him to remain in specialized foster care for an additional sixty days," the charges would be dropped. The deal was consummated and, of course, no sanctions were brought against the prosecutor or the physician.

British courts seem to take false accusations far more seriously than do American courts. It is my impression there have been a significant number of convictions based on the charge of "intending to pervert the course of justice."

Several months ago, a British appeal court was not gentle in its excoriation and condemnation of testimony rendered by three prosecution experts (Sir Roy Meadow and two of his colleagues) while reversing the conviction of Sally Clark, an attorney and reportedly loving mother, who had been charged with murder in a "shaken baby syndrome" case. The scientifically unfounded testimony of these "eminent experts" was exposed as misleading, fraudulent and reprehensible. The appellate court's published decision is instructive regarding many matters related to "shaken baby syndrome" in addition to the issue of uninformed testimony.

I have long admired the probity of British jurists and have recommended that American judges ought be tutored by their example. The initiatives reported in your article lead me to fear that the integrity of your legal system could be severely compromised.

Howard Fishman Philadelphia, Pennsylvania, USA

[For confirmation: email HFJustice@aol.com street address: 5805 Charles Street, Philadelphia, PA 19135, telephone (215) 774-5010]

The 7 O'Clock News
Shaken babies? Diagnosis in doubt

200 babies a year are diagnosed as having died following violent shaking.

These often become high profile cases, causing a media furore and emotive tabloid headlines about 'child-killers.' Remember British au pair Louise Woodward, sentenced to life for murdering a baby in the US? Despite the fact that her conviction was reduced to manslaughter and her sentenced slashed in 1998, she's back in the headlines as she begins work as a lawyer in Manchester

Like many so-called child-killers, she vociferously protested her innocence. Now new research, by a team at Wake Forest University in the US, may give such claims greater credence.

The team based their findings on the fact that many diagnoses of babies having been violently shaken are based on finding eye injuries in the child. The say these could just as easily be caused by any number of other factors. Bleeding eyes could be an indicator but doctors shouldn't jump to conclusions unless they find brain damage and bleeding in the brain as well.

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Shaking or falling TVs?
The researchers focused on the case of a healthy 14-month-old child who was brought to hospital with a severe head injury after a television fell on him at home.

Despite the father's repeated, detailed, and consistent account of the incident, Child Protective Services removed the child's three-year-old brother from the home because the baby had injuries to the retina of the eye.

Campaigning parents say this is a typical scenario: once evidence of bleeding in the eye is found, the authorites simply stop looking for other causes. They say hundreds of cases of misdiagnosis could exist as a result.

Lead researcher at Wake Forest Dr Patrick Lantz agrees, he told BBC News Online:

"If some doctors believe that this eye injury can only result from shaking and haven't critically reviewed the medical literature, false allegations of child abuse could exist."

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New approach
The Five Percenters - who support parents who say they have been wrongly accused of shaken baby syndrome - say the study proves what they've been saying all along. Director Rioch Edwards-Brown said:

"In approximately a third of cases their child's injuries followed a minor fall, but both birth trauma and difficulty in breathing can also cause bleeding under the skin and at the back of the eyes."

An editorial in the British Medical Journal has called for change. Forensic pathologist Dr John Plunkett and brain damage expert Dr Jennian Geddes argue the research suggests that the criteria used to diagnose shaken baby syndrome requires re-assessment. They say it is not unusual for shaken baby syndrome to be diagnosed on the basis of signs of bleeding from the eyes alone

It's a difficult balance between detecting a crime on which society is so sensitive and protecting the innocent.

As Dr John Plunkett puts it:

"...a natural desire to protect children should not lead anyone to proffer opinions unsupported by good quality science."

http://www.bbc.co.uk/bbcthree/news/7oclocknews/features/babyshaking_250304.shtml

Patrick E. Lantz, MD

Associate Professor of Pathology (Anatomic Pathology)

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