By: Tonya Sadowsky (Guest Blogger)
We have all seen headlines like these: “Father Arrested for Assaulting Newborn” or “Young Mother in Custody for Abusing Her Child, Claims Baby Fell – Doctors Don’t Believe Her.” Now imagine it was your world that just got one person smaller-your precious child just died. That fog in which you are wrapped is only masking an unfortunate reality all too true. Horrible, isn’t it? Now imagine that scenario with the added caveat of being accused of murdering your beloved tiny clone. Maybe your spouse was the one accused. Or even your babysitter or daycare provider, the one your baby responded to better than to his in-laws, which secretly made you proud because you thought she was an amazing sitter – until you thought she killed him. We all remember the reviled au pair [nanny] Louise Woodward from her case televised in the ‘90s. This scenariocould be happening to as many as three to four babies per day if we believe the CDC’s estimates. [1]
Regardless of the statistics, there are many who feel this is an overly-used diagnosis that too often overlooks any other possible causes for a child’s injury or death. From Time Magazine to The New York Times and NPR, media is becoming more aware of the controversial facets of this diagnosis. [2, 3, 4] Dr. Norman Guthkelch, credited with founding the syndrome, is now advising caution before choosing this diagnosis. [5] I am now one of those people, too. My daughter died in 2007, four months and three weeks after she was born. Due to a medical condition, her father dropped her, causing her to land on her head. She succumbed to her injuries after a few hours despite being given access to immediate medical attention.
There are dozens of potential reasons for my daughter’s injuries, but there was one repeatedly thought to be impossible: the truth. Because we gave that one unfortunate “story” rejected as completely unbelievable, we were immediately judged and convicted as liars covering up abuse. It has taken years, but research is advancing. Short falls are being proven to potentially cause multiple skull fractures, let alone single skull fractures in infants. One week after conviction, ABC affiliates broke their investigations of Bumbo seats, leading to its subsequent recall. Fourteen babies fell backward out of their seats resulting in skull fractures. The recall only lasted long enough to issuea warning sticker advising users not to place the seats on elevated surfaces. Seven years later two more babies suffered skull fractures even though their seats had been placed on the floor! [6]
Scientists are also studying brain injuries more than ever before. Those most helpful are from NFL players who received repeated concussions. This type of injury is currently under scrutiny because of the recent realization that helmets are only protecting the skull from fractures, but not the brain from traumatic injury. [7]
I began doing research on my own, paving the way to becoming a paralegal (initiation by fire). Although I believed whole heartedly in Shaken Baby Syndrome, at some point what I was being told had happened simply didn’t make sense. I wanted answers. I wanted to know the truth. So imagine my surprise when I stumbled upon an article claiming Shaken Baby Syndrome is an “unsettled science.” [8] Could it be possible that the homicide alleged to be the reason behind my daughter’s death might have been misdiagnosed?
I continued researching, not yet satisfied. I spoke to the emergency department pediatrician who told me that my daughter’s head injury was “normal” after ahead trauma and that there was no significance to the timing; it could have happened anytime within two hours to two days after a head trauma. What I then wanted to know was what qualifies as a head trauma if not falling five feet out of your father’s arms? I got the autopsy report and forced myself to look at the pictures. My daughter’s birthmark was described as “a bruise up to three days old.” Convenient, since there really wasn’t any other evident bruising other than the impact location. If the medical examiner could mistake a birthmark for a bruise, what else could she have gotten wrong?
It was then that I started looking at purported cases of Shaken Baby Syndrome in the news, throughout the U.S. and Canada. What I discovered is that the diagnosis is made with completely different injuries each time. It begs the question: what injuries are necessary for a diagnosis if these change from case to case? What becomes the standard for a diagnosis of this form of abuse? Doctors are not in agreement if the news stories are any indication. Any disorder or disease has specific indicators for diagnosis except apparently this one. Instead of finding a symptom and testing for its cause; this diagnosis is simply made after finding certain injuries present. No testing required.
Furthermore, once this diagnosis is reached and authorities are notified, the doctor has no legal requirement to perform further testing. This diagnosis tells police who did it (last person with the infant), why they did it (snapped because baby is crying) and how they did it (vigorous shaking episodes). This diagnosis over-extends the doctor’s field of expertise. Then the American Association of Pediatrics recommended changing the name to Abusive Head Trauma in 2009. [9] In other words, now this means no one knows how the abuse happened (unless you get a confession), only that the doctors are sure it’s abuse because those injuries are present.
Dr. Ronald Uscinski’s came to this conclusion in his paper The Shaken Baby Syndrome: “With regard to treatment of cranio-cerebral trauma, the differentiation between accidental and inflicted injury is of limited practical importance: injuries are injuries. For social purposes, however, the distinction is critical. While the desire to protect children is laudable, it must be balanced against the effects of seriously harming those who are accused of child abuse solely on the basis of what is, at best, unsettled science.” [8]
As paralegals, we know winning an appeal is difficult. The Innocence Project has helped hundreds of convicted murderers and rapists find freedom based on exonerating DNA evidence. Surprisingly, quite a few of those exonerated had initially plead guilty. The Innocence Project is now turning its head toward convictions of Shaken Baby Syndrome. In Wisconsin, in 2008, a woman named Audrey Edmunds won an appeal. She had owned a daycare, but was accused of abuse. After eleven years in prison for a crime she did not commit, she has written a book entitled, “It Happened to Audrey; It Could Happen to You.”
Another example I wish to highlight is of a couple from Virginia who took their daughter to the hospital where doctors discovered rib fractures. The father was arrested on charges of child abuse and the daughter was immediately placed into foster care. Seven months passed before the mother could get a court order to have their daughter tested for a medical condition she had. The baby girl tested positive for osteogenesis imperfecta, a condition with symptoms of multiple bone fractures. Despite this new diagnosis, the accusing doctors did not change their accusation. Seventeen months after being removed from their care, their daughter was returned home. In 2004, the Virginia Court of Appeals made a landmark ruling on an abuse case, overturning the conviction and declaring that the Department of Social Services had been in error. What might have been most surprising was his going on record to apologize on behalf of the government to this innocent man for what it had put him through. [10]
As a paralegal, we learn that we have a duty to “maintain integrity and a high degree of competency through education…and through continuing education insubstantive areas of law…” [11] Just like anyone in a specialized field, we can become cynical and jaded toward our firm’s clients, especially those accused of heinous crimes like those against an innocent child. We cannot let emotion overrule our duty because it just might be that they really are telling us the truth, it was an accident and he dropped her. It is our duty to suspend judgment and bias because if the CDC’s estimates are anywhere close to accurate, then the chances of a friend or neighbor risking these accusations are high. Maybe you already know someone who has had this happen to them. Maybe you always suspected they might have been innocent. If I can help one family not lose themselves, then losing my daughter wasn’t for nothing. If I can encourage doctors to employ evidence-based medicine principals before accusing another person of child abuse, then I will know that my daughter did not die for nothing.
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REFERENCES:
[2] Szalavitz, M. (2012) The Shaky Science ofShaken Baby Syndrome. Time. Retrieved fromhttp://healthland.time.com/2012/01/17/the-shaky-science-of-shaken-baby-syndrome/?xid=gonewsedit
[3] Bazelon, E. (2011) Has a Flawed DiagnosisPut Innocent People in Prison? A Re-examination of Shaken Baby Syndrome. TheNew York Times Magazine. Available fromhttp://www.theamandatruthproject.com/NYT.Magazine_Brazelon_(2011.Feb.6)_Has.a.Flawed.Diagnosis.Put.Innocent.People.in.Prison.pdf
[4]Thompson, A.C. et al. (2012) The Child Cases:Guilty Until Proven Innocent. NPR. Retrieved fromhttp://www.npr.org/2011/06/28/137454415/the-child-cases-guilty-until-proven-innocent
[5] Shapiro, J. (2011) Rethinking Shaken BabySyndrome. Retrieved fromhttp://www.npr.org/2011/06/29/137471992/rethinking-shaken-baby-syndrome
[6] Finney, M. (2012) Injuries Still Occur AfterBumbo Baby Seat Recall. Retrieved fromhttp://abclocal.go.com/kgo/story?section=news/7_on_your_side&id=8538195
[7] CDC (n.d.) Concussion. Retrieved fromhttp://www.cdc.gov/concussion/pdf/NFL_Player_Poster-a.pdf
[8] Uscinski, R. (2004) The Shaken BabySyndrome. J. of Am. Phys. and Surgeons Vol 9 #3 Retrieved fromhttp://www.jpands.org/vol9no3/uscinski.pdf
[9] Christian, C. et al. (2009) Abusive HeadTrauma in Infants. Retrieved fromhttp://pediatrics.aappublications.org/content/123/5/1409.short
[10] Shannon, S. (2007) A Parent’s WorstNightmare. Reader’s Digest. Retrieved from http://www.rd.com/advice/parenting/parents-wrongly-accused-of-child-abuse/4/
[11] NALA (2012) Code of Ethics and ProfessionalResponsibility. Retrieved fromhttp://www.nala.org/code.aspx
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Tonya Sadowsky lives in Cleveland, Ohio and is Founder and Executive Director of “The Amanda Truth Project”, an organization that advocates for families who have been falsely accused of Shaken Baby Syndrome. In addition to her advocacy and conference speaking engagements, Ms. Sadowsky authored and manages The Amanda Truth Project website, which is named after her own daughter who died in 2007. The Project is intended to educate the public and medical professionals about the potential for a misdiagnosis of child abuse by promoting evidence-based medicine practices before issuing a medical opinion of child abuse. The Project also provides emotional support to families and coordinates expert information-sharing with their defense counsel when wrongly accused.
Tonya can be reached through her website athttp://www.theamandatruthproject.com/
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