Home > Doctor Gagged For Doubting Shaken Baby Sndrome > Doctor Gagged For Doubting Shaken Baby Syndrome

Doctor Gagged For Doubting Shaken Baby Syndrome

29 July 2010 by Andy Coghlan

A PATHOLOGIST in the UK who argues that the trademark triad of symptoms of “shaken baby syndrome” (SBS) can have an innocent cause has been prevented from testifying in court as an expert witness. The restriction could stand until January 2012.

Yet, according to researchers and lawyers contacted by New Scientist, there are serious doubts about the safety of many shaken baby convictions. This is despite the fact that the triad of symptoms has been taken as evidence of murder for 40 years.

The pathologist in question, Marta Cohen of Sheffield Children’s Hospital, learned of the restrictions following a private hearing on 22 July before the General Medical Council, the body that investigates complaints against doctors in the UK.

“The decision is appalling,” says John Plunkett of the Regina Medical Center in Hastings, Minnesota, who has shown that short falls can cause the trademark symptoms said to be exclusive to child abuse.

The fear of similar outcomes means that British-based pathologists who dispute SBS are unwilling to take on cases of alleged child abuse. “It means that no one will take any head injury cases,” said one, who asked not to be named. “If you disagree with the prosecution, you risk being called before the GMC.”

The verdict appears under Cohen’s registration details on the GMC website, stating that: “She must not give evidence as an expert witness in cases where there is alleged non-accidental head injury to an infant or child.” It also makes clear that the restrictions are temporary precautions while the complaints against her are further investigated by the GMC.

It is not clear who complained to the GMC, but the motivation appears to come from criticisms circulated to prosecution services by a judge, Justice Eleanor King, following cases last year in which Cohen gave evidence. King’s criticisms included accusing Cohen of developing a “scientific prejudice”, of being “disingenuous” in her citing of research and unwilling to defer to prosecution expert witnesses.

The GMC will not explore the validity of the competing scientific theories about SBS, and will simply investigate Cohen’s “fitness to practice”. The GMC’s ruling comes at a time when evidence is mounting that innocent events such as the birth process itself, choking, short tumbles and breathing difficulties can cause the classic symptoms (BMJ, vol 2, p 430).

A triad of markers

The three markers for a shaken baby diagnosis are retinal haemorrhages in both eyes; subdural haemorrhages between the fibrous dura layer that protects the brain and the brain surface beneath; and swelling of the brain. Subdural haemorrhages are said to arise from ripping and shearing of so-called bridging veins. New lines of evidence challenge this hypothesis with the discovery that subdural bleeds are much more common in babies than generally appreciated, and for a host of innocent reasons (see “Anatomy of a murder?”).

Last year, Cohen and co-researcher Irene Scheimberg of Barts and the London NHS Trust examined post-mortem tissue from fetuses and newborns and found subdural haemorrhages in 16 of the 25 fetuses and 20 of the 30 newborns. They also found haemorrhages within the dural layer itself, suggesting that the bleeding started here (Pediatric and Developmental Pathology, DOI: 10.2350/08/08/0509.1). The research is just the latest of many reports to show that subdural bleeds can occur without shaking (see “Anatomy of a murder?”).

No one doubts that frenzied shaking could cause the triad of symptoms, but only after severe accompanying damage to the neck. A baby’s head striking a solid surface would also cause such damage but then there would be other evidence of an impact. For these reasons, there is increasing pressure for the triad not be used as evidence of guilt in the absence of any other evidence of child abuse. The American Academy of Pediatrics last year called for the phrase “shaken baby syndrome” to be replaced with “abusive head trauma”. In the UK, the Royal College of Pathologists last December cautioned against viewing the triad as “absolute proof of traumatic head injury in the absence of any other corroborative evidence”.

No independent witness has ever seen a shaken baby with such symptoms, the only evidence has come from confessions. Of 54 cases globally in which defendants admitted shaking a baby, only 11 had no signs of other injuries (The American Journal of Forensic Medicine and Pathology, DOI: 10.1097/01.paf.0000164228.79784.5a).

In 2001, Plunkett published 18 reports of all or some of the key symptoms in infants who had died after falling 60 centimetres to 3 metres (The American Journal of Forensic Medical Pathology, vol 22, p 1). In the same journal in 2004, (vol 25, p 89) Plunkett described evidence from a family video of a toddler with all the symptoms dying after a short fall.

The original concept of shaken baby syndrome arose not from research on babies but from road safety research published in 1968 on what happened to brains of adult monkeys when cars decelerated rapidly (Journal of the American Medical Association, vol 204, p 285). Since then, biomechanical studies using dummies as surrogates have concluded that shaking alone doesn’t cause the classic symptoms. Oxygen shortage has been proposed as a possible cause of brain damage in infants by Jennian Geddes, a retired pathologist formerly of the Royal London Hospital. Although dismissed by the UK Supreme Court in 2005, some concepts behind Geddes’s hypotheses have since been followed up.

In the US, momentum is building for a reappraisal of the status and validity of SBS as a way of diagnosing child abuse. There are also moves to reopen cases in which the triad may potentially have led to unsafe convictions.

The US Innocence Project, a nationwide network originating in New York City to identify and investigate potentially unsafe convictions, confirmed last week that they are looking into cases of SBS. “We believe there were a number of false scientific assumptions about these cases,” says Barry Scheck, a founder of the Innocence Project.

“I’m involved in conversations around the possibility of creating an ‘innocence commission’ to look specifically into SBS,” says Deborah Tuerkheimer of DePaul University College of Law in Chicago, and author of a recent law review calling for such a commission. She estimates that approximately 1500 Americans are serving sentences for SBS.

Tom Bohan, past president of the American Academy of Forensic Sciences, has been fighting for SBS to be reviewed for more than a decade. “All I’ve wanted is an impartial examination, as I’ve come to the conclusion that SBS is bogus,” he says.

All I want is an impartial examination. I’ve come to the conclusion that shaken baby syndrome is bogus

Shaking won’t damage vital brain veins

A central tenet behind the original concept of shaken baby syndrome is that the abuse would sever bridging veins that drain blood from the brain and direct it back to the heart via a channel in the brain.

Research is now showing that the bridging veins of infants are strong and seldom break when subdural haemorrhages occur. Julie Mack of Penn State Hershey Medical Center and her team found networks of hitherto unrecognised fluid channels and capillaries that develop in the protective dura about 30 weeks after birth. This is the time many shaken baby cases come to light (Forensic Science International, DOI: 10.1016/j.forsciint.2009.02.005).

These blood vessels are much more fragile and leaky than bridging veins. They can easily haemorrhage if lack of oxygen raises blood pressure, for example, which can happen if a baby is choking or a blood clot blocks the oxygen supply. In 2008, Veronica Rooks of the Tripler Army Medical Center in Honolulu, Hawaii, showed that in a group of 101 healthy newborn babies, 46 had subdural haemorrhages, presumed to be from the rigours of birth, all of which had disappeared by 3 months. These findings back up the suggestion that some of these fragile vessels can bleed again later in babyhood, perhaps after a fall or a choking episode.

Retinal haemorrhages too are proving to be more common than supposed. Evan Matshes of Southwestern Institute of Forensic Sciences in Dallas, Texas, re-examined 123 child deaths and found retinal haemorrhages are not limited to children who die of head injuries through abuse (Proceedings of the American Academy of Forensic Sciences, vol 16, p 272). Matshes says these injuries may be seen in a variety of situations.

Source:

http://www.newscientist.com/article/mg20727713.600-doctor-gagged-for-doubting-shaken-baby-syndrome.html?full=true

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  1. John Fryer Chemist
    July 29, 2010 at 9:27 pm

    A private hearing eh!

    This is the situation in the 1980’s and 1990’s when another doctor gave evidence for SBS and the like.

    His name? Professor Sir Roy Meadow.

    Not sure of the statistics in UK but in USA in the same time interval the prosecutions and convictions went up 20 fold in USA.

    USA prisons were brimming with the new “criminal” fraternity that went in for giving up 9 months of their lives, spending thousands of dollars on clothes, often giving up highly paid jobs and then “DOING IN” their new child often after taking them for their WELL health visits and killing them on return home.

    Still it helps keep the number that die after vaccines down to the million mark and stops the parents from complaining about what the vaccines have done.

    I mean if you need a few hundred thousand to defend an SBS suit you cant go around blaming vaccines.

    You have more important things to fight like retaining your liberty.

    Vaccines with organomercury are still toxic when diluted a hundred fold. At the same time NON TOXIC equivalents can be bought at a cost usually for those with MONEY.

  2. John Fryer Chemist
    July 29, 2010 at 9:33 pm

    John Emery was also a doctor in Sheffield England who looked at the Canning case. He suggested she move from where she lived. At the time her flats backed onto Porton Down chemical and nuclear and biological “research” establishment. The death rate there rose to 50 per cent for children. Looks like chemical, nuclear and bioloical warfare agents were doing their stuff?
    Professor Sir roy Meadow did his SBS stuff and Angela Cannings went down for double life.

    The dirty doctors got their way in court but the warfare place got a clean bill of health – well it did after all thes deaths when they decided to get rid of all the 1 000 ‘s of broken phials and still intact ones littering the next field to Angela slowly outgassing goodness knows what.

  3. John Fryer Chemist
    July 29, 2010 at 9:40 pm

    You know what the trouble is with Dr Marta Cohen disciplined by the GMC? She has been working too hard. why doesn’t she do what Professor Sir Richard Doll did? Just collect your 1 500 pounds a day tax free from Big p’Harmer and say and do NOTHING!

    If you think this is cynical – it is not.

    The medical profession has been doing nothing for nearly 50 years except knocking down the similar people too numerous to mention but one day someone honest will come along in government, medical and legal circles. But we may have to wait another 50 years and still get the same IDIOCY.

    I think in the USA nearly 2 out of three children are NORMAL despite all the toxic insults especially reserved for the 21st century child to go through before his 6 month birthday.

  4. Lee-Ann
    July 30, 2010 at 2:40 pm

    My daughter was diagnosis with SBS when she was 2-1/2 months old. She had fallen off a table and we took her to the hospital to make sure she was okay. She had bleeding in the brain and in both eyes. She never had any other symptoms and is a healthy four year old. However, our lives have never been the same. I can’t express how much I appreciate the efforts of those individuals that are fighting for the truth. Why on earth doctors refute the scientific findings of follow doctors at the expense of innocent families is something I’ll never understand. My heart goes out to Dr Cohen.

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