John D. Lloyd, Ph.D., M.Erg.S., CPE, CBIS
Board Certified Ergonomist & Certified Brain Injury Specialist
The occurrence of retinal hemorrhages has been proclaimed as one of the three cardinal features of the triad in the clinical presentation of an infant injured by repetitive rotational acceleration/deceleration from abusive shaking, where the retinal findings were asserted to be the unique primary result of vitreous traction on the retina. However, such claims are unconfirmed and biomechanically implausible. First, retinal hemorrhages are clearly not unique to infants abused by alleged shaking, since such hemorrhages have been reported to occur as a result of increased intracranial pressure of any etiology and are often found in cases of impact injury. Furthermore, efforts to confirm the vitreous traction hypothesis as a valid cause of extensive retinal hemorrhages, retinal schisis, or folds have failed.
In the vitreous traction hypothesis, it is asserted that traction is generated between the vitreous humor and the retina inside the eye (Figure 1 ), causing hemorrhage from ruptured capillaries in the retina. However, the relative densities of the vitreous humor and the retinal both approximate that of water (1.0 kg/l). Moreover the point of rotation of the infant head during ascribed non-accidental trauma is the lower cervical spine, therefore the radius of curvature of the retina and the vitreous traction are, for all intents and purposes, equal. Given equal radius of curvature and equal densities, it is highly improbable that a mechanical differential would be generated, particularly at the levels of rotational acceleration/deceleration that might be generated during an abusive shaking. Hence, the concept of vitreous traction cannot be supported by principles of physics.
It is now generally understood and accepted by medical professionals that retinal hemorrhages are caused by any etiology, which increases intracranial pressure of the brain. The eye is the only externally visible element of the central nervous system, where the optic nerve and central retinal vasculature are sheathed within the dura (Figure 1). Since we know that arterial pressure exceeds venous pressure, the venous return from the central retinal vein will be impeded prior to obstruction of blood flow in the associated artery, thereby increasing pressures within capillaries in the retina, which consequently burst producing of retinal hemorrhage. Furthermore, since the underlying etiology is increased intracranial pressure, bilateral observations would be typical, where the extensiveness of hemorrhagic findings would be proportional to the intracranial pressure.
In summary, retinal hemorrhages are no longer generally accepted by medical doctors to be caused by vigorous shaking of an infant.
By Christina England
February 14th, 2012
Some vaccine injuries are relabeled ‘child abuse’
A short while ago I exposed a series of thirteen papers which unequivocally proved that Prof Roy Meadow the UK’s most famous Munchausen Syndrome by Proxy (MSBP) expert, attended thirteen meetings on adverse reactions to vaccines just about the time MSBP rates rocketed.  Up to this time most people researching Meadow were only aware of him attending four meetings with the ARVI (Adverse Reactions to Vaccination and Immunizations) and a few with the CSM (Committee for the Safety of Medicine).
As exciting as the discovery of these new papers were, especially for those parents falsely accused of Munchausen by Proxy (MSBP) or Shaken Baby Syndrome (SBS) after a vaccine injury had affected their children, they only proved that Prof Roy Meadow had attended meetings discussing adverse reactions to vaccines; they did not prove that he actually participated in them. This is because the papers had all the professionals names blacked out by Freedom of Information (FOI). This made it impossible for the public to determine which comments were said by which professional.
Since I published my last paper however, I have received the cleaned up versions of four of those papers revealing exactly what was said and by whom. This is a breakthrough and enables parents of vaccine damaged children, accused of MSBP or SBS by Meadow, to finally have proof that Meadow not only attended these meetings but actually participated, advised and commented on the topics of cot death, seizures, anaphylaxis, and the yellow card reporting system (UK reporting system for adverse reactions to vaccines.)
These papers were deemed so confidential by the UK government that they have been hidden away in government files for over twenty four years. They were marked ‘Not For Publication Commercial in Confidence’. I doubt if anyone at that time bargained for the Freedom of Information Act.
Meadow rose to fame in 1977 when he wrote a controversial paper on Munchausen by Proxy for the Lancet. The paper entitled ‘The Hinterland of Child Abuse’  gives two highly suspect case studies as “evidence” of Munchausen Syndrome by Proxy existence. The paper was deemed problematic by many because the second case study describes a child presenting with excessive sodium (salt) in the blood. During Meadow’s discussion he discloses that this child was force-fed 20 g of sodium, with difficulty, by himself and his colleagues. Sadly the child died!
Since this time Professor Sir Roy Meadow has become known as one of the most influential and respected pediatricians of his generation. He is thought by many to be a lead thinker in the field of child abuse. Many experts say his work has saved countless children from unnecessary suffering.
After reading these papers I would beg to differ.
What Was Said At Those Meetings by Professor Roy Meadow
ARVI meeting 6th July 1987. 
Meadow first comments in section 5.4 however, there was a worrying trend of deceit arising earlier on in the minutes in the section marked Item 5 – MMR vaccine – 5.4 Postpartum Rubella immunization associated with development of prolonged arthritis neurological sequelae and chronic rubella arthritis Tingle et al. J of Inf. Diseases (1985), Vol. 152: pages 606-612.
The committee was discussing points raised in the previous ARVI meeting. Dr Cavanagh reminded the committee of a SSPE (SUBACUTE SCLEROSING PANENCEPHALITIS INCLUSION–BODY ENCEPHALTIS) – like syndrome reported from rubella virus infection and noted the reported maternal viraemia and transmission of rubella virus in breast milk discussed in the correspondence submitted. Several other professionals brought up points on this matter. Dr Christine Miller had completed a study of SSPE surveillance and it was thought that none of her cases were associated with rubella. Dr Wallace thought the report to which Dr Cavanagh had referred concerned congenital rubella syndrome, not acquired rubella.
It is interesting that professionals were discussing SSPE in relation to the MMR vaccine because Dr Rebecca Carley M.D. firmly believes that SSPE IS in fact autism. Dr Carley has made her thoughts on the subject very clear even stating on a radio show with David Kirby that autism is actually a non-fatal case of subacute sclerosing panencephalitis caused by demyelination following vaccine induced encephalitis, and that the name of the condition was changed to autism to hide this self evident fact  She says if you read the description that Harrison  gives on SSPE in his book used to teach internal medicine to medical students all over the world; it is clear that what he is describing is in fact autism. In fact if you read the 10th edition that the above page comes from published in 1983, 4 years before this meeting it says that SSPE can be caused by the measles vaccine.
I would like to point out that Dr Cavanagh did state ‘a SSPE– like syndrome reported from rubella virus infection’, indicating that this was a condition similar to SSPE, which is exactly what Dr Carley is saying today without the benefit of seeing these papers that had been tucked away for all these years.
On to Point 5.4 and the first comment by Meadow
This section shows the ARVI committee discussing how reports of adverse reactions to vaccines should be followed up after they have been reported to the ‘Yellow Card Reporting System’.
The committee’s concerns surrounded adverse reactions to the DPT vaccination.
The committee discussed the fact that in Holland a pediatrician was employed solely for the follow-up of all of the reports of adverse reactions to vaccination. He/she would interview the vaccinator, the parents and the child and carry out a long term follow up.
Various professionals discussed the problems that they felt this would raise.
The whole issue makes extremely sickening and disturbing reading especially in view of Sir John Badenoch’s comments that Holland’s policy posed the dilemma of the provision of huge lists of adverse reactions or of a distillate and commented that it was bad policy to collect useless information, however, he did feel that changes in incidence of reactions were important as was the awareness of permanent or long term sequelae from vaccination.
The minutes stated that Meadow felt that the subject would make an ideal research project for one four-month cohort, to be studied intensively with detailed scrutiny and examination of each report to provide a yardstick for further comparison.
Professor Breckenridge felt that definition of terms was essential and adverse events should be separated from adverse reactions. The ‘events’ he said could be excluded with consideration on the adverse reactions!
I would like to know how Professor Breckenridge justified the elimination of either of these terms. Surely this amounts to deception, as to exclude one from the other would give false results when assessing adverse reactions to a vaccine as both terms mean exactly the same thing.
Meadow asked whether the numbers of vaccines given the study time period should be ‘estimated’ to provide an indication of risk of reaction.
Surely if they were to estimate the number of vaccines then this would not give an accurate indication of risk factor? Estimation after all would enable the assessor to falsify results. Maybe this was what Meadow intended.
It appears to me that the committee were very concerned by the numbers of adverse reactions being reported and were looking for ways to cover this up.
Professor Meadow next commented in point 6.4 when the committee was discussing the JCVI’s (Joint Committee for Vaccination and Immunization’s) revised contra – indications to the pertussis vaccine.
Point six had been specifically discussing whether there was a link between the DPT vaccine and serious neurological illness. The committee felt to ascertain whether there was a significant risk they would need to re-read all the relevant whooping cough documentation from the JCVI, CSM, and the ARVI which they wanted to avoid. After careful consideration however, it was deemed that re-reading was impossible to avoid.
The committee then discussed whether or not the DPT vaccine was causing children to suffer from seizures. The committee concluded that the incidence of children suffering a seizure after the vaccine was no different to those children suffering a seizure who had not had the vaccine of the same age, however, it was decided that the vaccine did appear to worsen seizures in children with a seizure condition. This meant that seizures were a contra—indication of the DPT vaccine.
This section is confusing however, because it does not state whether all of the children were vaccinated. The committee had concluded that the incidence of children suffering a seizure after the vaccine was no different to those children suffering a seizure who had not had the vaccine of the same age, we do not know however, if these children had had the vaccine at an earlier age, which lets face it is a possibility.
(A contra-indication means – could cause harm to a certain group of children i.e. those with a seizure condition.)
Point 6.4 discussed whether or not in view of what had been disclosed the manufacturer’s guidelines should be changed to reflect the committee’s findings.
It was decided that any changes would need to be discussed in full with the manufacturers of the vaccines.
Sir John Badenoch commented that both the JCVI and the JCVI/BPA Working Party had tried to improve guidelines to give specific contra – indications; he said that an attempt should be made to reconcile these with data sheets and product licenses. He said that delay in the new memorandum might be worthwhile in order to obtain manufacturers agreement to changes in data sheets and also to allow the BNF (British National Formulary) opportunity to change its advice. Professor Meadow agreed with Sir John and welcomed the clearer advice from JCVI on pertussis contra – indications which he endorsed.
At this point Prof Miller commented that there was no need for the JCVI advice to change but there should be awareness of the implications of change.
There were discussions regarding the new guidelines that needed to be put into place and how these guidelines should be put forward to the manufacturers.
There was some concern that the new guidelines would be produced at a time of continuing pertussis litigation? Members then discussed the fact that there was likely to be a change in the pertussis vaccine in the near future. Sir John Badenoch agreed that the new pertussis guidance should be sent to the CSM but felt that the new guidance was a rationalization of the old contra-indications some of which he felt had no significance scientifically.
It was at this point that Meadow offered his firm support of the new changes, which he felt were not weakening the old recommendations but making the existence guidance clearer.
I find it of particular interest that Meadow was involved in meetings discussing seizures after vaccination, especially as he had discussed the subject of seizures in various papers describing cases where parents had said their children were suffering from seizures which he felt were caused by the parents. An example of this can be seen in a paper entitled ‘Fictitious Epilepsy’  written in 1984 where the abstract reads:
32 children and 4 adults had extensive investigation and treatment for epilepsy because of false seizures invented or induced by a relative, usually the mother. They also suffered needless hospital admissions and restriction of education and activities. Follow-up of the children suggests a danger of abnormal illness behaviour continuing into adult life. For a few young children seizures are really anoxic episodes caused by the parent. In some cases these lead to brain damage and death, and an important association with sudden unexplained death of infancy (cot death) is emerging.
As this is only the abstract we cannot be sure if Meadow went on to explain how he came to the bizarre conclusion that a seizure is really an anoxic episode caused by the parent, although somehow I doubt it.
This paper was written before the meetings took place so I guess that Meadow could have been forgiven if he had seen the light and realized the error of his ways and at least considered vaccines as a possibility but it is obvious that nothing much had changed because in 1991 whilst he is still seen attending these meetings  he proves that he is still accusing mothers of MSBP after a child is reported to be suffering from seizures. 
Minutes from 2nd October 1987 CSM/JCVI/ARVI 
The ARVI meeting October 1987 is the next meeting showing comments by Meadow.
Meadow is mentioned early on in the minutes, in point 5 during a discussion on the subject of Anaphylaxis. The committee was discussing the completion of the ‘recommendations for the memorandum’. The minutes state that Dr McGuinness had already provided valuable material for this purpose and Dr Salisbury offered to send Professor Meadow examples of this material by post.
The first time that Meadow is seen to make a comment during this meeting, is regarding the Yellow Card System in Point 7 where he questions the delays in reporting and coding.
Meadow next commented interestingly and crucially on the subject of Cot Death in Point 8. The section is entitled ‘Vaccination and Cot Death in Perspective.’
The committee discussed various reports made available on the topic; Meadow identified the need for the present information, that there did not appear to be a casual link between the pertussis vaccination and SIDS, to be dissemination (spread widely) and felt that the Foundation for the Study of Sudden Infant Death Syndrome was the best organization to promote the present knowledge. However, Dr Fine noted that there was a problem with saying that the pertussis vaccine was protective against SIDS as those risk factors for SIDS may overlap with the contra-indications for the vaccine and this issue had not been dealt with the submitted paper. Dr Fine felt that these should be discussed. Meadow immediately questioned this. Dr Fine went on to mention other factors that could be relevant such as ill health, social economic issues which he said inhibited the pertussis vaccine.
Quite right to, at least one of them had a conscience, however, interestingly it is at this point the conversation on this subject ceases and the committee move on to the flu vaccine.
I found this extremely interesting because Meadow has since been involved in many cases where vaccines have played a crucial part in the case. Not only did Meadow appear to misdirect the ARVI on the subject of cot death in the above meeting but it has been reported that Meadow also advised juries as an expert witness that vaccines cannot cause a baby to die in cases where vaccines have been mentioned as a possible cause of death.
Sally Clark spent three and a half years in jail wrongly convicted of murdering two of her babies. This was after Prof Meadow and another expert witness assured the jury that there was no other explanation for the sudden deaths of her children other than that she had deliberately smothered them. This was despite the fact that Harry died five hours after a DPT vaccine and that Prof Meadow had attended 13 meetings discussing adverse reactions to the DPT which included cot death.
The Spectator  reporting on the case states:
Not many people know these facts, because at Sally’s trial the defense did not mention immunization as a possible cause of death. Two prosecution witnesses, including the paediatrician Professor Sir Roy Meadow, assured the jury it could be discounted. Their statements went unchallenged, and the issue did not form any part of the appeal hearings. Professor Meadow, a former member of a Department of Health sub-committee on adverse reactions to vaccines, told the jury that he could not think of any natural explanation for Harry’s or Christopher’s deaths.
Surely, this is perjury? Not only did Meadow appear to lie under oath but as far as I am aware he did not declare any conflicts of interest to the court. If there had not been any mention of children dying after vaccination at those meetings, the committee would have not have been discussing this point in the first place, therefore, Meadow would have some knowledge that children can die after the DPT.
March 8th 1988 CSM/JCVI/ARVI meeting 
Prof Meadow is next found participating in the above meeting, where he is seen taking a very active role. In Point 5 ‘The Treatment of Anaphylaxis’ it states that:
The Anaphylaxis section of the forthcoming Memorandum on ‘Immunization against Infectious Disease’ had been written to incorporate the recommendations of Professor Meadow, Professor Hull and Dr McGuiness.
So now we have Meadow not only commenting and participating in meetings but being involved in writing guidelines for vaccines against infectious diseases!! Totally unbelievable!
The final proof that Meadow took an active part in meetings involving adverse reactions to vaccines that I have at this time is again in the above meeting.
In Point 6 Report on Yellow Card data
The committee discussed in detail the information supplied on adverse reactions to vaccines during 1987.
After several vaccines were discussed Professor Meadow and Professor Banatvala asked the committee if information could be made available in the future on reactions to plasma derived or recombinant hepatitis B vaccine.
Plasma derived Hep B vaccines were the first Heb B vaccines and were made using blood products. These were later banned from use in 1991.
(Since 1986, the only Hep B vaccine used in the US has been the recombinant vaccine. The way recombinant vaccines work is that they make a piece of the viral genetic material that codes for a protein on the surface of the virus; it is that protein which your immune system thinks is the virus and which causes antibodies to be produced.)
No further comments from Meadow have been found although that is not to say that he has not commented and made recommendations in other meetings past and present.
The fourth set of minutes that I have is the ARVI meeting 6th October 1989. Comments were made by several professional mainly covering the MMR vaccine Pluserix but sadly although there are comments in full, some parts of the minutes were redacted so we do not know if Meadow commented at this meeting or not. 
Discussion on Findings
These meetings were held around the time that the rates of autism and neurological disorders were beginning to soar. Professor Meadow was becoming recognized for discovering a new syndrome which he referred to as Munchausen Syndrome by Proxy. It seems only right that both MSBP and these problems should be married together, after all something was causing the children’s problems and if it were the vaccines, the government would need to cover this up as quickly as possible. After reading the paperwork in depth it appears likely that the government was trying to cover up the fact that vaccines were not only capable of causing the death of babies but causing seizures, anaphylaxis and neurological problems. It is my opinion that Meadow was brought in to these meetings as a tool by the government to misdirect various committees into believing that scores of parents were abusing their children in a bid to cover up vaccine adverse reactions.
It seems highly suspicious to me that Professor Meadow is found to be attending meetings at this time. Why was he participating, commenting and helping to write vaccine guidelines?
I have been told by the person who gave me these papers that it is usual for professionals to be announced and welcomed when joining these particular committee’s but there appears to be no such announcement for Meadow. This is not of course to say that he was not announced and welcomed; just that my informant could not find any record of this. It is also strange that he seemed to disappear from these meetings around 1991 as there appears to be no further meetings where is name is mentioned.
Lisa Blakemore-Brown was the first person to ever begin to connect the dots that make the very ugly picture we have today. In fact it was Blakemore-Brown herself who passed me the first papers identifying Meadow as a member of the ARVI.
Blakemore-Brown first began speaking out about her fears and concerns not long after Meadow attended these meetings in 1995.
The last meeting I have seen Meadow’s name on the list of attendee’s was in 1991. 
Blakemore-Brown first became concerned in 1995 after she was an expert witness in a case involving twins. She states 
In my first false case the twins 1 assessed had been born at just over 26 weeks in the mid eighties. They were tiny babies with horrendous complications. The evidence that such premature infants go on to have developmental problems including attention deficits, motor and social impairments is now indisputable, but it was tossed to one side in this MSBP case. One of the early troubling issues for me was that the MSBP accusers initially totally denied that these children had such birth complications! They said this was ‘what the mother said’ and that I had been ‘beguiled’ by ‘listening to the mother.’
Well, er, actually, I’d read the notes…………………….
I feel that it was around 1997 that Lisa Blakemore-Brown was first seen to be troublesome by the government and particularly to Meadow because it had become clear that Blakemore-Brown had seen exactly what was going on and had seen straight through their plot to use MSBP as a cover for vaccine damage.
In 1997 Blakemore-Brown had been asked to write an article for ‘The Therapist’, this was a year after Sir Roy Meadow had himself written an article for The Therapist. 
On reading Lisa Blakemore-Brown’s letter in the ‘Psychologist’ the Editor of ‘The Therapist’ contacted Blakemore-Brown to ask if she would write an article showing the opposite view to start debate.
Little did anyone know at that time just what this intuitive professional was going to write or how Blakemore-Brown without even realizing it had connected the dots and had seen exactly what had been going on.
In her article which she entitled False illness in children – or simply false accusations, she described a tragic case that she had been involved with involving a child that had developed a dangerously high fever, immediately after routine vaccinations. Shortly thereafter, he began to bang his head, soil and lost all his language. After many investigations, the child was diagnosed as having Asperger’s Syndrome. The mother began to suspect that the vaccinations were the root of the child’s problems and decided not to have her other children vaccinated. As time went on, she became desperate for help and turned to the social services, begging them for respite care because she was finding her elder son difficult to manage. Instead of the help this mother so badly needed, she was accused of MSBP and her children were taken away from her.
In foster care, the youngest child, a little girl, was vaccinated against the wishes of her mother. Instantaneously and tragically, her behaviour deteriorated the same way as her brother’s had, only this time the foster carer had video tapes of before and after vaccinations to prove this. Despite this evidence, both of the younger children were adopted.
It seemed as if Blakemore-Brown had hit the nail on the head and it was clear from that one article that she was not afraid to say what she had seen or what she thought.
Once she had began there was no stopping her and she began to speak of her concerns at every opportunity. In 2001 she wrote and presented a paper at a conference held at Durham University.  She wrote:
‘Since working as an Expert Witness in a MSBP case in 1995, I am of the opinion that gross errors of judgement are being made (Blakemore-Brown 1997) at the very beginning of the process of ‘identification’ when the easy and increasingly widespread use of the term interweaves with shock tactics and processes of suggestibility.
Once that first gossamer breath of a rumour has been triggered – it can be impossible to turn back. (Blakemore-Brown 1998)’
By this time Blakemore-Brown had already fully grasped that the vaccines were linked to the devastation that she was witnessing. Not great timing for Meadow as he had just been knighted by the government for his ‘amazing work’.
The more that Blakemore-Brown learned the more she began to realize that Meadow was connected. In an article on Prof Meadow on One Click news  she wrote:
In my very first experience as an Expert in Court case on so called Munchausen Syndrome by Proxy, with Sir Roy’s colleague David Southall, I was utterly shocked by the lack of logic, the lack of careful detailed examination and the lack of good detective work. In fact I saw the opposite and a profoundly cruel miscarriage of justice followed.
I wrote a letter to the British Psychological Society to express my deep concerns that there was no robust scientific basis to MSBP and I feared if it was not investigated thoroughly, many more miscarriages of justice would follow.
Colleagues of Professor Meadow immediately wrote a letter to the BPS with the aim of discrediting me and what I had to say and the BPS did not allow me a Right of Reply.
It was around this time that a Penny Mellor arrived on the scene and the rest is history as they say.  Sadly for Ms Mellor and the many others who tried to destroy Blakemore-Brown’s career, she is still around and it is my belief that she will come back stronger than ever to haunt them all.
It is interesting to see some seventeen years after Blakemore-Brown’s first concerns that MSBP was a cover being used to hide cases of vaccine injury; the proof that lay hidden for all those years is at last being discovered.
There are some of us who never doubted for one moment that she was correct and something very sinister was going on, however, proving it was another thing. I doubt if Blakemore-Brown will be surprised to see the level of corruption and utter deceit hidden in these documents. It is about time the governments and pharmaceutical companies were exposed for their lies and hypocrisy and Blakemore-Brown along with the many others who have been fighting for the families falsely accused of MSBP and SBS were vindicated and apologized to.
The fact that Meadow not only tried to misdirect committees discussing vaccine dangers and cot death but contributed in a memorandum outlining guidelines for the treatment of anaphylaxis called ‘Immunization Against Infectious Diseases’ is totally beyond belief, especially when it has been reported that he stood up in court and assured a jury in a murder case that vaccines could not have been responsible for the death of her child. I have been told by mothers falsely accused that he denied vaccines were responsible for the deaths of other babies in their trials as well. Let us hope that at last these parents will get the justice they deserve and their children can be laid to rest in peace at long last.
It is my opinion that for the crimes that this man has committed he should be striped of his knighthood.
- FOI Request Reveals Major Vaccine Conspicacy http://vactruth.com/2012/01/03/foi-request-reveals-major-vaccine-conspiracy/
- ‘The Hinterland of Child Abuse’ http://www.msbp.com/hinterlands.htm
- ARVI Meeting July 1987 http://www.profitableharm.com/sir_roy_medows_meetings_1.html
- RECENT FED CT DECISION IN AUTISM CASE PROVES DR. CARLEY RIGHT http://www.drcarley.com/dr_carley_critique_fed_autism_decision.htm
- Harrison http://www.reversingvaccineinduceddiseases.com/files/3638448/uploaded/SSPE_from_Harrisons%20optimized.pdf
- Fictitious Epilepsy Prof R Meadow 1984 http://www.ncbi.nlm.nih.gov/pubmed/6145941
- Munchhausen by Proxy and Pseudo-Epilepsy http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1627905/pdf/archdisch00753-0089c.pdf
- CSM/JCVI/ARVI October 1987 http://www.profitableharm.com/sir_roy_medows_meetings_1.html
- The Spectator http://www.spectator.co.uk/essays/all/30630/part_2/what-killed-sally-clarks-child.thtml
- CSM/JCVI/ARVI Meeting March 1988 http://www.profitableharm.com/sir_roy_medows_meetings_1.html
- ARVI October 1989 http://www.profitableharm.com/sir_roy_medows_meetings_1.html
- Durham paper http://www.profitableharm.com/an_autism_odyssey_text.html
- The Therapist http://www.profitableharm.com/images/therapist%201.jpg
- Meadow Blakemore-Brown http://www.theoneclickgroup.co.uk/news.php?id=4111#newspost
- The Professional Assassination of Autism Expert Lisa Blakemore-Brown https://medicalmisdiagnosisresearch.wordpress.com/2010/12/29/the-professional-assassination-of-autism-expert-lisa-blakemore-brown/
The Fifth Estate
Gillian Findlay examines the conventional wisdom around Shaken Baby Syndrome, discovering that those who question it often feel targeted by those who believe passionately in it. And yet new science suggests the so-called syndrome may be a physical impossibility.
“Diagnosis Murder” tells the story of several Canadian parents who say they were wrongfully accused–and the leading-edge medical researchers who believe they’re telling the truth. The stakes are high: Some have gone to jail. All have had their other children taken away from them.
One couple recently had their children returned after a four-year battle. Even though the courts in B.C. cleared Zabeth and Paul Baynes of charges they had shaken their baby, the couple feel they will carry the stigma for life. Another man in Ontario has now had his case put up for judicial review, giving him hope that his name may too be cleared.
Is Shaken Baby Syndrome conclusive evidence of murder? Or is it a scientific hypothesis that has convicted an untold number of parents as killers — when their children actually died from other causes?
By: Tana Fye
When I was a law clerk, the year after I graduated from law school, I had the opportunity to watch two separate criminal trials where the issue was shaken baby syndrome. In one trial, the defendant was convicted; in the other, the defendant was acquitted. In both cases, the prosecution and defense both presented the testimony of expert witnesses on this very topic. Needless to say, it was extremely interesting to watch and learn about. However, it made very clear to me that the diagnoses of shaken baby syndrome is far from a medical certainty. There are many variables that go into whether shaken baby syndrome is present in the particular child. But even more interesting (at least to me), is the question of whether shaken baby syndrome even exists, as well as whether shaking alone can cause injury or if an impact of the head is needed. I take no position on this, because frankly I lack the medical training to honestly evaluate it.
In the December 2011 issue of the ABA Journal, an American Bar Association publication, this very topic has been taken up. I urge you to read it and consider the issue for yourself. (The article is in the hard copy version of the ABA Journal, but hasn’t yet been posted on their website. Once it is, I’ll add the link.) The ABA Journal has also written about this topic before. This is a list of some of their other articles on the topic.
I preface this article with a comment on it by Dr. Harry Bonnell, a pathologist from San Diego and also a researcher into the theory of shaken baby syndrome.
A basic finding of the study is that ten of the 12 infants showing the nerve root changes, showed evidence of impact – again indicative of forces greater than those generated by shaking. Also the authors do not point out whether or not the changes they saw could be an effect of keeping the spine in a acid fluid for weeks to decalcify the bone.
July 5, 2011, 4:25 pm
When I wrote about shaken baby syndrome last winter for the magazine, a Canadian pathologist named Evan Matshes was working on intriguing new research that hadn’t yet been published. Matshes’s paper is just out, in Academic Forensic Pathology, the journal of the National Association of Medical Examiners. It opens a new avenue of inquiry for this difficult and fraught diagnosis.
In the most contested cases, shaken baby syndrome is diagnosed based on a triad of internal injuries in the brain: subdural bleeding, retinal bleeding and brain swelling. There is no evidence of impact, like a skull fracture. And there’s also no obvious sign of the kind of neck injury that comes with severe whiplash. In the absence of such external injuries, biomechanical engineers have raised doubts about whether it’s even possible to shake a baby to death. Many doctors who treat abused children, on the other hand, say that clinical observations make it clear that this does happen.
Matshes’s research shows how death from shaking could in fact occur — but not because of the traditional triad of injuries to the brain. As NPR notes: “The new findings split a lot of the difference between the warring camps on shaken baby syndrome. For supporters, there’s evidence that shaking alone can lead to a baby’s death. But it also says skeptics were right to suggest it’s not the head injury that causes death and that shaking deaths are likely rare.”
In investigating the deaths of 35 babies, Matshes did autopsies in a new way. The usual practice is to dissect only part of the spinal column. Matshes dissected the spine down through the neck and into the nerve roots. What he found was striking. He looked at the spinal columns of 12 babies whose history showed evidence of injury from hyperflexion — in other words, severe whiplash, from shaking or, for example, from a car accident. In all 12, he found bleeding in the nerve roots of the part of the spinal column called C3, C4 and C5. Matshes also dissected the spinal columns of 23 babies for whom there was not solid evidence of an injury from whiplash. (Most of the babies in this group died of SIDS, or from being smothered by an adult who was sleeping with them.) Only one baby in this group of 23 had bleeding in the same C3, C4, C5 region, and that child’s history, while inconclusive, made shaking a distinct possibility.
The C3, C4 and C5 are the part of the spinal column that controls the diaphragm. Babies depend on their diaphragms to breathe more than older children or adults. So Matshes thinks that damage to these nerve roots is fatal because by paralyzing a baby’s diaphragm, it stops the baby from breathing. This internal neck injury, previously undetected, could be the missing piece of the puzzle: the causal mechanism that the biomechanical experiments haven’t accounted for.
If Matshes proves correct about this, then his work indicates that pathologists should look beyond the traditional triad of injuries in the brain, and into the spinal column, to determine whether a baby was shaken. In other words, the current standard method of establishing that a child had been killed via shaking may not be reliable. Matshes says he’s no longer comfortable relying on subdural and retinal bleeding alone — no matter how extensive — to rule a baby’s death a homicide from shaking, given other explanations that need to be ruled out. “I just don’t know if I don’t look at the neck,” he says.
I sent Matshes’s paper to four doctors, two supporters of the traditional shaken baby diagnosis and two critics. They all said the paper, while based on a small sample, pointed to a new area worthy of more research. “It’s terribly important to direct us to look at the neck,” said Waney Squier, a pediatric neuropathologist in Britain who frequently testifies for the defense in shaken baby cases. “In terms of ideas, it’s a really interesting paper,” agreed Desmond Runyan, a professor of pediatrics on the other side of the debate, who will soon move to the University of Colorado to direct the Kempe Center for the Prevention and Treatment of Child Abuse and Neglect.
At the same time, Squier and Runyan both pointed to a methodological weakness in Matshes study: he knew the histories of the babies he autopsied when he examined their necks. His study was not “double blind” — the scientific gold standard for ensuring that a researcher doesn’t skew his findings in the direction that will confirm his hypothesis. Matshes says that pathologists doing autopsies are ethically bound to know the subject’s history. “In forensic pathology, since we can’t do randomized controlled double-blinded studies, we have to make certain concessions,” he said.
This week, Frontline, NPR and Pro Publica aired a joint investigation into prosecutions for child deaths blamed on abuse that raised questions much like the ones I raised in my article. (Here’s an online chat with the reporters that I participated in.) Runyan brought up this latest wave of coverage while we were talking about Matshes’ new paper. The latest wave of coverage, he said, “just goes to show we need better research,” he said. Amen to that.
12 May 2011 by Andy Coghlan
WATER-FILLED cysts in the brain of a dead baby should not be taken as proof that the infant has been shaken to death. New findings show that cysts are also found in babies known to have died of innocent causes.
If the brain is starved of oxygen – because of a breathing problem or a blood clot caused by trauma, for example – it will swell up. A study of swollen brains in 20 babies who died aged 5 months or less showed that the longer they had survived before dying, the more likely they were to develop water-filled cysts between the cerebral cortex and the inner regions of the brain.
“While these cysts may be seen as a consequence of trauma, they do not appear to be due to mechanical tissue disruption, and may occur after brain swelling from any cause,” says Waney Squier at the John Radcliffe Hospital in Oxford, UK (Early Human Development, DOI: 10.1016/j.earlhumdev.2011.03.003). Squier’s team suggests that the cysts arise because the brains of young babies have yet to fully develop the plumbing needed to drain excess fluid.
The paper is the latest to cast doubt on post-mortem evidence that has till now been taken to show that abuse has taken place. Last year, evidence emerged to challenge the use of the “triad” – the combination of brain swelling, and bleeding on the surface of the brain and at the back of the eyes – as evidence in such cases.
In January the Crown Prosecution Service in England and Wales issued new guidelines stating that the triad would no longer be sufficient to show that a dead infant had suffered “shaken baby syndrome”. As well as requiring additional evidence of possible abuse before a prosecution is started, the guidelines also rename “shaken baby syndrome” as “non-accidental head injury”.
“Squier has shown that sub-cortical fluid collections are not [always] the result of primary trauma to the cortex,” says Julie Mack, a pathologist studying infant brain injury at Pennsylvania State Hershey Medical Center.
One prominent radiologist in the UK who preferred not to be named says he agrees that the cysts can have innocent causes. But he questions the validity of the new study, adding that he seldom sees evidence of cysts in MRI scans of living infants with swollen brains.
New research on shaken baby syndrome could set Pamela Jacobazzi free
Something wasn’t right when Cynthia Czapski picked up her 10-month-old son, Matthew, from a Bartlett, Ill., day care on Aug. 11, 1994. The child seemed to be sleeping, but she couldn’t wake him up. Matthew was taken to the emergency room and then to another hospital, where doctors worked to relieve bleeding and swelling in his brain. He never woke up, remaining essentially comatose for 16 months before dying on Dec. 19, 1995.
The assumption from the start was shaken baby syndrome or “SBS,” a condition characterized by a “triad” of symptoms – bleeding and swelling of the brain and retinal bleeding, widely attributed to violent shaking of an infant. The last person to watch Matthew Czapski was Pamela Jacobazzi, then a 39-year-old day care provider in Bartlett, west of Chicago near Elgin, who had just started watching the child eight days earlier. Naturally, Jacobazzi became the main suspect, although no one actually saw her shake Matthew.
During her trial, Jacobazzi denied shaking the baby, but her only real defense was the assertion that Matthew’s injuries could have been caused when he fell forward from a sitting position on the kitchen floor and hit his head on the tile, or from a bump to the head sustained while he was playing with other children at the day care.
Jacobazzi, now 56, was tried and convicted of first degree murder in a DuPage County court in 1999 and sentenced to 32 years in prison, based on the testimony of the prosecution’s nine expert medical witnesses, who told jurors Matthew’s death could only have been caused by violent shaking that must have occurred while the child was in Jacobazzi’s custody. Jacobazzi has spent the past 11 years in Lincoln Correctional Facility, the all-female state prison 30 miles northeast of Springfield.
What seemed to prosecutors and the Czapski family like a straightforward case of child abuse seems like a miscarriage of justice to Jacobazzi’s defense attorney, Anthony Sassan of Crystal Lake, who says he genuinely believes Jacobazzi is innocent. He describes her as “about four feet, eleven inches tall, maybe about 115 pounds soaking wet.
“She is one of the calmest, most polite, pleasant persons that you’d ever want to meet,” he says. “Even when I’ve had to deliver bad news to her, in the times that I’ve met her, I’ve never seen her come close to losing her temper or getting riled up…just a very, very, very nice lady.”
None of the other children in Jacobazzi’s care showed any indications of child abuse, Sassan says, and Matthew Czapski had numerous pre-existing medical conditions that could have caused his death. Sassan is working on Jacobazzi’s third attempt at securing a retrial, and he’s getting some extra help this time.
The Downstate Illinois Innocence Project – based at the University of Illinois Springfield – has taken on Jacobazzi’s case and will work with Sassan to reinvestigate the case and gather new evidence. The project is celebrating its 10th anniversary on May 16, and a large federal grant has allowed them to hire an in-house attorney for the first time.
“I feel this is a case where she is actually innocent,” says Bill Clutter, a Springfield-based private investigator and founding member of the Downstate Illinois Innocence Project. “There’s medical evidence that would have changed the outcome of the jury verdict.”
Jacobazzi’s case is part of a national trend in which people accused of killing infants are challenging in court old assumptions about shaken baby syndrome. While some advocates against child abuse and even the federal Centers for Disease Control and Prevention say SBS (and the more inclusive “abusive head trauma”) account for three to four cases of child brain injury every day in the United States, critics of SBS say the condition is a creation of the legal system, developed without reliable medical research, as a misguided attack on child abuse.
Deborah Tuerkheimer, a professor at DePaul University College of Law in Chicago, estimates that about 200 people in the U.S. are convicted in SBS cases each year, adding that the legal system is slow to catch up to advances in the medical field, so court cases may not incorporate the most up-to-date information on SBS.
“…Dramatic changes [in medicine] have occurred since the 1990s, when the prosecution template emerged,” Tuerkheimer writes in a recent article titled “Science-Dependent Prosecution and the Problem of Epistemic Contingency: A Study of Shaken Baby Syndrome,” published in the Alabama Law Review. She says the science surrounding SBS has “decisively evolved,” and the “large and highly significant areas of consensus surrounding SBS have shifted.”
Though medical experts once commonly agreed on SBS in the 1990s, there are now legitimate challenges to the idea that shaking a baby is the only way the infamous “triad” of injuries can occur, Tuerkheimer notes. Despite that shift, she says the legal community – particularly prosecutors – have largely persisted in outdated views of SBS.
Jacobazzi’s trial occurred before the shift in medical understanding that Tuerkheimer describes, so the testimony from the expert witnesses in her trial may differ from that of current-day expert witnesses.
Jacobazzi’s attempts to get a new trial revolve around evidence known as the Nadelman records, named after Matthew Czapski’s pediatrician. The records show Matthew had sickle cell trait and abnormal hemoglobin, along with chronic bouts of infection, fever, anemia and dehydration. Additionally, the records show Matthew had a disproportionately large head indicative of external hydrocephalus – a condition in which the space around the brain is enlarged and filled with spinal fluid, often leading to increased pressure on the brain. To Sassan and two new expert medical witnesses recruited for the defense, those records suggest that Matthew’s prior medical problems could have caused his death without a violent force – or any force at all.
Jacobazzi claims her lead trial attorney, Anthony Montemurro of Chicago, failed to provide those records to the defense’s lone expert medical witness and didn’t use the records as part of her defense strategy, leaving unchallenged the prosecution’s assertion that Matthew was perfectly healthy when he arrived at Jacobazzi’s day care. If Jacobazzi can convince the circuit court that the absence of that evidence affected the outcome of her trial, she could get a second chance to assert her innocence.
Jacobazzi appealed her conviction to the Second District Appellate Court of Illinois, which sent the case back to the original trial court with instructions to hash out her claim of “ineffective assistance of counsel.” The lower court again ruled against Jacobazzi, saying Montemurro actually did provide the Nadelman records to the expert witness. Jacobazzi appealed again, this time arguing that the circuit court didn’t address whether the absence of the Nadelman records as evidence affected the outcome of her trial – the second requirement of a legal device known as the “Strickland test” that provides the legal precedent for proving ineffective counsel. The appellate court admitted in its most recent ruling on Nov. 17, 2009, that it had given unclear instructions to the lower court and sent the case back with clarifications.
Bill Clutter with the Innocence Project draws parallels between Jacobazzi’s case and a recently-dismissed Wisconsin case that happened around the same time. Audrey Edmunds of Waunakee, Wis., was accused in 1995 of shaking and killing six-month-old Natalie Beard at the day care she ran in her home. As with Jacobazzi’s case, no one saw Edmunds shake the baby, and there was no history of child abuse or outward signs of injury. For both women, the only evidence against them at trial was that of medical experts who concluded they must have been responsible. And like Jacobazzi, Edmunds spent several years in prison before the local chapter of the Innocence Project got involved.
Edmunds’ big break came when one of the expert witnesses against her realized that he might have misjudged the situation. Pathologist Robert Huntington III performed Natalie Beard’s autopsy and testified at Edmunds’ trial that it was “highly probable” the child was injured shortly before Edmunds reported finding her apparently choking on a bottle of baby formula.
Three years later, Huntington handled a similar autopsy, in which a child had been taken to the hospital with a description of being “clingy” and “fussy” but still responsive – the same description given to Natalie Beard by her parents when she was dropped off at Edmunds’ day care.
The child was in the hospital for 15 hours before doctors detected any brain injury in the child, leading Huntington to believe that there could be a delay in the appearance of SBS symptoms. That revelation caused him to doubt his testimony that the last person to have watched a child who dies from SBS symptoms must be responsible.
Huntington later recanted his testimony against Edmunds in an affidavit, which turned out to be crucial in securing her release.
Huntington’s reversal puts him in the company of a growing number of medical researchers who are rethinking suspected SBS cases. Some of those researchers, such as Dr. John Plunkett, a retired pathologist from Minnesota, are questioning the very principles and existence of SBS. Plunkett has testified in numerous SBS cases, and his research may act as a model for Jacobazzi’s defense team if she wins a retrial.
“As far as I’m concerned, every ********* conviction in this country over the past 25 years which is based on testimony regarding shaking has to be overturned,” Plunkett says emphatically. “It [shaken baby syndrome] doesn’t exist. It has never existed.”
Plunkett says any number of other factors, such as a short fall or a pre-existing medical condition, can cause the triad of SBS symptoms – bleeding and swelling of the brain and retinal bleeding. More importantly, he says, his and others’ research into the very mechanics of human injuries shows that brain injury cannot be caused by shaking a baby. He says the force generated by shaking is simply insufficient to cause the symptoms associated with SBS.
“Despite the fact that we have 30 years of medical testimony that it is a valid medical diagnosis, it is clear that you cannot cause brain injury by shaking a child,” he says. “You may very well be able to cause neck damage, but you cannot cause brain damage.”
Plunkett says a “lucid interval” – a period between when an injury occurs and when symptoms manifest – could explain why seemingly healthy babies can suddenly become ill, much like in the case Robert Huntington witnessed after testifying against Audrey Edmunds in Wisconsin.
Plunkett knows his statements may raise some eyebrows. He has taken mountains of criticism from the medical community, he says, including being accused in 2005 of making false statements as an expert medical witness in an Oregon SBS case. Two counts against Plunkett were dismissed before the trial began, and he was acquitted of the remaining two.
“A dozen years ago, I was the lone wolf,” Plunkett says, referring to his early criticism of SBS. “I was treated like the idiot fringe. The worst part of it is as soon as anybody questions the validity of this diagnosis, they are accused of being a defender of child abusers. It is simply not true for any of us. We all understand that child abuse occurs, but we also understand the importance of scientific integrity.”
Is this a question already settled within the medical community? One expert in Springfield is hesitant to choose one side or the other.
Dr. Tracey Lower, an assistant professor of pediatrics at Southern Illinois University School of Medicine and a staff member at St. John’s Children’s Hospital, says the science of medicine is constantly changing.
“There’s an evolution in what we know and what we’re learning about head injuries in children,” she says, adding that shaken baby syndrome first arose as a concept during the 1940s, before MRIs and similar medical procedures were developed to detect internal injuries. The historical record is largely silent on SBS during the 1950s, she says, until reports of child abuse began to emerge and be taken more seriously in the 1960s.
“There were a lot of assumptions, and I think what we’ve learned over the last five to ten years is that most of the time, the extreme injuries we see are a combination of mechanical forces,” she continues. “I certainly believe there can be severe injuries just by shaking, but usually abusive head trauma includes impact and other substantial injuries.”
Lower, who is also involved with Prevent Child Abuse Illinois, a statewide advocacy organization, says a physician’s primary obligation is caring for the children they treat, rather than investigating suspicions of child abuse themselves.
Plunkett takes that idea a step further. He says members of the medical community who don’t understand how force affects the human body should not even be allowed to testify about SBS in court cases.
“The pediatricians, pathologists and ophthalmologists…need to understand the mechanics of injury,” he says. “They need to understand biomechanics, applications of the principles of motion to human injury, before they open their mouths. If you ask these folks to define force for you, ask them to tell you Newton’s three laws, ask them to define acceleration – you will be shocked at the responses. If you don’t understand the mechanics of injury, I don’t think you should be allowed to be giving testimony on these issues.”
Jacobazzi’s first opportunity for parole is set for 2015, and if the pace of the case so far is any indicator of future progress, she could wind up serving the majority of her sentence before she gets another chance to assert her innocence. Her next hearing is scheduled for May 12.
“If you really get to know her, you would realize that this is not a person who loses her temper, loses her head or would do anything like this to any of the kids,” Sassan says. “It’s a shame. It’s horrible that she’s in this circumstance. As a criminal defense attorney, there are few people you represent that you can say, ‘I really think they’re completely innocent of anything.’ This is somebody who I think is really symbolic of the type of person that can get wrapped up in this theory [of SBS] that shouldn’t.”