Tuesday, 28 December 2010

SIDS: Action urged on cot deaths

DAVID KILLICK   |   December 17, 2010
A CORONER has lashed the Health Department for failing to act on her recommendations which she says would cut the number of cot deaths in the state.
Coroner Olivia McTaggart says she is still waiting for a response and for action on recommendations she made two years ago.
In the meantime 15 babies had died in unexplained circumstances. Many of the deaths may have been preventable, she said.
In coronial findings released yesterday, Ms McTaggart found a three-month-old baby boy died after being placed on his right side in his cot on April 16 last year.
She found his death was because of Sudden Infant Death Syndrome.
Ms McTaggart said she had made detailed recommendations after inquests into the deaths of four infants two years ago, including for the appointment of a full-time SIDS educator, but had not received a response despite repeated requests.
"Since the beginning of 2008 alone, 15 Tasmanian infants under the age of 12 months have died suddenly," she said.
"It appears that in a high proportion of this number preventable risk factors have been present.
"Such factors include co-sleeping with an adult, incorrect infant sleeping position and bedding and parental drug or alcohol sedation.
"I again urge that the Department of Health and Human Services consider implementing as a matter of priority a strategy to reduce the incidence of sudden infant death."
The department's director of children's services, Mark Byrne, said the department would consider the recommendations.
"The importance of safe sleeping is discussed by maternity unit staff and child health nurses with all new parents," he said.
"The blue book [personal health record] given to all parents requires nurses to discuss safe sleeping including the risks associated with Sudden Infant Death Syndrome at least four times with parents in the first four months of a baby's life."
The advice was based on guidelines accepted nationally.
He said the department was developing a DVD to help nurses and other health professionals reinforce the safe sleeping message.
1. Put babies on their backs to sleep. Do not sleep babies on their tummies or sides.
2. Parents should not smoke before or after the birth of a baby.
3. Sleep babies with faces uncovered. Use a light blanket tucked in securely or a safe infant sleeping bag. Do not put a hat on a baby to sleep.
4. Have a safe cot, safe mattress, safe bedding and safe sleeping environment for a baby day and night. Keep quilts, doonas, duvets, pillows and cot bumpers and fluffy toys out of the cot.
5. Do not sleep with the baby.
6. It is preferable to sleep babies in their own cots next to the parents' bed for the first six to 12 months.

SIDS: New York State: Colucci (Randy & Joseph)

Thomas J. Prohaska LOCKPORT — Defense attorneys for a Niagara Falls couple accused of murder in the death of their 22-month-old daughter are trying to keep the couple’s child care techniques out of their trial, now set for Jan. 31.
In Niagara County Court Friday, Joseph Terranova, attorney for Randy Colucci Sr., accused the prosecution of trying to portray Randy, 25, and his wife, Nicole Colucci, 24, as “a white trash family.”
Bringing in testimony about problems in the Colucci household that weren’t included in the indictment would expand the case, he said.
“It should not be expanded to show that these are just bad people who shouldn’t have children,” Terranova said.
The murder charge accuses the Coluccis of “depraved indifference to human life” in the way they treated 22-month-old Carmen, leading to her death.
About noon March 31, Randy Colucci discovered Carmen’s neck trapped between the top rail of a playpen and a mattress, weighed down by a TV set, that had been placed over the playpen to keep Carmen and her 1-year-old brother Randy Jr. from climbing out.
Carmen died April 8 after being taken off life support in Women & Children’s Hospital.
In an evidentiary hearing Friday, Niagara Falls Detective Patricia McCune testified that staffers at Niagara Falls Memorial Medical Center called her March 31 to report finding “abrasions and blistering around [Carmen’s] genital area.”
Assistant District Attorney Robert A. Zucco said the injuries were from “extreme diaper rash.”
Zucco charged that 9-year-old Shawna Starcher, the oldest of what at the time was a family of five children and stepchildren, had become the primary caregiver for her sib-lings. Nicole Colucci had another daughter Aug. 25.
“[Carmen] had open lesions from diaper rash from having a 9-year-old do it. That’s indifference,” Zucco said. “She caught her head because Shawna was the one to make sure she was safe before [Shawna] goes to school.”
Among the topics the defense lawyers want suppressed are the 2007 death of one of the couple’s other children from Sudden Infant Death Syndrome and another incident similar to the one March 31.
In that incident, Shawna rescued Carmen from potential death, Terranova said.
Last month in court, Zucco accused the Coluccis of hitting their children with sticks and duct-taping their legs together. The house on 22nd Street in Niagara Falls, also home to Randy’s parents, allegedly was strewn with garbage and animal waste.
“The prosecutor is trying to show this was a white trash family and that a level of neglect permeated the household,” Terranova said.
Zucco said that the two children were placed in the playpen at 7 p. m. March 30 and ignored until noon the next day while the adult Coluccis slept.
“If they had shown some care for this child even after putting her in a potentially lethal situation, this homicide, this death, would not have happened. That’s the crux of depraved indifference,” Zucco said.
Nicole’s lawyer, Assistant Public Defender Christopher A. Privateer, said the SIDS death of Sebastian Colucci should be out of bounds.
“It’s apparently an attempt to assign fault to my client for the death,” Privateer said.
McCune testified that Nicole told her that Carmen woke up about 10:30 a. m. March 31 and came downstairs on her own to have breakfast before going back up to nap.
McCune said she didn’t buy it. “I said, ‘She just came downstairs from bed. Why would she need a nap?’ I told her to be honest with me.” That was when Nicole conceded the children hadn’t been checked in 17 hours.
However, McCune said the whole interview was conducted March 31 without reading Nicole her rights. McCune claimed she didn’t have to do so because she didn’t consider Nicole a suspect at the time.
Officer Sanya Drinks-Brudes, the first to arrive at the home, said she found Theresa Colucci, the baby’s grandmother, performing CPR on Carmen on the dining room table. McCune testified that Nicole Colucci told her of changing Carmen’s diaper while CPR was going on.
Sperrazza reserved decision on admissibility of the uncharged accusations and said a hearing on Nicole’s statements to police must continue Jan. 4.

SIDS: CDC Life expectancy tables.

Americans lost about 1/10 of a year in life expectancy in 2008, The Centers for Disease Control’s National Center for Health Statistics released its report on the 2008 numbers last week.
The news for infants was particularly good in the 2008 numbers. The preliminary infant mortality rate fell to an all-time low — 6.59 infant deaths per 1,000 live births. Birth defects were the leading cause of infant death in 2008, followed by disorders related to preterm birth and low birth weight. Sudden infant death syndrome was the third leading cause.
The numbers are based on 99 percent of death certificates reported from all 50 states, the District of Columbia and U.S. territories.

SIDS: Surge in SIDS on New Year's Day


Researchers at the University of California, San Diego discovered a 33% rise in the number of sudden infant death syndrome (SIDS) cases on New Year’s Day.

The study, lead by David P. Phillips, examined 129,090 SIDS cases from 1973 to 2006. Researchers used the following three nationwide data sets: the Fatality Analysis Reporting System, computerized death certificates, and the linked birth and infant death data set.
While it isn’t a proven fact, authors of the study believe the rise in SIDS cases on New Year’s Day is a result of alcohol overindulgence by parents or other caregivers. There are a few facts, however, that support this theory, according to researchers.
Phillips and his team identified an increased rate of SIDS on weekends, the day after the Fourth of July and the day after April 20 — a celebratory day for those who smoke marijuana. Past research has also shown that the rate of SIDS is abnormally high if the child’s mother drinks alcohol. Intoxication can make simple tasks difficult; including caring for an infant.
While SIDS has decreased since 1994, it continues to be the leading cause of death for children between the ages of one month and one year.

SIDS: Washington: Mother Says Nojo Original Baby Sling Killed Her Daughter

TACOMA (CN) - A mother claims the poorly designed Nojo Original Baby Sling suffocated her 3-month old daughter. The grieving mom says Crown Crafts Infant Products dba Noel Johanna failed to warn consumers not to use the sling with infants younger than 4 months old, as it can cause positional asphyxiation.
     "The 'Nojo - The Original Baby Sling' is unreasonably dangerous as designed and can result in suffocation/asphyxiation because babies are contained entirely within the pouch of a sling with their face, including nose and mouth, pressed against the adult's body, impeding the airway," according to the federal complaint. "The sling can also place the infant in a 'C' position, or a chin-to-chest position, which can also impede the airway. When an infant is in the chin-to-chest position, suffocation and death can occur within minutes."
     Ann Heneghan says she was carrying her daughter in the sling while shopping and in less than 30 minutes, "she observed that her 3-month-old otherwise healthy baby was limp, pale, and not breathing. She observed blood-tinged mucous coming from Cathleen's nostril," the complaint states.
     "Ms. Heneghan began shouting for someone to call 9-1-1 and to help her with her baby. She carried Cathleen back into the store and commenced CPR with the assistance of a bystander. EMS units arrived within three (3) minutes and took over resuscitation efforts. Cathleen's heartbeat and breathing was restored and she was transported by ambulance to Children's Mary Bridge Hospital in Tacoma, Washington.
     "Cathleen was hospitalized in the pediatric intensive care unit for four days where she remained unresponsive and in a coma. According to medical records, evaluation of Cathleen's condition revealed that she was brain dead and had developed severe cerebral edema, seizures, aspiration pneumonitis, and an upper GI bleed, all associated with diffuse anoxic and ischemic injury. She was also found to have no cranial nerve function and no demonstrated respiratory efforts. Cathleen remained on advanced life support systems during the course of her hospitalization.
     "On October 27, 2004, Ms. Heneghan made the difficult decision to remove Cathleen from artificial life support. Cathleen died in her mother's arms at 11:50 a.m. that day."
     Heneghan says she was originally told that her daughter had died from Sudden Infant Death Syndrome.
     But "On March 12, 2010, Ms. Heneghan was contacted by the CPSC (Consumer Product Safety Commission) and was told that they were going to be issuing a warning regarding the dangers associated with the type of sling that Cathleen died in. Ms. Heneghan contacted the medical examiner who had conducted the original investigation and discovered for the first time that Cathleen's death was the result of positional asphyxiation - not Sudden Infant Death Syndrome as she had been told previously," the complaint states.
     "On March 12, 2010 the CPSC released a warning stating that 'infant slings can pose two different types of suffocation hazards to babies. In the first few months of life, babies cannot control their heads because of weak neck muscles. The sling's fabric can press against an infant's nose and mouth, blocking the baby's breathing and rapidly suffocating a baby within a minute or two. Additionally, where a sling keeps the infant in a curled position bending the chin towards the chest, the airways can be restricted, limiting the oxygen supply. The baby will not be able to cry for help and can slowly suffocate,'" according to the complaint.
     "Subsequent investigation revealed that the 'Nojo - The Original Baby Sling' is a dangerous sling because it allows babies to retreat into a curved/'C' shaped position where his/her head can be pressed against the mother's body causing positional asphyxiation. Investigation also revealed that the product did not contain any warnings or instructions telling Ms. Heneghan how to use the sling safely, that she should not use this type of sling with infants under four months old, and that the baby should be worn tight to the mother's body with the head out of the sling at all times. The dangers due to the design and lack of warnings associated with the 'Nojo - The Original Baby Sling' were unknown to Ms. Heneghan and were the result of Cathleen Delia Ross' tragic and unnecessary death," the complaint states

SIDS: Binge Drinking

LEE BOWMAN - Scripps Howard News Service   December 22, 2010
The percentage of people drinking alcohol is the highest it has been since the mid-1980s, and binge drinking has also risen sharply.
A recent report from researchers at the University of Texas School of Public Health looked at two national health surveys of adults (18 and older) in 1991-92 and 2001-02 by the National Institute on Alcohol Abuse and Alcoholism and found that more people overall were drinking at the start of the millennium. More recent data were not available to the researchers.
"The reasons for the uptick vary and may involve complex social and demographic changes to the population, but the findings are clear: More people are consuming alcohol than in the early '90s," said Dr. Raul Caetano, dean of the university's Southwestern School of Medical Professions.
"Drinking" was defined during both survey periods as having consumed at least 12 drinks with at least 0.6 ounces of any kind of alcohol within the past year. Anyone who had consumed less than that much alcohol or said they never drank was classified as a nondrinker.
By that definition, drinking was up 5 percent to 7 percent during that decade among men of all ethnic groups, so that 64 percent of white men, 60 percent of Hispanic men and 53 percent of black men were drinking. Among women, the rate rose by 8 percent to 9 percent, to 47 percent of whites, 32 percent of Hispanics and 30 percent of blacks.
Those numbers seem to fit closely with a mid-summer Gallup survey that found 67 percent of adults drank any alcohol at all, versus totally abstaining. That was the highest drinking rate since 1985.
The government surveys showed binge drinking --having more than five drinks in one day -- increased among all ethnic groups and genders, but particularly among men. The share of white men who consumed five drinks a day at least once a week rose from 9 percent to 14 percent, and there was a similar increase among Hispanic men. Among women, whites are also more likely than other ethnic groups to binge drink.
Caetano said the trends toward riskier drinking behavior suggest more individuals are problem drinkers who may require treatment, and he noted that the patterns are likely made worse by recession and other factors.
The surveys and many other studies show that for people who aren't addicted to alcohol, drinking tends to decline with age.
Statistics on alcohol-related injuries and deaths from traffic accidents, crime and risky sexual activity all point to the dangers of immoderate behavior.
The National Institute on Alcohol Abuse and Alcoholism notes that two or three times more people die in alcohol-related traffic accidents around Christmas and New Year's Day than during other times of the year.
Another study points to another sort of threat from drinking holidays -- infant sleeping deaths.
Researchers at the University of California, San Diego, analyzed more than 129,000 deaths attributed to sudden infant death syndrome between 1976 and 2006 and found that the deaths spike by 33 percent on New Year's Day.
The team, led by sociologist David Phillips, noted that the increase is well above an increase in SIDS deaths during the winter that has long been noted.
They also note that other research has found that the incidence of SIDS -- along with alcohol consumption -- rises on weekends and that babies of mothers who drink are more than twice as likely to die from SIDS as those whose mothers abstain.
Phillips said the large databases don't give enough detail about each death to determine just how alcohol use was related to the babies' deaths. "But we know that when people are under the influence of alcohol, their judgments are impaired and they are not as good at performing tasks, and this would include caretaking," Phillips said.
Medical examiners and infant death review boards around the country are increasingly finding that alcohol- or drug-impaired parents are more likely to place their babies in an unsafe sleep setting rather than putting them safely on their backs alone in a crib.
Investigators are finding that babies often die when parents or other family members roll over on them in their sleep in a bed, sofa or other setting, or become entrapped by heavy adult bedding. Infant death researchers at the Centers for Disease Control and Prevention and elsewhere are working to better count those deaths and understand the circumstances that led to them.
(Contact Lee Bowman at BowmanL(at)shns.com.)


SIDS: Crib deaths spike on New Year's

December 21, 2010 CBC News

Parents and caregivers are encouraged to place infants on their backs at night and nap time.Parents and caregivers are encouraged to place infants on their backs at night and nap time. (U.S. Consumer Product Safety Commission)
Babies are more likely to die of sudden infant death syndrome on New Year's than other days of the year, a new study suggests.
The reasons are not clear but researchers suspect that parents who celebrate the new year with heavy drinking aren't being attentive enough to their children and how they're put to bed.
The researchers examined a large U.S. database to explore connections between alcohol and SIDS — the sudden, unexpected death of an apparently healthy infant under one year of age.
The spike in deaths is beyond the normal winter increase in SIDS, sociologist David Phillips of the University of California, San Diego, and his co-authors report in this week's issue of the journal Addiction. They analyzed a database of 129,090 deaths from SIDS from 1973 to 2006 and 295,151 other infant deaths in those years.
The study doesn't give actual figures for the New Year's Day deaths from SIDS but said the number was about a third higher than would be expected on any other winter day.
To see if parental sleeping-in might be a factor rather than intoxication, the researchers checked for shifts in deaths when clocks are set back an hour in the fall. No rise in SIDS was found then.
The study doesn't show alcohol consumption is a cause of SID, but the findings raise concerns, Phillips said. Drunk parents could be doing something or not doing something that puts babies at risk, he suggested.

Impaired judgment?

"We know that when people are under the influence of alcohol their judgments are impaired and they are not as good at performing tasks," Phillips said in a release. "This would include caretaking."
Single-day jumps in cribs deaths occurred on July 5, the day after Independence Day.
Back to Sleep campaigns that recommend parents and caregivers place infants to sleep on their backs at night and nap time have been successful, the researchers noted.
"A similar campaign might now be implemented: There should be increased efforts to inform caretakers that alcohol impairs parental capacity and might be a risk factor for SIDS," the study's authors wrote.
The Public Health Agency of Canada also advises parents to lower risk of SIDS by:
  • Not smoking around the baby.
  • Avoiding dressing the baby in too many clothes or adding too many covers to prevent overheating.
  • Providing a safe crib environment that has no toys or loose bedding.
A second study by Phillips that analyzed mortality rates for the U.S. population found people are more likely to die during the Christmas season.
The analysis of U.S. death certificates between 1979 and 2004 found that in the two weeks starting with Christmas there were 42,325 natural deaths above the usual seasonal winter increase.
Again, the reasons are unknown. Possible explanations for the spike in deaths include overcrowding in emergency departments, winter travel, cold weather and substance abuse, the researchers said.

SIDS: New Years Day is dangerous to your baby's health

December 23, 2010, 9:54 a.m.
Brochures from the National Institutes of Health show parents and caretakers how a safe sleep environment can lower the risk of SIDS.
Babies who die from SIDS are 33% more likely to die on New Year's Day than any other day of the year, a new study finds. Researchers say alcohol use the night before by parents or caretakers may play a role in SIDS deaths.
The study from UC San Diego examined 129,090 cases of SIDS, or sudden infant death syndrome, between 1973 and 2006 by using data from the Fatality Analysis Reporting System. It suggests that caregivers who drink alcohol may not be following "safe sleep" recommendations, such as placing infants on their backs to sleep. Here's a news release that explains the findings recently published in the journal Addiction.
No one knows what causes SIDS. It remains the leading cause of deaths in babies between the ages of 1 month and 1 year. This Los Angeles Times story provides some of the latest thinking on SIDS.
Still, progress has been made. The overall rates of SIDS has dropped more than 50% since 1994, when medical experts urged parents to place babies on their backs while sleeping. Read more here from the Eunice Kennedy Shriver National Institute of Child Health & Human Development about the Back to Sleep campaign. And the American SIDS Institute provides more information here too.

SIDS: Blogger's Comment

As a personal point of view, I believe Sudden Infant Death should be (and by some is) known as "Cause Unknown" or "Uncertain" as used by some authors and pathologists.
Reference to case reports in my book, Calendar of Miseries shows the numerous cases where initial diagnosis was SIDS and the mother later explained it was murder.
The reason for this interjection at the end of the year is the several comments on the statistical finding that SIDS is so much more common on New Years Day -- clearly that is a human factor and not a metabolic, electrical or one of the other credible possibilities of unexplained cause of death.
Equally clearly, it is a factor that could be corrected. If we can work to remove traffic accidents due to alcohol in the "festive" season, so could we work towards reducing infant deaths.

Monday, 27 December 2010

CHILD ABUSE: Broader Use of Skeletal Surveys May Help Diagnose Physical Abuse of Children

News Author: Laurie Barclay, MD
CME Author: Penny Murata, MD

In the May 2009 issue of Pediatrics, the American Academy of Pediatrics recommended a skeletal survey for all children younger than 2 years who are suspected of being physically abused and for selected children 2 to 5 years old. Studies on the use of skeletal surveys usually include children for whom there is a strong suspicion or diagnosis of abuse. For example, in the February 1983 issue of Radiology, Merten and colleagues reported that 33% of children for whom there was a strong suspicion or diagnosis of abuse had fractures identified on skeletal survey.
This retrospective, descriptive study assesses the use of the skeletal survey to screen for clinically unsuspected fractures in consecutive children who presented to the hospital.

Study Highlights

  • Of 1147 children who had a skeletal survey during the 4-year study period, 703 children who presented for concerns regarding physical abuse were eligible.
  • Exclusion criteria were skeletal surveys ordered for other than suspected abuse or for an undetermined reason.
  • Chart review extracted data on sex, age, reason for presentation, reason for skeletal survey, and survey results.
  • Median age of the children was 8 months (range, 4 days to 12 years).
  • Age categories were younger than 6 months, 6 to 11.9 months, 12 to 23.9 months, 24 to 58.9 months, and older than 59 months.
  • 84% of children were younger than 2 years, 15% were 2 to 5 years old, and 1% were older than 5 years.
  • 57% were boys.
  • 97.2% of patients had a skeletal survey in the emergency department or other outpatient location.
  • A positive result was defined as a fracture that was not suspected clinically or recognized previously.
  • The child protection team classified positive skeletal survey results as definite, probable, possible, or no abuse.
  • Analysis categories of skeletal survey results were abuse (definite or probable) or no abuse (possible or no abuse).
  • An investigator reviewed the charts for skeletal survey–positive cases to determine whether the survey results influenced the diagnosis of abuse.
  • Skeletal survey results affected the diagnosis if the results changed the diagnosis from possible to probable or definite abuse.
  • Such results did not affect the diagnosis if definite or probable abuse was not diagnosed, despite positive skeletal survey results and if abuse would be diagnosed even if the skeletal survey results were negative.
  • Possible skeletal survey fracture results were positive if confirmed with radiographs or bone scans and negative if follow-up testing did not confirm fracture, was not performed, or was inconclusive.
  • The most common reasons for presentation to the hospital were trauma in 35% and symptoms of injury in 21%.
  • The most common reason for a skeletal survey were recognized fracture in 37% and child abuse features (bruising, burns, sexual abuse) in 19%.
  • 76 (10.8%) of children had positive results.
  • The rate of positive skeletal survey results was higher in children younger than 6 months vs children older than 6 months (16.4% vs 6.8%).
  • Of children with positive results, 55% had a single fracture, 24% had 2 fractures, and 21% had 3 or more fractures.
  • The most common location of fractures was the ribs.
  • Of 62 children with data on fracture age, 49 (79%) had at least 1 healing fracture (35 with healing fracture only and 14 with both acute and healing fractures), and 13 (21%) had only acute fractures.
  • Children with positive vs negative skeletal survey results had a lower median age (4 vs 8 months; P = .001)
  • Rates of positive survey results were higher in children who presented for an apparent life-threatening event or apnea (12 [18.2%] of 66; P = .05) or seizure (6 [33%] of 18; P = .02) vs other reasons.
  • These rates were higher if the reason for the survey was suspected abusive head trauma vs other reasons (20 [23%] of 88 vs 56 [9.1%] of 615).
  • Children with recognized fractures diagnosed before the skeletal survey were not more likely to have positive results.
  • Physical abuse was diagnosed in 58 of 76 children with positive skeletal survey results.
  • Of these 76 children with positive skeletal survey results, the results directly influenced the decision to diagnose abuse in 38 (50%). Of the remaining 38 children, the diagnosis would have been made even with negative results in 18 children, or abuse was not diagnosed in 20 children.
  • Study limitations were retrospective design and possible physician bias in ordering the skeletal survey.

Sunday, 26 December 2010

SBS: Arizona: Jonathan Edward Vandergriff

By JIM SECKLER:  December 22, 2010
KINGMAN — Several motions were argued Tuesday in Superior Court in the death penalty case of a Bullhead City man charged with murdering his infant son.
Jonathan Edward Vandergriff, 24, and his co-defendant, Staci Lynn Barbosa, 19, are each charged with first-degree murder, child abuse by domestic violence, sexual assault of a minor under the age of 15 and sexual conduct with a minor under the age of 15.
Only Vandergriff faces the death penalty if convicted of the murder charge. The couple could also face life in prison with or without the chance of parole after 35 years if convicted of murder.
Vandergriff’s Tucson attorney, Creighton Cornell, asked for a complete autopsy report from Clark County Medical Examiner’s Office, calling the report that he received incomplete. The report did not address exams of the child’s brain or retina. Cornell also wanted to make sure the child’s body was still being preserved and even hinted of possible prosecutorial misconduct.
Deputy Mohave County Attorney Greg McPhillips said he would provide any further evidence to the defense if the coroner provides it but described the defense’s motion as “sound and fury” without substance.
Court Commissioner Derek Carlisle questioned why defense attorneys waited two months since they received the autopsy Oct. 29 to file a motion but did order prosecutors to disclose any present or future reports from the medical examiner. The judge also questioned why defense attorneys have not requested a medical expert to review any medical evidence and said the deadline to request an expert is nearing an end. Carlisle also said Mohave County is handicapped by having to go to another state for an autopsy report.
The judge set Vandergriff’s next hearing for Jan. 20. Vandergriff’s case has been designated a complex case, which means he will not go to trial in less than 18 months. Vandergriff is being held on $500,000 bond and Barbosa is being held on a $250,000 bond.
Barbosa was arrested June 15 after she took her badly injured son, Matthew, to the Western Arizona Regional Medical Center. Vandergriff turned himself into police officers later that day.
Matthew suffered from bruises, broken ribs, broken femur, and swollen eyes and was malnourished and dehydrated. The infant allegedly showed signs of sexual abuse and shaken baby syndrome. Matthew was later taken to a Las Vegas hospital where he died the next morning.

SBS: New York State: Adoption

By Ed Reilly:
December 20, 2010
When Shantelle Songster from Buffalo was approached about being a temporary foster parent for a young disabled boy named Isaiah Henley, she opened up her heart and her home. What she didn't know was that her life would never be the same. "Once I met him, he gave me that Isaiah smile - my heart melted and I had to adopt him," says 25-year old Shantelle.
Monday in Erie County Family Court, Judge Patricia Maxwell signed the papers that made Shantelle officially Isaiah's new mom. "This is the ultimate Christmas gift. I can't ask for anything more. I have my little guy and I'm in love," replied a tearful Shantelle.
Gateway-Longview, Inc. placed the young boy in another foster home before Shantelle's. He was well cared for but his needs were more than the family could accommodate.
In June 2009, Gateway-Longview was searching for a temporary pre-adoptive home to care for Isaiah. They asked Shantelle, who is a teachers assistant for children with special needs, to care for him until a permanent home could be found.
Shantelle soon found that she loved little Isaiah so much that she filed papers to adopt him.
"This is very common," says Director of Foster Care and Permanency Services for Gateway-Longview Michelle Federowicz, "Temporary foster families fall in love with the children they care for and then decide to adopt them."
While it makes for happy endings, it depletes the number of temporary foster homes available. "We are always looking for people to serve as temporary foster parents." comments Federowicz.
Anyone interested in being a temporary foster parent can contact Gateway-Longview at 783-9187.

SBS: New Zealand: Adam Lock

Sun, 19 Dec 2010
By Brook Sabin
A mother whose five-week-old baby was shaken to death by her former partner has spoken out - exclusively to 3 News - hoping her message will affect every parent and save lives.
It's estimated around 3000 New Zealand babies are shaken each year - a number officials are trying to reduce with a major new campaign.
Shannel Tata asked that we black out her face for the interview, it's a big thing for her to talk to us about her son Jayhris.
Six photos are all she has left of him after he was shaken to death by her former partner.
“My son was only five-weeks-old, he was innocent - he was helpless,” she says before speaking about her partner. “I hate - I just hate him.”
In October, 22-year-old Adam Lock was jailed for seven years for Jayhris's manslaughter.
Infants are so vulnerable to being shaken because their neck muscles are too weak to support their disproportionately large heads and their young brain tissue and blood vessels are extremely fragile.
It's a problem which experts say is grossly unrecognised.
“The most concerning fact is that in New Zealand, among Maori children particularly, the rate is arguably the highest in the world,” says Dr Patrick Kelly, a Paediatrician at Starship Children’s Hospital.
Around 20 shaken infants are admitted to hospitals with serious or fatal injuries each year.
But international research indicates the true number of New Zealand children being shaken is around 3000.
Dr Kelly says many parents don't seek medical help - thinking they haven't caused any damage.
“What people don't realise of course is the damage that they cause from that head injury might be still with the baby and have an affect on them for life,” he says.
Auckland Hospital is spearheading a major new campaign which involves a meeting of all new parents to educate them about the risks.
The programme has been a huge success in New York state, where it first started, reducing rates there by almost 50 percent.
It's welcome news for Mrs Tata, who never wants to see another parent go through the turmoil she has.

SBS: Pennsylvania: Jamel Lee Billups acquitted

JIM HOOK Senior writer

A Chambersburg man was acquitted Friday of charges that he shook his 3-month-old daughter.
Jamel Lee Billups, 32, Chambersburg, mouthed a "thank you" to jurors after the verdict was read, and untucked the shirttail of his blue dress shirt.
"Thank you," he said quietly, looking upwards.
"I'm very happy," said Jacqueline Rosario, mother of the child Leiana, now 18-months-old. "He gets to come home to his kids. We'll be a family for the weekend. He hasn't seen them in 14 months."
The couple also has a 3-year-old daughter.
After hearing six days of medical testimony in Franklin County Court, the jury deliberated for two hours during lunchtime on Friday and had enough reasonable doubt they found Billups not guilty of aggravated assault and endangering the welfare of a child.
Billups has maintained his innocence from the beginning, according to Rosario and Defense Attorney Christopher Basner of Newport.
Billups' defense relied on complex testimony from a medical expert and recent medical research.
Defense witness Dr. Patrick Barnes, a pediatric neuroradiologist at Stanford University, testified that Leiana suffered brain damage from health conditions that mimic child abuse.
Leiana's doctors said that her "constellation of injuries" had no other explanation than child abuse, according to Franklin County Assistant District Attorney Lauren Sulcove. In her closing argument she singled out injuries to ligaments at the back of the child's neck and swelling at the back of her head.
"You've heard the old saying: If it walks like a duck, looks like a duck and swims like a duck, it must be a duck,'" Sulcove addressed the jury. "It's your job to call it what it is."
Sulcove maintained that Billups' testimony was not credible.
"He changes the facts every time he testifies," she said. "There's a bit of truth in every lie. You have to listen carefully."
Sulcove said Billups' prior conviction for robbery in New York nine years ago is evidence of his deception.
Judge Shawn Meyers instructed the jury that Billups' conviction must be used only to judge his credibility and not his innocence or guilt.
"There was a tragedy that happened on Oct. 19(, 2009); a young child suffered a stroke," said defense attorney Mark Freeman of West Conshohocken.
The girl's brain damage resulted from a rare disorder known as cerebral venous thrombosis, according to defense witnesses. The 16 fractures to her front ribs were the result of a likely deficiency of vitamin D at her birth. A severe lack of the vitamin is linked to congenital rickets, or fragile bones.
Investigators "had the blinders on" after seeing her condition, Freeman told the jury. They failed to follow up on low levels of Protein S, an indication of venous thrombosis. There were no signs of external trauma, classic signs of shaken baby syndrome.
"Sometimes you see what you're looking for," Freeman said. "The entire case is based on the presumption of trauma."
Sulcove countered: Leiana is "the one time on the planet" where venous thrombosis and bone fragility have come together. Abused children do not always have visual injuries.
Leiana, as of her last test in May could not see, will have difficulty walking and may be mentally retarded, Sulcove said.
Freeman, who specializes in elder law, appeared in his first criminal trial. Freeman said he previously researched false child abuse.
"A personal friend had almost the identical thing happen to him," Freeman said after the trial. "Child abuse is a horrible thing. Charging parents is a pretty horrible thing too. The real tragedy is they didn't have any defense at the dependency hearing."
But when Franklin County Children and Youth Department heard about Billups' defense expert Barnes, they quickly returned the two girls to Rosario, Freeman said.

SBS: Australia: Shaun Anthony Edwards

Amelia Bentley : December 22, 2010
    A Gold Coast man accused of shaking his newborn baby girl to death remains in prison after an application for bail was denied today.
    Lawyers for New Zealand-born Shaun Anthony Edwards, 23, argued in the Brisbane Supreme Court this morning that the case against their client "could not be described as strong".
    Mr Edwards is accused of murdering the 19-day-old girl, who died from head injuries after she was rushed to hospital in October last year.
    Pathologists say the girl died from brain injuries consistent with being shaken. She also had a fractured skull at the time of her death.
    The court heard Mr Edwards admitted to shaking the infant for "a few seconds" out of frustration.
    The child's mother told police Mr Edwards had also told her he slapped the baby while she was showering.
    Defence barrister Mark Johnson said the murder charge was "not strong", but there was a possibility a jury could convict him of the lesser charge of manslaughter.
    He said his client had been in custody for the past 15 months and it was not likely the case would reach a trial in the Supreme Court until the second half of 2012.
    Mr Johnson said there was a risk he would serve time in pre-sentence custody than he would receive behind bars if convicted of manslaughter.
    "He's a young man who seems to have been leading a normal and productive life," he said.
    In refusing bail, Justice Glenn Martin said there was always a risk those facing murder charge and a mandatory life sentence would flee the jurisdiction.
    He said it was unlikely, if convicted of manslaughter, Mr Edwards would risk being in custody on remand longer than he would be have been sentenced.

    SBS: Ohio: Erica Colopy

    A doctor from Nationwide Children’s Hospital who has extensive experience in observing cases of retinal hemorrhaging, testified Tuesday that the death of 4-year-old Donavon Poole was the result of shaken baby syndrome.
    Erica Colopy, the then live-in girlfriend of Ricky Poole, Donavon’s father, is on trial for involuntary manslaughter in Knox County Court of Common Pleas.
    Dr. Phillip Scribano, director for the Center for Child and Family Advocacy at Nationwide Children’s Hospital, told Knox County Prosecutor John Thatcher that Donavon’s eyes pointed to evidence of trauma.
    “These facts are consistent with a different mechanism than just impact,” said Scribano, pointing out the visual differences between injuries from a fall and those of a “shaking mechanism.”
    “This is what laymen may refer to in the term of shaken baby syndrome ... regardless of age,” said Scribano. In referring to Colopy’s report of Donavon falling on the stairway, “This is a history that is just incompatible with the injuries on Donavon,” said Scribano. “I do not believe his injuries are only the result of him falling down a stairway.”
    Scribano said he believes it is the result of the “shaking mechanism,” which can cause alteration in consciousness and an impairment of breathing. Other reasons for his conclusion, he pointed out, are documented ear injuries and genital injuries that are not expected from a fall down a flight of stairs and the retinal photos suggest insight involving a “shaking mechanism.”
    Thatcher then asked Scribano if Donavon died from injuries sustained in circumstances he had just described.
    “Yes,” Scribano said.
    Scribano said he observed Donavon after he was admitted to Nationwide Children’s Hospital in October 2009. Thatcher shared numerous photos with Scribano showing the injuries to Donavon, which Scribano stated showed bruises to the left side of his cheek, scars above one eyelid and bruising over his nose. Also reported were extensive bruising on his right flank, and bruising on parts of his back, as well as his pelvis and pubic area.
    A skeletal survey was also conducted, but Scribano stated it did not show any evidence of skeletal fractures.
    Colopy’s attorney, James Giles, questioned Scribano about his knowledge of literature focusing on retinal hemorrhaging which suggests young children are more susceptible to head injuries since they have a larger head-to-body ratio than adults. Giles suggested factors of distance and surface are paramount when looking at instances where children fall.

    SBS: Florida: Robbie Lee Hatcher

    A 38-year-old man was arrested Thursday on charges that he shook and seriously injured the 6-week-old baby girl he was supposed to be caring for, Pinellas deputies said.
    The infant suffered life-threatening injuries and was taken to All Children's Hospital.
    Robbie Lee Hatcher was arrested on a charge of aggravated child abuse and taken to the Pinellas County jail.
    The incident took place Monday. Hatcher called 911 for help from his apartment at 2346 Bent Tree Road about 3 p.m.
    Hatcher said he was feeding the baby when she began to vomit. He started shaking her, he told deputies, because he thought she was choking. But then she became "unresponsive," he said.
    The victim was not identified by deputies.
    Then detectives from the Crimes Against Children Unit started an investigation. Hatcher's explanation for her injuries "was not plausible based on the medical evidence," they said.
    Detectives determined that "the baby was severely shaken by the suspect," sheriff's reports state, "to the point where she sustained the serious injury."
    No update of the victim's condition was available late Thursday. Hatcher was being held without bail.


    SBS: Missouri: Greg Walker

    Damarion Walker.jpg
    Damarion Walker before his body was broken.
    Three-month old Damarion Walker has a blood clot on his brain, two broken femurs and an injured wrist. His injuries have been called "critical," and doctors believe his injuries are a case of "shaken- baby syndrome."

    KMBC Channel 9 interviewed Damarion's mother, Kinsey Starling, who told reporter Peggy Breit that she was shocked when authorities charged Damarion's father, Greg Walker, with aggravated battery. Starling told Breit there's no way Walker could have injured their son. Authorities say otherwise.
    Walker, 34, has "spent half of his life in prison," but Starling claimed those were crimes he didn't commit. "We're a happy family and we would never think of hurting our children, ever," she told Breit. "It's horrible and it's confusing to me because I know there's other things that can cause this, and all they're trying to focus on is child abuse."
    Starling and Walker have been together for two-and-a-half years. Starling was at work last week when Walker called and told her Damarion had been "fussing" and was now "unresponsive." When the baby boy was taken to the hospital, doctors believed they had a case of shaken-baby syndrome.
    Right then and there, they told me, 'Well, he had a blood clot on his brain and this is caused by a blow to the head,'" she said. "We thought, 'A blow to the head? Like who would really hit a child in their head?'"
    Authorities apparently believe Walker would -- despite Starling's protests. Now, as investigators sort out what happened, Starling has lost custody of Damarion as well as her other child. She's not allowed to see her son. Today, she'll reportedly be in court fighting for visitation.
    Meanwhile, Walker is locked up in the Johnson County jail, and we can only hope Damarion survives.

    SBS: Texas: Jose Trevino

    Dec 17, 2010 12:03 By Michael Slother

    LUBBOCK, TX (KCBD)-  authorities arrested 19-year-old Jose Trevino on a charge of injury to a child.
    According to the police report, Trevino was helping his girlfriend baby sit back in November when a 6-month-old boy began crying when Trevino's girlfriend was in the shower. In the report, Trevino admitted he was frustrated and says he shook the baby with a ‘back and forth motion.' In his statement to police, Trevino said he knew he shook too hard when the child's eyelids started to close and he stopped breathing.
    Lynette Wilson from the Family Guidance and Outreach Center of Lubbock picked up a doll to demonstrate what can happen when a baby is shaken hoping to stop the crying. She says it's the worst mistake you can make. The doll had red lights throughout the baby's head to show where bleeding occurs.
    It's called shaken baby syndrome, or SBS. Statistics from the Family Guidance and Outreach Center say 25% of those affected will die; the others can suffer severe brain damage leading to strokes, retardation, or blindness.
    Local physician Dr. Laszio Nagy showed us a CT scan of the brain of a shaken baby. Visible white patches from hemorrhages turned to missing portions of the brain after a few months.
    Wilson said SBS is the most preventable type of child abuse, and usually starts with a frustrated parent. She said if you can't get the child to stop crying, it may be best to leave the room. "You can exercise, you can go in the bathroom and scream, you can go outside and scream. You must remove yourself from that child," she said.
    Statistics from the center also suggest men are responsible for the majority of SBS cases, claiming they may be less familiar with the baby's needs. Dr. Nagy says experience is also a factor. "When parents are young and inexperienced, they are young and don't know what to do," Nagy said.
    That's exactly why Wilson hopes parents will combat the problem with education. "If only they knew that you never shake a baby and what can happen to that little brain, I do not believe they would shake their baby."
    The Family Guidance and Outreach Center of Lubbock offers classes to help educate parents on shaken baby syndrome and a variety of other topics at no cost.

    SBS: Oregon: DiNucci Family copes with anguish, lifetime of disability

    Mara Stine
    (news photo)  Jim Clark / The Gresham Outlook

    Ashley DiNucci was car shopping with her father when she saw a chubby baby gleefully biting its toes.
    In this moment, she truly accepted that her own baby, also just a few months old, would never reach such a milestone.
    At just 6 weeks old, Rockell DiNucci was shaken by her father, Brandon DiNucci, in September 2007. While being raced to the hospital in an ambulance, she stopped breathing a block from the family’s Gresham home.
    Doctors at Doernbecher Children’s Hospital said the baby was not viable. She’d never breathe, eat, talk or walk unassisted. Due to the extreme swelling of her brain and bleeding, most of her injured brain had turned to spinal fluid, or “melted away,” as doctors described it.
    Neurologists likened it to a leaf that dries up.
    If you hold it by the stem and blow with enough force, the leaf is stripped away while the stem remains.
    In Rockell’s case, her brain stem in the back of her brain remained intact. But the rest disappeared.

    Lucky to have survived

    Although there is no official central registry of shaken baby statistics in the United States, an estimated 1,200 to 1,400 babies die or are injured by being shaken every year, according to the National Center on Shaken Baby Syndrome.

    About a quarter of those children die, while most of the others sustain permanent brain damage.
    This spring, Time magazine reported a significant increase in cases of Shaken Baby Syndrome since the nation’s recession began.
    Researchers, led by a Pittsburgh child-abuse expert, analyzed data on 512 cases of head trauma at children’s hospitals in Pittsburgh, Cincinnati and Columbus, Ohio, and Seattle.
    The number of cases had increased to 9.3 a month as of Dec. 1, 2007, compared with six each month prior to that date. The rate had remained steady since 2004.
    Experts say the increase correlates with the recession and resulting financial stress parents may be under.
    Rockell’s grandfather, Jim Kaufer, doesn’t believe the economy was a factor in his granddaughter’s abuse. Brandon DiNucci, 20, pleaded guilty to first-degree attempted assault and was sentenced to five years in prison in March 2008. He is scheduled for release in 18 months, after which he can’t see Rockell for a year.
    Jim says DiNucci doesn’t have an anger problem.
    Instead, he said the man he considers a “gentle, soft beautiful kid,” was so eager to prove what a good parent he was that he took on too much and snapped.
    His drug use also was a factor, Jim said.

    Miraculous recovery

    Despite Rockell’s grave prognosis, she stunned doctors by breathing and eating on her own.

    Her family rejoiced. Rockell’s grandparents dubbed her a miracle baby and were convinced she’d make a full recovery. “When they’re that young, you hear them make a sound and you say, ‘See, they’re cooing. They’re going to be fine,’ ” Jim said.
    At first, Ashley also shared in their optimism. But as Rockell grew older, reality set in: Rockell would never grab her toes, let alone suck them, like that baby in the car dealership.
    Rockell, now 3, has had five brain surgeries. Her right eye is a prosthetic and doctors think she can only detect light with her left eye. She has about 20 small seizures a day. She also can’t stand or sit on her own.
    “Things have been much more of a challenge than we ever imagined,” Jim said. To help Ashley care for her, Lisa, Rockell’s grandmother, quit her job with Food Services of America, where Jim also works as a sales representative.
    Rockell can roll from her belly onto her back, but otherwise can’t really move. As a result, her mother and grandparents spend a lot of time holding her, almost like a rag doll.
    To prevent her hips from dislocating, Rockell spends a few hours a day strapped to a “stander” that her mother built for her.
    Rockell sees a physical therapist twice a week, but insurance only covers 24 visits a year. That leaves 80 uncovered visits, totaling $16,000 a year. Insurance also won’t pay for the $10,000 specialized walker she needs if she’ll ever be able to walk. She also needs a special chair to help her posture, but insurance won’t pay for that either.
    Jim recently partnered with a local coffee roasting company that has agreed to sell a few select blends as a fundraiser for Rockell’s ongoing medical care.
    Because of the long distance between Rockell’s physical therapist in Milwaukie, the family has moved out of its Gresham home – where they lived for 26 years – and into a house in Happy Valley. It’s just 10 minutes from Rockell’s physical therapist, who is confident the girl will walk someday.
    The mere mention of it brings a smile to Lisa’s face. Ashley, however, is much more guarded with her optimism.
    “It’s too depressing to live for the next day thinking she’s going to get better, only to see it not happen,” she said.
    “We’re not giving up, but we’re realistic,” Lisa said. “You just do everything you can. You can’t ever give up.”
    After all, the girl is absolutely adorable. She loves to be held. She has fantastic hearing.
    “Bionic,” Jim calls it. And she’s got spunk – she pretends to fall asleep if she doesn’t like what’s on her plate.
    “She knows happiness. She loves music. There are times when she breaks into a smile and you know she’s experiencing joy,” Jim said. “Will she ever be like Kaikoa?” he asked, gesturing toward Rockell’s 2-year-old cousin playing with her on the floor. “God only knows. She’s going to be whatever she’s going to be, and we love her for every inch that she’s got.”

    SBS: Georgia: Parents share story to help others

    Anne Hart  December 20 2010
    The Chatham County parents of a 10-month-old baby boy fully understand that shaken baby syndrome is a real and dangerous public health problem.
    They in no way want to downplay the fact that shaking an infant can cause severe and irreparable damage to a child.
    What they do want people to realize is that sometimes a baby showing some signs of shaken baby syndrome may be suffering from a different, unrelated medical condition, one that does not involve abuse.
    They believe this because that's what happened to them.
    The parents are sharing their story as a cautionary tale. They say there's a need for closer scrutiny when making such a harsh diagnosis as shaken baby syndrome.
    Their names are being withheld to protect the privacy of their son.
    The parents say that earlier this year, their only child - the child they call their "miracle baby" because they had tried for a year and half to conceive - was misdiagnosed with shaken baby syndrome.
    This commenced a nightmare that included temporarily losing custody of their then 5-month-old son for 56 days and spending roughly $60,000 in the legal battle to regain custody.
    The case was eventually dismissed, and the baby was returned to his parents.
    "There is abuse of children out there," said the baby's father. "But we are not that family."
    Their son turned out to be suffering from chronic subdural hematomas, which they say is a possible complication of being born one-month premature. The baby weighed 3 pounds, 4 ounces at birth and spent a month in the neonatal intensive care unit.
    Today, the baby is doing well. His parents take him regularly to Atlanta to be treated for the hematomas.
    The parents are also dealing with the emotional and financial fallout caused by the case and worry about other children being misdiagnosed with shaken baby syndrome.

    Protecting babies
    About 1,500 babies younger than age 2 in the United States are diagnosed with shaken baby syndrome each year, according to MedicineNet.com.
    Since the early 1990s, many hundreds of people have been imprisoned on suspicion of murder by shaking.
    But according to media reports, there is some question regarding the science behind diagnosing SBS.
    According to a Sept. 20 New York Times Op-Ed: "For the past 30 years, doctors have diagnosed the syndrome on the basis of three key symptoms known as the "triad:" retinal hemorrhages, bleeding around the brain and brain swelling. The presence of these three signs (and sometimes just one or two of them) has long been assumed to establish beyond a reasonable doubt that the person who was last taking care of the baby shook him so forcefully as to fatally injure his brain. But closer scrutiny of the body of research that is said to support the diagnosis of shaken baby syndrome has revealed methodological shortcomings. Scientists are now willing to accept that the symptoms once equated with shaking can be caused in other ways."
    Pediatric neurosurgeon Dr. David M. Wrubel of Children's Healthcare of Atlanta sees about 50 babies a month, if not more, who show the signs of shaken baby syndrome. He said it's rare that the cases turn out to be something else.
    "Unfortunately, with the majority of cases, it's shaken baby syndrome or some other type of abuse,'' Wrubel said. "There are always the unusual cases, such as chronic subdurals. That does happen, but not frequently."
    Wrubel is now treating the Chatham County child for the hematomas. Neither Wrubel or Children's Healthcare of Atlanta were involved in the initial treatment.
    Wrubel said the system is set up to make sure the child is protected. He said it's a tough situation because the parents or caregivers are considered guilty until proven innocent to protect the safety of the child.
    "There's not an epidemic (of misdiagnosed shaken baby syndrome cases),'' Wrubel said. "But unfortunately, sometimes innocent people get swept up in the process to protect the safety of the child."

    Contact Anne Hart at anne@southernmamas.com.

    Friday, 17 December 2010

    Child Abuse: Pennsylvania: Billups

    FRANKLIN COUNTY -- After hearing from doctors about her brain injuries for nearly a week, a Franklin County jury saw a smiling and squealing Leiana Billups in person on Thursday. Now nearly 18 months old, the apparently content little girl was carried into Judge Shawn Meyers' courtroom by her mother, Jacqueline Rosario, during the afternoon trial session.
    Most of the jurors smiled widely at the small child, who was allegedly shaken by her father when she was 3 months old.
    Both sides have now presented their evidence, and only closing arguments remain before the jury will be sent to deliberate whether Jamel Lee Billups was responsible for his daughter's permanent brain damage.
    The trial was expected to resume at 8:30 a.m. today, beginning with the defense's closing arguments. Meyers told the jury that he will instruct them to begin deliberating after both sides have finished, probably by lunchtime.
    Billups, 32, Chambersburg, is charged with aggravated assault and endangering the welfare of a child. He denies ever physically harming his daughter.
    A doctor in California told the jury via teleconference Thursday he believes the baby suffered from a combination of health conditions that "mimic child abuse." Defense witness Dr. Patrick Barnes, a pediatric neuroradiologist at the Lucile Packard Children's Hospital at Stanford University, appeared live on a television in front of the jury box.
    Having reviewed Leiana's medical history and test results,
    Barnes said he concluded the blood on her brain and retinal bleeding were the result of a stroke-causing disorder called cerebral venous thrombosis. According to previous testimony by other doctors, CVT is a rare disorder not known to cause the type of brain bleeding or the retinal bleeding seen in Leiana. But Barnes said recent advances in medical technology and research show this is not true.
    During her cross-examination, Assistant District Attorney Lauren Sulcove asked Barnes if he would agree that CVT is very rare.
    "Ten years ago, I would have agreed with that. Now I would not agree," he said. "It is much more common than we thought, especially in infants."
    Expert witnesses for both sides have testified that Leiana has tested deficient for an anti-clotting agent called "protein S." Barnes testified that lack of the protein is linked to the appearance of CVT.
    Barnes' testimony also addressed the appearance of 16 rib fractures found in X-rays taken when the girl was 3 months old.
    Doctors testifying for the prosecution said an X-ray taken when she was 11 days old showed no fractures, proving the injuries had occurred thereafter. The healing fractures were estimated at between four and eight weeks old.
    A vitamin D deficiency found in Leiana's mother indicates that the baby was likely deficient when she was born, Barnes said. A severe lack of the vitamin has been linked to a "bone fragility disorder" called congenital rickets.
    Barnes testified that the fractures may have actually occurred during Leiana's birth, but were too small to appear in a standard X-ray when she was only days old. He also pointed out that the fractures were in the front portion of the baby's ribs, not in the back as normally occurs in incidents of "shaken baby syndrome."
    Sulcove asked Barnes if he was aware of any other case where a baby was diagnosed with CVT and a bone fragility disorder in conjunction with the same type of brain and retinal bleeding as Leiana.
    "Not as of yet, that I know of," he said.
    Asked how many times this year he had testified in a child abuse trial on behalf of the defense, Barnes said it had been "at least once a month."
    Sulcove pointed out that a number of doctors who had helped treat the baby all determined the cause of her problems to be child abuse.
    "So they're wrong and you're right, even though you never met Leiana Billups?" she asked him.
    "That is correct," Barnes said.
    His testimony lasted all morning, and Meyers called a lunch recess shortly after noon. When the trial reconvened, the jury was introduced to Leiana.
    According to testimony Wednesday, Leiana and her toddler-age older sister have both been living at home with their mother since February 2010.
    After the baby's appearance, Chambersburg Police Detective Sgt. Dianne Kelso, who testified Monday, was called back to the witness stand to provide a rebuttal to statements made by Billups and Rosario during their testimonies Wednesday.
    Both had told the jury that Leiana's older sister, then 2 years old, was taken from them at Chambersburg Hospital on Oct. 19, 2009. They said they went to the police station that evening under the impression that they would get their older daughter back.
    Kelso testified Thursday that she spoke with the couple at the hospital, telling them that the child had been taken as a matter of standard protocol and that it would not be up to police to return her.
    After Kelso stepped down, Billups and Rosario were called back to the stand by the defense. Both said they were told that they would get the girl back after they gave a statement to police. Billups said he was "coerced."
    During cross-examination, Sulcove asked him if he was otherwise reluctant to speak with police because he had "something to hide." His response was heated.
    "Are you serious? Are you serious? No is the answer," Billups said.
    Before he adjourned court shortly before 3 p.m., Meyers instructed the jury to hold off on making any decisions about the case and to refrain from researching any of the complex medical information that had been presented.
    "You need to continue to honor your oath," he said.

    Thursday, 16 December 2010

    SIDS: Sudden Unexpected Death in Infancy and the Dilemma of Defining the Sudden Infant Death Syndrome

    Henry F. Krous
    Departments of Pathology and Pediatrics, UCSD School of Medicine and Rady Children’s Hospital-San Diego, La Jolla
    CA, USA
    Sudden unexpected death in infancy (SUDI) is an umbrella label that some employ to encompass all sudden unexpected infant deaths, whether or not explained, while others restrict its use to cases in which the cause of death is uncertain, but possibly due to asphyxia as may occur, for example, with sleeping prone, face down on a soft sleep surface, and/or being found with the head covered. Since sudden infant death syndrome (SIDS) is a diagnosis of exclusion, there is an inevitable interface between it and those cases whose deaths are potentially caused by unsafe sleep environments. This
    interface is especially blurred given the lack of definitive, easily identifiable postmortem marker(s) for SIDS. Therefore,
    present SIDS definitions are imprecise and its diagnosis remains one of exclusion. Improved death scene investigation has resulted in a diagnostic shift away from SIDS towards other causes of death such as positional asphyxia or undetermined.
    Unfortunately incomplete death scene investigation has hampered evaluation of the real circumstances of death in too many of the cases further contributing to confusion. In this report, the purposes for and primary definitions of SIDS are delineated. Subsequent discussion focuses on the increasing challenge to incorporate risk factors and the underlying
    pathology germane to the pathophysiology of SIDS into future definitions. This challenge is matched by the need to develop affordable and widely available testing that will identify pathology relevant to medical examiners and others
    charged with certifying the cause and manner of death.
    Current Pediatric Reviews,
    Blogger's Comment:
    An important article that analyses some of the abuse and misuse of the unsatisfactory nature of SIDS as a diagnosis.

    SIDS: Missouri: Quintine Schmidt

     December 10, 2010
    The Dexter infant found dead inside his home in October died of sudden infant death syndrome. Quintine Jeffrey Alexander Schmidt, the 6-month-old son of Erik and Candice Schmidt, died Oct. 12 at his residence.
    Dexter Police officers and Stoddard County Ambulance Service personnel responded to the Schmidt residence in the north sector of Dexter after a 911 call was received regarding a baby in cardiac arrest and not breathing. Upon their arrival, the infant was found unresponsive and subsequently was pronounced dead at the scene.
    The Stoddard County Major Case Squad was activated to investigate the infant's death and an autopsy was performed Oct. 14 at Mineral Area Regional Medical Center in Farmington, Mo., by Dr. Russell Deidiker.
    Dexter authorities recently received Deidiker's final autopsy report, which listed Quintine's cause of death as sudden infant death syndrome (SIDS) and his manner of death as natural, said Dexter Police Detective Trevor Pulley.

    SIDS errors: VIRGINIA: Ashkea Johnson

    By Brad Zinn/staff • December 11, 2010
    STAUNTON — A jury deliberated for nearly four hours Friday before convicting Staunton teen Ashkea Johnson on a charge of first-degree murder in the suffocation death of her 2-month-old baby.
    The 12-person jury also found Johnson guilty of attempted second-degree murder, bringing an end to the two-day trial.
    The 18-year-old Johnson, who did not testify, wept softly as the verdicts were read in Staunton Circuit Court.
    Johnson's baby, Rosaleeia Johnson, was lifeless when police and rescue personnel responded to the family's apartment at 337 N. Central Ave. the morning of Nov. 15, 2009, after a 911 call from Johnson.
    The baby died four days later at the University of Virginia Medical Center in Charlottesville after being declared brain-dead and taken off of life support.
    Johnson initially claimed she found her daughter unresponsive in her baby carrier after leaving the child alone for about five minutes.
    But under questioning by Investigator Chad Nestor of the Staunton Police Department, two weeks after the baby died Johnson confessed to smothering the child by placing a plastic diaper bag over her face, and demonstrated how she killed her daughter by using a CPR doll. On Thursday, the jury viewed the entire three-hour interrogation and again watched parts of the tape Friday while in deliberations.
    Assistant public defender David Smith, who in August lost a motion to have the confession thrown out, argued that Johnson was coerced into confessing. On the stand Friday, Nestor admitted he told Johnson she could get less prison time if she came clean about the killing.
    "So misleading is OK?" Smith asked.
    "I believe they call it bluffing," Nestor said of the common police tactic.
    With no forensic evidence to help support a murder charge against Johnson, the death could have fallen under the category of Sudden Infant Death Syndrome, said assistant Staunton prosecutor Anne Reed. She praised Nestor's work and said the state would not have had a case without the confession.

    SIDS: North Carolina: Child death investigation training called basic

    - The Charlotte Observer
    RALEIGH -- The state's top child advocacy task force will urge legislators to require all new police and deputies to take a course in child death investigation as part of basic training, the group voted Monday.
    The task force also decided to support regionalizing the state's medical examiner system, which would place trained investigators across the state to respond to deaths. Because the effort could cost a lot, the group doesn't expect it to happen this year. The proposals were spurred by a Charlotte Observer series this year, "Cradle of Secrets," that looked at five years of sudden infant death syndrome cases in North Carolina. The series detailed that police frequently fail to investigate the deaths thoroughly, if at all.
    The N.C. Child Fatality Task Force outlined its legislative agenda for 2011. The proposals involving child death scene investigation are designed to help gain "a standard for all death scene investigations," Brett Loftis of Charlotte, one task force committee chairman, said Monday. Currently, courses in proper child death investigation techniques are optional for North Carolina law enforcement officers.Many never take the courses; sometimes police don't respond at all to a child's unexplained death. North Carolina also doesn't have full-time trained investigators to send to most infant deaths, but a growing number of jurisdictions nationally do. Child death investigation is important, organizers say, because learning how children die can help the task force and other groups prevent deaths. Task force Chairman Tom Vitaglione said he was hopeful the N.C. Justice Academy, which trains all new officers, would agree to incorporate the plan. But if not, his group would push for a legislative order. The Charlotte Observer series also looked at the problem of safe-sleep education for parents. It found that at least two-thirds of babies who died of sudden infant death syndrome between 2004 and 2008 were sleeping in risky environments that suggested they could have suffocated. Those situations included sleeping with adults on beds or couches, sleeping among pillows and fluffy blankets or just sleeping on their stomachs. Studies have found that infants are more likely to die in these conditions. The Child Fatality Task Force also voted to ask for $150,000 for safe-sleep education in the coming legislative session, which begins in January. The amount is the same as the state spent last year, and that worried some committee members. The task force had talked this year about urging law enforcement statewide to complete optional checklists at child death scenes, which were designed to provide information about the child's sleep position and many other details. But the chief medical examiner's office decided this fall to stop using the Infant/Child Death Investigation Reports after learning they were public documents. The medical examiner's office had believed, and told law enforcement officers, that the information would be confidential. The task force looked at a wide range of proposals involving children's health. The group was created by statute and is among a few task forces that continue their work year after year.

    SIDS: Pennsylvania: co-sleeping

    Officials target infant deaths
    An increase in the number of accidental infant deaths in Lackawanna County has led to a new educational campaign by county and medical officials.
    There have been six infant deaths in the past two years that can be attributed to accidental suffocation while sleeping with an adult and Sudden Infant Death Syndrome, according to District Attorney Andy Jarbola.
    So far this year, three infants have died while sleeping in the same bed as their parents, Lackawanna County Deputy Coroner Tim Rowland said.
    Every child's death is investigated by the county's Child Death Review Team. What the group has found is that many infant deaths could have been avoided if more education were available for parents and caregivers.
    On Wednesday, the team launched what it is calling the Safe Sleep Initiative, wherein educational information will be distributed at doctors' offices and hospitals and through brochures, posters, billboards and public service announcements.
    Having a child die in this way "is one of the worst things that could happen to a parent," said Jeanne Rosencrance, project director for the Child Death Review Team. "There's a tremendous guilt on the part of the parent."
    When adults share a sleeping space with infants, they could unknowingly roll over onto the child, cutting off his or her oxygen supply, according to Dr. Stanley Blondek, director of pediatrics and newborn services at Moses Taylor Hospital. The child also could become wedged into small spaces between the wall and the mattress or next to the headboard, officials said.
    Parents also could fall asleep while holding or nursing an infant, dropping or accidentally suffocating the child, Mrs. Rosencrance said.
    There have been several cases of SIDS in the past few years, too. SIDS is a term used to describe a sudden and unexplained death of a baby, usually between 1 month and 1 year old.
    Experts say the best way to avoid SIDS is to place infants on their backs when putting them down to sleep. But many caregivers are not aware that babies should sleep on their backs, Dr. Blondek said.
    Mr. Jarbola said new parents still need to be educated on the proper way to put an infant down in the crib - on his or her back and without any toys, blankets or pillows.
    "Nothing but a baby should be in the crib," he said. "That's the message we're carrying."
    Contact the writer: enissley@timesshamrock.com

    SBS: British Columbia: Avtar Basi

     LOUISE DICKSON,  December 11, 2010  
    A Victoria provincial court judge will decide in January whether Avtar Basi violently shook an 11-week-old baby girl in frustration or whether her devastating injuries were caused by his misguided attempt to resuscitate her.
    Basi, 33, is charged with the aggravated assault of Baby E on Nov. 26, 2008 in the Central Saanich foster home run by his girlfriend, Micheline Slader.
    The trial, which began in September, continued Wednesday with final submissions by Crown prosecutor Nils Jensen and defence lawyer John Green. Towards the end, Basi started to cry. Slader sat behind, patting him on the back.
    The evidence clearly established that Basi applied force to Baby E and caused the injuries that resulted in her troubling, sad and permanent disability, Green told Judge Adrian Brooks. But in order to convict Basi, the court must be satisfied beyond a reasonable doubt that the force he used on Baby E was not done for the purpose of caring for her. The court must also be satisfied that excessive force was used, said Green.
    At trial, Basi testified that, on the morning of Nov. 26, the baby went limp and, in a panicked reaction, he shook her three times.
    “If you accept what Mr. Basi told you, he must be acquitted,” said Green. “This was a resuscitative attempt rather than anger.”
    Green reviewed the evidence of medical experts including Dr. Katherine Wambera, who testified about breath-holding episodes. The spells, which are more common in toddlers and might affect about three out of 1,000 infants, are marked by a period of loud crying, followed by a period of 15 to 30 seconds when the baby cannot get his or her breath. Wambera said she would not be surprised by a fearful reaction by an inexperienced caregiver witnessing a breath-holding spell.
    Green also reminded the court that infants are physically frail, with their large heads and weak neck muscles.
    “You can get significant injury without application of a great deal of force,” said Green. “Not very much force for an adult translates into a lot of force for an infant.”
    Both Basi and Slader liked the baby and wanted to adopt her, Green said. Baby E had no annoying or frustrating behaviour. There was no hint of abuse.
    “There is simply nothing before you to suggest this man would explosively go off and injure this infant,” said Green. “This shaking occurred in a disastrous, tragic resuscitation attempt.”
    Jensen reminded the court that Baby E suffered a life-threatening traumatic brain injuries which destroyed half her brain. Basi knew that shaking could harm a baby, Jensen said.
    “Ms. Slader confirmed that he handled her appropriately by holding the back of her head when picking her up,” he said.
    At trial, three medical experts testified that any reasonable observer who witnessed the shaking of Baby E would know it would cause death or bodily harm, Jensen said.
    He urged Brooks to reject Basi’s evidence that he tried to resuscitate Baby E because she stopped breathing.
    “The baby stopped breathing because of the shaking, not before the shaking,” argued Jensen.
    Nothing was troubling this child, the prosecutor said. She was a perfectly healthy baby and it is very rare for a baby younger than six months to experience breath-holding spells.
    On the other hand, Baby E’s cessation of breathing is completely consistent with very violent shaking. It is clear from the evidence, the more violent the shaking, the more quickly the symptoms of severe head trauma appear, Jensen said.
    In court and in conversation with an undercover officer who befriended him, Basi minimized how hard he shook the infant, Jensen said. Even defence witness, Dr. Charles Ferguson, director of the Child Protection Centre at the Winnipeg Children’s Hospital, who watched five videos clips of Basi demonstrating how hard he shook Baby E, said it was unlikely such shaking would result in any injury.
    Jensen also observed that Basi did not tell anyone including the dispatcher, Slader, paramedics, doctors or police that he tried to revive Baby E.
    Eventually, he told the undercover officer he shook the baby out of frustration.
    “When he finally confessed, it was accompanied by heartfelt tears and remorse because it was the truth,” Jensen said.