Ed Meyer , Apr 04, 2011
Aaliyah Ali, age 23 mos.
The Summit County case of a 20-year-old baby sitter accused of murdering a toddler is being challenged in a new report.
An expert for the defense asserts that blunt impact to the little girl's head ''did not cause her death'' and was of such a nature that ''she could have recovered.''
Accidental death cannot be ruled out, the report concluded.
The forensic report by Ronald H. Uscinski, a neurosurgeon on the faculties of Georgetown University Hospital and George Washington University Medical Center in Maryland, was filed in Common Pleas Court for the upcoming trial of Tiffani D. Calise of Green.
And by the court's own admission, it could carry considerable weight in the determination of innocence or guilt. Uscinski has garnered headlines for past testimony on behalf of defendants in shaken-baby cases.
Judge Alison McCarty addressed the importance of forensic analysis of the toddler's injuries when the two sides met in a pretrial hearing last November, saying this is a case in which ''medical testimony is going to be rather crucial.''
Calise is to go to trial April 11 on charges of murder, involuntary manslaughter and two counts of child endangering.
Evidence not in dispute shows she was caring for two children at her Mayfair Road apartment — her 34-month-old daughter and a 23-month-old, Aaliyah Ali — when Aaliyah suffered a head injury late in the evening of Aug. 9.
Calise, who had been baby-sitting the children for two days over the weekend, told sheriff's deputies and family members she gave Aaliyah a bath and left her alone in a nearly empty tub for only moments to retrieve a towel.
While she was away, Calise said, she heard a thud and returned to find Aaliyah unconscious.
According to the autopsy's Report of Investigation, Calise called 911 and tried to administer CPR, following the dispatcher's instructions.
A Green emergency squad arrived at the apartment nine minutes later, at 11:52 p.m, and found Aaliyah unresponsive.
Aaliyah was face up on the living room floor ''with a small amount of vomit on the floor next to her,'' a medical examiner's investigator, Michael McGill, said in his report.
Some 30 minutes later, Aaliyah arrived at Akron Children's Hospital. Emergency room personnel tried unsuccessfully at 12:31 a.m. to insert a breathing tube.
Hospital reports stated that doctors found a bread-like substance obstructing Aaliyah's airway, removed it and inserted the breathing tube in a second attempt two minutes later.
Brain scans showed bleeding had occurred in the right side of the brain. Aaliyah did not improve and was pronounced dead at 1:57 a.m. Aug. 12.
That is where the medical dispute begins, and why the court agreed to pay for a forensic expert for the defense.
The Summit County Prosecutor's Office has declined to comment about the case, saying any comment could jeopardize the fairness of trial proceedings or the selection of the jury.
But from subpoenas it appears that much of the prosecution case has been built around forensic evidence from the Summit County autopsy report; the testimony of the forensic pathologist who performed the autopsy, Deputy Medical Examiner Dorothy E. Dean; and the testimony of Dr. R. Daryl Steiner, who heads the Children's Hospital child abuse center.
In Dean's autopsy report, she said that Aaliyah died from ''complications of blunt impact(s) to the head.''
Dean's ruling on manner of death was ''homicide, assaulted by another person(s).''
The ''Opinion'' section of the report contained Dean's observation that Aaliyah died ''from the severe injuries to her brain that she sustained during the assault.''
According to Dean, those injuries included internal pressure on the brain; bleeding between the brain and skull layer; optic nerve and retinal bleeding; bleeding of the right-side gel in the eye; and oxygen deprivation in the brain.
As he has done in numerous Summit County cases during the past three decades, Steiner is expected to testify that Aaliyah died from brain injuries in a case of shaken baby syndrome.
The forensic report by the defense expert, Uscinski, who has more than 40 years of experience in neurosurgery, is expected to counter those findings.
Attorney William T. Whitaker, co-defense counsel for Calise, said it would be inappropriate for Uscinski to comment about his findings before the trial.
But in Uscinski's forensic report, filed March 21 in the court record, he said Aaliyah suffered a ''subdural hematoma'' — the term for collection of blood on the brain's surface — ''not inconsistent with the reported fall in the bathtub.''
''The right-sided subdural hematoma is not large and the impact that resulted in the subdural hemorrhage [bleeding] did not cause her death and was an injury from which she could have recovered,'' Uscinski's report stated.
Uscinski noted that vomiting is one of the ''common effects of a head injury resulting from an impact of this nature.''
He said the breadlike substance found in Aaliyah's throat ''would serve to obstruct her airway and resulted in an interruption in Aaliyah's ability to breathe, and this resulted in lack of oxygen to the brain.''
Uscinski also noted that the brain has ''an absolute metabolical requirement for oxygen,'' and that after about four minutes of complete oxygen deprivation, brain cells begin to die.
The breadlike substance was removed from Aaliyah's throat ''some 30 or more minutes'' after she began vomiting, Uscinski said.
Results of the hospital CT scans were consistent with brain-cell death from oxygen deprivation caused by the obstruction ''to the airway of this baby,'' Uscinski wrote.
A nonaccidental injury such as abuse or assault, as noted in Aaliyah's Summit County autopsy, ''is a diagnosis that is only arrived at after ruling out all other reasonable possibilities.''
''In this case,'' Uscinski concluded, ''I do not believe other reasonable possibilities including accidental injury have been ruled out. Therefore, I do not believe there is any basis upon which to conclude that Aaliyah Ali's death was caused by the intentional infliction of trauma by Tiffani Calise or by anyone else.''
Whitaker, Calise's lawyer, won a case in juvenile court several years ago by challenging Summit County autopsy findings and Steiner's shaken-baby testimony.
The forensic expert in Whitaker's juvenile case also was Uscinski.