SIDS: Hypoxia, Long QT interval and Sudden Infant Death Syndrome (SIDS)

Marianne T. Neary, 

Timothy J. Mohun and 

Ross A. Breckenridge*

+Author Affiliations

1. MRC NIMR, London, UK

1. ↵*Author for correspondence (rbrecke@nimr.mrc.ac.uk)

Summary

The pathology of Sudden Infant Death Syndrome (SIDS) is poorly understood. Many risk factors, including hypoxia, have been identified. Prolongation of the ECG QTc interval is associated with elevated risk of SIDS but its aetiology in most cases remains unknown. We characterised electrocardiographic changes in the newborn mouse in the hours and days following birth. There was a steady increase in heart rate alongside significant decreases in QTc interval, QRS duration and QTc dispersion over the first 10 postnatal days. Birth into hypoxia (10% FiO₂) prevented electrocardiac maturation, downregulated cardiac ion-channel expression and led to neonatal death. We found that risk of death decreased with increasing age of exposure to hypoxia. Genetic elevation of cardiac hypoxia-signalling after birth in αMHC-Cre::VHL^fl/fl mice also prevented electrocardiographic maturation, leading to arrhythmia and death before weaning. Immunohistochemistry and western blotting revealed internalisation and dephosphorylation of Connexin43. We conclude that increased ambient oxygen concentration after birth drives maturation of the cardiac electrical conduction system, failure of which leads to aberrant ion channel and Cx43 expression and predisposes to arrhythmia and sudden death. This is consistent with known risk factors of SIDS and provides a link between neonatal hypoxia, ECG abnormalities and sudden death.

SIDS: Death sparks warning for child car seats

The safety of children is paramount when they are riding in a vehicle, as there’s no way of predicting an accident. This is why child seats were invented. However, there are also safety concerns about children staying in their car seats for too long, according to Which? and the death of a four-month-old girl from Derbyshire.

Lily Aiken died from natural causes after she slept in her child seat indoors over a long period of time. The girl’s parents said that she slept in the seat on a regular basis because they couldn’t get her to settle down in her carrycot. Sometimes she would even sleep in the child seat overnight. According to the postmortem examination, nothing was found that could explain why Lily died. The cause was concluded as Sudden Infant Death Syndrome (SIDS), which can be the result of sleeping in unsafe positions. There are several other factors that can cause SIDS.

Although a direct link wasn’t found between this death and sleeping in a child seat, medical studies have found that oxygen saturation levels are lower when kids are in car seats due their air passages being restricted. The research has found that average oxygen saturation levels fall to 95.7% when children are in a child seat for one hour. However, when they are in a cot, the average falls to 97.9%. The lowest average level was found at 83.6%.

Physicians say that these levels aren’t an immediate risk, but they are good reasons of why children shouldn’t be left in car seats for any purpose other than travel. Victoria Pearson, the child car seat expert for Which?, says that parents shouldn’t use child seats for extended periods or to replace cots. However, they should always be used when the child is travelling in a vehicle.

Aside from this advice, Which? has called on parents to take just ten minutes and ensure that their child’s car seat is well fitted in their vehicle. The consumer group spent the day with Portsmouth City Council road safety experts helping parents ensure the correct fit of their child’s car seats. They found that nearly two-thirds of the 40 seats checked had been incorrectly installed, with only 35% being fitted correctly. Several of the parents who had their child seats checked had purchased second-hand seats. Which?, however, advises that new ones are bought, giving parents the best chance of getting a car seat that complies with the most recent standards for safety.

The Royal Society for the Prevention of Accidents (Rospa) has reported that about 15 children aged 11 and under are killed every year while riding in a car. About 225 are seriously injured, and over 5,000 are slightly injured as well. Children are safest in cars when they sit in a child seat that’s suitable for their size and weight.

Pearson says there are so many ways child seats can be installed, and parents face struggling about which one to buy that will be right for their vehicle and child. Many were close at fitting them correctly, but they made small mistakes that meant nearly two-thirds of the seats they inspected weren’t fitted correctly. This could affect how well a child is protected in the event of a car accident. They urge every parent to make themselves familiar with how to install child seats and spend ten minutes checking how well its fitted.

SIDS: Gene affecting breathing may be linked to 'cot death'

10 September 2012

By Dr Zara Mahmoud

Appeared in BioNews 672

US researchers have identified the gene, Atoh1, as vital in mice for their ability to recognise dangerous levels of carbon dioxide in the bloodstream. This study may provide clues to the genes involved in neonatal Sudden Infant Death Syndrome (SIDS) in humans, also known as cot death.
Professor Huda Zoghbi of the Baylor College of Medicine, Texas, USA, who led the study said: 'The death of mice [lacking Atoh1] at birth clued us in that Atoh1 must be needed for the function of some neurons critical for neonatal breathing, so we set out to define these neurons'.
The findings, published in the journal Neuron, showed deletion of the gene Atoh1 in mice from a subset of neurons called the retrotrapezoid nucleus (RTN) neurons, results in an impaired response to levels of carbon dioxide in the blood.
'This population of neurons resides in the ventral brainstem. When there is a change in the makeup of the blood, lack of oxygen or build-up of carbon dioxide, the RTN neurons sense that and tell the body to change the way it breathes', said Mr Wei-Hsiang Huang, a graduate student working on the project with Professor Zoghbi.
RTN neurons, located in the posterior part of the brain called the brainstem, respond to high carbon dioxide levels by sending a message to the respiratory centre of the brain. This triggers an increase in the rate of ventilation, which helps to flush out the excess carbon dioxide and increase levels of oxygen in the blood.
Using gene knockout studies in mice, researchers removed the Atoh gene in increasingly narrow regions of the brain, until they eventually identified the subset of neurons that had the most pronounced effect on the survival rates of young mice. Almost 50 percent of young mice born without the Atoh1 gene in their RTN neurons died at birth.
Their research showed that the protein produced by the Atoh 1 gene was vital in helping the RTN neurons orient themselves in the brainstem during early development. This is critical to establishing a link with a part of the brainstem known as pre-Bötzinger complex (preBötC), which is responsible for establishing a breathing rhythm in response to fluctuating levels of oxygen and carbon dioxide in the blood, to ensure tissues receive sufficient oxygen.
'Without Atoh1 the mice have significant breathing problems because they do not automatically adjust their breathing to decrease carbon dioxide and oxygenate the blood', said Mr Huang.
Another recent study, led by Professor Lavezzi at the Lino University of Milan, Italy, investigating neonatal and prenatal infant deaths found defective RTN neurons in 71 percent of infants that died either of SIDS or sudden intrauterine unexplained death. These two studies, in combination, may offer insights to the genetic factors responsible for SIDS.

SIDS: Healthy tot died from cot death, inquest is told

Tuesday, September 11, 2012

Derby Telegraph

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A 10-MONTH-OLD girl who was found "unresponsive" in her cot died from sudden infant death syndrome, an inquest has heard.

Charlotte Newman was described as a "well-nourished and well-cared for" baby during the hearing yesterday at Derby and South Derbyshire Coroner's Court.

1. ​
   Little Charlotte was taken to Royal Derby Hospital

The inquest heard she had been well when she was put to bed in April this year but she could not be roused the next morning and paramedics were called.

Charlotte, of Derby Road, Duffield, was taken to Royal Derby Hospital but later pronounced dead.

The inquest was told that paramedics had arrived promptly and Charlotte got to the hospital 19 minutes after the 999 call was made.

Deputy coroner Louise Pinder said: "The family have indicated they are extremely grateful to the paramedics for everything they did."

The inquest also heard that Charlotte had previously had chicken pox but a post-mortem examination confirmed this had not contributed to her death.

Pathologist Dr Mudher Al-Adnani, who carried out the examination at Sheffield Children's Hospital, said the cause of Charlotte's death was sudden infant death syndrome – also known as cot death. This is defined as a sudden and unexplained death.

Ms Pinder recorded a verdict of death by natural causes.

SIDS: Cot death babies may lack vital protein which helps them to breathe

• At least 300 babies die suddenly and unexpectedly every year
• Scientists have pinpointed a gene that meant young mice were more likely to struggle with oxygen intake - they think the same effect could occur in humans

By DAILY MAIL REPORTER

PUBLISHED: 16:05 GMT, 6 September 2012 | UPDATED: 07:02 GMT, 7 September 2012

Cot death babies may lack a vital protein that helps them to breathe, according to new research.

Experiments on mice found those without a vital gene struggled with their oxygen intake, with one in two dying at birth.

Survivors were less likely to respond to excess levels of carbon dioxide as adults, according to the finding published online in the journal Neuron.

Researchers believe the same may apply to humans and, if so, could lead to a genetic test to identify those most at risk of cot death, also known as Sudden Infant Death Syndrome (SIDS).

Babies should be placed on their backs with their feet at the bottom of the cot as a safety precaution

A recent study of cot death victims also found abnormalities in exactly the same set of neurons.

The syndrome claims the lives of at least eight babies in Britain each week and is the main cause of death in babies more than a month old.

It was already known mice without the master gene Atoh1 struggle in their breathing. So neuroscientist Dr Huda Zoghbi and colleagues set out to explain the reason in a bid to look for clues in the cause of cot death.

They demonstrated that when the gene is absent in neurons called RTN (retrotrapezoid nucleus), roughly half young mice die at birth. 

Dr Zoghbi, of the Baylor College of Medicine, Houston, said: 'The death of mice at birth clued us in that Atoh1 must be needed for the function of some neurons critical for neonatal breathing, so we set out to define these neurons.'

The syndrome is most likely to strike when a baby is 13 weeks old, but the risk drops dramatically after six months of age. Deaths can occur anywhere - in cots, prams, cars, beds or a parent’s arms.

Wei-Hsiang Huang, who works in Dr Zoghbi’s laboratory, said: 'We took a genetic approach to find the critical neurons.'

With careful studies to ‘knockout’ the activity of the gene in a narrower and narrower area in the brain, they slowly eliminated possible neurons to determine loss of Atoh1 in the RTN neurons was the source of the problem.

Dr Zoghbi said: 'Discovering Atoh1 is indeed critical for the RTN neurons to take their right place in the brainstem and connect with the breathing centre helped us uncover why they are important for neonatal breathing.'

Mr Huang said: 'This population of neurons resides in the ventral brainstem. When there is a change in the makeup of the blood, lack of oxygen or build-up of carbon dioxide, the RTN neurons sense that and tell the body to change the way it breathes.'

A defect in these neurons can disrupt this response. He said: 'Without Atoh1 the mice have significant breathing problems because they do not automatically adjust their breathing to decrease carbon dioxide and oxygenate the blood.'

And it turns out the findings from this mouse study are relevant to human research.

Mr Huang added: 'A paper just published reports developmental abnormalities in the RTN neurons of children with sudden infant death syndrome or sudden unexplained intrauterine death may be linked to altered ventilatory response to carbon dioxide.'

Read more: http://www.dailymail.co.uk/health/article-2199329/Cot-death-babies-lack-vital-protein-helps-breathe.html#ixzz273RdKdjU
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SIDS: Lack of Atoh1 master gene can lead to sudden infant death syndrome

Published on September 7, 2012 at 4:24 AM 
When mice are born lacking the master gene Atoh1, none breathe well and all die in the newborn period. Why and how this occurs could provide new answers about sudden infant death syndrome (SIDS), but the solution has remained elusive until now.

Research led by Baylor College of Medicine and the Jan and Dan Duncan Neurological Research Institute at Texas Children's Hospital demonstrates that when the gene is lacking in a special population of neurons called RTN (retrotrapezoid nucleus), roughly half the young mice die at birth. Those who survive are less likely to respond to excess levels of carbon dioxide as adults. A report of their work appears online in the journalNeuron.
"The death of mice at birth clued us in that Atoh1 must be needed for the function of some neurons critical for neonatal breathing, so we set out to define these neurons," said Dr. Huda Zoghbi, senior author of the report and director of the Neurological Research Institute and a professor of molecular and human genetics, neuroscience, neurology and pediatrics at BCM. Zoghbi is also a Howard Hughes Medical Institute investigator.
"We took a genetic approach to find the critical neurons," said Wei-Hsiang Huang, a graduate student in the Program in Developmental Biology at BCM who works in Zoghbi's laboratory. With careful studies to "knockout" the activity of the gene in a narrower and narrower area in the brain, they slowly eliminated possible neurons to determine that loss of Atoh1 in the RTN neurons was the source of the problem.
"Discovering that Atoh1 is indeed critical for the RTN neurons to take their right place in the brainstem and connect with the breathing center helped us uncover why they are important for neonatal breathing," said Zoghbi.

SIDS: New Zealand Infant death cause not determined

By Hana Garrett-Walker on Tue, 11 Sep 2012

News: National

The sleeping arrangements of a six-week-old infant were dangerous, but a coroner has been unable to pinpoint exactly what caused her death.

Coroner Garry Evans today released his findings into the death of Majesty Toki, who could not be revived after falling asleep while breastfeeding on her mother in their Porirua home last October.

Majesty's mother Tewinia Toki often breastfed the baby about 6am before the pair fell asleep on her bed for another two hours, Coroner Evans heard.

In the days before Majesty's death she developed a cough and was taken to her family doctor, but the doctor concluded she was well.

On the morning on October 25 Majesty woke about 4am or 5am and Ms Toki breastfed her for about half an hour.

Ms Toki fell asleep while Majesty was feeding but woke when she finished. She then latched Majesty back on to her breast before falling asleep again.

At 7.30am Ms Toki woke and let her sister into the house, with Majesty still in the position she had fallen asleep in.

The electric blanket was on and Majesty was wrapped in her own fleece blanket, with Ms Toki's own two duvets also covering her, Coroner Evans said.

Ms Toki woke and left the room again. When she returned five minutes she noticed Majesty was still in the same position.

Ms Toki picked her up and was unable to revive her.

A post-mortem examination by Jane Zuccollo found Majesty's cause of death was sudden and unexpected. Factors included possible thermal stress associated with flu, sleeping with an adult and having the electric blanket turned on, and mild dehydration.

"As stated by Dr Zuccollo this is a complex case," Coroner Evans found. "It is not possible to be exact in causal terms."

Coroner Evans said Majesty's sleeping environment was unsafe but noted she was well loved and very well cared for and her parents were not neglectful.

"They were simply unaware of the risks in the environment in which majesty was put down to sleep before she died."

Last week a coroner's report into the death of 10-week-old Rakaua Rawhira Rongen concluded that he died of sudden infant death syndrome while sharing his parents' bed last October.

Rakaua was put to sleep in his parents' bed, but was unable to be revived the next morning.

Coroner David Crerar recommended the Ministry of Health should "strengthen and broaden" advice around infant care practices and safe sleeping environments. He hoped publicity about the risks would help reduce similar deaths.

Coroner Evans did not make any specific recommendations in today's report.

In late August Chief Coroner Neil Maclean issued a report into sudden infant deaths and found there had been 163 cases in five years.

In another 30 cases a coroner found that babies died from asphyxiation while sleeping on their stomach or in bed with someone else.

SIDS: Illinois State register

Department of Public Health: Sudden Infant Death Syndrome Case Management Files, 1982-2002 | Illinois State Archives

Title: Department of Public Health: Sudden Infant Death Syndrome Case Management Files, 1982-2002

ID: 205/022

Extent: 47.0 Cubic Feet

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Scope and Contents: Files document the department's investigation of instances of suspected sudden infant death syndrome statewide.  Each file includes the name of the deceased infant, names and addresses of parents, the county where the death occurred, a narrative of the circumstances surrounding the infant's death, and a case number.  Variously included are copies of birth and death certificates; coroner's, medical examiner's, or forensic pathologist's reports; prehospital care or ambulance reports; inquest reports; departmental investigation report forms; and related correspondence and memoranda among investigators and with patients.

SIDS: ? gene related

Christi Myers
More: Bio, Facebook, News Team

HOUSTON (KTRK) -- Some Houston researchers have made an important discovery. Their finding may someday help predict which babies are at risk for sudden infant death syndrome.

RelWhen a baby dies of sudden infant death syndrome, it's tragic for the family, and even the doctors who can't explain why. Texas Children's Hospital Dr. Barbara West has worked with many families who have lost a baby to SIDS.

"If this could ever lead to some way to identify ahead of time babies with a special increased risk that would be enormous," Dr. West said.
And today, Houston researchers are one step closer to predicting which baby might die of SIDS. Dr. Huda Zoghbi and a team of Baylor and Texas Children's researchers have discovered that babies who die of SIDS may be missing brain cells carrying genes that remind newborns to breathe.
"This gene is important to migrate and take the right place in the brain stem so they can make connections in the right place to generate breathing rhythm. If they don't make that connection, that generator is not working well so babies don't take a breath," Dr. Zoghbi said.
Their discovery, featured in "Neuron," a prestigious medical journal, could help predict newborns at risk.
Researchers are hoping that someday they'll be able to test every baby to see if they're at risk for SIDS, and those families will know to be extra vigilant in the first six months of life.
Dr. Zoghbi says they have much work to do but when they are certain they've found the major genes that lead to SIDS, she says making a test for newborns will be easy.
"Once you find the gene and you think this gene is really important for a function, it's really easy to get DNA and do a blood test," she said.
Developing a blood test to predict SIDS was unimaginable just a decade ago.
For now, doctors still recommend that babies sleep on their back until they're one year old.

SIDS: 14 COT DEATHS IN COUNTY IN SIX YEARS

By Chris Story

Published at 10:53, Saturday, 15 September 2012

COT death is continuing to claim young lives in Cumbria.

Latest figures show there were 14 unexplained infant deaths in the county between 2004 and 2010.

Office for National Statistics research shows the north west had the highest rates for such deaths in England during 2010.

Cot death – Sudden Infant Death Syndrome (SIDS) – is the sudden unexpected death of an apparently well infant. Its exact cause is not known, but it is more common in babies with a low birth weight or in those born prematurely.

Health chiefs in the county are urging parents to take steps to reduce the risk of their newborns falling victim.

Dr Rebecca Wagstaff, the county’s deputy director of public health, said: “Cot death is a sad event which is very traumatic for parents and families. Although we don’t know the exact reasons why it affects some babies and not others, there are steps parents can take to protect their children.

“One of the most important steps which parents or potential parents can take is to avoid smoking around their baby or unborn child because of the long term damage it can cause and the heightened risk of cot death.”

Steps to reduce the risk include:

Place your baby on its back to sleep.

For the first six months place the baby’s cot in the same room as you sleep in.

Do not smoke while pregnant.

Do not let anyone smoke in the same room as your baby.

Do not share a bed with your baby, especially if you’ve been smoking, drinking or taking drugs.

Never sleep with your baby in an arm chair or on a sofa.

Do not let your baby get too hot.

Use sheets and thin blankets in your baby’s cot and don’t use duvets or pillows.

Tuck the baby’s blanket firmly around them no higher than their shoulders.

Do not cover the baby’s head.

Place your baby in the feet to foot position, with their feet at the end of the cot or pram.

At five or six months old, babies will start rolling over by themselves, but the risk of cot death dramatically reduces at this age.

Help on stopping smoking is available by 01900 324222, texting QUIT to 82540 or by visiting a pharmacy.

Published by http://www.newsandstar.co.uk

SBS: Alfonso Tapia-Lopez sentenced

Jeff Weiner, Orlando Sentinel

5:29 p.m. EST, August 10, 2012

A man accused of fatally injuring his 8-week-old son in 2010 was sentenced to more than two decades in prison on Friday.

Alfonso Tapia-Lopez, 31, pleaded no contest to second-degree murder last month. Investigators said his son, Alfonso Angelo Tapia, suffered brain injuries consistent with shaken-baby syndrome while in Tapia-Lopez's care in October 2010.

SBS: Stephanie Spurgeon sentenced

FILE, POOL PHOTO

An infant who attended Stephanie Spurgeon's day care for one day was found to be lethargic, and later died.

Related

• 
  Babysitter convicted
• 
  Attorneys: State withheld evidence

By TBO.COM | Staff 
Published: August 20, 2012
Updated: August 20, 2012 - 5:12 PM

» 7 Comments | Post a Comment

A former Palm Harbor home day care provider was sentenced today to 15 years in prison in the death of a baby in her care. Stephanie Spurgeon was found guilty of manslaughter in February.

Spurgeon ran a daycare out of her home in the Deep Spring subdivision. On Aug. 1, 2008, the grandmother of 1-year-old Maria Harris picked her up after her first day at the home, to find Harris limp and not acting normally.

Maria died soon after.

Through tears, grandmother Pat Harris said: "I loved that baby so much. I would've gladly died in her place."

Judge Cynthia Newton said the jury spent almost 24 hours deliberating on this case. "That's longer than any other trial I've had," she said.

"Considering all the circumstances and testimony, the only just sentence in this case would be the 15-year maximum."

During the trial, medical evidence about "shaken baby syndrome" was presented. The prosecution presented doctors that testified Maria Harris had been thrown onto a bed or shaken very hard.

Spurgeon's defense team countered that nobody saw their client hurt the child, and the infant's injuries could have happened long before being dropped off at the day care center.

SBS: Kelly M Kline trial

By Nick Sabo

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A fall, and not shaken baby syndrome, led to the death of a 15-month-old Wooster girl, a defense attorney said Monday, Sept. 17.

At the start of a jury trial charging Kelly M. Kline, 34, of 4599 S. Firestone Road, Shreve, with murder, defense attorney John Johnson Jr. said toddler Ella Young’s death March 29, 2011, was caused by an injury that started with a fall at home that got progressively worse.

Wayne County Assistant Prosecuting Attorney John Williams said Kline caused Ella Young’s death by violently shaking her, causing injuries consistent with shaken baby syndrome.

Johnson and Williams said they will both provide medical testimony through the course of the jury trial. Williams said doctors at Akron Children’s Hospital and the Summit County coroner’s office will show that Ella’s injuries could only have happened in a short period of time.

“Kline was the only adult in the home from 8:30 a.m. til everything broke loose,” Williams said. Williams continued to state that Ella’s injuries were of the kind that develop symptoms immediately and “are noticeable.”

Johnson said testimony from forensic pathologist John Plunkett will show that Ella died from a head injury causing progressive swelling on the brain that came to a critical state March 28.

“Kelly Kline is no murderer,” Johnson said. “But this 34 year old mother of three is on trial because she happened to be the unfortunate last person to be with Ella Young when she had her final, respiratory collapse.”

Ella’s mother, Michelle Young, testified Monday that she hired Kelly Kline as a baby sitter for Ella and her second child, Ethan, in August 2010. In March 2011, Ella and Ethan were being watched in Kline’s home while Michelle was at work in her job as a first-grade elementary school teacher for Wooster Township Elementary.

Michelle Young said that Ella fell down the lower level stairs of their split level home March 22, 2011. Michelle Young said she checked Ella for injuries and looked into Ella’s eyes with a flashlight to see if her pupils were dilating. After the fall, Ella “was fine,” Michelle Young said.

The next morning, Michelle Young took Ella and Ethan to Kelly Kline’s house. Michelle asked Kline if she was working with Ella on how to go down stairs, and Kline said she would work on it with her. When Michelle Young picked Ella and Ethan up later that day, she noticed a small mark on Ella’s forehead. Michelle Young testified that Kline said Ella had gotten frustrated learning stairs, and “slammed her head on the steps” in a tantrum.

The next day, March 24, when Michelle Young picked up Ella from Kline’s after school, Kline said Ella had vomited seven times.

Michelle called off work for the next day and stayed home with Ella. Ella was sick after eating breakfast but ate lunch “and kept it down,” Michelle Young said.

Michelle Young said Ella’s behavior was normal through the weekend. Ella woke earlier than usual Monday, March 28, and Michelle Young told Kline that morning that Ella might need an early nap.

Kline called Michelle Young at school at approximately 12:30. Kline said she could not wake Ella after Ella laid down to take a nap. Kline asked if she should call 9-1-1, Michelle Young said.

“I asked her, if this was your child, would you, and she said yes,” Michelle Young said. “I told her call 9-1-1, I’m coming right over.”

Michelle Young said she arrived just as New Pittsburg emergency medical personnel were getting ready to transport Ella to the hospital. Ella was flown to Akron Children’s Hospital by medical helicopter. She died there at 12:10 a.m. March 29.

Michelle Young testified that a physician told her Ella’s death was likely caused by “unaccidental traumatic brain injury that occurred between the time I dropped her off at Kelly’s” and the 12:30 p.m. phone call.

Williams played a phone message left at 12:16 p.m. March 28 on Michelle Young’s home answering machine. The person in the brief call identifies herself as Kelly and asks Michelle to “give me a call after you get this.” The call was placed approximately 14 minutes before Kline called Michelle Young at school, Williams said.

New Pittsburg EMS Chief Brad Stull was the first to respond to Kline’s residence when she called 9-1-1 at approximately 12:35 p.m. Stull testified that Ella was lying on her back on the living room floor, unresponsive, with fluid in her nose and throat. Stull said he was met at the door by a woman talking into a phone and carrying a small child. Stull identified her as the baby sitter, and said he could not be sure if Kelly Kline was the person who met him at the door.

Stull said he used a bulb syringe provided by the baby sitter to clear Ella’s nose and throat of fluid. He contacted other EMS personnel and carried Ella out in his arms to the ambulance as soon as it arrived.

New Pittsburg EMT/paramedic Scott Martin said Ella was breathing six times per minute and she appeared to be a “critical patient.” Martin described the squad run as a “load and go,” with Ella being examined and treated in the ambulance en route to Wooster Community Hospital.

Stull and Martin testified that Ella had no visible injuries.

Ella was visited at Michelle Young’s residence by her father, Jason Young, March 24, and her maternal grandparents, Linda and Donald Baney, March 27. Jason Young and the Baney’s testified Monday that Ella seemed normal both days.

Kline is further charged with involuntary manslaughter, two counts of endangering children and two counts of assault.

The trial is expected to continue through Wednesday.

Published: September 18, 2012

SBS: Jennifer del Prete

A Letter to the Editor

SPOTLIGHT ON SHAKEN-BABY SYNDROME

The sister of convicted home daycare worker Jennifer Del Prete sent this note to the Medill Innocence Project. Del Prete has been incarcerated since 2005 for allegedly shaking an infant, resulting in her death nearly a year later. We have been investigating Del Prete’s case since March, and filed motions in federal court in August to access medical records in the case.

Published: Sept. 19, 2012

I want to extend my gratitude to all students and professors involved in this project. This is an amazing thing that you are doing offering more resources and expertise to the falsely accused and their families. We feel so lost, so helpless to fight for my sister Jenni’s freedom. The legal system is so complicated and so extensively and horrifically turned its back on us in my sister’s case. My eyes are blurry with tears because I am so happy and thankful that you took so much time and care to investigate her case. On behalf of my whole family and all her supporters we thank you for doing such great work to find the facts. You are so brave to push the limits with your access and use all your rights and freedoms to find justice for all.

I encourage you to continue your good work for not only my sister Jenni but all potentially wrongfully convicted victims. I look forward to reading and hearing more of your work on her case as you access medical evidence. I am so impressed with the experts you have spoken with already.

My sincerest gratitude,

Summer Neal