Thursday, 13 September 2012

SBS: Taos jurors dismiss ‘shaken baby’ case amid medical skepticism

Posted: Monday, September 10, 2012 12:00 am | Updated: 3:17 pm, Thu Sep 6, 2012.
A Questa man is free after grand jurors chose not to indict him late last month on charges of child abuse amid doctors’ accusations that he shook his infant son in May.
Damian Stow, 19, has been cleared of the single child abuse charge that kept him imprisoned for two months while the Eighth Judicial District presented its case to grand jury Aug. 23.
While grand jury records are sealed from the public, The Taos News spoke with Stow’s attorney, John Day, who called emergency medicine physician Steven Gabaeff as an expert during the proceedings. Gabaeff is an outspoken skeptic of Shaken Baby Syndrome.
“In recent years, the whole shaken baby theory has come under fire as misguided and wrong,” Day said in a phone interview Tuesday (Sept. 4). “There are a combination of relatively normal illnesses that could have caused brain swelling that put pressure on the retinal tissue.”
Day was speaking to allegations made in the criminal complaint, when emergency room doctors at Albuquerque’s Presbyterian Hospital called the police when they suspected that hemorrhaging in the 3-week-old boy’s eyes was the result of someone shaking him.
According to the criminal complaint New Mexico State Police filed in Stow’s case, doctors at Presbyterian told Agent Matthew Martínez that the child had “intracranial pressure caused by internal bleeding  in the front and rear of the skull.” In addition, doctors told Martínez they found “no fractures to suggest blunt force trauma” to the child.
Doctors told Martínez it was their professional opinion that hemorrhaging in both of the baby’s eyes led them to believe that the child was “shaken in a front-to-back motion.”
While the child was undergoing tests to rule out spinal meningitis as a cause of the pressure, doctors told Martínez they were unable to perform a spinal tap or an MRI on the child because he kept having seizures.
Dr. Lisa Petersen, Presbyterian’s child abuse specialist, told Martínez that in a previous interview with Stow and the child’s mother, Stow had “minimal interaction during the interview and was focused on eating a sub sandwich.” The child’s mother, Petersen told police, said that Stow had been the child’s primary caregiver while she worked.
Intracranial pressure
In an interview with police, Stow said that the 3-week-old had been congested and had had trouble breathing. The previous Tuesday (May 15), they’d taken the baby to the doctor to address the problem, Stow said. Stow said on Friday, the baby had trouble breathing and “not much of an appetite.”
When the mother returned home from work around 11 p.m. and tried to feed the baby, she noted that he was “pale and remained limp and unresponsive,” which prompted them to take him to Holy Cross Hospital, where he was later airlifted to Presbyterian’s Pediatric Intensive Care ward.
But emergency medicine physician Dr. Gabaeff, the expert witness for the defense, said that the doctors at Presbyterian may have misdiagnosed the child’s problems for any one of a number of conditions that explain intracranial pressure that can result in bleeding in the brain and eyes.
“Inexperienced doctors go automatically to [Shaken Baby Syndrome] when this child had a history of other medical conditions,” Day said. “All it took was a more experienced eye looking at the records. This is why people should be healthily suspicious of initial charges of SBS.”
Eighth Judicial District Attorney Donald Gallegos said Tuesday (Sept. 4) that he and his staff plan to speak to a variety of medical experts about the child’s condition and medical history before they proceed or recharge Stow in the incident.
Medical conditions
While Gabaeff was on vacation and not available for comment when this article was written, he published a 2011 article in the Western Journal of Emergency Medicine contending, at length, the relationships of different medical conditions that account for so-called indicators of Shaken Baby Syndrome.
In the article, Gabaeff offered a litany of medical problems that could account for increased intracranial pressure and its relationship to retinal bleeding, including “extreme coughing and valsalva, which can occur with choking episodes,” “high altitude cerebral edema,” and even “the compressive forces of labor alone raises [intracranial pressure] in the head,” which Gabaeff cites as happening in “45 percent of all births” and often causes retinal bleeding.
Gabaeff is also a frequent online commenter on news stories involving alleged Shaken Baby Syndrome cases, where he chastises the syndrome’s origins.
“The syndrome was born in the imagination of Caffey and Guthkelch in the seventies without any independent experimentation,” Gabaeff wrote in 2010. “All the biomechanical experiments and neuropathologic research that has been done since undermine every aspect of this supposed form of abuse.”
First called “whiplash shaken infant syndrome,” pediatric radiologist John Caffey first coined the condition in 1946. The condition became a household concern in 1956, when Newsweek wrote an extensive article about the case of Virginia Jaspers, a nanny who was convicted of killing three small children left in her care. Jaspers admitted to shaking the children.
In 1971, pediatric neurosurgeon Norman Guthkelch published an article in the British Medical Journal in which he studied what he considered a direct relationship between parental shaking of small children and bleeding in the brain and eyes, along with a reduction of oxygen supply to the brain, Guthkelch refers to these three conditions as a telling “triad” of Shaken Baby Syndrome.
It’s worth noting that Guthkelch, now in his late 90s, said in an episode of NPR’s Morning Edition  in 2011 that the “triad” could have other causes besides shaking.
“I don’t think that the famous triad, however well some people think it’s defined, can ever be so well-defined that you can say that and nothing else caused it — that meaning shaking,” Guthkelch said during the 2011 NPR episode.
The same year, Gabaeff wrote that he was concerned that doctors were using “group think” to diagnose the syndrome, using “medical problems and accidents to misdiagnose abuse.” He also called the false allegations surrounding Shaken Baby Syndrome “the biggest medical fraud in history.”
“I have held dead, abused babies in my arms. When it is real, it is easy to see. When it is conjured up via the misdiagnosis of accidents and medical problems, it is equally obvious,” Gabaeff wrote. “There are thousands of people in jail falsely convicted of an act that no one saw and no one can prove causes damage to the brain or the eye.”
But not, Day said, his client Damian Stow.
“In this case, the system worked,” Day said. “Unfortunately, an innocent man had to sit in jail for 60 days.”

No comments:

Post a Comment