To the Editor:
Re “Anatomy of a Misdiagnosis” by Deborah Tuerkheimer (Op-Ed, Sept. 21):
Shaken Baby Syndrome/Abusive Head Trauma is a real and recognized public health problem. Mainstream scientists and medical organizations like the American Academy of Pediatrics, the National Association of Medical Examiners and the American Academy of Ophthalmology have published position statements recognizing S.B.S.
The Centers for Disease Control and Prevention has published an S.B.S. prevention guide for health departments and community organizations and recognizes S.B.S. as a “public health issue.”
The National Center on Shaken Baby Syndrome just concluded the 11th International Conference on S.B.S./A.H.T. in Atlanta, which was attended by 625 of the most recognized and well-respected medical, legal and prevention experts working in the field. There is no shift in mainstream medical opinion among these experts.
Shaking is a recognized mechanism of injury that can cause severe and irreparable damage to a child. Any claim to the contrary lacks substantiated medical evidence.
The center would implore those making such claims to review the medical literature and the clinical evidence and re-evaluate their position before continuing with an opinion that causes debate about a subject where no debate exists.
Marilyn Barr
Ogden, Utah, Sept. 22, 2010
The writer is founder and executive director of the National Center on Shaken Baby Syndrome.
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To the Editor:
Deborah Tuerkheimer, a law professor, calls for skepticism about the diagnosis of shaken baby syndrome.
As pediatricians who evaluate and care for abused children at Yale-New Haven Children’s Hospital, we do not believe there has been a “shift in scientific consensus” about the syndrome. There is, however, growing scientific evidence that what is now called abusive head trauma is real; that it can be caused by shaking an infant or by shaking and striking the head on a surface; and that it can result in serious brain injury and death.
This is a major public health problem affecting approximately 1,500 children under the age of 2 in the United States.
Doctors come to a diagnosis of abusive head trauma after taking a careful history, examining the child, ordering diagnostic tests, consulting the scientific literature, and, most important, considering and objectively excluding a range of other possible diagnoses.
John M. Leventhal
Andrea G. Asnes
New Haven, Sept. 21, 2010
The writers are, respectively, a professor and an assistant professor of pediatrics at Yale Medical School.
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To the Editor:
As a pediatric ophthalmologist, I was called to consult on an infant with retinal hemorrhages, to confirm the pediatrician’s diagnosis of shaken baby syndrome.
In my note, I suggested that the infant was suffering instead from Ehlers-Danlos syndrome. Unfortunately, my note was ignored and the child was reported to the authorities, the parents were convicted and the infant was placed in a foster home.
Months later the child was brought to the emergency room with fractures and further hemorrhages. This time my note was discovered, and the child was returned to his parents, who were exonerated.
The moral of the case is that there are many congenital or acquired causes of brain and eye hemorrhages, and even fractures. Defense lawyers should be diligent about finding good pediatric specialists to examine such children.
Heskel M. Haddad
New York, Sept. 21, 2010
The writer is a clinical professor of ophthalmology at New York Medical College.
http://www.nytimes.com/2010/09/25/opinion/l25baby.html