Tuesday, February 05, 2008

Shaken Baby Syndrome: A Faulty Diagnosis?

If the medicine underlying those convictions is faulty,
many of these people may be serving jail sentences unjustly.


The Cool Justice Report
Feb. 5, 2008

EDITOR'S NOTE: This column is available for reprint courtesy of The Cool Justice Report, http://cooljustice.blogspot.com

Shaken Baby Syndrome might not be such a reliable diagnosis when trying to determine how an infant was injured.

In Wisconsin, a woman sentenced to 18 years in prison for the "shaking" death of a 7-month-old in 1996, convinced that state's appeals court to grant her a new trial based on medical research raising doubts about traditional beliefs about the syndrome.

In the case of Wisconsin native, Audrey Edmunds, the District 4 Court of Appeals was convinced that enough new evidence existed to warrant a new trial. The court noted that a fierce medical debate has developed concerning whether an infant can die from severe shaking.

At the time of her trial, the mainstream medical evidence supported the concept of shaken baby syndrome. Those doctors who argued against it were viewed as extremists. Today those poles have begun to reverse.

The National Center on Shaken Baby Syndrome defines it as, "the constellation of signs and symptoms resulting from violent shaking or shaking and impacting the head of an infant or small child." The amount of shaking and the force of the impact are believed to be directly related to the degree of brain damage that defined the syndrome. Infant victims have no voice to accuse or even define their symptoms. Irritability, lethargy, tremors, retinal hemmorhage and vomiting are among the neurological sequelae traditionally associated with the syndrome.

Rarely is there direct evidence that corroborates the medical opinions. Conversely, defending such cases has always been difficult because of the sympathy generated by the death of a helpless infant. There are no real concrete markers found at autopsy that categorically relate the death to shaking. By comparison if there has been impact trauma there are generally defined medical findings that demonstrate that the child has suffered some type of blunt force. In the case of claimed shaking, alone, it is opinion testimony that has proven the cause of death. Once an expert is qualified, courts permit opinions to be given so long as there is an appropriate factual foundation for the conclusion the expert voices.

Retinal hemorrhage had long been considered a hallmark finding in such cases and many medical experts considered retinal hemorrhage with certain characteristics to be emblematic of shaking. Recent studies have challenged that. One researcher who has studied the literature has gone so far as to state: " the evidence for shaken baby syndrome appears analogous to an inverted pyramid, with a very small database (most of it poor quality original research, retrospective in nature and without appropriate control groups) spreading to a broad body of somewhat divergent opinions." (Donohoe M. Evidence-based medicine and shaken baby syndrome. Part I: literature review, 1966-1998. Am J Forensic Med Pathol 2003;24:239-42.)

The medical evidence militating against traditionally accepted concepts supporting shaken baby syndrome had to be substantial for an appellate court to overturn a conviction and order a new trial. There are many caregivers, like Audrey Edmunds, who have suffered the loss of liberty in similar cases. If the medicine underlying those convictions is faulty, many of these people may be serving jail sentences unjustly.

Bridgeport attorney Richard Meehan Jr. was the lead defense counsel for former Bridgeport Mayor Joseph Ganim's corruption trial. Meehan is certified as a criminal trial specialist by the National Board of Trial Advocacy since 1994 and serves on the organizations Board of Examiners. He is a Charter Fellow, Litigation Counsel of America -- Trial Lawyer Honorary Society. Meehan has also obtained multi-million dollar verdicts and settlements in complex medical and dental malpractice and personal injury litigation. He is a past president of the Greater Bridgeport Bar Association and appears regularly on Court TV. Website, www.meehanlaw.com

  • Meehan law firm
  • No comments: