Showing posts with label misdiagnosis. Show all posts
Showing posts with label misdiagnosis. Show all posts

Wednesday, December 2, 2015

How the State of Oregon Kidnapped Our Son

Unexplained Injury

On November 8th, 2011 we noticed my son was feeling some pain and was running a low grade fever (100.2° F). I was concerned so I called an advice nurse that my wife's insurance provided. The nurse on the line was very polite and recommended that we go to the ER because my son was only five weeks old. Her concern was that at that age a fever could mean something was seriously wrong and we needed to have it examined.

The First Hospital 

We went to the local hospital in our home town to see a doctor there. Upon arrival the triage nurse performed her introductory evaluation, noting that there were "no bruises, swelling, or any external abnormalities" while also noting that "all four extremities are moving strongly and equally." 

We were brought to a room in the ER where a doctor performed a number of tests. This included a hip flexing check and saw that the legs were pulled up tightly towards the abdomen. He explained that sometimes when babies have abdominal pain they'll pull their legs in tightly. While the doctor manipulated my son's legs he let out a very loud scream, quite unlike we had heard before. This was very different than the experience with the triage nurse just minutes before.

The doctor ordered an x-ray to view my son's abdomen and hips. The doctor's belief was that their could possible be an obstruction in my son's intestines causing the pain. 



The X-Ray Technician

My wife needed to return home at this point. In our haste to get to the ER we had forgotten to bring a change of clothes and diapers, and while there our son soiled his outfit. I stayed and the x-ray technician came in to take a number of images. At one point while we were moving my son the x-ray technician looked at me in a confused way and asked if the doctor had mentioned anything about my son's left leg. I replied that he hadn't other than a possible abdominal issue. 

The technician left after taking his initial x-rays, and came back half an hour later. He was told to take specific pictures of the leg. He then came in again one more time after another half an hour to take a clearer picture of the leg. My wife had returned at this point and the Doctor came in and told us that our son had a spiral femur fracture (We later learned that it was actually an oblique fracture and not a spiral). The doctor informed us that as protocol he had to notify the authorities and an investigation would take place. (It was also noted that he had gaseous distention from the x-rays)

The First Police Office

We spoke to the police officer that came to see us and explained that there hadn't been anything traumatic that happened. Nobody dropped him, no one fell with him, nothing happened. While we spoke to the police officer we mentioned we came in because our son was having abdominal pain, thought to be bad gas, and a low grade fever. We mentioned that he had no bruises (which was confirmed by a nurse that was in the room at the time) and we told him we had no idea there was a fracture. Our son hadn't screamed in pain as he did until the doctor manipulated his leg.

My son was only mildly more fussy than normal prior to our visit, and as young parents we thought that as long as he was eating he was okay. The night before we also noticed a fever and we went to the store so he could have baby Tylenol and Gripe Water (Natural medicine to reduce gas). This seemed to work as it lowered his temp and calmed him down.

The Children's Hospital

The Children's Hospital was notified. Their EMT crew and a pediatrician arrived and wrapped up my son's leg. My son was transferred to the Children's Hospital in an ambulance with my wife. I had to run home and pick up some things for my son, and then I drove out there myself. 

While in the ambulance, my wife was able to hear a pediatrician and an EMT discuss that they thought this was clearly abuse and that it was only protocol to bring a parent. When they arrived at the Children's Hospital a complete trauma workup was performed on my son. It was noted again that there were no bruises, swelling, lesions, abrasions, and that my son was content beyond his leg. It was noted that my son had extra cartilage on his skull but it was not trauma related, and I remember wondering what that meant. My son showed no symptoms of being in any pain or distress, though he did have a low grade fever. 

My wife had been advised to ask the ER doctor what could cause such injuries in an infant. She was rudely told that "It was either child abuse or you're lying (about there being no accident)." 

My son was sent to have a head CT done immediately. His results came back perfectly normal. There was no bleeding on the brain, no hemorrhaging, no skull fractures, or signs of trauma. My wife requested that a new doctor be placed with our son after the encounter with the previous doctor, and was given an advanced resident to look over our son. A full blood workup was run, including a spinal tap, to check for infection because of his low grade fever. My son, minus the blood drawing, remained content, fed well, and soothed easily. It was very hard for the doctors to draw blood from our son, and it took quite a lot of time for them to finally get anything, causing my son great pain in the process. On the spinal tap, one of the residents missed the spinal fluid and hit a vein, causing blood to become mixed in with the spinal fluid. They also took new x-rays while in the Children's Hospital ER. Even after taking the blood, a number of tests were lost or not valid. 

The Inpatient Room

We were eventually moved to an inpatient room. They tried to draw more blood during the night, but they didn't tell us what the blood was being drawn for. We were also informed not to feed our son throughout the night so they could reset the bone, and he cried through the night in hunger pains. We followed the directions we were given. Despite all this, he wasn't given any medication because he was still soothing himself. The room was very cold at night, yet my son maintained a high temperature and was even sweating. None of the nurses adjusted the temperature at night, nor did they tell us how. 

In the morning a new nurse came in and said my wife could feed our son. They took a full skeletal survey in the morning where they noted a number of fractures. These inculded:

  • An acute left femoral diaphysis angulated oblique fracture, 
  • Age-indeterminate bilateral distal femoral, 
  • Probable left and right proximal tibia metaphyseal corner fractures, 
  • Probable age-indeterminate left proximal humeral metaphyseal corner fracture, 
  • Probable partially healed proximal right tibia and fibula fracture, 
  • And healing bilateral rib fractures (Probably three). 
Note, the only fully confirmed fracture has been the left femur fracture and an age-indeterminate posterior rib fracture. This is also the point where they say it was on oblique fracture and not a spiral. A doctor came in to look at my son's eyes. She saw no retinal hemorrhaging, but noticed a mild discoloration in his eyes. She called in a superior who also noted that there was nothing wrong with his eyes, but that he did have mild discoloration. Again, My son was only 5 weeks old at the time. 

My son had seen many different doctors in this time, all noting that he look healthy an happy. My son had been in for a 1 week check, 2 week check, at about 3 1/2 weeks he was circumcised, he had visited the hospital twice because he was jaundice, and my wife's midwife had also seen him during one of her post birth visits the day before we went to the hospital.

They attempted to draw more blood, and continued to be unsuccessful, taking a full second day to gather the blood needed to send out for the Osteogenesis Imperfecta (OI) test and a few other tests regarding bone health. He was still on no medication until they decided to put an IV in his head where they used morphine. They took an abdominal CT because my son had high liver enzymes, but his CT came back perfectly normal. He was put into a Pavlik harness to help heal his femur fracture. 



The State Intervenes

A Child Protective Services (CPS) worker, a detective, and a police captain interviewed me, my wife, and my wife's parents. They agreed that everything we have said had been consistent. There hasn't been any trauma, and certainly no outward signs abuse. The police never filed criminal charges.

We had to appear in court for an emergency hearing as requested by CPS. I had already obtained a lawyer but my wife hadn't had time yet. During the hearing the judge seemed to want to give us both of our children back. But CPS boldly lied and said there was liver damage and stated that all fractures were fact, rather than possibilities. The judge reluctantly had our son put into a "Medical" foster home, while allowing us to keep our daughter (As long as we were in sight and sound of Linda's parents with our daughter).

At 3 Months

CPS continued to hold our son, and was attacking our parenting skills and the well being of both of our children. We had 3 1-hour visits a week with our son, and during that last month we discovered that our son now had an umbilical hernia (which may have been developing while he was still with us). We asked CPS to take our son to see a doctor, but they informed us they had another appointment set up for his two month check and will have it looked at than. 

We have since discovered that our son does have low calcium, low vitamin D, high alkaline phosphatase. We have looked into many different possibilities, including OI, Rickets, Temporary Brittle Bone Disease (TBBD), and other diseases that could have caused this. The OI test came back negative, but there are other options, but at this time it was very difficult to have our son tested. 

Back in the Womb

My wife had a rough pregnancy because of his size. We discovered that she has a retroverted uterus. This made our son's birth even tougher. He was born at 41 5/7 weeks by induction with pitocin. My son had severe shoulder dystocia during birth, and had an initial APGAR score of 3, taking a full minute to even breath. During the later stages of pregnancy my son was unable to move much, but certainly was noticeable due to his large size. My son only moved at night when my wife was able to lay flat, especially during the third trimester. His birth weight was 9lbs 7oz and 21 1/2 inches. 

The Judicial Hearing

We started the Judicial Hearing Process on January 5th, 2011. The hearings were held on the 5th, 6th, 9th, 10th, 11th, and 18th. One of the worst problems with this process is that it is held in the Juvenile Courts, and rather than using "Beyond a reasonable doubt" they use "Preponderance of Evidence" which refers to balancing the evidence (50/50), and whichever side is over the 50% mark wins the case. 



We clearly should have had more than enough evidence to prove that we had not abused our son. Firstly, it was made clear that the hospital had lost blood tests, including a very important vitamin D, phosphorus, ionized calcium, and the PTH tests, all vital for diagnosing Rickets. They also noted elevated liver enzymes related to bone breaks which were elevated even higher after our son was in foster care, after declining to a normal level at the hospital. 

The Expert and the Villain

We had hired Dr. David Ayoub to testify about what he saw from the x-ray and CT images. He testified that he could see from the radiological evidence that our son had neonatal rickets. Dr. Ayoub even had images taken directly from My son's X-rays and CT scans to show these signs. 

The state provided numerous medical witnesses, and each of these witnesses, except Dr. Villain (A Child abuse Expert who has been certified by American Board of Pediatrics, Child Abuse Pediatrics since 2009), had admitted that if our son had a medical condition of bone fragility that it could explain his fractures. It was also noted that our son had no bleeding on the brain, no subdural bleeding, no retinal hemorrhaging, no bruising, no swelling, no internal organ damage, no brain damage, no cuts or lesions, and no tissue damage. The only thing noted were the unexplained bone fractures without local tissue trauma. 

It was even noted in court that there was very likely a new rib fracture after our son was placed in foster care. There was even a physician's assistant who noted that if our son did have bone fragility he himself could have accidentally broken our son's ribs during a routine well baby check. 

The ER doctor who saw our son when we brought him to the hospital still can't give a clear answer about whether or not he broke our son's femur, and when asked on the stand said "I don't believe I did." rather than a simple yes or no. The pediatrician who is currently seeing our son was even confused why they were calling this abuse when there clearly were other things that needed to be looked at first, and recommended that our son see and endocrinologist and geneticist. 

There were two doctors who testified that the obvious fact that all of the normal signs of abuse were missing meant it was unlikely to be abuse when evaluating the differential diagnosis. 

The State recalled two of their medical witnesses to discredit Dr. Ayoub's work simply because his current study hadn't been published in a peer reviewed journal yet. Dr. Villain (who had never actually seen our son, nor viewed his full medical history) claimed that he didn't care if our son had a medical condition. He (in a very belligerent attitude)believed that this was abuse anyways, and would not be convinced otherwise.

The Judge's Ruling

So the Judge erred on the side of caution and adjudicated my wife and I of abusing our son. We we able to keep our daughter home with us, because she was in perfect health. He even stated that we should bring new medical evidence to him should we have any.

We tried to have CPS take our son to specialist to evaluate him, and the judge even order them to do it. This never happened. We fought for our innocence, and after 17 month we got our son back. The verdict hadn't changed, but the judge had decided that we were trustworthy enough to have our son back.

The new evidence

In 2013 we finally had the opportunity to have our son evaluated by a endocrinologist at the very same children's hospital. They thought the situation was very odd. While they found no endocrine problems, they suggest that our son be evaluated for Ehlers-Danlos with a geneticist.

We finally were able to see the very busy geneticist in 2014, and they said that our son clearly has Ehlers-Danlos type-III (Hypermobility). We were told that his was very likely the reason our son was injured without a traumatic accident. We thought that it was great to finally know what we as a family were dealing with. The syndrome isn't life threatening for our son, but it isn't a simple disorder either. He deals with fatigue and soreness frequently.



We haven't been able to return to court, because it is very difficult to find an attorney who wants to reopen finished cases.

We didn't abuse our son, and they shouldn't be able to take our son like this without reasonable cause. 



Our story has been passed on, and we hope people continue to share it. So please repost and spread the word about this huge injustice to all your friends and family. This isn't about just our family anymore. This scenario is happening over and over again all across the country and internationally. So please share this story, it may help a family be saved.

Thursday, September 20, 2012

Adoption halted as court told baby milk led to 'innocent' couple being accuse of abuse


Vitamin supplements in baby milk may have led an innocent couple being condemned for battering their newborn son, a top family judge has heard

Adoption halted as court told baby milk led to 'innocent' couple being accuse of abuse
Adoption halted as court told baby milk led to 'innocent' couple being accuse of abuse Photo: ALAMY
The boy, who cannot be named, was taken away from his parents and was poised to be adopted after multiple broken bones were put down to child abuse.
But Lord Justice McFarlane halted the process yesterday after hearing how an extraordinary combination of medical events could have led to a case of congenital rickets being overlooked.
The parents, who have fought a three-year custody battle, have been given a final chance to get their son back.
It came after lawyers had what they described as a "light bulb moment" and understood the full significance of the child's medical records.
Michael Shrimpton, for the family, who are from the north of England, told the Court of Appeal in London that there is evidence that the boy was born with a Vitamin D deficiency, inherited from his mother, leading to "soft bones" and rickets.
It suggests that the broken bones could have occurred during his difficult forceps birth, or even in the womb.
Blood tests to check for signs of vitamin deficiency, when the boy was four weeks old were normal.
But the court heard hat it is possible that it was "masked" by the formula milk given to him by his mother – which contained Vitamin D supplements.
He added that there was "striking" evidence of severe abnormalities in the functioning of the baby boy's liver, an organ instrumental in processing Vitamin D.
The judge temporarily halted the adoption process and ordered urgent medical reports.
Having a child taken away is an “exceptionally awful” ordeal, he remarked, adding that it was essential to examine whether the Vitamin D deficiency explanation for the boy's injuries was "more than an intellectual possibility".
He also noted that there was no evidence of emotional difficulties, domestic violence, alcohol or drug abuse, or any signs of dysfunction within the family, to indicate a risk of child abuse.
Mr Shrimpton said that one of the country's top endocrinologists, Professor Stephen Nussey, who has carried out pioneering work on the causes and effects of Vitamin D deficiency, will be instructed to carry out that task if he is available at short notice.
Observing that medical knowledge on the causes of infant injuries is in a state of constant movement, the barrister added: "This is an important case. It is starting to take on the appearance of a leading test case".
After hearing expert evidence in June last year, a judge at Sheffield High Court ruled that one or other of the parents must have been responsible for the baby's injuries. The same judge refused to change her mind earlier this year and freed the boy for adoption.
However, Lord Justice McFarlane observed: "Medical knowledge of how some children may have bones that are more susceptible to injury than normal children has moved on".
Emphasising the extreme urgency of the case in light of plans for the boy's imminent adoption, the judge gave the parents 28 days to obtain a report from Professor Nussey, or another expert, in support of their case.
The local authority involved in the case had informed the Appeal Court that suitable adoptive parents have already been found for the boy but no further steps in the process would be taken prior to the court ruling on the case.
The case will return to the Appeal Court once the expert medical report has been obtained.

Sunday, September 16, 2012

New doubts in 'shaken baby' fatalities

by Richard Ruelas - Sept. 15, 2012 10:53 PM
The Republic | azcentral.com

Read more: http://www.azcentral.com/news/articles/20120904shaken-baby-fatalities-doubts.html#ixzz26caFCTUv


Drayton Witt kept insisting he had nothing to do with the death of his 4-month-old baby. He said it the night he brought the near-comatose infant into the emergency room on June 1, 2000. He said it during his sentencing, following his conviction on murdering the boy by shaking him. And he was still proclaiming his innocence as he started serving his 20-year sentence in 2002.

His lamentations didn't gain legal and medical weight until 2012. The Arizona Justice Project, a volunteer group of attorneys, filed a motion to toss out his murder conviction based on the evolving science around what was known as shaken-baby syndrome. The state did not file an argument in response. Witt was released on May 31, becoming the second Arizonan in the last two years to see his guilty verdict in a shaken-baby case erased.

Among those who helped secure Witt's freedom was the 97-year-old British pediatric neurosurgeon who, in 1971, first identified the trio of telltale symptoms that became accepted as proof that a baby had been violently shaken. Attorneys also secured a sworn statement from the medical examiner who originally ruled the baby died from being shaken. His revised conclusion was that the baby died of a disease.

Fifteen months earlier, in February 2011, a Buckeye man named Armando Castillo, 42, had his conviction overturned in the 1998 death of a toddler. Like Witt, Castillo maintained his innocence throughout. And, like Witt, Castillo would be imprisoned a long time before attorneys found medical evidence to back up his story.

In both cases, judges ruled that a jury would likely acquit each man after hearing the new medical understanding of the evidence.

The overturned convictions didn't erase the charges, just sent the cases back for a possible retrial. Prosecutors decided to keep pursuing murder charges in both cases. Castillo pleaded guilty to a reduced charge to avoid the risk of a retrial. Witt's murder trial is scheduled for 2013.

Maricopa County Attorney Bill Montgomery said that his office still believes that Witt was responsible for the death of the 4-month-old baby boy. "Obviously, we believed it the first time around," Montgomery said.

He said prosecutors now focus more on proving that a child was injured, not necessarily that he was shaken. Montgomery said speculation that suspected abused children died from diseases was just defense-attorney theories.

"I think we're still looking at cases where children were injured," Montgomery said. "How we prove that may change."

That's because a growing body of medical and legal experts, nationally and internationally, are casting doubt on what became known as shaken-baby syndrome. Pediatric neurologists and forensic pathologists say the long-held triad of symptoms -- bleeding on the brain, swelling of the brain and bleeding in the eyes -- thought to indicate a baby was violently and intentionally shaken could also be caused by a host of diseases, including infections.

DePaul University law professor Deborah Tuerkheimer, who wrote a 2009 study on the use of shaken-baby syndrome in courtrooms, said the easily spotted symptoms became not only a medical diagnosis but also a legal tool adopted quickly and used convincingly in courtrooms nationwide.

Physicians would testify that a shaken child would become unresponsive or go limp almost immediately after the abuse. So the last adult with the child would be the primary suspect. And the shaken-baby diagnosis also provided a motive: a frustrated caregiver looking to quiet a crying child.

Some shaken-baby cases included other signs of violent abuse, such as broken bones, bruises or fractures. But others, like in Witt's case, had no outward signs of injuries. Cases were built solely on the symptoms of shaken-baby syndrome.

"(The syndrome) did all of the work," Tuerkheimer said. Jurors would hear the experts testify with certainty and couple that with an "inclination to want to convict and hold someone responsible for such an awful outcome," she said.

In the last half of the 1990s, the Maricopa County Attorney's Office handled shaken-baby cases at the rate of two a week. During one stretch, it had a conviction rate, in non-fatal cases, of 84 percent.

Tuerkheimer said many of the defendants were convicted in emotional trials, while others took plea deals because they saw little chance of winning. She said there's no way to know whether the Witt and Castillo cases are isolated wrongful convictions or signs of a systemic flaw that will produce hundreds of reversals.

"No one has any sense of the numbers here," Tuerkheimer said.

Witt knows he is No. 2, the second shaken-baby conviction in Arizona to be vacated. But he figures the pattern that police and prosecutors followed in his case was repeated many more times.

"The system is flawed," he said. "I'm sure there's a lot of people like that."

* * *

Maria Holt's baby son, Steven, was just shy of being 5 months old on June 1, 2000. Dressed in a blue and white onesie, he slept in his car seat as Witt dropped Holt off for her evening shift as a waitress at the Bill Johnson's Big Apple restaurant in north Phoenix.

Witt, then 18, and Holt, then 20, had been boyfriend and girlfriend since they'd met two years before, but Steven had been conceived with another man during a breakup. Regardless, Witt saw the baby as his son; he was in the delivery room when Steven was born, and the child carried his last name. It was routine for Witt to care for Steven when Holt was at work; she often called home between tables to check in.

During one call around 8 or 9 that night, Witt told Holt he thought Steven might have had another seizure. His eyes appeared odd, Witt said, and he was fussy. Holt said to come get her at the restaurant and they would take the baby to the emergency room.

Steven had been a sickly baby, in and out of the hospital three times during his short life, including a six-day stay at Phoenix Children's Hospital just a month earlier when doctors couldn't get a bead on what was causing the baby's vomiting and seizures.

On this night, the boy stopped breathing during the 6-mile drive from the restaurant to Paradise Valley Hospital. Witt pulled over and climbed into the back seat to perform CPR while Holt took the wheel. At the hospital, doctors worked to get Steven breathing again. Then the baby's heart stopped. It took them about 30 minutes to stabilize him, after which he was flown to Phoenix Children's Hospital.

A doctor at Paradise Valley Hospital, in a report, diagnosed the cardiac arrest and said the baby was suffering from dehydration and possibly sepsis, a severe reaction to bacteria. He also expressed concern about brain injury caused by dehydration, too much acid in the blood, and not enough oxygen. There was no mention of suspected abuse.

Witt and Holt left Paradise Valley Hospital to drive to Phoenix Children's. Expecting another long hospital stay, they stopped by their home to pick up extra clothes.

* * *

The idea that violent shaking of infants could cause brain injury was first proposed in a medical-journal article in 1971. Not only did it gain acceptance in the medical community over the next two decades, it also seeped into popular culture. Child-abuse prevention groups started awareness campaigns; the phrase "shaken-baby syndrome" entered the Random House dictionary in 1996.

By 2001, the American Academy of Pediatrics produced a position paper on shaken-baby syndrome, saying that doctors should presume abuse in any baby under a year old who had head injuries absent obvious trauma, such as a car accident. The paper, published in the journal Pediatrics, said the "constellation" of injuries in a shaken baby could not result from an accidental trip or fall.

The article also offered a psychological profile of adults who shake a child. "Such shaking often results from tension and frustration generated by a baby's crying or irritability," the journal article said, "yet crying is not a legal justification for such violence." It went on to warn that shaken babies were often misdiagnosed, meaning doctors needed to be extremely vigilant to spot them.

After Steven arrived at Phoenix Children's Hospital, a doctor who evaluated him wrote that the baby had no bruising or skull deformities, but showed some bleeding in the eyes. The doctor also noted that "the infant is flaccid. There is no response to pain."

At 3 a.m., a pediatrician wrote on a progress report that the baby's symptoms "raise the possibility of non-accidental trauma."

Medical records show doctors knew their infant patient had been at the hospital a month before for projectile vomiting and flulike symptoms. But by 7 a.m., doctors felt sure of what they were looking at.

"The findings are most consistent with shaken baby, plus or minus hypoxia injury," read a doctor's progress report on the case. Hypoxia refers to an injury caused by lack of oxygen.

Steven's condition did not improve. At noon, doctors declared him brain dead. One wrote the following: "Mom is currently hugging the patient and we are planning to withdraw support and allow him to progress to cardiac death later on this afternoon. The police have been notified of the findings."

Steven was pronounced dead at 3:30 p.m. on June 2.

* * *

In a case where shaken-baby syndrome seems a possibility, events quickly and simultaneously move along parallel tracks: doctors working to save a baby, police working to find a suspect.

But once doctors and police believe they are dealing with a shaken-baby case, they often ignore evidence that might suggest a different reason for a baby's illness, said Christina Rubalcava, an attorney with the Arizona Justice Project.

"You're already locked in to what it is," said Rubalcava, an attorney with Osborn Maledon who volunteered her time on the Witt case. She says that in general, once a doctor sees the triad of symptoms, a call to child-welfare agencies and police becomes automatic. The belief in shaken-baby syndrome "is like gospel to them," she said.

But Kathy Coffman, a pediatrician at Phoenix Children's Hospital who specializes in abuse cases, denied that doctors automatically diagnose shaking and ignore disease or infections or other causes. "We go through all the factors to make sure we're not missing something," Coffman said.

Coffman, a pediatrician for 20 years, was not at Phoenix Children's Hospital when Steven was treated and would not comment specifically on this case. She now is the medical director of a specialized unit at the hospital, made up of doctors and social workers, that handles suspected cases of abuse. "I don't think anybody who works in this field, law enforcement or anybody, is cavalier about making these calls," she said.

"The absolute last thing I want to do," she said, "is have someone go to prison for something they didn't do."

In the early morning hours of June 2, Phoenix police interviewed Witt and Holt as they sat in a room near their child. The questions seemed accusatory from the start, Witt said, and he ended the interview. A worker with the state's child-protection agency, in a report written later that morning, would say officers described Witt as "short-tempered and volatile."

After Steven died and Witt and Holt were leaving the hospital to go home, they found their car missing; police had seized it from the parking lot to search it for possible evidence. Friends drove them home, where they found two officers, armed with a warrant, who had been searching the trailer since 11:30 a.m. -- 4 hours before Steven died -- to find evidence to build a case.

"One thing after another," Holt said. "It's heartbreaking."

The police left at 9:30 p.m. They had pulled up carpet samples and took some baby items. The next day, officers knocked on the door and asked to take Witt in for questioning.

"Let's go," Witt said. "I ain't got nothing to hide."

Witt is a man of few words and didn't offer many to police. When detectives questioned him about what happened to the baby, Witt replied that he didn't know and that they should ask the doctors.

Witt was booked into jail on charges of first-degree murder and child abuse. He would remain jailed until his trial.

Holt said the arrest was devastating. "I lose my son, and then I lose the man who's done nothing but love me and love my son," she said. She had support from her extended family but felt some friends slip away. When she visited Witt in jail, which was often, she worked to buoy his spirits: "You'll be home soon," she would say. "This is just a misunderstanding. We know the truth."

Witt had a public defender who tried to get a plea deal, but Witt refused to take it. "When they arrested me, I figured somewhere down the line they'd come to their senses and figure out the right stuff," Witt said. "But clearly they didn't."

The trial started in February 2002.

"Steven Witt lived only five months," the prosecutor, Dyanne Greer, told the jury in her opening statement, according to a transcript. "He died as the result of violent, severe shaking. ... He died at the hands of a person who was supposed to be the caretaker ... and that man, ladies and gentlemen, is Drayton Witt."

Holt was called to the stand; she would be the first witness. It would be her job to tell the couple's story: how they "just clicked" when they first met through a friend; how Holt's extremely protective dog immediately warmed up to Witt; how, when she became pregnant by another man, Witt treated the child as if he were his own. She also told the jury about the baby's history of illnesses and hospitalizations, which included a respiratory infection, pneumonia, seizures and vomiting, and how the medicine he was given only seemed to make him worse.

After Holt, four doctors and the medical examiner took the stand. Each testified that Steven's injuries were most likely caused by shaking. To the jury, the evidence would have seemed strong and specific: The boy had certain injuries that, in the absence of major trauma, were possible only if he had been shaken violently. And the narrow, medically accepted time frame of the onset of the baby's symptoms pointed to Witt.

Witt, seated at the defense table, still held out hope. But his defense attorney called only one expert to cast doubt on whether the injuries were caused by shaking. Karen Griest, a forensic pediatric pathologist and former New Mexico coroner, said that "shaken-baby syndrome is sort of a hot topic of debate in the medical community. It's sort of an evolving process to figure out what is going on."

In closing arguments, the prosecutor painted a picture for the jury of Witt shaking the child.

"The defendant knowingly grabbed Steven, shook him so violently that he started to seize," Greer said. "Drayton had to know that Steven was being violently injured while he was shaking him to death, inches in front of his face," she said.

Jurors found Witt guilty of second-degree murder. When it came time for Witt's sentencing in April 2002, he told the judge that although he had been an unruly teenager, he had turned his life around with Holt and Steven. But he was not apologetic.

"I am not sorry, for I didn't do no wrong," Witt said, according to a transcript of the hearing. "I came up here to tell you how much my son meant to me."

The judge sentenced him to 20 years.

* * *

Though Witt asked for protective custody in prison, he said the request was denied, and he was put into the general inmate population. Three years into his sentence, he was attacked in the recreation yard by three men with improvised knives. Witt tucked himself into a ball and tried to cover his head, but said he was stabbed some 70 times before it was over. Ten of those wounds went through one or the other of his hands.

Witt was flown to a Flagstaff hospital, where doctors did surgery to repair his hands. Holt was at work when she got the call from Witt's parents telling her of the attack. When she saw him in his hospital bed, she knew they had to get married.

"Just wanting to make sure that he knew that I was there," she said. "And no matter what, he knew that if it came to 2020, I might be old and gray, but that I would be the one standing by that gate (waiting) for him to come home."

The wedding was in September 2006. The groom wore orange, his "carrot suit," as Witt called it. Prison rules dictate what a bride may wear: A wedding dress must have a neckline above the collarbone and sleeves that cover the arms. And no orange; that color is reserved for inmates. In the end, Holt just bought a dress she liked -- it was maroon -- and pulled a T-shirt over it during the ceremony to cover enough bare skin.

Tradition endures even in the strangest of settings. Witt said he paced in his cell nervously before the ceremony, held just before visiting hours. He would get to wear his wedding band in prison, but the bride had to provide prison officials proof of purchase. Guards did allow the groom to kiss the bride.

"It's emotional, no matter what," Holt said.

At the time of the wedding, all of Witt's appeals had been denied and exhausted. It appeared he would be in prison until 2020.

* * *

In 2009, Deborah Tuerkheimer published her paper, "The Next Innocence Project: Shaken Baby Syndrome and the Criminal Courts" in the Washington University Law Review.

"In its classic formulation, SBS comes as close as one could imagine to a medical diagnosis of murder," Tuerkheimer wrote. "Prosecutors use it to prove the mechanism of death, the intent to harm, and the identity of the killer."

Also that year, the American Academy of Pediatrics revised its position paper on shaken-baby syndrome. It urged physicians to stop using that term and instead describe injuries as "abusive head trauma." The group said it urged adoption of the "less mechanistic term" to stop the focus on shaking. Instead, the journal said, doctors should look at a wider range of possible causes.

Witt's prison records show that he was a model inmate after his marriage. He had been moved into protective custody following his assault. While there, he met Armando Castillo, another man who had been convicted of shaking a child to death.

The Arizona Justice Project filed its motion in Castillo's case in April 2010; his conviction was vacated 10 months later. The project took up Drayton Witt's case in 2011, and the news was a blast of hope, Maria Witt said. "You get that light sparked back in your life."

Those working on Witt's case assembled a list of medical experts who reviewed Steven's autopsy photos and medical records. Most concluded that Steven's death was likely caused by a blockage in the vein that drained blood from his brain.

The attorneys also spotted a letter in the New York Times Magazine from Norman Guthkelch, the British pediatric neurosurgeon who first wrote about the symptoms that indicated a shaken baby. In the letter, a response to an article about the changing medical opinions about shaken-baby syndrome, Guthkelch defended his 1971 paper that concluded babies can get severe brain damage from shaking. The city under Guthkelch's name: Tucson.

The Project attorneys asked Guthkelch to look at the records in the case. He filed an affidavit in support of Witt, which marked his first legal involvement on behalf of a person trying to reverse a shaken-baby conviction.

"The death of Steven Witt is the type of case where a diagnosis of Shaken Baby Syndrome should not have been made," Guthkelch wrote. He said there were too many other possibilities that could explain the baby's death, and that while his process offers a possible explanation for some head injuries, any presumption that an injured child was shaken was a "distortion" of his theory.

Also key to the case was the affidavit of A.L. Mosley, the county medical examiner who performed the autopsy on Steven. Mosley was shown new analysis of his autopsy by doctors who spotted errors in his work. Most notably, doctors said, autopsy photos showed a blocked and swollen vein that was not noted in the report.

Mosley, in his affidavit, concluded that "if I were to testify today, I would state that I believe Steven's death was likely the result of a natural disease process, not (shaken-baby syndrome)."

Witt's attorneys filed the motion in February. The state did not file a response. The judge vacated Witt's conviction and ordered his release.

* * *

The newly cast scientific thought on shaken-baby syndrome is affecting other cases. A 2007 case against Lisa Randall, a day-care operator, originally filed as a death-penalty case, was tossed out before it reached trial. An expert hired by the prosecution in 2010 concluded that the child did not die from shaking as originally thought.

In 2009, prosecutors dropped murder charges against Craig Rettig in a shaken-baby case from 2004. The defendant's lawyer located experts who found that the baby died from striking his head on a coffee table, not from being shaken.

Also, in 2009, Keith Roberts asked that expert testimony about shaken-baby syndrome not be allowed in his trial on charges that he killed his infant son. The Maricopa County Attorney's Office argued that both sides should present their experts and leave it for the jury to decide. The judge agreed. Roberts took a plea offer the day before his trial was scheduled to begin. He was sentenced to eight years in prison.

Witt was released from custody wearing a jail-issued paper suit. He borrowed a cellphone from a passer-by to call his wife. It was 8 a.m. She had been told he wouldn't be released until noon. She broke speed-limit laws driving from the opposite end of town to get him.

Maria Witt said having her husband out of prison is validation.

"To finally have people believe in me," she said, "and be able to start the grieving process and what we missed out on, and be able to start on the life that we missed out on, is more precious than anything."

Drayton Witt, who is working on a construction crew, said he often feels like a modern-day Rip Van Winkle, awakening to find a world where so much is accomplished by cellular phone, or that there are self-checkout lanes at the grocery store.

Witt does not want to take a plea deal like his friend, Castillo, did. He hopes prosecutors drop the case before his trial next year.

He does not blame police or prosecutors for the decade he spent behind bars. He said officers and attorneys were just doing their job. And he always figured the truth would win out.

"You keep screaming," he said. "Eventually, someone will hear you."

Reach the reporter at richard.ruelas@arizonarepublic.com.

Read more: http://www.azcentral.com/news/articles/20120904shaken-baby-fatalities-doubts.html#ixzz26ca27TaF

Friday, April 20, 2012

Our rotten obsession with child abuse is destroying perfectly innocent families


The child abuse
Society should learn some hard lessons from the terrible case of the young Islington couple who were wrongly accused of shaking their baby son to death. The ordeal suffered by Rohan Wray and Chana Al-Alas shows just how destructive the modern-day obsession with child abuse can be. Here was a couple who took their four-month-old son to the doctors in 2009 because he had a fractured skull, which later caused him to die from brain damage. But instead of working out that this baby was suffering from severe rickets, which can cause bone and skull tissue to weaken, the medical staff and police presumed that Wray and Al-Alas had shaken him violently. And so they were arrested.
It gets worse. While awaiting trial for something they didn't do, the couple's second child, a baby girl born in 2010, was snatched from them in the delivery room by Islington's social workers and taken into care. Their first son dead, their second child taken away, the couple had to wait more than a year before being cleared of all criminal charges and finally having their baby daughter returned to them.
This is more than a story of gross incompetence on the part of hospital staff and Islington council. It also reveals how rotten and destabilising the contemporary obsession with child abuse and suspicion of parents can be. Today, in our post-Baby P world, where you are never far from an NSPCC poster informing you that children are being abused all over the place, we are all encouraged to be constantly on the lookout for depraved parents and abused children. Medical staff and social workers in particular are trained to view every cut and bruise as a potential sign of parental wickedness – that is, they are invited to be permanently suspicious of every family they see.
Officialdom's cultivation of suspicion has dripped down into society at large. Sensationalist newspaper articles about isolated cases of depraved parenting, feminist-led campaigns against the allegedly dangerous "patriarchal" family, NSPCC propaganda about an unseen flurry of child abuse – all of this contributes to the pretty warped idea that every parent is a potential abuser and every child a potential victim. In the case of Rohan Wray and Chana Al-Alas, we can see where this culture of suspicion and thirst to uncover evil leads us – to doctors who are more keen to catch "abusers" than diagnose a disease and social workers who will take newborn babies away from innocent parents.
People often say that child abuse in the family home has a destructive impact on society. But you know what else screws up society? A culture of mistrust and parent-bashing, where, Orwellian-style, we are all encouraged to assume that if a child is hurt, then it must have been abused.

http://blogs.telegraph.co.uk/news/brendanoneill2/100152326/the-case-of-the-couple-wrongly-accused-of-killing-their-baby-shows-how-destructive-the-obsession-with-child-abuse-can-be/

Tuesday, April 3, 2012

A change of mood towards drugging kids

OPINION: What on earth has a five-year-old got to feel depressed about?
That was our initial reaction to stunning revelations that children as young as five are receiving counselling, and in some cases drugs, to combat the apparent early onset of mental health issues.
The Fairfax Media story published last week also revealed that 3240 New Zealand children between the ages of 10 and 19 were given anti-psychotic medication last year, a spike of close to 50 per cent over the previous four years.
Many of our readers would have been similarly horrified that such young children would be prescribed mood- stabilising drugs, let alone have the mental problems to require such seemingly radical intervention.
But a little research reveals this is not the only country in which its youngest members need the support of drugs to lighten the mood.
The United States has also experienced a sharp increase in the use of anti- psychotic drugs for children.
One study revealed that one in five children visiting a psychiatrist was prescribed mood-stabilising medicine.
Not surprising for a nation where over- medication appears to be the default position and its victims include celebrities such as Heath Ledger, Whitney Houston and Michael Jackson.
But another study highlighted a factor of even greater concern. It noted that while prescriptions were on the increase, "literature on effects on children is poor".
It went on to say that "studies are few, methodology is flawed, limiting the conclusions to be drawn". And that younger patients were less able to "articulate symptoms", which meant there was "more scope for confusion and diagnosis".
A major concern when the medical professional is contemplating administering heavy-duty drugs for impressionable minds.
That dearth of quality research to support the medical profession's largesse was highlighted in another online report, which said the "impact of depression and its treatment on the brain in adolescents is understudied".
That is not to say that such treatments are automatically bad or not warranted. This country has a sad and shocking record when it comes to youth suicide, which indicates that mental illness can become evident well before the person is introduced to the daily grind and vicious cycle that adulthood can represent.
But what is clear is a lack of certainty around how young minds can be affected by an early introduction to anti-psychotic and mood-stabilising drugs. And a growing tendency for over-anxious parents and care-givers to over-dramatise and over- correct their child's possibly aberrant behaviour.
It is worth noting that in America, the sharpest rises in mental health drug use has been in its white communities.
Presumably, for ethnic groups, medication for their youth is either culturally unacceptable or simply too expensive.
And no doubt they will be the richer for that.
- © Fairfax NZ News

Rickets! Could Your Child Be at Risk?

Rickets! Could Your Child Be at Risk? 
By Daniel Dossey
April 03, 2012

          Rickets isn't something that most people think about these days. In fact, most have never heard of the disease. For those who have, they think of it as a disease from the Great Depression, or something that only happens in poverty stricken countries. But that isn't the case. Rickets is something very real. This disease is so misunderstood that there are many in the medical community who still don't understand how great this problem is. There are thousands of infants born in the Northern States, Canada, and even Europe who suffer from Rickets, and because the medical community is still behind the times, many are being wrongfully accused of child abuse.
          Our family has been hurt by this disease. The disease itself has nearly healed with the help of Vitamin D supplementation. It is the lack of knowledge in the medical community that has hurt us. Rickets often mimics the signs of child abuse, and when a hospital doesn't know how to diagnose this disease they often choose to diagnose child abuse instead. This has led to many different problems across the country.
          When we brought our son to the hospital we merely thought he had a fever and a stomach ache. But after hearing our son scream when a hip check was performed, our life changed forever. The ER doctor ordered a stomach x-ray, and the technician noticed that our son's leg wasn't moving, and was causing my son pain. A later x-ray revealed a fractured femur. Upon reviewing the medical notes it seems clear that the ER doctor must have accidently broken our son’s bones. Of course we didn't realize that at the time, and were transferred to a children's hospital where we were put in the suspected child abuse area. A full body skeletal survey revealed more possible fractures, and this led the doctors to assume there was abuse. Fortunately, we were able to talk to a magnificent man, Dr. David Ayoub, and he was able to diagnose our son with neonatal rickets with 100% certainty. But unfortunately, our justice system didn't want to hear that answer and chose to listen to a doctor with far less experience. Erring on the side of caution seemed to be more important than keeping an innocent family together.
          When speaking to other specialists, they find our case confusing. They ask "how can this be abuse?" Our son had no bruising, no internal organ damage, no retinal hemorrhaging, no subdural hematoma, no scratches, no burns, and the tissue damage around the fracture had no damage. In fact, other than a broken bone there were absolutely no other signs of abuse. We also have a daughter who is perfectly healthy. This just doesn't make any sense. And with a diagnosis of rickets it seems even more unusual that the State would not return the child home.
          The key here is to teach others about rickets, and more importantly, Vitamin D. Vitamin D isn't just important in bone development, but also in many other areas of health. Vitamin D has been linked to autism, SIDS, depression, MS, and many other body functions. Infants who are solely breast fed need to be extra careful, and Vitamin D supplementation should be used. If your pediatrician doesn't know why Vitamin D is important, let them know that your child's health could depend on their understanding of its importance.
          In closing, rickets is real. It is in our modern world, and it is affecting far more then people give it credit for. Our government needs to catch up with these new medical discoveries, and our judicial system needs to stop tearing apart families and hurting innocent people. Pediatricians need to understand that Vitamin D is vital to the health of youth. Right now our society lives in fear, and the phrase "in the best interest of the child" has manipulated many people into following bad decisions made by our government. The best interest of the child is to have their medical issues taken care of rather than assume guilt first. Protect yourself, protect your family, and make sure that your child has a healthy Vitamin D level.
Daniel Dossey may be contacted at iamdandossey@gmail.com