Wednesday, February 29, 2012
Tuesday, February 28, 2012
Couple denies abusing son as they battle state for custody
Couple denies abusing son as they battle state for custody
MCMINNVILLE, Ore. – The state accuses two McMinnville parents of abusing their child, but the couple insists they're innocent.
The state took custody of Linda and Daniel Dossey's baby boy, Joss, after the couple brought him in with a fever in November and say doctors found what appeared to be fractures in the child's leg and ribs. But the couple says their son has a medical condition called neonatal rickets.
The couple says they were shocked after a doctor told them Joss had a broken femur.
"We're like he's been kicking around fine," said Linda. "He seemed a little fussy but not in pain."
Linda said the doctors' response to the child's injuries was it "must have been shaking. That this was (a) grabbing motion that must have occurred that caused the shaking."
The Dosseys say social services interviewed them and took Joss the next day.
"We're grasping for anything," Linda said. "We know that our son has something medically wrong here. Figure it out."
Looking for an explanation, the couple found a specialist in Illinois who reviewed Joss' medical file and diagnosed him with neonatal rickets, a rare medical condition that can cause weakened bones.
The specialist testified on their behalf at a custody hearing last month but his expert opinion wasn't enough to get their son back.
"It hurts. That's all you can say is it just hurts like beyond anything," Daniel said.
The Dosseys say there is no proof they abused their son but they have to go through mental evaluations with the state next month. Until then, Joss remains in foster care.
"You're innocent until proven guilty. We know we didn’t do anything, this will be easy, and then know that it's not really that easy," Linda said.
DHS won't comment on the case. According to OHSU, where Joss was treated before going to foster care, it cannot comment on the specific case but it follows state law, which requires reporting any suspected child abuse.
The state took custody of Linda and Daniel Dossey's baby boy, Joss, after the couple brought him in with a fever in November and say doctors found what appeared to be fractures in the child's leg and ribs. But the couple says their son has a medical condition called neonatal rickets.
The couple says they were shocked after a doctor told them Joss had a broken femur.
"We're like he's been kicking around fine," said Linda. "He seemed a little fussy but not in pain."
Linda said the doctors' response to the child's injuries was it "must have been shaking. That this was (a) grabbing motion that must have occurred that caused the shaking."
The Dosseys say social services interviewed them and took Joss the next day.
"We're grasping for anything," Linda said. "We know that our son has something medically wrong here. Figure it out."
Looking for an explanation, the couple found a specialist in Illinois who reviewed Joss' medical file and diagnosed him with neonatal rickets, a rare medical condition that can cause weakened bones.
The specialist testified on their behalf at a custody hearing last month but his expert opinion wasn't enough to get their son back.
"It hurts. That's all you can say is it just hurts like beyond anything," Daniel said.
The Dosseys say there is no proof they abused their son but they have to go through mental evaluations with the state next month. Until then, Joss remains in foster care.
"You're innocent until proven guilty. We know we didn’t do anything, this will be easy, and then know that it's not really that easy," Linda said.
DHS won't comment on the case. According to OHSU, where Joss was treated before going to foster care, it cannot comment on the specific case but it follows state law, which requires reporting any suspected child abuse.
Causes: LINFIELD ALUMNA FIGHTS FOR CHILD CUSTODY IN RICKETS CASE
We've posted a section on our cause where those who are struggling with false allegations of abuse or who are suffering with rickets can post their stories. Please visit us here and read our story as written in the Linfield Review. Please share your stories! Thank You.
Monday, February 27, 2012
So they want to move our son...
The McMinnville CPS decided that it would be okay to move our almost 5 month old son to another foster home today. Some how they seem to think they can follow their own rules and avoid the law and just ignore using a family placement. As many of you know, our son should never have been taken from us in the first place because he has a medical issue and was not in any way abused or neglected.. But McMinnville CPS doesn't seem to care. In fact, they are even going against what Honorable Judge Tichenor stated in our disposition hearing where he didn't want our son to have to suffer from bonding issues. Yet, despite all of that, CPS thinks that putting our son with family isn't very important.
This is a section from the email our caseworker sent us:
"Thirdly, [Your son] had been referred and was seen by Dr. Madison, an endocrinologist at OHSU today. The doctor asked about his history, even though she has received all of the previous notes/labs and she gave him a thorough examination. Blood was drawn for a panel which will test various bone/blood levels, including his vitamin D and phosphate. The results will be sent to DHS and Dr. Whittaker, who referred him. Dr. Whittaker is not referring him for a third bone scan of his ribs. At the time of his testimony he had not seen the second scan. Now that he has, he is not referring for another scan.
This is a section from the email our caseworker sent us:
"Thirdly, [Your son] had been referred and was seen by Dr. Madison, an endocrinologist at OHSU today. The doctor asked about his history, even though she has received all of the previous notes/labs and she gave him a thorough examination. Blood was drawn for a panel which will test various bone/blood levels, including his vitamin D and phosphate. The results will be sent to DHS and Dr. Whittaker, who referred him. Dr. Whittaker is not referring him for a third bone scan of his ribs. At the time of his testimony he had not seen the second scan. Now that he has, he is not referring for another scan.
Finally, I contacted [Linda's cousin-in-law], who indicated that her and her husband [Linda's cousin] want to be the resource for [your son]. The assigned certifier has attempted to contact them two times over the past week and has received no phone calls back. Also, [family friend] has not contacted the certifier either. Please understand that I am working to get him into a relative placement. He will be moved to another foster home on Monday 2/27/12, in McMinnville, and will remain there until DHS can certify a relative and can place [your son] there."
The reason they are moving our son according to the CASA worker is: "All I know is that the current foster mom has a family emergency which forced her to ask DHS to remove [the baby] asap. Also, per an email to your client on Wednesday from DHS, family members who have offered to be placements for Joss have not followed thru. Linda should have been able to tell you that." Clearly she hasn't been paying attention to what has been going on, and clearly she isn't looking out for the best interest of our son.
From conversations with numerous family members it has been made very clear that there has not been an attempt to contact anyone. DHS/CPS isn't being honest, and we have our entire family group to testify to that. It is clearly wrong for CPS to pretend that they are trying to help our son or anyone in our family. The longer they have him in their custody, the more money they get. Our son has a medical condition, and they don't want to be proven wrong. We will continue to fight for what is right and true, and we will prevail. Just wait.
Linfield Review 27 Feb 2012
Our Story has been published on Page 6!
Linfield Alumni Fights For Child Custody In Rickets Case
Linfield Alumni Fights For Child Custody In Rickets Case
Sunday, February 26, 2012
Dr. David Ayoub
David Ayoub, MD
David Ayoub, MD is a board certified diagnostic radiologist practicing in Springfield Illinois as a senior partner in a large, multispecialty private practice group, Clinical Radiologist, SC. He is a volunteer faculty member at Southern Illinois University School of Medicine where he teaches radiology residents and medical students. His areas of interest are metabolic bone disease, including rickets, pediatric skeletal trauma and vaccine injuries. In the last two years he has reviewed over 75 cases of alleged child abuse presenting with multiple fractures. He is currently preparing several research papers on the subject of infantile rickets misdiagnosed as child abuse and a review paper on the limitations of the Classic Metaphyseal Lesion (CML). He is a member of the Society of Skeletal Radiology and the International Bone and Mineral Society.DAVID. M. AYOUB, M.D.
Diagnostic Radiology Curriculum Vitae
Last updated February 25, 2011
EDUCATION
Peoria High School, Peoria, Illinois, 1977
University of Illinois at Urbana-Champaign, Illinois 1981, B.S.
University of Illinois College of Medicine, Peoria, Illinois 1985, M.D.
POSTGRADUATE MEDICAL TRAINING
Internship, Weiss Memorial Hospital, Chicago, IL 1985-1986
Diagnostic Radiology Residency, Southern Illinois University
Affiliated Hospitals, Springfield, IL 1986-1990
Fellowship, Cardiovascular and Interventional
Radiology, University of Iowa, Iowa City, IA 1990-
1991
Active Medical License
State of Illinois
State of Iowa
State of Missouri
Medical Certification
American Board of Radiology, 1990
American Board of Radiology, subspecialty certification in
Vascular and Interventional Radiology, 1995
Titles
Chief Resident, Diagnostic Radiology, Southern Illinois University, 1989-1990
Section Head, Interventional Radiology, Memorial Medical Center, Springfield, IL
1993-1998
Section Head, Division of Cardiovascular and Interventional Radiology, Rush-
Presbyterian St.
Luke’s Medical Center, Chicago, IL 1998-1999
Fellowship Director, Cardiovascular and Interventional Radiology, Rush-Presbyterian
St. Luke’s
Medical Center, Chicago, IL 1999-2000
Treasurer, Board of Directors, Affiliated Radiologists, S.C., 1999-2000
Treasurer, Chicago Vascular and Interventional Radiological Society, 1999-2001
Employment / Appointments
Clinical Radiologists, S.C., Springfield, IL, July 1991-May 1998
Affiliated Radiologists, S.C., Chicago Il, July 1998 –July 2000
Clinical Radiologists, S.C., Springfield, Illinois July 2000-present
Clinical Associate Professor (Volunteer), Southern Illinois University School of Medicine,
July 1991 through May 1998; July 2004 - current
Active Professional Memberships
Radiological Society of North America
Illinois State Medical Society
Sangamon County Medical Society
Central Illinois Radiologic Society
Society of Nuclear Medicine
American College of Radiology
Society of Skeletal Radiology
International Bone and Mineral Society
American Society for Bone and Mineral Research
Recent Publications – Letters to editor
Ayoub D, Plunkett J, Keller KA, Barnes PD. Are Paterson's critics too biased
to recognize rickets? Acta Paediatr. 2010 Sep;99(9):1282-3.
Response to Taylot et al: Comments on Making the Diagnosis of Rickets in
Asymptomatic Young Children. Hyman CJ, Ayoub D, Miller ME. Clin Pediatr
(Phila). 2010 Dec 2. Epub 2010 Dec 21.
Response to Vinchon. Hyman CJ, Ayoub D, Miller M. Childs Nerv Syst. 2011
Feb;27(2):201
Poster Presentations:
Barnes, PD, Keller, KA, Ayoub D and Ophoven, J. Dating the CML: a radiologic-
pathologic case report and review of the literature. Presented at the 53rd Annual Meeting
of the Society of Pediatric Radiology Boston, MA. April 14-17, 2010.
Ayoub D, Hyman C and Miller M. Metabolic bone disease in young infants with multiple
unexplained fractures: Multifactorial in etiology and often confused for child abuse.
Gordon Conference on Biomineralization, Colby-Sawyer College, New London, NH.
August 15-20, 2010.
Ayoub D, Miller and Hyman, C. Evidence of metabolic bone disease in young infants
with multiple fractures misdiagnosed as child abuse. American Society for Bone and
Mineral Research 32nd Annual Meeting. Toronto, Ontario, Canada. October 15 - 19,
2010.
Annual Society Meeting Scientific Presentations
Ayoub D, Miller M and Hyman C. The forgotten signs of healing rickets in early infantile
Hypovitaminosis D. Radiology Society of North America Annual Meeting. Chicago,
Illinois. December 3, 2010.
Grand Rounds
Infantile rickets vs. child abuse. Southern Illinois University Radiology Staff Grand
Rounds. June 25, 2010. Room A132 Memorial Medical Center, Springfield, Illinois.
Invited Presentations:
Classic metaphyseal lesions or classic metabolic lesions? National Child Abuse Defense
& Resource Center (NCADRC) Annual Conference, Las Vegas, Nevada, August 26,
2010.
Congenital Rickets and Misdiagnosed Child Abuse. Third International Pediatric Abusive
Head Trauma: Medical, Forensic, & Scientific Advances & Prevention Sir Francis Drake
Hotel, San Francisco, California July 7-8, 2011.
Saturday, February 25, 2012
How the state encourages CPS workers
In case anyone was wondering, this is how our state rewards those who commit themselves to taking children from their families. This is the caseworker that took our son out away from us.
http://www.oregon.gov/DHS/features/2012-01-31-cps-worker-recognized.shtml
"CPS worker recognized as tireless, passionate and dedicated to protect victimized children
Becky Brewster Here is what Captain Dennis Marks, McMinnville Police Department, said in his nomination letter:
Becky Brewster has worked tirelessly for many years to protect children in the Yamhill County area which includes the City of McMinnville. She is very knowledgeable in the policies and laws related to protecting children and assisting families. She is a tireless and unwavering advocate for the safety of and the best opportunity for each child she is involved with. Every one of our detectives enjoys working with her and appreciates the skills and tenacity she brings to any case she is involved in.
She has earned the respect of our detectives for her willingness to take a stand if anyone proposes an idea that is not ethically acceptable in regards to the treatment of a child or in regards to the potentially conflicting responsibility of protecting parental rights. Becky has been a long standing partner to the McMinnville Police Department. She is able to quickly identify when there is a need for immediate action and promptly follows through with her responsibilities while staying aware of the roles that other agencies/partners will take. Becky is very aware of the importance of working as a team and understands we all have the common goal keeping children safe.
During the 2011 calendar year, Becky has assisted our detectives with many very difficult and intensive cases; many very significant sex abuse cases, including some with multiple victims in multiple families; and several other cases involving seriously injured babies often with no initially obvious suspects.
Becky has worked in DHS Child Welfare for over 27 years and assesses an average of approximately 144 cases of abuse or neglect per year. Over her career, this means she has worked nearly 4000 cases. We here at DHS thank the McMinnville Police Department for their nomination for the award. The McMinnville Branch has long known of Becky's passion for doing her job and believes this award is a welcome acknowledgement of her years of dedication to child safety. Congratulations!"
http://www.oregon.gov/DHS/features/2012-01-31-cps-worker-recognized.shtml
"CPS worker recognized as tireless, passionate and dedicated to protect victimized children
Becky Brewster Here is what Captain Dennis Marks, McMinnville Police Department, said in his nomination letter:
Becky Brewster has worked tirelessly for many years to protect children in the Yamhill County area which includes the City of McMinnville. She is very knowledgeable in the policies and laws related to protecting children and assisting families. She is a tireless and unwavering advocate for the safety of and the best opportunity for each child she is involved with. Every one of our detectives enjoys working with her and appreciates the skills and tenacity she brings to any case she is involved in.
She has earned the respect of our detectives for her willingness to take a stand if anyone proposes an idea that is not ethically acceptable in regards to the treatment of a child or in regards to the potentially conflicting responsibility of protecting parental rights. Becky has been a long standing partner to the McMinnville Police Department. She is able to quickly identify when there is a need for immediate action and promptly follows through with her responsibilities while staying aware of the roles that other agencies/partners will take. Becky is very aware of the importance of working as a team and understands we all have the common goal keeping children safe.
During the 2011 calendar year, Becky has assisted our detectives with many very difficult and intensive cases; many very significant sex abuse cases, including some with multiple victims in multiple families; and several other cases involving seriously injured babies often with no initially obvious suspects.
Becky has worked in DHS Child Welfare for over 27 years and assesses an average of approximately 144 cases of abuse or neglect per year. Over her career, this means she has worked nearly 4000 cases. We here at DHS thank the McMinnville Police Department for their nomination for the award. The McMinnville Branch has long known of Becky's passion for doing her job and believes this award is a welcome acknowledgement of her years of dedication to child safety. Congratulations!"
Thursday, February 23, 2012
Bring Babies Home Member Drive - Update!
Hello All!
We have done fairly well in our quest to educate and spread the word that our child protective services system is corrupt. So far we've doubled our members in the last week, but we'd still love for anyone who hasn't joined yet to come and participate. This is just the start, and there certainly will be more to come. Thank You for helping bring babies home.
We have done fairly well in our quest to educate and spread the word that our child protective services system is corrupt. So far we've doubled our members in the last week, but we'd still love for anyone who hasn't joined yet to come and participate. This is just the start, and there certainly will be more to come. Thank You for helping bring babies home.
If You Take Oral Vitamin D You MUST Avoid Making This Serious Mistake
http://articles.mercola.com/sites/articles/archive/2012/02/23/oral-vitamin-d-mistake.aspx?fb_ref=fbLike&fb_source=home_oneline
Posted By Dr. Mercola | February 23 2012 | 156,363 views
By Dr. Mercola
Did you know there are two types of vitamin D, and they are NOT interchangeable?In fact, taking the wrong one could do you more harm than good...Drisdol is a synthetic form of vitamin D2—made by irradiating fungus and plant matter—and is the form of vitamin D typically prescribed by doctors.This is not the type produced by your body in response to sun or safe tanning bed exposure, which is vitaminD3.A recent meta-analysis by the Cochrane Databaseilooked at mortality rates for people who supplemented their diets with D2 versus those who did so with D3, the form naturally produced by your body, highlighting the significant differences between the two.The analysis of 50 randomized controlled trials, which included a total of 94,000 participants, showed:
- A six percent relative risk reduction among those who used vitamin D3, but
- A two percent relative risk increase among those who used D2
According to the Vitamin D Councilii:"You would think a paper that took a look at tens of thousands of subjects and analyzed the efficacy of prescription vitamin D (D2) and over-the-counter vitamin D (D3) would warrant a news story or two.To my knowledge, these papers are the first to paint such a clear picture about the efficacy between D3 and D2.While there may be explanations for D3's superiority other than improved efficacy, for the time being, these papers send doctors a message: use D3, not D2."
The Difference Between Supplemental Vitamin D2 and D3
The notion that vitamin D2 and D3 were equivalent was based on decades-old studies of rickets prevention in infants. Today, we know a lot more about vitamin D, and the featured study offers compelling support for the recommendation to take vitamin D3 if you need to take an oral supplement—which is the same type of D vitamin created in your body when you expose your skin to sunlight.Supplemental vitamin D comes in two forms:
- Ergocalciferol (vitamin D2)
- Cholecalciferol (vitamin D3)
I personally recommend getting your vitamin D from safe sun exposure (or a safe tanning bed), as there's compelling reason to believe the vitamin D created in your skin in response to sun exposure has some slight but important differences that make it even more beneficial than supplemental vitamin D3. I will address this more in just a moment, but first, let's review the differences between the two types of supplemental vitamin D. Aside from the featured findings that supplemental vitamin D3 reduced the relative mortality risk by six percent, while D2 actually INCREASED mortality risk by two percent, the two types differ in the following ways:
- According to the latest research, D3 is approximately 87 percent more potentiii in raising and maintaining vitamin D concentrations and produces 2- to 3-fold greater storage of vitamin D than does D2.
- Regardless of which form you use, your body must convert it into a more active form, and vitamin D3 is converted 500 percent faster than vitamin D2.
- Vitamin D2 also has a shorter shelf life, and its metabolites bind poorly with proteins, further hampering its effectiveness.
What about Dietary Sources? Animal-Based versus Plant-Based Vitamin D
Aside from taking an oral vitamin D supplement, you can also obtain small amounts of vitamin D from your diet. Here too, it's important to realize that not all food sources provide the same kind of vitamin D. Plant sources provide you with D2. The more beneficial D3 can only be had through animal-based sources such as:
- Fish, such as salmon, mackerel, tuna and sardines
- Egg yolk
- Raw milk
Dairy processors producing pasteurized milk have also been fortifying milk with vitamin D since 1933. Today, about 98 percent of the milk supply in the U.S. is fortified with approximately 400 International Units (IU) of vitamin D per quart. While dairies used to fortify their milk with vitamin D2, most have now switched over to D3. But, if you still drink pasteurized milk (which I don't recommend), check the label to see which form of vitamin D has been added. (If you drink raw milk, then you're getting the naturally-occurring vitamin D in the milk fat.) Keep in mind that although milk is fortified, other dairy products such as cheese and ice cream does typically not contain added vitamin D.
Vitamin D Can Make or Break Your Health, So Get the Right Kind!
There's overwhelming evidence that vitamin D is a key player in your overall health. This is understandable when you consider that it is not "just" a vitamin; it's actually a neuroregulatory steroidal hormone that influences nearly 3,000 different genes in your body. Receptors that respond to the vitamin have been found in almost every type of human cell, from your brain to your bones.Just one example of an important gene that vitamin D up-regulates is your ability to fight infections, as well as chronic inflammation. It produces over 200 antimicrobial peptides, the most important of which is cathelicidin, a naturally occurring broad-spectrum antibiotic. This is one of the explanations for why it can be so effective against colds and influenza.Optimizing your vitamin D levels should be at the top of the list for virtually everyone, regardless of your age, sex, color, or health status, as vitamin D deficiency has been linked to an astonishingly diverse array of common chronic diseases, such as:
| Cancer | Hypertension | Heart disease |
| Autism | Obesity | Rheumatoid arthritis |
| Diabetes 1 and 2 | Multiple Sclerosis | Crohn's disease |
| Cold & Flu | Inflammatory Bowel Disease | Tuberculosis |
| Septicemia | Signs of aging | Dementia |
| Eczema & Psoriasis | Insomnia | Hearing loss |
| Muscle pain | Cavities | Periodontal disease |
| Osteoporosis | Macular degeneration | Reduced C-section risk |
| Pre eclampsia | Seizures | Infertility |
| Asthma | Cystic fibrosis | Migraines |
| Depression | Alzheimer's disease | Schizophrenia |
The IDEAL Way to Optimize Your Vitamin D Levels
While this article is focused on the two types of oral vitamin D supplementation, it's important to realize that the IDEAL way to optimize your vitamin D levels is through appropriate sun or safe tanning bed exposure. While your skin does create vitamin D3 in response to sun light, which is theoretically the same as the D3 you get from an oral supplement, there's cause to believe that the vitamin D created from sun exposure may have additional health benefits, and here's why:
- When you expose your skin to the sun, your skin also synthesizes high amounts of cholesterol sulfate, which is very important for heart and cardiovascular health. In fact, according to research by Dr. Stephanie Seneff, high LDL and subsequent heart disease may in fact be a symptom of cholesterol sulfate deficiency. Sulfur deficiency also promotes obesity and related health problems like diabetes
- When exposed to sunshine, your skin also synthesizes vitamin D3 sulfate. This form of vitamin D is water soluble, unlike oral vitamin D3 supplements, which is unsulfated. The water-soluble form can travel freely in your bloodstream, whereas the unsulfated form needs LDL (the so-called "bad" cholesterol) as a vehicle of transport. According to Dr. Stephanie Seneff, there's reason to believe that many of the profound benefits of vitamin D are actually due to the vitamin D sulfate. As a result, she suspects that the oral non-sulfated form of vitamin D might not provide all of the same benefits, because it cannot be converted to vitamin D sulfate
- You cannot overdose when getting your vitamin D from sun exposure, as your body has the ability to self-regulate and only make what it needs
So essentially, getting regular sun exposure has much greater health ramifications than "just" raising your vitamin D levels and preventing infections. Sun exposure also appears to play a role in heart and cardiovascular health, and much more!If you cannot get your vitamin D requirements from sun exposure, I recommend using a safe tanning bed (one with electronic ballasts rather than magnetic ballasts, to avoid unnecessary exposure to EMF fields). Safe tanning beds also have less of the dangerous UVA than sunlight, while unsafe ones have more UVA than sunlight. If neither of these are feasible options, then you should take an oral vitamin D3 supplement. It will certainly be better than no vitamin D at all.
How Much Vitamin D Should You Take?
Some 40 leading vitamin D experts from around the world currently agree that there's no specific dosage level at which "magic" happens; rather the most important factor when it comes to vitamin D is your serum level (the level of vitamin D in your blood). So you really should be taking whatever dosage required to obtain a therapeutic level of vitamin D in your blood.That said, based on the most recent research by GrassrootsHealth—an organization that has greatly contributed to the current knowledge on vitamin D through their D* Action Study—it appears as though most adults need about 8,000 IU's of vitamin D a day in order to raise their serum levels above 40 ng/ml.4 For children, many experts agree they need about 35 IU's of vitamin D per pound of body weight.At the time GrassrootsHealth performed the studies that resulted in this dosage recommendation, the optimal serum level was believed to be between 40 to 60 ng/ml. Since then, the optimal vitamin D level has been raised to 50-70 ng/ml, and when treating cancer or heart disease, as high as 70-100 ng/ml, as illustrated in the chart above.What this means is that even if you do not regularly monitor your vitamin D levels (which you should), your risk of overdosing is going to be fairly slim even if you take as much as 8,000 IU's a day. However, the only way to determine your optimal dose is to get your blood tested regularly, and adjust your dosage to maintain that goldilocks' zone.For more information, including an in-depth explanation of everything you need to know before you get tested, please see Test Values and Treatment for Vitamin D Deficiency.
References:
- i Vitamin D Supplementation for Prevention of Mortality in Adults, The Cochrane Database of Systematic Reviews, July 6, 2011: (7); CD007470, G. Bjelakovic, et al.
- ii Meta-analysis Looks at Efficacy of D2 vs D3, Vitamin D Council, November 16, 2011: Dr. John Cannell.
- iii Vitamin D3 Is More Potent Than Vitamin D2 in Humans, The Journal of Clinical Endocrinology and Metabolism, March 1, 2011: 96 (3); E447-E452, Robert P. Heaney, et al.
Tuesday, February 21, 2012
One Hospital’s New Plan to Catch Questionable Cases of Child Abuse
One Hospital’s New Plan to Catch Questionable Cases of Child Abuse
February 21, 2012, 12:11 pm ET
E-MAIL THISThe Child Cases, our film on questionable convictions in child death cases, rebroadcasts tonight on PBS (check your local listings). You can also watch itanytime online.
Last year, as part of our ongoing investigation into the troubled state of death investigation in America, FRONTLINE, ProPublica and NPR took a closer look at what can be the most troubling and the most difficult cases — the suspicious deaths of young children.
We discovered a growing awareness in the medical community of a variety of diseases that can mimic abuse, including hereditary blood disorders, leukemia and vitamin K deficiency.
Nearly a year later, one doctor we spoke to — Dr. Michael Laposata, a pathologist and blood-clotting expert at Vanderbilt University who co-published a 2005 landmark study on diseases that can mimic abuse — is pioneering a new blood testing regimen to thoroughly rule out these types of disorders.
“If you’re lucky, most places … do the three routine tests: PT, PTT [both blood-clotting tests] and a platelet count, and that’s it,” Dr. Laposata told FRONTLINE in a phone interview. “It turns out most of the kids that have a bleeding problem have something other than that.”
“The problem is, you have to actually think about what [test] to order next,” he explains.
So Laposata and colleagues devised a system to make blood testing as foolproof as possible for doctors in cases of potential abuse: They created a tiered series of blood tests, known as a “Non-Accidental Injury Coagulation Panel,” which can identify underlying disorders that are more common in children. And they’ve learned how to do these tests with a small amount of blood, which is key when the patient is a baby.
“I think it’s the most comprehensive evaluation for a bleeding disorder that anybody has put forth to date,” Laposata said. The panel is expected to be introduced soon at Vanderbilt, and Dr. Laposata hopes to study its efficacy and to follow cases through the system over the years.
Because blood tests like these can only be performed on living patients whose blood is still flowing, a gap remains in diagnosing underlying conditions in cases where a child has died. But Dr. Laposata hopes that advances in genome testing could someday allow for hereditary disorders to be better identified.
He also told FRONTLINE that he hopes his coagulation panel “will spur more panels to evaluate bone injuries and skin changes that are also misdiagnosed as child abuse.”
Dr. Laposata was one of a number of doctors and other experts to offer testimony during the appeals process of Ernie Lopez, a Texas man convicted in 2003 of sexually assaulting 6-month-old Isis Vas. Isis, who had bruising and bleeding in both the brain and vagina, later died. Lopez was sentenced to 60 years in prison. After reviewing lab tests performed on Isis before hear death, Dr. Laposata concluded that they contained “clear abnormalities” and suggested that Vas suffered from a bleeding disorder known as disseminated intravascular coagulation (DIC). He gave an affidavit in the case in 2010.
Last month, the Texas Criminal Court of Appeals voided Ernie Lopez’s conviction, saying Lopez received ineffective counsel because his attorneys did not adequately challenge the prosecution’s medical evidence. Potter County District Attorney Randall Sims says he will retry Lopez.
“What’s very clear is that the major misdiagnosis out there with child abuse is missing it,” Dr. Laposata maintains, but he makes clear that there are serious consequences to misdiagnosing abuse. “Overdiagnosis may be even worse than underdiagnosis, because not only are we affecting the child, we are now affecting another person.”
Dig Deeper: Take a look at Dr. Laposata’s PowerPoint presentation that highlights the difficulty in diagnosing abuse cases. On one side is a photo of a child with bruises from a bleeding disorder; on the other, a photo of a child who was abused.
“I’ve been looking at patients with bleeding problems for years, more than two decades,” he said. “And if you show me the two children with the bruises on their legs, I couldn’t tell you that that one is the bleeding disorder. I’d have to do the blood test to find out.”
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