HOME: THE JOHN LAVERTY, JR. CASE-- FALSE SBS CHARGES, WRONGFUL CONVICTION & IMPRISONMENT

THE "SHAKEN BABY SYNDROME" MYTH: Why top scientists say it isn't possible to shake an infant hard enough to cause the symptoms used to diagnose SBS and the probable real causes

INSTRUCTIONS PER CLINICAL MANUAL GUIDELINES--Emergency pediatric medical procedures in cases of suspected abuse: Take the history. If it doesn't match the severity of the symptoms, assume abuse. To provide evidence of abuse, do testing--differential diagnosis--to eliminate other possible causes.

Those are the medical guidelines doctors are given to follow in cases of suspected child abuse, including Shaken Baby Syndrome-Abusive Head Trauma. Tragically for all involved, almost all investigation stops at "assume abuse" when the symptoms believed to be diagnostic of SBS/ABT are found, in direct violation of published medical instructions. Even worse, those symptoms have been proven by biomechanical engineering studies (the experts in injury causation analysis) to be caused by something other than manual shaking, which doesn't provide enough force to cause the brain swelling and hemorrhaging found in these cases, in previously healthy infants, unless there is severe injury to the neck, cerebral-spinal column and/or spinal cord but these kind of actual whiplash injuries are never seen in cases diagnosed as SBS.

The following excerpt is from a page on this site addressing
biomechanical studies

"http://www.jpands.org/vol9no3/uscinski.pdf

Journal of American Physicians and Surgeons Volume 9 Number 3 Fall 2004
Ronald Uscinski, M.D.

TheThreshold of Injury
The Shaken Baby Syndrome

In 1971, Guthkelch hypothesized that subdural hematomas could be caused by manually shaking an infant, without the head impacting any surface. One year later, Caffey alluded, in a paper describing .parent-infant traumatic stress syndrome. (PITS), to manual shaking causing intracranial injury in the form of subdural hematoma and cerebral contusions in infants. Two further papers by Caffey over the next two years emphasized shaking as a means of inflicting intracranial bleeding in children.

After publication of these papers, shaken baby syndrome became widely accepted as a clinical diagnosis for inflicted head injury in infants. However, in 1987 and again in 2003, careful laboratory investigations based on the known biomechanics of head injuries showed that human beings cannot achieve the necessary accelerations for causing intracranial injury in infants by manual shaking alone, but that impact is required. Moreover, after more than 33 years, despite numerous reports of series of case studies, an actual witnessed incident in which an infant sustained an intracranial injury as a result of shaking alone has yet to be documented.

As is true in other scientific disciplines, knowledge of medicine should, and generally does, advance in two distinct ways. The first is clinical observation of various physical and physiologic manifestations of disease processes, with an attempt to verify underlying etiologic, anatomic, and physiologic principles. The second is laboratory investigation of both normal and abnormal (or disease) processes, in an attempt to arrive at underlying mechanisms. Ideally, both should aim to discover treatment principles."

The following excerpt from the manual explains why caretakers are automatically suspected of abuse on the basis of symptoms alone, regardless of physical evidence or lack of evidence and testimony to the contrary in the history provided. It also lists some (not all) differential diagnosis (other causes) and what tests to run for them. When abuse is suspected, they are rarely done in spite of these published guidelines which indicate they represent standard operating procedures doctors are instructed to do in their emergency medicine training, or at least provided for in published guidelines such as that below.

Not included in the list:

"Caffey's disease" (Infantile Cortical Hyperostosis) is listed as a possible healing stage of infantile scurvy in some online sources, and may represent a form of prenatal scurvy that manifests in the womb or shortly after birth.

At the time ICH was named by Dr. John Caffey (and others), scurvy was discounted because they weren't expecting to see it other than from dietary sources that took 6-7 months to manifest in infants, usually related to or involving formula feeding, although some cases of scurvy were seen in breast-fed infants. There were some mentions of recent cases being treated with vitamin C supplements, to no effect, but Dr. Archie Kalokerinos, who prevented SIDS and adverse effects in aboriginal babies who had been dying up to 50% after vaccinations made compulsory, used INJECTED vitamin C.

However, scurvy is always listed as a "differential diagnosis" (other cause) in ICH articles or studies. They didn't realize in those days that subclinical or prenatal infantile scurvy (Barlow's disease) was a possibility or that "modern" practices like junk food consumption, sugar, coffee, smoking, formula feeding, vaccination, antibiotics and antihistamines could accelerate or be the underlying cause of vitamin C deficiency, elevated blood histamine levels, or endotoxin bacterial poisons could all cause the same effects of "capillary fragility"--the hemorrhagic condition seen in scurvy--at an accelerated rate and in variant manifestations.

Online Clinical Manual
pages 543-44  Published 2002
$44.99
McGraw-Hill Professional Emergency Medicine
762 pages
ISBN:0071377506

This is where the the online pages ended, since only sample pages are provided free of charge. I will try to get a copy of the rest of this chapter including the Table 19-1 from another source. The yellow highlighted words reflect the key word search, not words that have been marked by me.

Updated information on autopsy medical tests that need to be ordered in unexplained death cases within a month of vaccination: A Parent’s Guide: What to do if Your Child Dies After Vaccination

Shaken Baby/Impact Syndrome: Flawed Concepts and Misdiagnoses
(Based on Review of a Series of Cases)
Harold E Buttram, M.D.
August 18, 2003

TESTS

"With findings of retinal and subdural hemorrhages, check plasma ascorbate and
serum histamine, to rule out subclinical scurvy; check prothrombin and partial
prothrombin times, fibrinogen level, fibrin split products, D Dimer test, and blood
smears to check for fragmented red blood cells to rule out coagulopathy, and if
DIC presence is indicated, to differentiate between acute and chronic DIC. With
elevated prothrombin and thromboplastin times, a PIVKA test should be done
along with thrombin time and fibrinogen to test for late-form hemorrhagic disease
of the newborn. In addition to the more standard blood tests including blood
counts and chemistries, there should be a serum iron, triglycerides, and absolute
neutrophil count in instances with low white blood cell counts. A metabolic
screening by tandem mass spectronomy would desirable to test for inherited
disorders of fatty acid oxidation, sometimes a cause of unexpected infant deaths.
(Refer to dhchace@neogenscreening.com, or Neo Gen Screening, PO Box 219,
Bridgeville, PA 15017)

- In cases of skeletal fractures, test plasma ascorbate and serum histamine along
with appropriate textbook tests for rickets; bone densitometry should be done to
rule out temporary brittle bone disease. If there are skull fractures and the baby
comes to autopsy, specific measurements of skull thickness should be required.

- When there is significant lowering of hemoglobin, hematology consult should be
requested and the patient evaluated for hemolysis."

"Comment: The differentiation between acute and chronic DIC is of utmost importance in
the courts, as it places the initial events causing brain hemorrhage in entirely different
time frameworks. Acute DIC of course reflects a recent event, on which basis most
shaken/impact baby accusations are made, but chronic DIC would tend to implicate other
causes of earlier origin."

Suggestions for researching a case.

• Assess diet during pregnancy.

• Review obstetric files.

• Get all of the labor and delivery files, and every piece of paper in the baby's files after deliver to discharge.

• Work out what was "normal" from what was "abnormal", from researching the symptoms. One may not realize what symptoms are relevant.

• Make a chronological account of all events preceding the final one--symptoms, vaccinations, medications, treatments, etc. "What happened" from beginning to end.
  
• SBS cases where violent shaking/impact is only assumed because the caretaker account doesn't match the severity of the symptoms, and where there were no physical signs (abnormal bruising can be caused by medical conditions) nor documented reports of abuse, these cases usually stem from a multi-factorial situation:

Inadequate diet during pregnancy, including processed foods, junk food, excess sugar and coffee (inadequate prenatal medical counseling in many cases) Smoking, second-hand smoke Health conditions, medications, vaccinations during pregnancy Baby born with low levels of vitamin K and C, and other micro nutrients. Vaccination sequelae Baby formula, or breast feeding followed by formula feeding--nursing disrupted and formula substituted Vaccinations in a baby too nutritionally and immunologically fragile to cope --resultant cascade of symptoms caused by lack of vitamin C, vitamin K, vitamin D. Secondary infections due to lowered immunity and a toxic internal terrain from vaccine poisons and virulent microbes causing rebound vitamin C deficiency. End result: a coagulation disorder and long term bone matrix disorder causing beading or healing bone callus arising from subperiosteal hemorrhage, misinterpreted as fractures. (They are identical on x-rays and require special testing to differentiate.) Proper microscope evaluation of callus formations on bone to accurately diagnose any long term malnutrition and resultant biochemical disarray. Abnormal bruising is classic for a progressional long term vitamin C deficiency and other hemorrhagic conditions, such as heparin-induced thrombocytopenia. Vaccines may medically overwhelm an infant or child already in a fragile condition from lack of or an inability to absorb and assimilate nutrients. There are reports of food allergies and digestive enzyme deficiencies resulting from vaccination, which further complicates nutrition.

---

http://www.bmj.com/cgi/eletters/328/7451/1316  Response to an SBS-related article by Dr. Michael Innis

Brian Morgan notes that findings of fact in the family courts and convictions in the criminal courts have been cited in biomedical literature in support of suggestions for assessment of child abuse. Both categories are subject to review and asks “how should the literature be amended?”

Based on my analysis of the records of 22 such cases I suggest the following amendments be made to ensure Justice in both the family and criminal courts:

1.The publication entitled “The Fabricated or Induced Illness Report” put out by the Royal College of Paediatrics and Child Health contains such statements as “Frank bleeding from the nose or mouth is significant of physical intervention, and to be distinguished from blood tinged secretions.” This and several other statements are likely to mislead the inexperienced with limited knowledge of haemostasis and should not be admitted as evidence of child abuse in the law courts.

2.The diagnosis of Shaken Baby Syndrome (SBS) is a fabrication and should no longer be considered a valid diagnosis. From evidence I have all the alleged cases of Shaken Baby Syndrome can be accounted for by the following:

a.Adverse reaction to a vaccine administered within 21 days of the onset of symptoms. (Check the history, Vitamin C and Histamine in the blood)

b.Haemorrhagic Disease of the Newborn or, more correctly, Vitamin K Deficiency Bleeding.(Check PT, APPT and PIVKA)

c.Malabsorption or Malnutrition which is often associated with low birth weight and prematurity (Check Serum ALBUMIN, UREA, ALKALINE PHOSPHATASE and ESSENTIAL AMINOACIDS)

d.Infections – both viral and bacterial (Check for EB Virus and perform test for C-Reactive Protein and FBC. CSF, Blood and Urine cultures)

e.Liver disease causing deficiency of clotting factors.(Check AST, ALT, GAMMA GT, PT, APTT, PIVKA)

f.Vasculitis including Kawasaki Disease and Microscopic Polyangiitis (Check AST/ALT, p-ANCA, c-ANCA and AECA)

While I do not have any cases of Alloimmune Thrombocytopenia, Bernard -Soulier Syndrome, Prekallikrein deficiency and other exotic bleeding or congenital disorders among the cases sent to me it is imperative that they be considered before making the erroneous diagnosis of Shaken Baby Syndrome.

I can produce documented evidence to support each of the categories, a – f, and I invite Professors Reece, Craft and Hall and the other 105 doctors [1,2] who believe SBS is not fabricated to produce a SINGLE case which cannot be accounted for by the conditions listed above.

If they cannot do so they should admit the diagnosis ‘Shaken Baby Syndrome’ has no legitimacy and should be abandoned forthwith. But judging from the huge financial considerations recorded by Tracy Emblem [3] it is unlikely they will do so and the only alternative is for the Law Courts in England, America and Australia to ignore a diagnosis of SBS as a Brisbane Court ignored MSBP as a diagnosis.[4].

Because it is necessary to restrict the word count one can look up 'Laboratory Medicine' The Selection and Interpretation of Clinical Laboratory Studies Edited by Noe DA and Rock RC. for the abbreviations.

Michael D Innis MBBS; DTM&H; FRCPA; FRCPath. Honorary Consultant Haematologist, Princess Alexandra Hospital Brisbane Australia.

References

1.Reece RM The evidence base for shaken baby syndrome: Response to editorial from 106 doctors BMJ, May 2004; 328: 1316 - 1317.

2.Craft AW, Hall DMB Munchausen syndrome by proxy and sudden infant death BMJ, May 2004; 328: 1309 - 1312

3.Emblem TL SBS Proponents Should Disclose Funding http://bmj.com/cgi/eletters/328/7451/1316#62462,

4.R v LM ttp://www.courts.qld.gov.au/qjudgment/ca04_151.htm (192)

---

http://www.bmj.com/cgi/eletters/328/7451/1316

"As a mother who went through the agony of temporarily loosing custody of my infant son, and nearly loosing custody of him forever, because it was wrongly claimed, he had been shaken, I understand how other similarly charged parents’ feel and suffer. I am therefore morally obliged to do whatever is possible to prevent this happening to other parents and carers unnecessarily.

In Australia, health workers, and others, are legally compelled to notify authorities, such as The Department of Youth and Community Services and the police, when there is evidence or suspicion of abuse – and this includes what has become known as ‘shaking’.

Unfortunately, few individuals understand the complexity of the issues involved. Often, from the beginning, a decision is made that the ‘cause’ of the problem is ‘shaking’, and there is no need to proceed through what should be the routine of what is known as a ‘differential diagnosis’. This involves a consideration of all possible causes, the collection of evidence and the performance of an array of special medical investigations.

Unfortunately this procedure is rarely followed. Worse still, as recent cases demonstrate, prosecuting witnesses sometimes deliberately withhold information, invent information, become extremely careless, break many of the rules relating to the collection and interpretation of evidence – and escape relatively unharmed when one compares their fate with the sufferings of those falsely, or wrongly, accused and charged.

In medical journals throughout the world the vastness of information that is pertinent to the pathologies found in so-called ‘shaken babies’ is impressive. This should be collected, carefully considered, and made ‘compulsory reading’ for all those involved in the investigation of cases. I have no doubt that, if this is done, justice will be served, and we will emerge from one of the darkest pages in the history of medicine into a better understanding of the nature of infant illnesses.

To begin, I suggest that the following investigations be considered:

Case history - including family history, pregnancy, labour, birth, and continue to the time of collapse, recovery or death.

The number of medical consultations, including those with nurses and specialists.

Reasons for these consultations.

Feeding, and gastrointestinal problems, including diarrhea

Antibiotics administered and reasons for why

All medications administered, Reasons why. Were there side effects or potential side effects? Were parents properly counselled about this?

All medications administered and reasons why. Was counselling about side effects provided to the parents?

Vaccine history including batch numbers in case some were known to be ‘hot’ batches. That is known to have produced excessive side effects.

Eardrums. Inspect on admission, and daily. If an infant dies both middle ears should be inspected during the autopsy and swabs taken to enable tests for bacteria and viruses. At the same time, if excessive fluid is present some should be collected and tested for endotoxin levels

Perform and record electroencephalogram, electrocardiogram, CT scan, MRI, brain ultrasound, Ophthalmic investigations, including retina, Retcam (retinal photographs), head circumference (repeat daily”, pupil size, record and repeat as necessary.

Neurological observations.

Skeletal survey – if possible.

Endotoxin levels in blood, and, if prudent, in the CSF.

Look for 'toxic' strains of gut bacteria. These produce excessive amounts of endotoxin. If an autopsy is performed light and electron microscope studied may reveal the presence of toxic strains and the damage done to the gut.

Look for abnormal gut viruses

Genetic testing of patient, parents, and siblings.

When ‘fractures’ exist, light and electron microscope studies of bones, including epiphyseal and fracture areas. This is recommended because, sometimes, fractures can be due to bone disorders related to the effects of endotoxin and an increased utilization of Vitamin C.

Extensive coagulation/bleeding profiles, including (despite some difficulties) platelet functions, capillary fragility, and bleeding time.

Blood levels of Vitamin C and histamine

Von Willebrand factor

Factor x111

Vitamin K levels.

D-dimer levels – to the end-point.

Liver and kidney functions

Bruise should be carefully examined, during life and autopsies – despite known difficulties. This includes (during autopsies, cutting into the areas, and light and electron microscope examinations.

Glutaric acid levels.

Some of these tests are expensive and laboratories will need to establish the necessary facilities. The alternative is to jail some innocent individuals for long periods and destroy their families.

If the doctors involved in the investigation of cases do not agree to do these tests, and satisfactory reasons for such actions are not produced, charges of negligence should be set in motion.

Parents claiming to be innocent should be entitled to know why these tests are not being done. During the 2001 International Conference on the Shaken Baby Syndrome, in Sydney, I asked Dr Ryan, who often gave evidence as an expert for the prosecution, why extensive tests were not done and he answered, in a packed lecture theatre, ‘Its too expensive’. My response was, ‘Then why are the parents and family not offered the opportunity to have these tests performed at their own costs?’ There was no answer.

Clearly, if parents and carers are innocent, and doctors and authorities claim that the cause of the pathologies is ‘shaking’, the only option available is to demand that tests be done. Furthermore, if tests are not done quickly, at the time of admission, as time goes by the presence of some causes may be absent or masked.

Despite the fact that retinal haemorrhages alone are not necessarily diagnostic of ‘shaking’, experts have been allowed to offer the opposite opinion without demonstrating that all other possible causes have been eliminated. This is medical and legal lunacy. The claim that certain ‘types’ of retinal haemorrhages are diagnostic is also a falsehood.

A PERSONAL NIGHTMARE

I was 5 months pregnant with my son, Codey, when our daughter developed diabetes.

At the 6 months stage I was found to have borderline gestational diabetes, and iron deficiency.

Codey’s birth-date, after an induction, was on February 28, 2000. He was artificially fed, and then quickly developed gut problems. His paediatrician found it necessary to change the formula 3 times in the first 2 months.

Progress was not normal. May 5, 2000, developed cold/flu

May 8, 2000, vaccinations – DPT, Polio, and HIB

Mid May 2000, Nasal congestion, trouble breathing – chest checked.

Early June 2000, Bronchiolitis and productive cough.

Mid June 2000, Bronchiolitis, fever, productive cough.

Antibiotics administered

June 21, 2000, Back to GP, a level of distress, concern about cry –query pneumonia, inflamed eardrums.

June 21, 2000, attends paediatrician. No improvement on antibiotics. Chest X-ray, otitis media. For check with GP in 6 days.

Deteriorates, extremely high temperature, crying, and severe coughing.

June 26,2000, Grand mal seizure. Admitted to hospital.

1st admission High temperature on arrival of ambulance.

Blood taken for tests on day of admission. These showed a leucocytosis, reactive thrombocytosis, high platelet count, high white cell count, and high glucose level. Intravenous drip. Antibiotics administered intravenously. Panadol and painstop administered frequently, alternatively.

Discharged June 30, 2000 – on augmentum for 8 days. Panadol and painstop continued.

Between June 30 and July 11, continues to have fevers, crying, back arching, little improvement. Antibiotics, panadol and painstop continued.

June 11, 2000, taken to GP. Given the ‘4 month’ DPT/polio and HIB, DPT/polio and HIB boosters

High temperature followed, arched back, crying. Panadol and painstop prescribed by paediatrician.

July 12, second admission. Another seizure. Hospital records show ‘Post vaccination febrile convulsion’.

Managed with pulmonary resuscitation, and high flow oxygen. Likely cause for seizure was said to be fever - post vaccination.

At this point Codey was not weighed. An overdose of antibiotics was administered intravenously. Next morning the consulting physician stopped this medication.

24 hours after admission Codey was diagnosed as a ‘shaken baby’.

Immediately, all tests were stopped. The authorities were called in, and we began a roller coaster ride that threatened to destroy our family.

Codey was removed to unknown foster care. – A day we will never forget!

August 4, similar presentation to that of July 12. Foster carer could not be located. Codey was hungry, and no formulae was available. Codey had a rash on his back, was unsettled, crying, and had loose, green and offensive stools.. A list of what was not done is as follows:

No blood tests

No liver tests

No ECG

No EEG

No MRI No CT scan

No brain ultrasound

No eye examination

No measurement of head circumference

No neurological monitoring

No pupil scale record

No skeletal survey

No intensive coagulation/bleeding studies.

13 months of court battles followed. Legal fees were $150,000. The effort involved was huge. It was as if we spent 25 hours a day and 8 days every week researching the literature so that we would at least understand what was going on in Codey’s little body. What we found was certainly not pretty. It was, in reality, a nightmare of unbelievable proportions.

The cause of what happpened? It was not something that we had done. It was not something that that was unknown. It was ‘the system’ that indoctrinated doctors, and others, in a way that closed all the doors to understanding and fed poison into the minds of those who were supposed, because of their special skills and training, to know better.

We know that Codey was never shaken.

We know that statements like, ‘Codey was a previously well baby’, were ludicrous to the extreme.

We know that only standard coagulation/bleeding profiles were done at admission, and never repeated.

We have reasons to believe that medical negligence contributed to the pathologies.

We know that the diagnosing paediatrician (who provided the evidence that was relied on for the diagnosis of ‘shaking’) later admitted that he should have carried out extensive coagulation tests, inclusive of testing for Factor X111 abnormalities.

The Department of Youth and Community blamed the hospital for errors. The hospital blamed that department.

Codey is now home and reunited with our family unit. He is safe, well, and has never been vaccinated again or prescribed antibiotics.

Our family believes in, and praises, the immunization schedule. However, we also believe that, for some children, immunizations can cause a number of side effects, (as stated in the TGA records), specifically when combined with other toxins and illnesses.

We also know that, today, as I write, sadly, there are innocent Australian families currently caught in the system and while in the system (ie, the Children’s Court) no-one can, and will, assist or intervene – even though those charged are innocent. The cry of HELP falls on deaf ears. There is no support, nowhere to turn! Hundreds of thousands of tax payer’s dollars, could be saved if SBS diagnosing physicians took greater care. I know. I have been there!

A few weeks ago in England, news-papers headlined, ‘Scotland Yard changes tact over suspicious baby deaths’ (Sandra Laville, Wednesday July 14, 2004, The Guardian). I was delighted to read this, and learn that UK authorities are progressing towards the reversal of unlawful convictions for what was stated to be the ultimate crime – shaking a baby to death.

Wrongly accused mother's like Angela Canning’s, Sally Clark and Trupti Patel, have, at last, through the efforts of a handful of dedicated individuals, been freed, physically and mentally, from terrible accusations.

The English authorities have stated, in response to criticism, that they now intend to ‘get it absolutely right, and that these investigations are something which need expertise and particular skills’. I quite agree!

I believe that it is possible to shake a baby to death. I also know that, often, there are causes for the pathologies that have nothing to do with inflicted trauma.

BOTTOM LINE

We NEED a DIAGNOSTIC PROTOCOL - WE NEED to get it RIGHT!

If authorities do not agree with what I have stated, particularly because there is a huge amount of supporting literature, they could be, and should be, regarded as being negligent. If they refuse to perform adequate tests, not pay adequate attention to case histories, and simply farm out the problem to individuals or organizations that are not properly qualified to handle the issues, they should be compelled to provide reasons for such actions – or face legal actions. They should not be allowed to wash their hands and walk away.

References:

1. Greenwald MJ, Weiss A, Oesterle CS, Friendly DS Traumatic retinoschisis in battered babies. Ophthalmology 93(5):618-625, May 1986

2. Vanderlinden RG, Chisholm LD Vitreous hemorrhages and sudden increased intracranial pressure. J Neurosurg. 1974 Aug;41(2):167-76

3. Tomasi LG, Rosman NP Purtscher retinopathy in the battered child syndrome Am J Dis Child. 1975 Nov;129(11):1335-7

4. Pollack JS, Tychsen L Prevalence of retinal hemorrhages in infants after extracorporeal membrane oxygenation. Am J Ophthalmol. 1996 Mar;121(3):297-303

5. Goetting MG, Sowa B Retinal hemorrhage after cardiopulmonary resuscitation in children: an etiologic reevaluation. Pediatrics 85(4):585 -588, April 1990

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13. Weissgold DJ, Budenz DL, Hood I, Rorke LB Ruptured vascular malformation masquerading as battered/shaken baby syndrome: a nearly tragic mistake. Survey of Ophthalmology 39(6):509-512, May-June 1995

14. Gutman FA Evaluation of a patient with central retinal vein occlusion Ophthalmology. 1983 May;90(5):481-3

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37. Gable EM Brandonisio TM Ocular manifestations of Donohue's syndrome. Optom Vis Sci. 2003 May;80(5):339-43 38. Donohoe M Evidence-based medicine and shaken baby syndrome: part I: literature review, 1966-1998 - Am J Forensic Med Pathol. 2003 Sep;24(3):239-42

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