Junk Science – Shaken Baby Syndrome

Episode Notes

Transcript

Michael Semanchik:

Probably the most prolific example of well-entrenched junk science is shaken baby syndrome. Not only did it attract widespread support from law enforcement, but it also misled the entire medical profession. It was based on faulty studies that were not properly tested for causation. And unfortunately, those studies set the stage for a vicious cycle of circular logic that set the perfect trap for the innocent, but the worst part, everyone involved thought they were doing the right thing. My name is Michael Semanchik, and you’re listening to Junk Science – Shaken Baby Syndrome.

Singer:

Spent most of my life in prison chasing our dreams called chasing our dream, chasing the dream. Won’t somebody, please hear my peace? Won’t somebody, please set me free…

Michael Semanchik:

For those unfamiliar, back in the 1980s and nineties, there was a widespread belief that many infants and small children were being violently shaken to death when their frustrated parents lost their tempers. A key part of the theory was that this type of abuse caused unique injuries. And whenever those telltale injuries were seen, an immediate suspicion fell upon parents or caregivers. Obviously, the death of children invokes visceral emotions in our society. And so when one of these cases made the news, it created a huge media fervor. As time went on in industry grew up around education and prevention of shaken baby syndrome, there were nationwide media campaigns warning against the dangers of shaking a baby. Medical schools taught their students about it. Law enforcement learned how to investigate it. Shaken baby syndrome quickly achieved solid and seemingly unchangeable validity. But there was one huge problem. Those telltale injuries were not unique to Shaken baby syndrome, and unfortunately, many innocent people went to prison for murders they did not commit.

If you heard Zavion’s story from an earlier episode, you know how difficult one of these cases can be. For a defense team, this will be one of our most important episodes. The issues surrounding Shaken baby syndrome are very complex. It’s 100% true that violently shaking an infant can cause irreversible injury or death. The problem for law enforcement is proving that’s what actually happened. Just because a child dies with certain injuries does not automatically mean their parents abused them, but it also doesn’t mean they didn’t. So what is law enforcement supposed to do with that? I talked with Katherine Bonaguidi about this. She used to be a staff attorney at the California Innocence Project, but today she works as a San Diego County public defender. She is nationally recognized for her expertise in shaken baby syndrome. Here she is helping us navigate through the complexities.

Katherine Bonaguidi:

So it was initially called Shaken Baby Syndrome. Later the term shaken impact syndrome became a little more popular, and more recently it’s been called AHT, which stands for Abusive Head Trauma. These are all essentially different names for the same fundamental concept. And the idea basically that the medical theory was that someone would usually out of frustration or anger with a child, typically a crying child or what have you, that a person would vigorously and violently shake a child resulting in either very serious injuries, intracranial injuries, or in some cases death. And the scientific theory behind it was that essentially this vigorous force, this acceleration and deceleration, if you can picture someone shaking a baby and the baby’s head moving back and forth, that acceleration and deceleration force is so strong that it actually ruptured parts of the brain and caused bleeding in the brain, which in turn caused swelling and then resulted in all this intracranial damage. And typically the diagnosis was defined by what was termed the triad, a triad of three symptoms. So the first is subdural hematomas, the second is retinal hemorrhaging, and the third is essentially brain swelling. So those are sort of the three things that were really the hallmark of shaken baby syndrome, and sometimes they’re referred to as a constellation of injuries or the triad, whatever the term used. Those are basically the three types of symptoms and injuries we’re usually talking about.

Michael Semanchik:

Okay, so far we’ve learned what Shaken baby syndrome is and we know what injuries are associated with it. Another important aspect is the history of this junk science. Its origin story explains a lot. Why was there so much invested in it? Why was everyone so sure of its accuracy? Shaken baby syndrome is a classic example of junk science, good intentions with bad results. There’s a lot to unpack here. Here’s Katherine telling us about how Shaken baby syndrome came into public awareness.

Katherine Bonaguidi:

So it’s really interesting actually, you kind of have to go back in time to around the early 1960s. Back at that time, the societal view of child abuse in general was different. Child abuse was kind of a hidden problem. There was no such thing as mandated reporters we have now. It was often viewed as of a more familial or domestic problem, not really a societal one that other people got involved in, like teachers or physicians and so forth. And then there was a doctor, a pediatrician named Dr. Kemp in 1962 who published this article called the Battered Child Syndrome. And he basically was kind of ringing the alarm on the child abuse issue. And he wrote that basically pediatricians had a duty and a responsibility to identify and report child abuse. And he believed that there were lots of children being abused and not enough done about it.

And frankly, he was probably right at the time. So he suggested that doctors do a couple of things, essentially, number one, that they presume abuse, so that if there were ever signs of abuse, they should essentially presume in favor of it being abused and reporting and proceeding accordingly. And secondly, that doctors should undertake something of an investigation that they should ask questions beyond just medical questions, but factual questions. Questions about what had happened, what was going on in the family, the different people’s lives, and he was rather straightforward about this. Also, essentially attempt to solicit admissions from caretakers and family members and so forth. So Dr. Kemp was kind of the first person who really, really sounded the alarm on child abuse as a problem in our culture, and that pediatricians doctors should have a role in identifying and managing that.

Michael Semanchik:

As this podcast continues, we’re going to hear more examples like this where societal problems cause our society to react. And although that reaction begins with good intentions, it ultimately causes countless people to suffer. Sometimes in our haste to fix things, we create more problems than we started with.

Katherine Bonaguidi:

Then in time, a few years later, in the late sixties comes a neurosurgeon named Dr. Oma Aub Oma, and he’s doing research on whiplash injuries, how people are injured as a result of car accidents, what happens to human necks as a result of car accidents is what he’s looking at and wanting to know about. But he does a study on monkeys, on Reese’s monkeys, and I won’t give you all the details because they’re pretty distressing actually. But essentially what they were doing was heavily anesthetizing these monkeys and then subjecting them to acceleration and deceleration forces of a level and caliber equivalent to a car accident, a motor vehicle accident. So some really extreme forces on those monkeys to see what the results were. And lo and behold, many of the monkeys were exhibiting subdural, hemorrhaging, subdural hematomas, even though they had no impact, right? So this was very interesting to the doctors because typically subdural hemorrhaging was associated with impact trauma. Again, like something hitting the head, whether it’s a car accident or whatever else. But what Dr. Amaya was showing was that these monkeys were having those same injuries, the subdural hemorrhaging just as a result of the whiplash, the shaking the forces without any impact.

Michael Semanchik:

Just to make sure we don’t get lost in the details, Dr. Aya was doing a car accident study on monkeys. He was testing to see what would happen if they were subjected to rapid acceleration and deceleration. The one thing that was missing was a sudden impact. What was fascinating is that even though the monkeys never experienced that sudden impact, their internal brain injuries were very similar to the monkeys who did. Dr. Amaya’s observation was noticed by Dr. Norman Gut who had a couple of infant patients with similar internal injuries. He began putting two and two together and came up with a hypothesis about the injury causes. Soon others would join and take it to the next level, all in an effort to fix a societal problem.

Katherine Bonaguidi:

Then a couple years later in 1971, there’s a well-known British neurosurgeon named Dr. Guth Kel Norman Gch, and he was very intrigued by Dr. Omaha’s study of the Monkeys. And Dr. Gu Kch had a couple of patients, infant patients that were exhibiting subdural hemorrhaging without any evidence of impact. So these kids did not have skull fractures or any evidence that anything had hit them on the head or any kind of external trauma, and he’d been trying to figure out in the absence of that external trauma, what had happened to these children. And based on Dr. Amaya’s study with the monkeys, Dr. Gut, KCH started to hypothesize, and I want to emphasize the word hypothesize, that perhaps what had happened to these children was shaking. Perhaps they had been shaken, and that’s what had caused their intracranial injuries, just like the whiplash motion had caused those injuries in the monkeys.

Then it comes another doctor, Dr. Caffey, who was a pediatrician who wrote an article called Whiplash Shaken Infant Syndrome, and his article was essentially just based on Dr. Amaya’s article about the monkeys and Dr. Gus KO’s hypothesis. So he had read those two articles and wrote his own and this syndrome that he developed, and this is essentially the underpinnings, this is the beginning of what would later be termed Shaken baby syndrome. He surmised is that any time you have subdural hemorrhaging and retinal hemorrhaging in the absence of any evidence of impact, you should presume essentially that there has been shaking

Michael Semanchik:

And not just shaking from let’s say a car accident, but a human could shake a person and cause those same things.

Katherine Bonaguidi:

Right? Exactly. And that began again as sort of a theory of his. He didn’t conduct a study of his own. The concept was based on the two articles before him. And interestingly, since that time, Dr. Guth Ke has come out and said that he’s very saddened that what was merely a hypothesis of his and unproven hypothesis may have resulted in a great medical misunderstanding and in turn, many wrongful convictions.

Michael Semanchik:

Just to summarize and catch us all up, shaken baby syndrome started as an unproven hypothesis. What is so scary is how it gained nationwide acceptance in the medical profession without actually being tested. Doctor after doctor simply assumed its validity. Articles were written about it, medical students learned about it. There were public service announcements about it. The more people talked about shaken baby syndrome, the more they believed in it, even the main pillars of the medical profession were in total support of the theory. As a result, shaken baby syndrome cases became notoriously difficult for defense attorneys. After all, most people trust their doctors and for good reason. But truth be told, doctors are human and can make mistakes just like the rest of us. Unfortunately, the juries were not in a good position to push back. The apparent expertise of doctors essentially prescribed a decision to the jury through a medical diagnosis. What is a medical diagnosis? Katherine coined this term. Here’s more from her.

Katherine Bonaguidi:

The term a medical diagnosis is just that a combination of a medical theory and a legal one. So let me back up a little bit. By the time the SBS theory had been the common understanding in the medical community, doctors were coming into court in the context of criminal prosecutions and also family law where there were efforts being made to take children away from their parents. The doctors were coming in and testifying unconditionally that these injuries were the result of abuse, and I really want to emphasize that word unconditionally, because they weren’t saying this could be the result of abuse or this probably was the result of abuse, or more likely than not, or in my experience, this is a result of abuse. They were essentially saying there is no other explanation for these injuries besides abuse. And sometimes they would follow it up with the only other possible explanation for these injuries besides abuse would be a gross motor vehicle accident or a child falling out of a window from several stories high. Those are the only other two scenarios where injuries like these would result.

Michael Semanchik:

This part is terrifying. What scares me specifically is that doctors are at their core scientists, they’re taught to question, they’re taught to test and challenge theories. Western medicine depends on this lifelong student philosophy, and yet with Shaken Baby syndrome, the conclusions were so reflexive and automatic given the amount of trust we put in our doctors, a word or belief from them goes a long way, and that can spell doom for an innocent person wrongfully caught up in our criminal justice system.

Katherine Bonaguidi:

So basically the doctors are telling juries, yeah, if you don’t have evidence that this kid fell out of a window or was in a horrific auto accident, then I’m telling you this child was abused. And I’m telling you, the person sitting at the defense table is the person who did it. So let me come back to what I term this sort of medical diagnosis of murder essentially. And the reason that is, is because the Shaken Baby syndrome cases became real slam dunks for prosecutors, easy convictions for prosecutors. And here’s why, because the syndrome itself established all the elements that the prosecutor needed to prove up. The doctors are saying, when you see the triad, when you see subdural hemorrhages, retinal hemorrhages and brain swelling, that means there was abuse and it means this person sitting at the table did it. Here’s why. Number one, we know the manner of death, the mechanism of death, okay?

So they’re testifying to the jury that’s shaking, no room for reasonable doubt. There something that that’s easy then for the prosecutor to prove up. The second thing is the intent, right? Why? Because the doctors were saying these cases were very clearly not accidents. Hey, ladies and gentlemen of the jury, this child didn’t just fall accidentally or get pushed by another kid or something accidental. These weren’t accidents at all. These were incidents of abuse shaking. And by the way, the shaking is so vigorous and so violent that there’s no way this person just gave a small shake or accidentally picked up the child roughly or something like that without understanding the effects of their conduct. In other words, this shaking was so violent, it was done knowingly, maliciously with intent, right? And then the third thing was that it easily allowed the prosecutors to prove up the identity of the perpetrator. So at the time, the common medical understanding was that a child would collapse almost instantly after the event. So if a child was shaken either essentially immediately or moments later, the child would stop breathing, collapse and so forth.

Michael Semanchik:

I want us to keep an ear out for this timing aspect of Shaken baby syndrome. This false belief that death occurred immediately after a child was shaken was extremely consequential for innocent defendants. As we will soon hear, if you happen to be the adult who was with the child when they collapsed, it was automatically assumed you were the one who caused the injury.

Katherine Bonaguidi:

So doctors could be certain in their minds that whoever was with the child when they collapsed was the person who caused the injury. So whoever was with this kid when the kid lost consciousness is at fault, and that’s the guilty party. They’re guilty of abuse, and they’re the bad guy in the black hat. So again, these were really easy cases for prosecutors to get convictions on, and I think it’s an important point. I know I use the term a medical diagnosis for murder, and I use the term murder, even though these aren’t your standard murder cases. More typically, they would be prosecuted under a different charge, which was assault on a child resulting in death. And I’ve often wondered whether juries convicting people of that had any idea that this charge carries the same sentence as murder, and it carries a sentence of 25 to life.

This is my opinion. I don’t have a way, there’s no way to collect data on this, but I have often thought that this is a way for prosecutors to essentially get a murder conviction without having to persuade jurors that this was in fact a true murder and that perhaps jurors might’ve conceived of these cases as something more similar to a manslaughter where a parent is just at their wit’s end and they snap and then begin to shake. And then all the while that the jurors had no idea that this person would be sentenced 25 to life and potentially die in prison.

Michael Semanchik:

Although the medical studies supporting Shaken baby syndrome were fundamentally flawed, it did not stop junk science from taking root. And it’s easy to see why everyone thought they were doing the right thing. Doctors were just using their education to help law enforcement believed they were getting another abuser off the street. The desire to help children outpace the truth. This was a major blind spot, and it led to needless suffering. At the root of the problem is how the scientific studies were set up to support a result rather than actually test it. These flawed follow-up studies reinforce the original incorrect assumptions. Katherine walks us through how the experts got this so wrong.

Katherine Bonaguidi:

So I get asked this a lot, and I think it’s a really important point to make because most doctors who go into the work they do are intending to help people. They’re not lying. They’re only talking about what they have learned and what they have been taught, and I think their hearts are in the right place and they’re trying to help children. So I think that’s an important point to establish that it’s easy to malign what other people have said or done, but I think the majority of physicians who testified in this case were testifying to what they were taught in medical school. So there were a lot of studies, but the studies were no good. Let me tell you why. First of all, I think it goes without saying there could never be classical studies done, normal scientific studies done on children for obvious reasons, obvious ethical reasons that prevent people from experimenting on children.

So that goes without saying. But the other problem is that most of these studies that existed were essentially establishing an association between child abuse and these particular injuries, the triad injuries rather than a causational relationship. We’re talking about correlation versus causation. Yeah, exactly. So let me kind of explain what I mean. The studies that existed over a couple of decades basically established that the triad was more associated with abuse than it was with accidental trauma. The studies were establishing that retinal hemorrhages, subdural hemorrhages, and brain swelling, this constellation of injuries was more associated with abuse than with accidental trauma. But here’s the problem. The studies were deeply flawed, and it’s a circular reasoning issue. Here’s why. The studies were essentially designed. What they were trying to do was look at cases where children had been abused and catalog what the injuries those children were manifesting were.

So they were basically surveying data from hospitals and so forth, looking at the kids that had been abused and saying, now, what injuries do these children have and what conclusions can we draw from that? Well, the only problem was that the way they were identifying which kids were the ones who had been abused was because they had certain injuries in the first place. So basically what they were doing was identifying which children had been abused by the fact that they were presenting with the triad symptoms. Then when the researchers would go back and look at the kids who had been categorized as abused, and they would go see what their injuries were, the injuries were always the triad symptoms. So it’s obviously a methodological problem, right? You cannot assume in your research a set of circumstances that is the very thing you are trying to test or trying to prove. And that’s basically what they were doing in study after study after study.

Michael Semanchik:

Did you catch all that? It was really subtle, but this part is very important to understand how faulty studies and circular logic sent innocent people to prison. At the very beginning, doctors wanted to figure out what was causing some children to mysteriously die. Although these children had internal brain injuries, the so-called triad injuries, they did not have visible external injuries that would explain how those internal injuries got there. So the doctors gradually began to theorize in a series of unproven reports that violent shaking caused the mysterious deaths wanting to protect children from these mysterious deaths. Law enforcement studied those early shaken child reports and started training their investigators to look for the triad injuries. When they would find those injuries, they would categorize child abuse as the cause of death. Healthcare professionals were also aware of those early reports, and in similar fashion, they would categorize child abuse as the cause of death.

And because of the new reporting guidelines, they were often the ones calling the police when they discovered triad injuries. Years after all of that got started, different groups of doctors and researchers would initiate their own studies regarding child deaths, and they used the information from those police reports and hospital records. Naturally, all of these later studies noticed the same pattern of injuries resulting in the death of a child, child was shaken, child suffered triad injuries, and then the child died over and over. The result was the same. But the problem with those studies is that the doctors incorrectly assumed that both law enforcement and the hospitals accurately identified the causes of death in the first place. As we will soon hear, that assumption was ill placed because actual causation was never proven from the very beginning. And unfortunately, the misunderstanding kept getting affirmed in this flawed circular logic, echo chamber garbage information in and garbage information out.

What started as a mere hypothesis in some early unproven reports turned into training and follow-up studies that continually reinforced entirely false conclusions about shaken baby syndrome. Everyone meant well, everyone applied the best information they had at the time, but they all got it wrong because it is both immoral and unethical to experiment on children. There was no way to fully test causation. Both law enforcement and the medical profession failed to look at other causes for the triad injuries. As a result, countless innocent parents and caregivers were falsely accused and convicted of child abuse. Here’s more from Katherine on how this began to unravel.

Katherine Bonaguidi:

So it really became no surprise that retinal hemorrhaging, subdural hemorrhaging became associated with abuse because those were the same kids that it was being determined had been abused. Does that make sense?

Michael Semanchik:

Yeah. And you’re not looking at those kids that had succumbed to some sort of accident, right? I mean, you’ve totally just eliminated them because they don’t fit those same circumstances. Then you’re not looking to see where an accident might be the same cause of the same,

Katherine Bonaguidi:

Right? And people weren’t studying the brains of those kids yet, although they would later. And that kind of comes to an important point in a few minutes. But I think it’s important to note that there was a major study done, a comprehensive survey by the Swedish government in 2016 where they basically looked, they looked at all the metadata, they looked at all these other studies over the decades that had been done on the subject of shaken baby syndrome, shaken impact syndrome, abuse of head trauma, all these different names, and they looked at all these studies and they found that all of them, but for two, were deeply flawed and basically of low quality. In other words, essentially no scientific value. So this is the same institution, this governmental agency that hands out the Nobel Prize. This was the most comprehensive study that was ever done, looking at all the different data from different studies across the US and different parts of the world over different time periods and different scenarios. And this is the conclusion they reached that basically this whole body of research was deeply methodologically flawed, essentially because of problems of circular reasoning, and thus a very low scientific quality and value.

Michael Semanchik:

So just to rehash on how the Shaken baby syndrome Echo chamber got so firmly entrenched, a flawed study suggested that the triad symptoms, those so-called telltale injuries were proof positive that a child was killed by abuse from shaking that study’s results were never properly tested. As a result, a generation of doctors falsely believed Shaken baby syndrome had unique symptoms and could be conclusively detected that misplaced faith was passed along to first responders and law enforcement. Law enforcement would identify those symptoms and incorrectly assign a cause of death without considering alternative causes. Then follow-up. Medical research would use those same false reports to once again draw false conclusions about the uniqueness of triad symptoms. As a result, the junk science wheel would spin round and round, reinforcing false data, false causations, false accusations, and eventually false convictions. Countless innocent people are still in prison because of this.

Imagine how awful that was. An innocent parent loses their child and freedom at the same time. This tragic story would repeat itself for decades. It wasn’t until much later when video evidence came out that things began to change. What was not understood at the time was that children can suffer traumatic brain injuries from seemingly harmless falls. It’s extremely rare, but it does happen. Although the medical profession knew about these falls, it was not easy to accept because children fall down all the time without dying. But that all changed when home videos surfaced, showing small falls that killed children. These real life documented deaths were extremely sad and disturbing, but the information gathered would begin to change Opinions about shaken baby syndrome,

Katherine Bonaguidi:

We now know that there are a lot of other things that cause retinal hemorrhages, so one of them is shortfalls. Other things can be edema, essentially swelling. There are all kinds of other natural accidental causes of retinal hemorrhages, meningitis, it can be serious infection. All these kinds of things can cause retinal hemorrhaging. And the same is true with subdural hemorrhaging. So natural diseases and accidents can cause all these same symptoms that were once thought to be exclusively diagnostic of abuse and specifically of shaking. We now know that there are other mimics out there. Some of them are accidental, some of them are medical, but there are other things that can cause a lack of oxygen to the brain and in turn, the triad symptoms. The second thing is shortfalls. So as I have been saying, we now know that shortfalls can tragically kill kids. I can give you some examples of there’ve been a lot of studies published again over the last probably 20 years or so, I’d say, especially since maybe around 2006, documenting some really terrible incidents where kids have fallen and either ended up in a coma or unfortunately have died.

And these sorts of situations include falls off of a place structure, one of those plastic play structures that’s about two and a half feet off the ground in a garage. Another one like that happened on a play structure at the mall. Another one was off of a couch. Another one was at a bowling alley where the kid fell backwards. Another one, a child falling off of a lawn chair at a birthday party, another one with the child falling off a laundry basket. Another one where an infant was dropped by its mother in a parking lot. There are several instances of cases like these. There have been many, and the ones I’m just describing to you right now are the ones that are documented. That means either they’re videotaped or they basically occurred in public or were witnessed by several people. We have no idea how many times things like this have happened in the household where nobody had a video camera rolling or there weren’t a bunch of people around. So yeah, there could be instances of a child falling off a counter or out of a Hyatt chair or off a couch or what have you, but because there weren’t witnesses to that, people presumed abuse. And now that person’s sitting in prison,

Singer:

Try as you might.

Michael Semanchik:

It is awful to think that it took videotaped tragedies to start debunking the flawed use of shaken baby syndrome, but sometimes we just have to see something with our own eyes before we believe it.

Unfortunately, there was one more domino that needed to tumble before the criminal justice system corrected its perception of shaken baby syndrome. And this was a critical aspect to understand that critical domino was something known as lucid intervals. A lucid interval is that time between a fall and the moment when a child collapses from their unknown injury. During that time, the child would appear to be totally normal, even though they were actually fatally injured. Such lucid periods could last up to 72 hours. So whoever was with the child when they finally collapsed would often be blamed, even though they had no clue what happened. And remember from earlier, doctors believed death was immediate following a shaking event. Lucid intervals threw a huge wrench in their logic machinery.

Katherine Bonaguidi:

So back in the day when doctors were testifying on shaken baby syndrome cases, they were telling the jury, listen, this kind of injury to a child is so violent and so extreme that the child collapses almost immediately. It’s more than this child’s body could withstand, and they are going to collapse, lose consciousness, stop breathing in a matter of minutes, maybe an hour. That’s basically what doctors were testifying to uniformly across the country in years past. Now, we know that lucid intervals can happen. So what are these lucid intervals? They’re a period of time in between the injury, whatever it might be, whether it’s accidental, abusive, or anything else between the time of an injury and the time that that child stops breathing or collapses. There’s sometimes a period of time during which the child essentially behaves normally, maybe they cry a little bit, but after an injury or something like that.

But they have this window of time sometimes where they might eat, they might talk, they might be a little fussy, but they’re essentially normal. They’re not losing consciousness. Sometimes they’re not even losing their appetites. So there’s this whole window of time that is now possible between the moment of an injury and the manifestation of the symptoms. What that means is that you’ve just dramatically broadened the window of time during which this injury might have occurred, and that means you’ve now just broadened the parameters of who may have caused this injury or how this injury may have been caused. So most doctors will agree that lucid intervals can last up to about 48 hours. Some will say 72 hours. Essentially, they’ll all agree now that it’s several hours, a couple of days, sometimes more than that. That really changes the narrative. They may have been injured hours earlier or days earlier, which means they might’ve been injured as a result of an accident or perhaps as a result of abuse. But if it was abuse, we don’t necessarily know who perpetrated it, or at least we know it’s not necessarily the person that was with the child at the moment. They collapsed.

Michael Semanchik:

When did we see people actually looking in a different direction other than this assumption or this automatic thought that it had to be shaking and it had to be by the person that was last with the child?

Katherine Bonaguidi:

So I would say like anything else, things don’t happen overnight. There’s a shift that begins to happen until it results in a major, what some courts have called the sea change in the science. But in general, I would say that change started around 2001. And it really started, I would say, with a study by Dr. Gettys in the United Kingdom. And she was a British neuropathologist who in 2001 started looking at the actual brains of children who tragically had died, and she started comparing the brains of these different kids, and she compared the information she had about the brains of children who had died as a result of supposed abuse with the brains of the children who had died supposedly of accidents and other things, sometimes natural causes. And she started looking at the brains of all these different children and realizing that essentially the injuries were the same.

And what she concluded from that was basically two things. Number one, that these injuries were caused not necessarily by abuse or trauma, but essentially by a lack of oxygen to the brain so that the subdural hemorrhaging, retinal hemorrhaging is a secondary effect of a lack of oxygen that is a result of the various things that are going on and the swelling in the brain. There’s a lack of oxygenated blood being delivered to the brain, and that’s what results in these injuries. Now, a lot of different things could cause that. In other words, those injuries don’t require abuse, and more specifically, they don’t require that acceleration and deceleration force that was supposedly distinctive of shaking. To the contrary, this lack of oxygen can be caused by a variety of things, whether it’s abuse, whether it’s accidental trauma or some natural causes, medical causes.

Michael Semanchik:

These new studies were a great start, but unfortunately, it would take many more tragedies to reveal flaws. With the original studies, it would not happen overnight, but things were beginning to change. The unquestioned faith in shaken baby syndrome would gradually give way to open minds.

Katherine Bonaguidi:

So the Getty study really started to change the way these cases were viewed by the medical community. Slowly, there was another important study that came out, an article that was published by a pathologist in Minnesota named John Plunkett. And John Plunkett had sadly, very sadly, a video of a child falling off of a play structure who died not long afterwards. And as tragic as that scenario is, and the video was, it was hugely important because now there was documented evidence of a shortfall causing the death of a child, whereas before doctors had been testifying in court that that was impossible. That could not happen. Now, there was video evidence of it. So John Plunkett wrote an article about that, and he started also asking a lot of questions, posing a lot of questions to the medical community about the importance of biomechanics and studying how different forces work in the injury of a child. So by looking at the short fall of which he had the video footage, he started searching what the forces are of falls and how shortfalls can create just as much or in fact more force than actual shaking could. So he kind of rang the bell to alert everybody to the importance of biomechanics and understanding that in fact, the forces of a shortfall can be just as lethal and in fact, far more lethal or dangerous to a child than shaking would be.

Michael Semanchik:

As we just heard, the lucid interval really changes the investigations. Shaken baby syndrome used to be considered an instant event, and so whoever was with the child when they collapsed was the first to get blamed. Now, with a lucid period of days, causation gets really tenuous. But looking back, when you factor in alternative causes like disease, accidents and shortfalls, it’s no wonder why so many people could be falsely accused. What’s even more frustrating is that the whole original physics argument behind us BS didn’t pan out either. As it turns out, the unique physics required to create those signature triad injuries are not likely to occur virtually. No one has the strength to cause the rapid acceleration and deceleration force needed to injure an infant’s brain without also injuring their neck. So even if someone actually shook their child to death, there would be neck damage accompanying the head trauma.

Here’s Katherine and I wrapping this up. I want to talk really briefly just about something that you said that I think a lot of people can probably relate to. And it was about something that Dr. Plunkett had talked about in one of his studies, and that’s that he wasn’t finding neck damage. And I know as a parent, when you have a young child and you’re holding that young child, you have to be mindful of the child’s head because they don’t have a very strong neck. So talk more about that. Talk specifically about what we should see or what you would expect to see if there was this violent shaking with regard to a child’s neck.

Katherine Bonaguidi:

Yeah, so we now know that the forces caused by shortfalls are actually biomechanically greater than the forces caused by any kind of shaking. We know that essentially the typical adult is in fact incapable of shaking a child hard enough to cause the kind of injuries that were symptomatic of the triad. I don’t want you to misinterpret what I’m saying as somehow condoning shaking or saying shaking is okay. What I’m saying is there’s no scientific data to show that shaking causes these injuries. So a person would have to shake a child so hard to create the quantity, the amount of acceleration and deceleration necessary to cause these intracranial injuries that a neck injury would have to accompany that. So maybe a simpler way to say it is that it would be almost impossible to shake a child hard enough to cause subdural, hemorrhaging and retinal hemorrhages without also damaging their neck. And time and time again, there has not been neck injuries in these cases, so it defies common sense. Baby’s heads are so heavy and their necks are so fragile that if someone were really creating that kind of force upon a child, a force so great that it would cause bleeding and swelling and rupturing in the brain, that certainly there would also be spinal damage, cervical spinal damage, and that just hasn’t existed.

Michael Semanchik:

Do you have any kind of an estimate as to how many people might be sitting in prison in the United States on an SBS theory of shaking?

Katherine Bonaguidi:

I have no idea what that number is. I don’t have a good way to gauge it. I can only say, again, I shudder to think

Michael Semanchik:

We will probably never know how many innocent people in their families were impacted by shaken baby syndrome. Discredited sciences are one of our biggest concerns for innocence cases, since more than one piece of evidence can be relied on by jurors when they convict. It’s not easy to know how influential a particular science was versus another that makes appealing a conviction based on junk science. Much more complicated, and that’s what we’ll discuss next time when we wrap up our conversation about junk science undoing the damage. Thank you for listening. We hope you enjoyed this episode. Brought to you by the generous support of Clio, the legal operating system for client-centered law firms. Produced and written by Laurence Colletti Audio Engineering by Adam Lockwood. Special contribution of music and sound elements by real life exoneree, William Michael Dillon. You can find his catalog of [email protected]. That’s frameddillon.com. Until next time, I’m your host, Michael Semanchik, and you’ve been listening to For The Innocent here on Legal Talk Network.

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