Shaken Baby Syndrome or Shaky Justice?
By Douglas M. Smith MD, PhD
Shaken Baby Syndrome (SBS) was born in 1971 in an article entitled “Infantile Subdural Haematoma and its Relationship to Whiplash Injuries”[1] written by Dr. Guthkelch, a British neurosurgeon. He was trying to explain why many children with multiple bony fractures of different ages indicative of child abuse (battered child syndrome) had bleeding in the brain (subdural hematoma) but did not have a skull fracture or scalp bruises that pointed to an impact of the head. He suggested that whipping of the head back and forth during violent shaking might tear small veins that bridge the space between the brain and the skull.
This theory has evolved to explain subdural hematomas in infants who have no other signs of child abuse. Over time, medical examiners and prosecutors have built in proof of intent by excluding the possibility of an accidental injury. Common testimony has included that such injuries cannot be caused by short accidental falls but would instead require an automobile accident or a fall from at least a second story (greater than 10 feet). Testimony has also included statements such as the caretaker usually shakes the baby until their arms get tired.
The physical findings were expanded to include bleeding in the back of the eyes (retinal hemorrhages) and swelling of the brain. This has become known as the classic triad, which has been testified to as absolute proof of intentional violent shaking of the infant. The mechanism of these findings was initially explained as direct injuries due to the shaking motion but over time, as other non-traumatic conditions have been shown to cause identical physical findings, the explanations have changed. What has not changed is the commitment of some medical examiners and pediatricians that shaking can be proven beyond a reasonable doubt by finding the classic triad and that the person caring for the child at the time they became unconscious was responsible for the shaking. In the last 15 years, these assertions have become very controversial and there have been a number of post-conviction exonerations and challenges to the admissibility of such expert testimony.
Dr. Guthkelch has since disavowed what SBS has become, which is a pre-packaged murder case[2].
· “While society is rightly shocked by any assault on its weakest members and demands retribution, there seem to have been instances in which both medical science and the law have gone too far in hypothesizing and criminalizing alleged acts of violence in which the only evidence has been the presence of the classic triad or even just one or two of its elements.”
As technology has made “nanny cams” and other surveillance video more common, there have been a number of shaking or whiplash incidents caught on camera. In none of these cases, was there a head injury similar to that described as SBS. There have also been several short falls recorded on video that have resulted in the classic triad (unfortunately the short fall videos are in sealed records of the court so I cannot show you those).
By Douglas M. Smith MD, PhD
Shaken Baby Syndrome (SBS) was born in 1971 in an article entitled “Infantile Subdural Haematoma and its Relationship to Whiplash Injuries”[1] written by Dr. Guthkelch, a British neurosurgeon. He was trying to explain why many children with multiple bony fractures of different ages indicative of child abuse (battered child syndrome) had bleeding in the brain (subdural hematoma) but did not have a skull fracture or scalp bruises that pointed to an impact of the head. He suggested that whipping of the head back and forth during violent shaking might tear small veins that bridge the space between the brain and the skull.
This theory has evolved to explain subdural hematomas in infants who have no other signs of child abuse. Over time, medical examiners and prosecutors have built in proof of intent by excluding the possibility of an accidental injury. Common testimony has included that such injuries cannot be caused by short accidental falls but would instead require an automobile accident or a fall from at least a second story (greater than 10 feet). Testimony has also included statements such as the caretaker usually shakes the baby until their arms get tired.
The physical findings were expanded to include bleeding in the back of the eyes (retinal hemorrhages) and swelling of the brain. This has become known as the classic triad, which has been testified to as absolute proof of intentional violent shaking of the infant. The mechanism of these findings was initially explained as direct injuries due to the shaking motion but over time, as other non-traumatic conditions have been shown to cause identical physical findings, the explanations have changed. What has not changed is the commitment of some medical examiners and pediatricians that shaking can be proven beyond a reasonable doubt by finding the classic triad and that the person caring for the child at the time they became unconscious was responsible for the shaking. In the last 15 years, these assertions have become very controversial and there have been a number of post-conviction exonerations and challenges to the admissibility of such expert testimony.
Dr. Guthkelch has since disavowed what SBS has become, which is a pre-packaged murder case[2].
· “While society is rightly shocked by any assault on its weakest members and demands retribution, there seem to have been instances in which both medical science and the law have gone too far in hypothesizing and criminalizing alleged acts of violence in which the only evidence has been the presence of the classic triad or even just one or two of its elements.”
As technology has made “nanny cams” and other surveillance video more common, there have been a number of shaking or whiplash incidents caught on camera. In none of these cases, was there a head injury similar to that described as SBS. There have also been several short falls recorded on video that have resulted in the classic triad (unfortunately the short fall videos are in sealed records of the court so I cannot show you those).
Babysitter brutally shaking and throwing baby
Nanny camera video 60 year old shakes 5 month old baby
9 year old Attacks Toddler, Protect Your Children, Nanny cam
http://www.koat.com/news/protesters-storm-state-office-after-day-care-shut-down/35542820
In subsequent articles I will try to explain in more detail how many people have been sent to prison for long sentences or sentenced to life in prison based upon questionable expert testimony.
More info: http://abc7.com/news/mother-of-ie-twins-abused-speaks-out---exclusive/349676/
[1] Guthkelch, AN “Infantile Subdural Haematoma and its Relationship to Whiplash Injuries” British Medical Journal, 1971, 2, 430-431
[2] Guthkelch, AN “Problems of Infant Retino-dural Hemorrhage with Minimal External Injury”, Hous. J. Health L. & Policy 201-8, 2012
In subsequent articles I will try to explain in more detail how many people have been sent to prison for long sentences or sentenced to life in prison based upon questionable expert testimony.
More info: http://abc7.com/news/mother-of-ie-twins-abused-speaks-out---exclusive/349676/
[1] Guthkelch, AN “Infantile Subdural Haematoma and its Relationship to Whiplash Injuries” British Medical Journal, 1971, 2, 430-431
[2] Guthkelch, AN “Problems of Infant Retino-dural Hemorrhage with Minimal External Injury”, Hous. J. Health L. & Policy 201-8, 2012