NYT: Shaken-Baby Syndrome Faces New Questions in Court

[Guest guest]

Were the experts Wrong? Shaken-Baby Syndrome Faces New Questions in Court By EMILY BAZELON Some doctors are taking issue with the diagnosis of the syndrome, raising the possibility that innocent people have been sent to jail...Medical experts, however, have begun to point out that clinical observations show that it’s possible for a child to have a brain injury and still remain conscious. The child may be lethargic or fussy or may not eat or sleep normally for hours or days, while the subdural hemorrhage and other injuries become more serious, ending in acute crisis. This has made some doctors wary of pinpointing the timing of a child’s injury — even when they are sure that abuse occurred — lest the wrong adult take the blame. “The police want us to time it within one to three hours,” says Leventhal, a Yale pediatrics professor and medical director of the child-abuse programs at Yale-New Haven Children’s Hospital. “But sometimes we can only time it to within days.”...The defense relied primarily on Uscinski, a neurosurgeon on the faculty of the medical schools of Washington University and town. When he took the stand, Uscinski refuted all the prosecution experts who said that Noah’s hemorrhaging was acute — the sudden result of a new injury. Uscinski testified that he saw chronic subdural bleeding on the scans, which he said was the result of trauma at birth. “Rebleeds” like Noah’s, he testified, “can occur with minimal or no trauma. They can occur spontaneously.”...A dozen years ago, the medical profession held that if the triad of subdural and retinal bleeding and brain swelling was present without a fracture or bruise that would indicate, for example, that a baby had accidently fallen, abuse must have occurred through shaking. In the past decade, that consensus has begun to come undone. In 2008, the Wisconsin Court of Appeals, after reviewing a shaken-baby case, wrote that there is “fierce disagreement” among doctors about the shaken-baby diagnosis, signaling “a shift in mainstream medical opinion.”...A small but growing number of doctors warn that there can be alternate explanations — infections or bleeding disorders, for example — for the triad of symptoms associated with shaken-baby syndrome...