Unlike Barnes, other experts who testified for the prosecution in the Woodward trial continue to support the validity of SBS. One of these is Eli Newberger, an assistant professor of pediatrics at Harvard Medical School, who was among the physicians at Children’s Hospital in Boston who treated Matthew Eappen in 1997. Newberger founded the hospital’s child protection unit in 1970 and has testified in more than 600 child abuse cases since then, dozens of which, he says, were SBS cases. Although he remains affiliated with the child protection unit, he retired from hospital work in 1999. He continues to teach, write, and provide expert testimony in child abuse cases.
“By the time I was asked to testify in the Louise Woodward case...there was a great deal of clinical understanding about [SBS-related] trauma,” Newberger says. “The infant’s head is disproportionately larger in relation to the rest of its body than our heads are. A child can’t stop the to-and-fro excursions of the head with its neck. The brain bobbles about. The infant’s brain is softer than the adult’s.”
SBS skeptics, he says, muddy the waters “with so-called theoretical or historical perspectives on abuse.”
Money, Newberger suspects, has brought otherwise good people over to what he and his colleagues call the “dark side,” doubting SBS. “I have never ceased to be amazed about what highly regarded, well published, scientifically informed doctors will do when they’re offered large amounts of money,” he says.
For the record, Newberger charges $450 per hour to consult and testify in SBS and other child abuse cases. The University of Florida’s Alexander charges $300 per hour as an expert consultant but notes that all the money goes to the university. Uscinski has, by his own estimate, been in the courtroom as an expert witness in SBS trials nearly 100 times since 1997. His SBS work constitutes 15 percent of his income, he says. His rates are up to $750 per hour as a consultant and up to $10,000 per day on the witness stand for out-of-town cases. “If it’s a public defender’s case, you get paid half that or one-third of that, or even less,” Uscinski says. “Not everybody can afford that, and I charge according to what people can pay.”
Despite his confidence in the existence of SBS, Newberger adds that he has consulted for the defense on two or three SBS cases in which, he says, a “juggernaut” develops. “The department of social services sends out a social worker,” he says, describing the usual procedure after a doctor reports a possible SBS case to the authorities. “If a parent does not know exactly what’s happening, very frequently the first conclusion is that they’re trying to hide something. And sometimes parents are racking their brains, coming up with one or two possibilities. Then it looks like they’re changing their stories. That can be used to damn them.”
The Haynes family of Rantoul, Illinois were caught in just such a juggernaut. In October 2005 the father, Neal, was charged in a civil case with shaking his then 3-month-old son, Jake (not his real name). Although not accused of shaking the baby, the mother, Christy, was also charged with abuse and neglect (for permitting the alleged shaking). Jake had been hospitalized three times over two months for fever, infection, difficulty breathing, and symptoms of seizures. He survived his third hospitalization and returned home healthy, with his parents. However, when emergency room doctors discovered retinal and subdural hemorrhages, they concluded that Jake’s medical problems must have stemmed from his being violently shaken.
“The traditional school of thought says whoever had that child [last] is the one who gets the ticket to the ball,” says Kristen Fischer, Neal’s attorney.
Court-appointed advocates for Jake assembled a time line that made Neal the likely alleged abuser. State child protective services then seized Jake and helped launch a civil trial to terminate both parents’ rights to raise Jake or potentially ever to see him again. (Both the Champaign County Court Appointed Special Advocate executive director, Genevieve Lambert, and her attorney on the Haynes case, John DeLaMar, declined an interview for this article.)
Lawyers for the family ultimately called in Uscinski, among other experts. As the chief pediatric neurosurgeon at Georgetown University Hospital from 1983 to 1993, Uscinski operated on the brains of, he estimates, four babies who were said to be victims of SBS, and he saw three or four others. “I noticed something in each instance,” he says. “I noticed that there was always a better explanation in that particular case than shaking.”
In the Haynes case, Uscinski rendered a professional opinion that concluded, “There is no question but that [Jake] Haynes had a chronic subdural hematoma.” As a chronic (rather than acute) case, by definition the “hematoma had its genesis weeks or months earlier.” Uscinski suggested that baby Jake’s breech birth could have itself produced enough force on the brain to cause subdural bleeding. This kind of wound sometimes doesn’t heal and can go undetected for weeks or months, he says.
F. Edward Yazbak, a Massachusetts-based pediatrician, examined Jake’s medical records and wrote a 51-page report for the defense that pointed to other possible causes of baby Jake’s hemorrhages, including adverse reaction to his vaccinations, a vitamin C and K deficiency, and/or a toxic level of histamine in his blood.
In fact, because doctors had already concluded the cause of Jake’s internal trauma was shaking, and therefore that the child was safe from further injury, they made a crucial mistake in his follow-up care. Leaving aside the judicial impact of an incorrect SBS diagnosis on caregivers, this may be the most worrying aspect of such a mistake: the impact on the child’s health.
In Jake’s case, by early December 2005 his head had swollen to the point that he was above the 97th percentile for head circumference. In mid-December, Fischer recalls, the doctors “decided that the hematoma hadn’t grown, but the brain was atrophying from the terrible abuse.” They sent the child home.
By late December, following the ongoing case, the defense’s Yazbak learned about Jake’s enlarging head size—brought about, he concluded, by a subdural hematoma that was in fact bleeding again. “[Yazbak] said this child has got to see a specialist immediately,” Fischer says. “If it’s unchecked, he’ll die.” The lawyers called a meeting with state child protective services, petitioning for a second opinion on Jake’s condition. Ultimately he was sent to a hospital in St. Louis, where doctors operated on the hematoma and put in a shunt.
The doctors “had gotten into the routine that it was shaken baby syndrome,” Fischer says. “And they could not get out of that routine.”