Neal and Christy Haynes spent $200,000 on their defense—retaining Yazbak and Uscinski as well as experts in pediatric ophthalmology and neuroradiology to provide expert testimony—and endured 14 months of trials and hearings. Then the charges against them were dropped. “The court further finds that...[Jake] Haynes is neither an abused minor nor a neglected minor,” Judge Chase Leonhard ruled. “Let this boy become a man in the home of loving parents and family. Please make it so.”
The fact that the Hayneses were able to tap leading medical experts who were willing to reduce their rates to devote scores of hours to their case is just the first of a number of fortuitous turns their story took. According to jury consultant Blake, theirs is more the exception than the rule.
“What Shaken baby skeptics say ?is generally not believed by a vast majority ?of doctors or medical organizations.”
SBS cases today, she says, practically require top-flight, credentialed medical SBS specialists on the witness stand who can produce a credible alternative scenario—more than just the reasonable doubt that courts theoretically require. Otherwise, she says, what remains is typically the testimony of doctors who believe that, absent a serious car accident or a two-story fall, only shaking can produce a subdural hematoma. And shaking means someone is guilty of child abuse.
“For the jury...the defense needs to prove what happened to this baby,” she says. “Unless you’ve got the money to hire top experts, you’re probably going to prison....It’s guilty until proved innocent.”
Cheri Landers, chief of the division of pediatric critical care at Kentucky Children’s Hospital in Lexington, says that if an infant were brought into the emergency room suffering seizures and was discovered to have a subdural hematoma and retinal hemorrhaging, she would want to ask the family about the background before rendering a diagnosis. “We would need to find out...was there any known trauma?” she says. According to Landers, a severe car accident, for instance, could explain subdural and retinal hemorrhages and consequent seizures. She points to a 1993 article in the journal Neurosurgery that examined the retinas of 140 children involved in car accidents. Two had hemorrhages, and both were in high-velocity side-impact crashes.
“When we discover no reason for the trauma,” she adds, “that is the point where we come to the conclusion that there is no reason for this other than shaking.” Landers cites a 2000 study in the journal Pediatrics that evaluated 19 Florida infants with subdural hemorrhages who were referred to the state’s child protective services in 1997. The authors selected nine of these cases and followed them up, reporting that every child was the victim of “inflicted injury, inappropriate infant handling, and/or high-risk social settings” such as a family with a history of domestic violence.
Neuropathologist Jan Leestma of Children’s Memorial Hospital in Chicago, who testified for the defense in the Woodward case, has come to a different conclusion. Leestma reviewed 324 apparent or alleged child abuse cases from 1969 to 2001 and published his results in a 2005 issue of the American Journal of Forensic Medicine and Pathology. Fifty-four of these cases involved shaking a baby. He found only 20 percent (11 cases) yielded no evidence of any impact to the baby’s skull—such as a fall from a changing table.
“When you have an impact, that trumps everything else,” Leestma says. Shaking means “10 g’s, versus 200 g’s” for an impact.
Impacts and falls are a world apart from shaking. Impacts could be anything from a simple but tragic accident to negligence to child abuse. But shaking means one thing: attempted infanticide.
What happens to infants when they are shaken or suffer an impact? Kirk Thibault is a biomechanical engineer with the Essington, Pennsylvania, firm Biomechanics, Inc. A research scientist who has studied the physical properties and stress loads of infant and adult brains, Thibault has been hired as an expert in, as he recalls, “seven or eight” SBS cases since 1998. (His father, Lawrence, is a research pioneer in the field and testified for the defense in the Woodward case.) Thibault the younger charges $300 per hour for expert consultation and testimony.
“I do not think of myself as an advocate for anyone, but I do advocate for the science,” he says.
Thibault points to a 2003 study in the Journal of Neurosurgery that used lifelike infant dolls with crash test dummy accelerometers inside their heads. A team of four bioengineers and neurologists from the Children’s Hospital of Philadelphia then simulated vigorous infant shakings—as might happen in an SBS case—as well as shakes that ended in an impact and drops from one-, three-, and five-foot heights.
The group concluded that shaking their model infants produced results “statistically similar” to one-foot falls onto concrete or a carpet pad or higher falls onto a foam mattress. These results were well below reported thresholds for causing the kind of intracranial bleeding observed in SBS babies, suggesting that shaking wasn’t enough to induce SBS.
“It’s drilled into people’s heads that shaking will kill these kids,” Kirk Thibault says. “I don’t know that shaking can’t kill a child. I assume you can probably shake a child to death. I have no idea.... What I specifically look at is whether shaking can cause loads [on the brain] that...can cause subdural hematomas. The flip side of that is people abuse kids,” Thibault says. But he adds, “You can’t simply categorically say this is all nonaccidental. I say one case at a time.”
Neurosurgeon Jean-Sébastien Raul, an assistant professor at the Institute of Legal Medicine at the University of Strasbourg in France, says he has a computer model of infant shaking that could help clarify the controversy. In a 2006 paper published in the International Journal of Legal Medicine, Raul concluded that, biophysically, shaking alone can produce the kinds of subdural hematomas that are seen in SBS cases.
Raul’s group drew from published properties of human baby brains and skulls and pig brains and skulls—markedly similar, he says, in biophysical properties. The group ran computer simulations that examined the behavior of veins that bridge the brain and the covering tissue surrounding the brain. Rupture of “bridging veins,” he says, is a known and well-understood cause of subdural hematomas.
Raul says he knows the 2003 Journal of Neurosurgery paper well but argues that the authors looked only at acceleration inside the skull. “We are looking at the relative motion between the brain and skull,” he says. It is this additional factor, he thinks, that produces the bleeding inside the shaken infant’s skull.
Thibault points out that Raul’s group conducted computerized experiments involving unknown situations without first confirming that their model could reproduce known experimental results. For instance, in 1984 Nobuhiko Aoki and colleagues at Nagoya University in Japan studied medical case records of infants who had fallen and hit their heads. Some had died, some had survived. All, Aoki said, had subdural hematomas and retinal hemorrhages and thus could potentially be seen as SBS cases. “You first have to [run your computer model] outside of the vacuum of your model,” Thibault says. “At least demonstrate that you can draw a line and say this is a threshold...and now I’m going to re-create every single one of Aoki’s falls.”
