Pathologists

[2009 Jan] The pathologist challenging shaken baby syndrome

[2008 Oct] Inquiry blasts pathologist Smith and his overseers

[March 2007 Jean Charles de Menezes] Dr Kenneth Shorrock

"Death was certified to be due to the Shaken Baby Syndrome on the evidence of Pathologists, Paediatricians and Radiologists when all the haematological and biochemical evidence clearly indicated death was due to a coagulopathy following hepatic insufficiency and malnutrition."--Michael D Innis

[2009 Jan] The pathologist challenging shaken baby syndrome  The problem with the shaken baby controversy is that it's very dogmatic. If I don't accept religious dogma (and I don't), I'm not going to accept scientific dogma. If it's there, it can be proven. I do recognise that some adults are capable of doing nasty things to children, but I'm uneasy about people saying: "Oh, if a baby has got subdural haemorrhage (SDH), retinal haemorrhage and brain swelling, it can only be shaken baby syndrome." I'm trying to find out the mechanism of bleeding in the brain in babies who have not been shaken.
     I'm exploring all sorts of theories. My colleague Marta Cohen from Sheffield Children's Hospital and I have just published a paper with observations of our autopsy work on fetuses and babies over the last couple of years. We selected 55 cases - 25 late third trimester fetuses who died shortly before delivery and 30 newborns - who had haemorrhage within the membrane that covers and separates the two halves of the brain, and compared this with the level of brain hypoxia, or oxygen deficiency. We knew that none of these cases could possibly be inflicted trauma. We found that all those with severe brain hypoxia and half of those with moderate brain hypoxia had SDH. This is the same type of SDH that some people describe as specifically indicative of shaken baby syndrome. A similar pattern of haemorrhages has been described in the retinas of newborn babies dying of natural causes. We think that in these cases the haemorrhaging is caused by the hypoxia.
    My concern is that by relying on this famous triad of symptoms - brain hypoxia, SDH and retinal haemorrhages - to diagnose shaken baby syndrome, when there's no evidence of inflicted trauma, we may be sending to jail parents who lost their children through no fault of their own. As scientists it's our duty to be cautious when we see the triad, and to take each case on its merits. We owe it to the children and their families.