The Child Cases

Shaken Baby Syndrome: A Diagnosis Challenged

by Gretchen Gavett

In the fall of 1997, America was gripped by the trial and conviction of Louise Woodward, a British nanny who was accused of shaking 8-month-old Matthew Eappen to death. Dr. Patrick Barnes, a pediatric radiologist who worked at Boston's Children's Hospital, testified that the child's injuries were "a classic picture of acute shaken baby injury" and that he died from a combination of shaking and a skull fracture.

But as he explains in the above clip, Barnes is no longer convinced that shaking played a role in Matthew Eappen's death. And he's not alone -- a growing number of experts are now questioning the frequency of the diagnosis. In fact, our partners at NPR report that Dr. Norman Guthkelch, the man often credited with discovering shaken baby syndrome, now worries that the finding is overused, and that medical examiners aren't considering other possibly causes when a child is injured or dies.

Shaken baby syndrome was a fairly accepted diagnosis through the 1980s and '90s -- an excellent primer on its history and controversy can be found in Emily Bazelon's February 2011 New York Times Magazine article on the subject. While some forensic pathologists no longer consider shaken baby syndrome when doing autopsies -- one, Dr. Jon Thogmartin, told us that his colleagues are backing away from it "in droves" -- there is still fierce disagreement about the subject in the forensic, medical and legal communities. And for good reason: There is little room for error when a child is injured or dies under mysterious circumstances. Defenders of the diagnosis say that the "triad" of symptoms -- subdural and retinal hemorrhaging and swelling around the brain -- more often than not points to abuse from shaking.

Statistics show that more than 1,000 children are diagnosed with shaken-baby syndrome per year, and anywhere between 100-200 of these cases result in a criminal trial. In the course of reporting The Child Cases with NPR and ProPublica, we found several instances of people being convicted of shaking a baby to death, only to be exonerated after new evidence came to light. And, importantly, the problem is not only the misdiagnosis of shaken baby syndrome; there are a myriad of other diseases that can mimic child abuse, including blood disorders and vitamin deficiencies.

As for Dr. Barnes, who now helps run a child abuse task force at Stanford University, his role in the Woodward case drastically changed his career. "I was really affected," says Barnes, "and began to question my role as a pediatric radiologist and a neuroradiologist as part of the child abuse team in these particular cases and [decided] that I needed to be more proactive … and insist that we do more thorough investigations."


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Posted June 28, 2011

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