Angela's legacy

Death in the Family

April 05, 2008
Three of her children were dead. Now the fourth was sick. The verdict seemed obvious but then came a reversal in medical opinion. So why can't Kathy get her daughter back? Mark Whittaker reports.

A social worker woke her. “Kathy, we want you to come with us to answer some questions about Eve.” It was 11pm. Kathy got up fully clothed from the squeaky fold-out bed beside her sick baby’s cot.

“Why?” she asked.

“We have concerns for your daughter’s safety.”

“Excuse me?”

As Kathy followed the social worker along dimmed hospital corridors, he turned to her: “You know the police are up here.” They entered an office where the child protection team got straight to the point. Unusual bacteria had been found in Eve’s abscesses, giving them reason to believe Kathy was injecting saliva or perhaps dirty water into her daughter to make her sick. They were taking Eve.

As the witching hour approached, she was escorted back to Eve’s room to collect her clothes. Her 18-month-old daughter was awake and crying, but Kathy was forbidden to soothe her.

That was 10 years ago this week. Kathy had just lost her fourth child. Her first three had all died young, and anybody familiar with the cutting edge of child abuse in 1998 knew Meadow’s Law: that “one sudden infant death is a tragedy, two is suspicious and three is murder, until proved otherwise”.

When she tried to get her daughter back through the courts, the NSW Department of Community Services went to great lengths to protect the child. Kathy had been diagnosed as having Munchausen’s Syndrome by Proxy – whereby carers, usually mothers, are said to harm their children in order to get attention for themselves – and so the department called on the world’s foremost expert in MSBP, Professor Sir Roy Meadow, to give evidence against her. Apart from having popularised Meadow’s Law, Sir Roy had coined the term Munchausen’s Syndrome by Proxy in 1977. He was as big as you got in the child protection world. And it seemed to him that two of Kathy’s three dead babies had probably been murdered, probably by the mother. He didn’t need to meet her to make this conclusion.

Meadow’s evidence clinched it. Eve would be saved from this murderous woman, who from now on would get to see her daughter just four times a year for two hours, with two social workers always standing guard.

Sir Roy had saved thousands of such kids. Thanks to the diagnosis of MSBP, some 5000 children have been taken from their parents in Britain, where the problem was vigorously pursued. In Australia, there were about 25 cases a year. But as the millennium turned, authorities here were working harder on locking them up. Then, last October, the day after Victorian woman Carol Matthey beat charges that she had murdered her four babies, the case against Kathy collapsed for the same reason – the legal requirement for there to be evidence against an accused.


KATHY’S first pregnancy was not ideal. She was young. She hadn’t known the father long. Doctors found problems with the baby’s heart before he was born. At birth, in July 1983, baby Jarod was whisked into intensive care, then surgery. Kathy didn’t get to hold him until his christening. He died at five days old.

Her second child, Maree, was born the next year to the same father. Maree was retarded and had heart problems. She was often sick through her early years. In 1988, aged four and still in nappies owing to her incontinence of bowel and bladder, Maree developed an abscess on her right thigh. She spent two months in hospital, then a month after her release it flared again and this time another one appeared on her lower back. Doctors operated and gave her intravenous antibiotics, but the infection appeared to spread to her heart and lungs. There were multiple bacteria in her blood and in the abscesses. Her temperature continually spiked and abated until she died in May 1989, two-and-a-half months after her second admission. There was no autopsy.

Kathy’s third baby, Sandra, was born 17 months later to a different father, Gary. Sandra was a full-term, healthy baby. At eight months, however, she developed a fever and cough. After three days of symptoms, she was admitted to Westmead Hospital in Sydney’s west. X-rays showed shadowing on the lung. Pneumonia. The virus responsible was later identified as respiratory syncytial virus, a common infection in infants. A blood sample came back positive to multiple bacteria, but the laboratory presumed it was a contaminated sample (as 42 per cent of all samples were). She was treated with antibiotics, but after four days this was stopped because there was no evidence of any bacterial infection. Sandra’s condition worsened and she died eight days after admission.

The autopsy found minor swelling in the tissue around the brain (meningitis) and pneumonia. She had an enlarged liver and spleen, consistent with a viral infection. There was no evidence of bacterial infection in her body.

Despite all the grief, Kathy and Gary began trying for another baby straight away, but it was a little over five years before Kathy’s fourth child, Eve, came along.

Eve was a healthy, full-term baby. Cute as, she won second prize in a baby photo competition. But soon after her first birthday she started getting sick. Kathy carted the wheezing and feverish kid back and forth to different doctors but there was no clear diagnosis. At 17 months, she was admitted to hospital with a raging fever and chest infection. A blood test showed an unusually large number of white blood cells, so she was treated with intravenous penicillin to fight off any bacterial infection. The next day, a weird red mark appeared above her belly button.

The following day, a red swelling appeared on her right arm. More powerful antibiotics were thrown at her. Four days after her admission she became extremely ill with what was thought to be septic shock. The next day, more inflammation and blistering appeared on her right foot. Meanwhile, the samples from her belly button and arm had grown a mixture of bacteria commonly found in the mouth. It was accepted wisdom that multiple bacteria in the blood or abscesses was a strong indicator of MSBP – the thinking being that mothers inject these germs into their children to keep them sick. In the absence of any other explanation for Eve’s illness, and given Sandra and Maree’s deaths, a group of doctors decided Kathy had MSBP.

PEDIATRICIAN Paul Knight remembers the “accelerating suspicion” that Kathy was about to kill her fourth child. As the treating doctor for all four of Kathy’s children, he didn’t see any evidence of it. He thought his colleagues were in a bizarre fantasy land. Nevertheless, he’d instructed the sister in charge of the ward to move Kathy and Eve to a private room and have the most senior nurse in there at all times. He’d then rung the doctors in the hospital’s child protection unit and told them to back off his patient. They were set to thrash it out at a meeting the next day, April 1, 1998, between social workers, police and doctors. They would probably install a hidden camera to gather evidence.

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Link to article in the Australian

Defending Parents

Written by David Crowe

Monday, 14 April 2008

by David Crowe

Any parent’s nightmare is the death of a child. Yet, there is one thing far, far worse – to be accused of killing the child you have just started grieving. While the risk of a child dying is thankfully low, if it does happen, the risk of such horrendous accusations is significant if the death does not have an obvious explanation. The overwhelming influence of doctors on judges and juries, and the widespread belief that forensic evidence is unassailable make a false conviction quite likely.

Once accusations fly, so may friends and family, confusing accusations with proven facts, and adding to the stress and grief. If a conviction follows even fewer will stick by the jailed parents. The stress and lack of financial resources, may even drive parents to plead guilty, coerced into a plea bargain believing proscecutor’s threats to toss them in jail and throw away the key if they fight back.

An Epidemic of False Accusations

The epidemic of false medical accusations against parents is worldwide, particularly in richer countries where the allopathic medical industry has its strongest grip on the public consciousness and the legal system. In Canada, numerous convictions have been overturned or are being re-examined, due to the sloppy and possibly malicious testimony of one of Ontario’s top pathologists, the now disgraced Dr. Charles Smith. In one infamous case he failed to recognize the distinctive marks left by dog’s teeth and accused a mother of stabbing her daughter with scissors. Only later was it discovered that a pit bull had been present at the time of her death.

In another case, William Mullins-Johnson spent twelve years in jail convicted of raping and killing his niece because of Dr. Smith, always in danger of being killed by other prisoners. He was released when it became clear that all Smith’s evidence was unreliable. Two years later he was fully acquitted with a judge apologizing to him, “It is regrettable that as a result of flawed pathological evidence you were wrongfully convicted and spent so long in custody.” He has described the trauma of family and friends turning their back on him, and how even after his innocence was proven, his family is still torn. [9,10]

In England, similar cases have gained widespread national attention and concern. In one of the best known cases, Sally Clarke’s son Harry had not been doing well since being given three vaccinations when he was eight weeks old (he was born three weeks premature). This was discounted at the trial and she was sentenced to prison for life for killing him, although released 3-1/2 years later. Her fate was sealed by the opinions of prominent pediatrician Roy Meadow. Sadly, she never recovered emotionally from these compounded tragedies and committed suicide. [6,7,8]

Roy Meadow also testified in the case of Angela Cannings, accused of smothering two of her children because Meadow testified that two cases of SIDS in one house was a statistical impossibility. Cannings spent two years in jail before her conviction was overturned on appeal.

The number of proven miscarriages of justice became so great that Britain decided to review all 258 convictions of a parent accused of the death of a child based solely on medical evidence in the past ten years.

Being on the witness stand allows doctors to play God. Judges and juries defer to the opinions of medical experts, even when there is no visible evidence of harm on the child’s body. Those accepted as experts by the court are allowed to have their opinions taken as evidence. This power may go to the head of some who know it is unlikely that they will face judgment for any injustices they cause.

The reaction of the medical profession when these problems come to light is generally lamentable. In the Sally Clark case Richard Horton, the editor of the prestigious journal Lancet, wrote a strong defense of Roy Meadow when his license to practice was under review by the UK doctor’s association. Horton did not argue that the conviction was erroneous, but wanted the blame spread around, rather than only punishing the man who gave false evidence. This attitude puts the right of a man who has done something horrible to continue working above the suffering he caused to a mother who has to grieve her baby alone in a cold cell.

Dr. Mohammed Al-Bayati

One man who single-handedly has saved many parents from such dire consequences is the California-based pathologist and toxicologist Dr. Mohammed Al-Bayati. He understands how coroners can see their role as securing convictions rather than seeking the truth or accepting uncertainty. He has seen how easily they jump to conclusions based on accepting the fraction of the available data that is concordant with their theory.

The children described in this article are real cases, documented in the scientific journal Medical Veritas by Dr. Al-Bayati.

Destiny Jacobo

Destiny Jacobo died suddenly before her second birthday. Los Angeles County coroner, James K. Ribe, reported the death as Shaken Baby Syndrome compounded by forcible rectal insertion (i.e. brutal physical and sexual abuse). This resulted in her parents being tried for murdering their own daughter. The mother was persuaded to plead guilty to receive a ‘lighter’ sentence and was sent to jail for life in 1996.

Almost a decade later Al-Bayati reviewed the autopsy report and discovered many facts that contradicted Ribe’s strongly stated accusations. He found bleeding had occurred in several organs, not just in the head, that the pancreas was severely damaged and that the lungs excess fluid in them, probably caused by pneumonia.

He found no evidence of anal trauma and the bleeding, while in the rectal area, was actually outside the physically undamaged rectum. It is clearly impossible to insert a blunt object into the anus without physical damage to the entryway.

He concluded that Destiny died from infections, including pneumonia, possibly due to Vitamin K deficiency. This vitamin is produced by intestinal bacteria which are susceptible to depletion by drugs such as antibiotics and antifungals. Deficiency causes bleeding and increases the risk of bone fractures which obviously can easily be confused with symptoms of physical abuse.

While the mother is still locked up, the father did not plead guilty and, while also sentenced to prison for life, was actually released only five years later when he proved he was not physically present. The father is appealing the mother’s conviction and has complained about Ribe’s conduct to the California Medical Board.

The Death of Baby Nadine

Baby Nadine died in Sweden when her heart suddenly stopped on her fortieth day of life. Accused of shaking her to death, her father was sentenced to five years for manslaughter.

Again, doctors ignored evidence of pre-existing health problems beginning before birth, and rushed to accuse. Another jury was swayed by faith in the pronouncements of doctors.

Nadine’s health problems began before birth. Her mother’s membranes ruptured prematurely and she was delivered by a C-Section. Her mother also smoked and drank. At birth several metabolic abnormalities were measured, including jaundice (a bilirubin level almost double the maximum ‘normal’ value), indicating that Nadine was already suffering from an infection and inflammation.

Nadine was sickly and had an extremely low weight gain during her short life. Partly because of this, during her first month of life she received three courses of antibiotics. Her mother, who was breastfeeding, also took antibiotics.

An appeal to the Swedish Supreme Court was rejected, but Peter Althin, a famous lawyer and member of parliament has taken up the case, and supporters hope to achieve a retrial on the basis that the Supreme Court used as an expert the very doctor whose testimony had resulted in the conviction in the first place.

Baby Stryker’s Death

Baby Stryker had serious health problems starting from birth, resulting in the use of antibiotics and other medications. His mother had also previously had two stillbirths. When only 55 days old Stryker stopped breathing in the middle of the night. Heroic efforts by the father and paramedics were not able to revive him.

Among the many findings in the autopsy were elevated levels of methanol and formic acid in the blood and the parents were accused of poisoning their baby with methanol (“wood alcohol”). A report by Al-Bayati revealed the evidence of other health problems and the lack of evidence for methanol-induced damage. He point out that the methanol and formic acid were probably due to contamination of blood samples with formalin, a compound containing both methanol and formaldehyde (which can be converted into formalin by enzymes present in red blood cells).

After these accusations the other two children were taken and, in a heart-wrenching twist, a third child was snatched from the mother’s arms right after birth. The investigation dragged on for two years but after a family court hearing in September, 2007, the children were returned to their parents with full custody, although the police still have a murder investigation open.

Baby Averial’s Death

Unlike most of the other babies in this article, Averial had a normal birth. Like many other American babies she was given a Hepatitis B vaccination before leaving the hospital and was fed formula. The parents noticed that she was always fussy, did not sleep deeply and had serious diarrhea, problems which conceivably were due to the vaccination and the formula.

When Averial was less than two months old she suddenly stopped breathing and went limp in her father’s arms. The hospital treated her with epinephrine and sodium carbonate to revive her and reduce the acidity of the blood. This treatment has a risk of significant bleeding and hospital data shows her blood volume decreased 21% in three hours. Despite intensive treatment she died about 10 days after admission.

Imaging done at the hospital showed skull and rib fractures as well as extensive internal bleeding, evidence that damned the parents. The Medical Examiner claimed that these symptoms must, because there were no external signs of abuse, have been caused by the father shaking his daughter to death. The father remains accused of capital murder.

Al-Bayati was able to use the hospital’s own information to show that the testimony was false. The earliest images clearly show no fractures and bleeding, and so these problems must have been due to aggressive treatment at the hospital. Al-Bayati believes that the skull fracture was due to the internal bleeding triggered by epinephrine and sodium carbonate treatment, leading to massive swelling. He believes that her death was due to unrecognized bronchopneumonia and respiratory distress.

Averial’s father is out on $200,000 bail still awaiting trial more than three years after his daughter’s death.

What You Should Do

The best defense against false accusations is a good offence and you need to find a medical expert not scared to buck the system. Sadly such experts are not common, because most doctors support each other instinctively. A strong report founded on solid science will often cause legal authorities to back off, knowing that the case will probably attract publicity and may, in the end, make them look heartless, sloppy and incompetent. If the case does go to trial a strong contrary medical report based on science may well sway the jury. Even if jury does not fully believe in the parent’s innocence, they may at least accept that the cause of death is uncertain.

A common factor in many cases is a combination of pre-existing health problems and aggressive medical treatment that only makes things worse. Vaccines and antibiotics are often seen as completely innocuous, and many medical experts are reluctant to question these pillars of pediatric treatment.

Most of all, do not trust the legal system to find truth. The legal system commonly fails people who cannot afford to hire good lawyers and experts. If you are facing medical accusations in court you need to throw all your financial resources at the case to minimize your risk of joining the long list of parents in prison under false pretences.

Side Bar or End Note?

Financial problems with these cases are common, as 200 to 300 hours of medical research are required for each case, or even more. Dr. Mohammed Al-Bayati has set up a non-profit organization, the “International Center for Better Medicine”, so that other people can assist with the payment of his fees. Checks can be sent to this organization at 150 Bloom Drive, Dixon, CA, 95620. While Al-Bayati has acted pro-bono in several cases, he cannot always afford to do so. Every $100 donated ensures that accused parents get one hour of the best medical-legal expertise.

David Crowe HBSc is a medical and science critic based in Calgary, Canada. He is currently writing “The Infectious Myth”, questioning the infectious basis of several important diseases. He can be reached at David.Crowe@aras.ab.ca.


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