On Friday, I wrote about the sort of case that outrages me every bit as much as cases of cancer quackery that lead to the death of patients. I'm referring to the case of Amanda Sadowsky, a four month old infant who died after suffering traumatic brain injuries that appeared consistent with shaken baby syndrome (SBS). As I've pointed out before, what I've found to be one of the most disturbing antivaccine claims of all is the assertion that SBS is a "misdiagnosis for vaccine injury." As you might recall, SBS is the name originally given to a triad of findings consisting of subdural hemorrhage, retinal hemorrhage, and encephalopathy. More recently, because the syndrome is more complex than the original description suggested, these days the syndrome is more properly referred to as non-accidental head injury or abusive head trauma. This particularly vile antivaccine lie is currently being used by Tonya Sadowski to try to exonerate her husband Elwood Sadowsky, who is currently in prison for having killed their baby. In addition to a passel of contradictory and dubious arguments, Mrs. Sadowski is claiming that vaccine injury was a major cause of Amanda's death. As I learned in the comments of my post from Friday, she even maintains a web page she calls the Amanda Truth Project. If you think the arguments in the original article that brought the Amanda Sadowski case to my attention were bad, you need to check out this website.
Before I start, let me just say: I understand why Mrs. Sadowski might behave this way and might grasp at straws. She lost her baby. That's horribly traumatic loss for anyone to endure. Worse, to add to her trauma, she truly doesn't believe that her husband did it, at least not intentionally. (By her own story, there's really no doubt that at the very least Mr. Sadowski dropped the baby.) She might even have a valid argument; it's hard to know, although Elwood Sadowski does have a criminal background not unlike that of Alan Yurko. Be that as it may, and no matter how much sympathy I might have for her, Tonya Sadowski is doing great harm by using the Alan Yurko defense ("vaccines and other nasty stuff done it"). She begins by invoking the claim that, just because there is a lot that's not known about sudden infant death syndrome (SIDS) and shaken baby syndrome (SBS), her husband has been unjustly accused. While it's true that there is a lot that is not well understood about both conditions, it does not follow from that ignorance that vaccines could be a cause. That doesn't stop Sadowski from writing:
Babies have died and been diagnosed with SIDS when doctors couldn't figure out why. Now the "I don't know" syndrome has been termed: SBS (and often times, usually in the UK, MSbP - see MSbP Myth for more information). Only this time loving parents and caregivers are accused of horrible acts including child abuse, shaking infants and toddlers, striking their heads against objects, etc. (Though this happens, the injuries themselves do not indicate the mechanism for their presence and the bias of SBS is used to diagnose).While it is true that there are those out there who have abused their children, it is also becoming quickly just as true that there are a lot of falsely accused people sitting in jails and prisons, and caregivers' good names are raped in their communities.
And:
Science will catch up eventually, as it always does. [1] the earth is not the center of the universe nor does the sun revolve around the moon, [2] infants do indeed feel pain and therefore most doctors do not operate without anesthesia any longer, [3] FDA recalls drugs every year because they are found too dangerous for the benefits, [4] new studies in the NFL right now are discussing closed head injuries such as that of Natasha Richardson, the actress who died after a skiing accident in 2009, [5] new methods of observation, experimentation and measuring have altered the way scientists believe (such as is Pluto a planet? are there other solar systems and universes? PET scans and fMRIs lead to more knowlege of the brain), [6] new sciences were discovered such as biochemistry, [7] germ theories stopped childbirth fever simply by having physicians wash their hands (a wild idea and it received much scoffing), etc, etc, etc.
This latter argument is known as the "science was wrong before" canard. I mean, jumpin' Jesus on a pogo stick, she even invokes the "demotion of Pluto" canard. The "demotion" of Pluto from being considered a planet is not really evidence that "science was wrong before"; it's more of a case of correcting nomenclature to be more consistent. She also doesn't understand germ theory. Ignaz Semmelweis discovered that requiring practitioners to wash their hands when going from the morgue to the delivery room greatly decreased the incidence of puerperal fever decades before Louis Pasteur demonstrated germ theory to the point where physicians and scientists started to accept it. In fact, part of the reason why Semmelweis encountered so much resistance from his colleagues was because at the time he made his observations, there was no known scientific mechanism to account for his observations. In fact, his observations actually conflicted with the dominant concepts of the time, namely that diseases were due to imbalances of the four humors or caused by miasmas ("bad air"). In fact, it's not unreasonable to speculate that if germ theory had been developed before Semmelweis, his observations would likely have been rapidly accepted as evidence supporting germ theory.
But is it really true that there is an epidemic of false or mistaken accusations of shaking babies to death, with all sorts of innocent parents sitting behind bars for crimes they didn't commit? Certainly no compelling evidence is presented to suggest that this might be true. Worse are the reports on Sadowski's website prepared by Michael Innis and Harold Buttram. They're recycling the same sorts of arguments used to try to get Alan Yurko off, but they're not doing a particularly good job of it given the very evidence that they have posted right there on Sadowski's website.
For example, there are things there like this CT scan report from the hospital to which Amanda was first taken (Fairview Hospital), which found:
- Bilateral temporoparietal and right occipital skull fractures.
- Hemorrhage is seen adjacent to the falx, in the dependent portions of the occipital horns, and in a subtle area of parenchymal hemorrhage in the left parietal lobe.
- There is an area of decreased attenuation in the left posterior parietal region compatible with a remote injury and focal encephalomalacia.
Note that Amanda presented to Fairview Hospital in full arrest, was resuscitated, and then was flown to Rainbow Babies & Children's Hospital in Cleveland, where from Buttram's report it is not clear whether the following represent a new head CT or an interpretation of the head CT done at Fairview:
Multiple skull fractures. Bilateral cephalhematoma. intraparenchymal, subdural, subarachnoid, and intraventricular hemorrhage.
Diffuse loss of sulci and cisterns as well as gray-white differentiation consistent with global edema. Downward herniation cannot be excluded.
This is some major trauma. It is not subtle. The most likely explanation for such massive trauma is, well, trauma. What do Buttram and Innis claim? Dr. Innis claims:
I conclude that Amanda suffered from undiagnosed Neonatal Hepatitis as shown by the abnormal Liver function Tests and as a consequence developed Vitamin K Deficiency Disease which caused her death. An Adverse Vaccine Reaction resulting in a fall in the level of Vitamin C cannot be excluded.
Which is a common theme among conspiracy theorists who think that SBS is in reality some combination of vaccine injury and nutritional deficiencies. Buttram, in particular, likes the idea that vitamin C deficiency is a cause of SBS and that vitamin C deficiency is caused by—you guessed it!—vaccines:
Returning to the importance of vitamin C in relation to vaccines, one of the prime roles of vitamin C in the body is its action as an antioxidant in donating electrons to quench free-radical and inflammatory damage from toxins and/or infections, with our consideration here being vaccine toxins. In the process of donating electrons, vitamin C necessarily becomes depleted. Once the level is reduced to the point that it can no longer protect the brain, which is unduly susceptible to toxic and infectious damage, it (the brain) may become subject to free-radical damage.
This is, of course, utter nonsense. It's also utter nonsense that vaccines commonly cause encephalopathy so severe that it can be mistaken for SBS/abusive head trauma. With this as a way of background, it's not surprising that Buttram does what he does best in his report for the Sadowskis. He Gish gallops. It's vitamin K deficiency that caused bleeding! It's a vaccine reaction! It's rickets making the baby's bones brittle! It's birth trauma! It's liver dysfunction! It's nutrient deficiencies caused by Amanda's mother having been given ampicillin (I kid you not):
The mother did attempt breast-feedings supplemented with formula but ultimately abandoned breast feedings, primarily because of the infant’s difficulty in sucking. Under normal circumstances, breast-feeding establishes a prevalence of highly beneficial and protective Lactobacillus bifidis in the infant’s intestinal flora, but the mother was administered 2 grams of ampicillin intravenously during her labor with Amanda, which would have largely eliminated the L. bifidis. This in turn would have opened the way for yeast infestations, later manifesting as cradle cap, “yeasty” neck folds, and intestinal yeast overgrowth, the true source of the intractable colic and reflux problems. These in turn in all likelihood would have led to unrecognized nutrient mineral and vitamin deficiencies including calcium, magnesium, zinc, and vitamins A, C, and D.
The ridiculousness of this claim speaks for itself. Such are the sorts of arguments used by antivaccinationists who have drunk the Kool Aid that vaccines somehow contribute to a syndrome that is frequently mistaken for SBS/abusive head trauma. I don't know if Elwood Sadowski really did kill his daughter. Maybe he did fall accidentally while carrying her, resulting in fatal injuries. I suppose it's possible (although the story given is not convincing). However it happened, Tonya Sadowski's grief at the death of her daughter does not excuse her abuse of science and embrace of the worst kind of antivaccine pseudoscience in order to exonerate her husband.
Alan Yurko was the prototype for a defense against SBS that fuses antivaccine conspiracy mongering with copious pseudoscience to try to exonerate parents and caregivers accused of SBS. Indeed, if you peruse the website of Mohammed Al-Bayati, the "expert" who wrote a fallacy- and pseudoscience-laden report designed to win Alan Yurko a new trial, you'll see several reports trying to prove that babies thought to have died due to SBS were in fact killed by other causes, many of which find their way into Buttram's and Innis' reports for Tonya Sadowski. Al-Bayati, you might recall, is the same "expert" who produced a particularly risible and nonsensical report that tried to "prove" that Eliza Jane Scovill, daughter of prominent HIV/AIDS denialist Christine Maggiore, didn't die of the HIV encephalitis or Pneumocystis carinii pneumonia found on autopsy, but rather of an allergic reaction to amoxicillin. (I'm tellin' ya, ya can't make stuff like this up).
The bottom line is that the claim that SBS is in reality due to "vaccine injury" ignores the wealth of clinical data indicating that SBS (now more frequently and formally referred to as "abusive head trauma") is a distinct clinical entity that has been well-studied and is probably underdiagnosed. Although there is controversy over the pathophysiology of SBS, how much force is necessary to produce it (hence the additional term to describe it), and whether it's underdiagnosed, whatever controversy there is over the symptoms and findings in SBS, there is no controversy that SBS is not "vaccine injury." When antivaccinationists insist that it is, they abuse science, reason, and morality by using such a myth to exonerate baby killers.
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This is just another example of a combination of conspiracy theorists taking advantage of a desperate parent's guilt and sadness. It's completely deplorable.
There are some convincing arguments that SBS is extremely prone to misdiagnosis, especially in terms of implicating a particular person of the guilt. There was a great article in the Times ( http://www.nytimes.com/2011/02/06/magazine/06baby-t.html?_r=4&pagewante…; ) - I haven't read it recently, need to re-read it.
None of those convincing arguments involve vaccines. But there could be plenty of reasons to believe the finger of blame is inappropriately pointed.
AUGH!
It's one thing reading these whackadoodle theories on a blog somewhere. It's another reading them as a defense for infanticide.
On the plus side, any vaccine "skeptics" who support these defenses conveniently out themselves as people who willingly sacrifice children on the altar of their ideology.
Foolish idiots!!! Unbelivable what some sink too. Poor bubba :(
I was reading Buttram's report, in which he claims that shaking a baby could not cause damage to the brain without also causing damage to the neck. Amanda Sadowsky's discharge reports states:
C5 and C6 are the part of the neck usually damaged by whiplash. Am I missing something here?
Mattie, no doubt miscarriages of justice occur. However, it alarms me that those so against vaccination are willing to stand behind child murderers like Yurko in the furtherance of their agenda. Let's remember that in both Elwood and Yurko's case both admit to actions (be they deliberate or accidental) that would have harmed those children.
I guess what I don't get is the idea these people have, that you wouldn't call your doctor immediately after something like that happened. Drop my baby? You can damn well bet I'm going to be on the phone with the doctor ASAP to report it and possibly have the baby seen if needed to check for injuries. Baby stops breathing? I'm calling 911 immediately, not "putting [him/her] into their bed and letting them sleep cause they are unresponsive".
Maybe it's my medical background; I don't know, but I do know my friends who DIDN'T have medical backgrounds were calling their doctors more than I was for injuries. None of them would have NOT called the doctor if they had accidentally dropped their baby on its head!!!
No medical background needed, MI Dawn, just common sense. As a father of two, hell, as a human being, child abuse angers me like nothing else. Child abuse by their parents makes me livid.
1) Calling the doctor: yep. I remember when Offspring the Elder was 9 mos old and was crawling around the bed and thump! Off he goes. Damn straight we called the doc (ok my SIL who is a GP). We always consult (at least) when the kids are ADR
2) Kreb - "No subluxation is evident"
Whoa! The CT scans were done by a chiropractor? I was not aware subluxation was a radiology term.
ETA: a baby stops breathing and you STILL don't call the doc? Holy smokes! That's just bloody negligent.
Like the Yurko case, I suggest you would be better to admitthe shaking, and plead ignorance of how serious it could be. I find that to be much more understandable than, "she stopped breathing so we put her to bed but didn't call the doctor"
Yes, suspended disbelief.
If anyone wants, I can dig up the Ohio shaken baby case where the infant was put on life support, was verified to be in a persistent vegetative state and then a legal battle started between the mother's family and the father/alleged perpetrator for custody of the child.
The mother (and her family) wanted to remove the child from support, which would lead to the child dying and the police had already said they would charge the father in the child's death at that time.
The father wanted the child to remain on support, so that he could only be charged with abuse/assault.
In the end, justice was delayed but not denied. The mother won custody, the support was removed, the child passed away, the father was charged, convicted and sentenced in the death.
The father was not only an abuser, he was a coward as well. I can't say that it's unexpected. I don't know many stories where the perpetrator sobs that he loved his child, he never meant to hurt it, that he's sorry. Usually they lie. The man who said that he was playing "pro wrestling" with a four year old and "body slammed" the child on a bed. Child was in arrest when the first responders arrived and was unable to be revived.
Tell the truth? Confess? Rarely. The average perp is a bully and a coward at a minimum.
If there was ever a website that cried out for a "POOR" WOT rating in "Trustworthiness" and"Child Safety"... This is it.
@Amj
We had a case like that in Calgary that recently where both parents played the religion card in an attempt to keep the child they had persistently neglected abused (the child and its' twin were half the normal body weight for their age) on life support to avoid more serious charges. The appeal court was having none of it. This morning on the news there was a report that two family members had been arrested in the case of a baby who had died after "falling down stairs". The autopsy indicated the injuries were not consistent with that claim.
MMM,
Medical sublaxations exist; it just means a joint is partially dislocated. The ones seen by chiros are mostly imaginary.
David S Schilling - would you mind expanding on that thought a little? I'm having difficulty understanding your intent or the basis for you comment. Thanks.
Stairs are often the culprit in the perp's stories. However, the injuries are rarely consistent.
Various parts of the story usually don't fit with the evidence. An injury that supposedly happened very recently looked older. Injuries you'd expect from the story aren't present, injuries you wouldn't expect are present. Who exactly was present can also get unclear.
The one thing that usually is clear is that someone is afraid - not for the child, but for themselves.
MO'B, WOT is web of trust rating: http://en.wikipedia.org/wiki/WOT_Services and I do believe that Mr. Schilling's post is in regards to Sadowsky's website failing to be trustworthy and an embodiment of child safety.
I apologize in advance if my tags don't work - I'm not familiar with the commenting system yet.
MI Dawn:
"I guess what I don’t get is the idea these people have, that you wouldn’t call your doctor immediately after something like that happened."
I would think any sane parent would do so. I might even argue that the failure to contact a trained medical provider after an injury could be a sign of neglect.
In my own case, when my daughter fell and hit her head on a fireplace hearth, she was immediately taken to the ER. This wasn't because she was severely injured because she only had a small cut, but it was because the force at which her head hit the stone was enough to scare us as parents, and we weren't willing to be a statistic of those who failed to act.
She was checked at the ER and given a fully battery of tests to ensure there was no head injury. Her cut was glued shut (it was too small for stitches and likely could have been treated with a bandage had we opted against the glue), and we were told she was fine.
Even with that said, it was a long night. We checked on her throughout the night and even disturbed her sleep several times as a precaution. I cannot fathom how a parent could drop a child and NOT seek medical attention if the child landed on his or her head.
The fact the child in this case had multiple skull fractures as well as spine injuries both new and old is enough evidence to suggest to me the parents were negligent at best, and abusive at worst. Considering all the other evidence, and the complete story and context, as well as expert testimony it seems quite clear the injuries sustained were a result of abuse... not a vaccine or one-time accidental fall (drop).
I'm not sure what is worse - the parents who abuse their children, or the anti-vaccinationists who seem to condone such behavior by formulating excuses as they attempt to point the finger at vaccines.
Anj - I don't think there is necessarily a disconnect between "I love my child and didn't mean to harm him" and the story you relate. It is very easily described as a father playing with his son, but doing it too roughly. Another example of "I didn't realize I could hurt him so badly by doing that." That's not a monster, just someone who is clueless. It's a textbook case of manslaughter, but that doesn't require maliciousness. I compare it to what I do with my son - for example, I carry him into his room at night and toss him into bed on a pile of blankets. If I did that, and he hit wrong and broke his neck, I would be responsible, but it wouldn't mean I was a monster, abuser, or didn't love him (BTW, although he loves that game, I am so bloody paranoid that I do it as gently as I can, and always toss him on a pile of soft blankets so that he lands on his butt first)
Of course, the proper response if you accidently cause damage is still to accept that responsibility. If I did something idiotic that led to the death of my kids, I'd be so torn up about it that I would feel I deserved to be punished. Yes, I did it. I didn't realize it would result like that, but I did it. And then when I am in jail, I'd be thinking of ways that I could help others realize the risks of what I did, so that they wouldn't make the mistakes, too.
If it was REALLY an accident, and unintended, then own up to it. Yeah, you screwed up, but if it really was an accident, it doesn't make you a bad person. Refusing to accept responsibility for your behaviors, however, does. Accept that you made a mistake, and do something about it. Don't let others make the same mistake you did.
Unless, of course, you are hiding something...?
... and glancing before dealing with cranky college kid.
MI Dawn:
Yep. That is what I did when the baby went down the stairs when she was four months old eighteen years ago. A few years ago I called 911 when her oldest brother had full blown convulsions as a toddler (which needed lots of follow-up),
The daughter is fine (working on learning a third non-native language), but son has never been the same since those seizures.
Science Mom - Thanks.
I have grandchildren now and when one of my kids calls and asks if their child should go to the ER the answer is always yes. If you have to ask the question you have to take the kid.
In my younger days my daughter, then age one bumped her head on a carpeted concrete floor when her dad dropped her and then she vomited . They were playing,she wiggled too much and he couldn't hang onto her. There was an immediate ER visit, much checking during the night and no more roughhousing in the basement. Also a ton of parental guilt but the ER staff was told exactly what happened because the most important thing at that time was my daughter's life. There was no problem and she is now an artist and she and her husband are expecting baby number four in January.
My SIL, the doctor, says, they are allowed ONE vomit after a fall. However, a second is an immediate trip to the ER.
I think a fall and one vomit still warrants a call to the doc, though, for sure.
My MIL completely accidentally tripped while carrying my 2 month old and she ended up getting a bump on her head -- and yes, we called the doc and checked her through the night and had a follow up visit. We were lucky that she wasn't hurt worse.
My friend was terrified after accidentally jerking his toddler's arm out of her socket (she was about to run in front of a car) that he was going to be charged with child abuse. The doctor popped the arm back in and said "was she playing in traffic?" I think docs are generally good about knowing when parent-inflicted injuries are "nursemaid's elbow" and otherwise unintentional.
There are all sorts of training and pathological tests to determine when a child's injuries are the result of falling down the stairs or being yanked out of traffic or sustaining other normal baby injuries and when they are the result of repeated and long standing abuse. A newborn with broken ribs partially healed over and no record of prior injuries? Who wouldn't give that the side eye?
C5 and C6 are the part of the neck usually damaged by whiplash.
Ah, but you will notice in the Buttram report that in addition to vaccine damage, Amanda had gestational rickets due to the mother's vitamin D-deficient diet... so like her six fractured ribs and earlier head injuries, the spinal damage can be ascribed to weak-bone birth trauma.
"Infantile scurvy" comes into the report as well (to explain the superficial bruising). Buttram simply doesn't care how many subsidiary hypotheses he has to pile up, one on top of the other.
The pathology report notes the older head injuries -- "Organizing cerebral infarction with destruction of cerebral gyrus, acute and organizing hemorrhage with fibrocapillary proliferation and prominent hemosiderin-laden macrophages, and marginal reactive gliosis", and "organizing epidural hemorrhage" in the spine. The "hemosiderin-laden macrophages" mean there were white corpuscles scavenging red corpuscles while clearing away an old clot. This doesn't start until a few days after an injury, and takes several weeks, but in Buttram's bizarre interpretation, it was all lingering from a birth injury four months ago (you would think that brain damage would be noted at birth, but no, Amanda had a normal Apgar).
There had been bleeding within the lungs a few days or weeks before Amanda died (the "Pulmonary hemosiderosis" of the autopsy)... this can be from blunt-force trauma to the chest, or from suffocation.
There's another science blogger/doctor who has posted about this case. I don't the opportunity to post there right now. Perhaps some of you would like to peruse the post and the comments:
http://www.sciencebasedmedicine.org/index.php/the-antivaccine-lie-that-…
I had never seen the term "Gish Gallop" before reading this column, so I looked it up and found that it refers to that creationist guy Duane Gish. About 25 years ago, I saw Gish give a talk in a large midwestern university where I was working as a research biologist. I was surrounded by creationists, who seemed to be ready and willing to absorb his nonsense.
It's true that Gish used the Gish Gallop, even in a non-debate format. He kept telling half truth after lie after half truth. I eventually started saying "That's a lie" out loud as he continued to lie. The audience got angry with me, started saying angry things to me, and after half an hour or so of this intellectual torture, I left.
I do remember a couple of his remarks. One was that the big bang theory says that the matter making up our universe was an electron before it expanded. Of course, Gish was simply misstating the concept that the wavelength of something is inversely proportional to its energy, so if you compress all the mass-energy of our universe into a single particle, it's going to have a wavelength that is pretty small. Still, it's a lie, and intended to mock the science behind the big bang theory.
Another lie/half-truth he told was in response to an audience question which referred to a standard creationist bit of mythology. The question involved the probability of putting together a gene properly by randomly assembling the A, G, C, and T subunits. Gish gave a big smile, said he was glad the question was asked, and proceeded to write four times four times four etc on the blackboard. In other words, the likelihood of assembling even one gene properly by random assembly is awfully low. This is, of course, a straw man argument at best, but the crowd loved it.
I later saw the other grand old man of the creationist movement, Henry Morris, do an actual debate in a crowded auditorium. The biologist who debated him pretty much held his own, but the rhetorical tricks that the creationist folks use, such as a totally nonsensical argument involving entropy, are obviously hard to refute in that kind of setting. I recall that the creationists pointed out (by distributing a pamphlet before the debate) that scientists had predicted that the surface of the moon ought to be deep in powdery dust if it really were millions of years old, and one of the audience members dutifully asked about that issue, just to put the biologist on the spot.
There is a science blogger who does the site Good Math Bad Math, who likes to refute the more recent generation of creationist nonsense.
Perhaps some of you would like to peruse the post and the comments:
http://www.sciencebasedmedicine.org/index.php/the-antivaccine-lie-that-…
Commenter 'elloyd' seems to be engaged in a form of free-association humour / art performance, but I was not sufficiently inspired to respond.
Marry me Mindy. I have regularly experienced the grief, guilt and ongoing pain of parents who have seen children aquire disabilities through accidents. regardless of whether the accident was preventable - a drunk driver hitting them with all children in safety seats etc or a split second of innattention. The self doubt and self punishment never completely goes away. I have only ever once experienced a mother who threw her child against the wall and caused significant brain damage. Her pain was anger at "the system" and her family that should have seen she wasn't coping and taken the child away from her.
I have worked with literally hundreds of families with children with aquired disability - that mother and her reaction still disturbs me.
lilady:
It is like those bloggers are thinking with the same mind. :-)
hdb, I was thinking there was some gender confusion in that person.
posted for posterity on AoA:
So we are the mindless skeptic drones who dare to question vaccine injury as the cause to shaken baby syndrome? how disgusting and it's no Wonder we need a surveillance system for you guys and gals...
Alain
herr doktor bimler,
"this can be from blunt-force trauma to the chest, or from suffocation."
Grotesque. It implies that they may have been trying to kill her or at least smother her into silence repeatedly until they finally did kill her.
Hardly an isolated OhSh_t incident.
Then again, the most common perp is one who has a history of similar behavior toward the victim or others.
Mattie:
Here is a response to that NY Times magazine article:
http://www.dontshake.org/sbs.php?topNavID=3&subNavID=25&navID=277
.... posting wrong links. Here is the correct one:
http://www.dontshake.org/pdf/02-09-11-NewYorkTimesMagazineNCSBSresponse…
Though the other was useful in that it addressed some papers Mr. Praay posted and an oddly similar one posted by a similar sounding person on SBM.
It implies that they may have been trying to kill her or at least smother her into silence repeatedly until they finally did kill her.
That was the pathologist's interpretation, anyway -- the report contained a sub-heading of 'chest injuries'.
Between that, the six healing rib fractures, and the previous brain and spinal bleeds as well as the ones that killed Amanda, I can see why Elwood's lawyers encouraged him to accept a plea-bargain and a guilty plea.
Hardly an isolated OhSh_t incident.
Buttram's report describes Amanda as crying a lot, with reflux -- a colicky baby IOW. The combination of sleep deprivation and learned helplessness' from frequent unpredictable crying is not good for people, so colic is a risk factor for 'non-accidental injuries'.
But the obvious cause-and-effect explanation is too simple for Buttram, hence his theory of multiple unrecognised vitamin deficiencies causing both the colic and all the symptoms of being slowly beaten to death.
Odd that those multiple unrecognized vitamin deficiencies resulted in weakness only in chest, neck, and head bones and not in the long bones as would be expected...
Jay: Good point. I am not a doctor, but if I remember correctly, in rickets, don't the legs tend to become crooked?
@Politicalguineapig: yes. My parents have a series of books - the Life Science Library. One of the books had an old drawing of a leg bone from a person with rickets. The bones were curved.
I'm guessing the argument would be that they haven't been alive or walking long enough to have the classic rickets curved femurs. That doesn't excuse the fact that if any bones break due to vitamin D or calcium deficiency they should be either the long bones (femur, humerus) or the pelvic girdle, small curved bones that bear no weight would not be the first or only to go.
Here are some X-Rays and an excellent diagram of the bones affected by rickets:
http://emedicine.medscape.com/article/412862-overview