Nexus - 0706 - New Times Magazine-pages

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There was laryngopharyngitis and moderate microvesicular steatosis present in the liver... Cytomegalovirus was isolated from a nasal swab. She said that cytomegalovirus was a viral pneumo- nia which she would not expect to cause death but would expect to cause something like a bad cold, maybe bronchitis... She was not able to say how long Ricki Lee had been suffering from viral pneumonia. "The microscopic examination of the subdural haemorrhage told her that the haemorrhage occurred within around 12 hours prior to Ricki Lee's death." The forensic pathologist determined that the direct cause of death was subdural haemorrhage occurring up to approximately 12 hours prior to death. No antecedent causes or other significant conditions that may have contributed to the death were listed. In cross-examination, the following questions and answers were put and given: Q: And first of all, it is the case, is it not, that there is some controversy within the medical profes- sion about this whole issue of shaken baby syndrome? A: Yes. Q: There are those who would debunk the whole idea completely? " A: There are certain people that say that He was ur shaking alone is insufficient to cause the child injuries, that there must be impact as . well; and there are others that say that vaccinated the shaking is sufficient. prior to tl pathologist, he [paediatrician] did not refer to it in his report. He said in relation to it: ‘It is not something I think I could comment on, but I think I was concentrating largely on the injuries that were documented but it is obviously important in the context.’ 'Q: When you say you cannot comment on it, are you saying you cannot comment on microvesicular steatosis?’ "A: Yes, I would have to be told what that is. I don't know what that is.' "Lam surprised [said Judge Black], in view of those answers, that the paediatrician felt able to be as positive in his conclusions as he was." conditions that may have contributed to the death were listed. ¢ A neuropathology professor also gave evidence for the In cross-examination, the following questions and answers were Crown. Commenting on his testimony, Acting Judge Black put and given: wrote in his Judgment: Q: And first of all, it is the case, is it not, that there is some "Injuries are consistent with the child having been shaken. He controversy within the medical profes- was asked, 'Would it be possible for a child sion about this whole issue of shaken to have received these injuries and to appear baby syndrome? normal to a number of adults over a period A: Yes. of hours?’ A: 'Yes.' When asked to put a Q: There are those who would debunk time frame on this, he said, 'The injuries the whole idea completely? " could have happened twenty-four to forty- A: There are certain people that say that He was unaware that eight hours prior to the arrival of the injuries, that there must be impact a the child had been aware that the child had been vacinated well; and there are others that say that vaccinated three days three days prior to the death. He noted the the shaking is sufficient. prior to the death presence of cytomegalovirus but that did not cause him any concern, nor did he see any ¢ The paediatrician, Chairman of the He noted the presence relationship between that and the Child at Risk Committee at Westmead i vaccination. Hospital, Sydney, reported: of cytomegalovirus but "He did not consider whether scurvy was "The clinical and pathological find- that did not cause him a problem and said, ‘Scurvy is a diag- ings are almost certainly the result of a i nosis that...again I am no [more] expert violent shaking injury to the child in the any concern, nor did he on the clinical aspects of vitamin defi- short time prior to her death." see any relationship ciencies than I am on the vitamin between that and the vaccination." Slightly later in his report, he said aspects of brain problems, but scurvy this: does not normally cause any brain "The only other possible explanation pathology’." for a spontaneous haemorrhage into the It was clear from the medical evi- brain would be some form of haemor- dence tendered that the subdural rhagic disease such as vitamin K defi- haemorrhage was the cause of death ciency in the neonatal period. I under- and was probably less than 24 hours stand that she did receive her vitamin K old. The retinal haemorrhage would injection and this would virtually rule have occurred near the time of death out this possibility." and could have been caused by resus- In his Judgment, Acting Judge citation. In other words, there were Black commented on the paediatrician's findings: two instances of haemorrhage allegedly caused by the baby being "In the course of his evidence, the paediatrician had said that he shaken. felt strongly about his position and I asked him to clarify what he meant by that. He said it was not because he was trying to make © DOCTORS CALLED BY DEFENCE LEGAL TEAM out that he was zealous about the matter; it was just that because Two medical practitioners were called on behalf of the defence of the range of injuries within the brain, he felt it was consistent in the case of Regina v Scott Warren Walters. with violent shaking, way out ahead of any other possibility; in ¢ Dr Mark Donohoe, MB, BS, gave the following testimony:’ terms of percentages, something like 99 per cent, something like "The contributing and unusual factors in this case do make it that. difficult to attribute the intracranial bleeding to a single cause. "He was not aware that the child had been vaccinated about The range of contributing and potentially causative factors three days before her death. include: hepatic mitochondrial abnormality (as evidenced by the "He says that the presence of cytomegalovirus would not be a microvesicular steatosis of the liver); antibiotic use in the neonatal contraindication for immunising the child. He said the current period; cytomegalovirus (CMV) infection causing pneumonia; advice is that immunisation should be done unless there is a par- poor feeding and fluid intake causing a depletion in glutathione; ticularly serious illness. multiple antigen vaccination administered while she was suffering "In relation to the microvesicular steatosis found by the forensic a significant viral infection; adverse reaction to the vaccination; vaccinated three days prior to the death. He noted the presence of cytomegalovirus but that did not cause him vaccination." DOCTORS CALLED BY DEFENCE LEGAL TEAM Two medical practitioners were called on behalf of the defence in the case of Regina v Scott Warren Walters. ¢ Dr Mark Donohoe, MB, BS, gave the following testimony:’ "The contributing and unusual factors in this case do make it difficult to attribute the intracranial bleeding to a single cause. The range of contributing and potentially causative factors include: hepatic mitochondrial abnormality (as evidenced by the microvesicular steatosis of the liver); antibiotic use in the neonatal period; cytomegalovirus (CMV) infection causing pneumonia; poor feeding and fluid intake causing a depletion in glutathione; multiple antigen vaccination administered while she was suffering a significant viral infection; adverse reaction to the vaccination; NEXUS 37 "He was unaware that the child had been OCTOBER — NOVEMBER 2000