Junk Science Defeated!
Tuesday, December 14, 2021
by: Elizabeth Leedom, Erin Seeberger, Jonathan Litner, Bennett, Bigelow & Leedom and Bertha B. Fitzer & Jennifer Veal, Tyson & Mendes

Section: Fall 2021

Elizabeth Leedom, Erin Seeberger, Jonathan Litner of Bennett, Bigelow & Leedom and Bertha B. Fitzer and Jennifer Veal of Tyson & Mendes, successfully defeated the latest and most dangerous attack on evidence-based medicine.  In a highly contested medical malpractice case, involving a gravely impaired child, a Pierce County Superior Court jury returned a unanimous defense verdict in Link v. Multicare Health System, et. al on October 26, 2021 
All medical personnel provided excellent care.  A pediatric cardiologist diagnosed a vascular abnormality in utero via fetal echo.  Two weeks after the infant’s birth, a second cardiologist made the further diagnosis of a right aortic arch.  At age six weeks, the baby was diagnosed with failure to thrive and was brought to Mary Bridge Hospital.  MRI imaging revealed a vascular ring, of a type that rarely causes problems before a child starts taking in solid foods. An upper GI study demonstrated that liquids flowed freely around the indentation caused by the vascular ring into the stomach.  The baby was treated for malnutrition and observed for five days at Mary Bridge Hospital.  The mother was taught proper feeding techniques and the baby rapidly gained weight.
Two months after the care in question, the infant arrived nonresponsive, with a GSC of 3 at a rural emergency room.  Up until 11:00 pm that evening, the baby had been completely normal.  Left alone with the mother’s boyfriend when she left to go buy him drugs, the baby collapsed into a coma.  Imaging in the ED revealed subdural hematomas and torn cortical bridging veins.  The baby was again transported to Mary Bridge Hospital.  Physicians then discovered retinal hemorrhages and other brain injuries, leading to the diagnosis of abusive head trauma. (AHT)
The mother’s boyfriend admitted to shaking the baby, allegedly because she had choked on formula. He was charged with Assault of a Child in the First Degree and ultimately pled guilty to Child Assault in the Third Degree, with Aggravating Factors.  He was sentenced to 36 months in prison.  
Building off the theories and expert opinions that the criminal defense had developed to obtain a reduction in the charges, plaintiff filed a civil medical malpractice suit against the pediatric cardiologists and Mary Bridge Children’s Hospital.  To support that the claim that the vascular ring should have been surgically repaired before the events, plaintiff launched a frontal attack on the scientific basis for a diagnosis of AHT.  Plaintiff’s experts asserted that the vascular ring caused the baby to choke, which then caused hypoxic ischemic injury and/or cerebral venous sinus thrombosis (CVST) which then caused the retinal hemorrhages.  Not even Dr. Stephen Glass would support this theory.  Although he was called to comment on the life care plan and damages, he firmly declined to offer any opinions regarding the cause of the infant’s injuries.
Plaintiff’s case is part of a national phenomenon, a concerted attack on the causation of injuries commonly associated with AHT.  A small group of biomechanical engineers, forensic pathologists and radiologists have advanced similar explanations for the injuries commonly associated with abusive head trauma.  This small group of modestly credentialed experts are appearing in criminal cases around the country, occasionally convincing judges that there are many wrongly convicted individuals imprisoned based on this allegedly faulty diagnosis of shaken baby syndrome.  
The American Academy of Pediatricians, (AAP), along with sixteen other professional associations combined efforts to rebut this attack on evidence-based medicine.  In 2018, the group published a “Consensus statement on abusive head trauma in infants and young children in the journal Pediatric Radiology.”  The Consensus Statement unequivocally concludes that there is no controversy regarding the medical validity of the existence of AHT.  It further states that: “That there is no reliable medical evidence that the following processes are causative in the constellation of injuries of AHT: cerebral sinovenous thrombosis, hypoxic ischemic injury, lumbar puncture or dysphagic choking/vomiting.”  
Citing to the Consensus Statement, defendants attempted to avoid the expense of a needless trial by moving for summary judgment on the issue of causation.  With the support of declarations from national experts in pediatric neuroradiology, cardiology, and child abuse, defendants argued that plaintiff’s evidence could not meet the Frye standard, or the standards required of ER 702.  The trial judge denied the motion.  Efforts to obtain interlocutory review were unsuccessful.
Two years of extremely expensive litigation followed culminating in a five-week trial. Despite the efforts of national counsel for the plaintiffs and experts asserting that the diagnosis of SBS or AHT involved a “conspiracy,” the jury made short work of the case.   After little more than an hour deliberation, the jurors summarily rejected the plaintiff’s $111 million damages claim.
Plaintiff filed Notice of Appeal and defendants have cross-appealed.  It is hoped that this case becomes a vehicle for resolving the confusion in the civil and criminal courts.  It is time to definitively reject these fringe theories regarding the medical validity of an abusive head trauma diagnosis.