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By Harold E. Buttram, MD and Alan Yurko
ABSTRACT: Medical evidence grossly neglected during a court case and conviction of a father for allegedly murdering his four month old infant, Amanda, is presented. A reasonable forensic investigation evidenced multiple risk factors for fetal brain hemorrhage from birth trauma. These factors could have sourced the material finding of hemosiderinladen macrophages found in brain stroma at autopsy. These risk factors included a primiparous mother with slight body frame, pitocin-assisted labor that likely prolonged labor contractions, and an unusually large fetal head of 95 percentile resulting in fetalpelvic dysproportion and likely cranial stress and strain during birth. Both father and his sister had Moyamoya disease, a poorly understood occlusive disease involving large intracranial arteries occurring mainly in Asian children and young adults. The father probably was experiencing transient ischemic attacks (TIAs) on the day of Amanda’s fatal injury. The father testified that he
accidentally dropped Amanda approximately four and a half feet with her hitting headfirst onto a thinly carpeted concrete floor; with a lethal minor fall (LMF) being the cause of death rather than inflicted child abuse. The “healing rib fractures” demonstrated on X-rays during terminal hospitalization probably occurred from birth trauma. The mother had virtually no sunshine exposure during her pregnancy, her consumption of vitamin D-containing foods was negligible, and prenatal vitamins were taken irregularly. Consequently the fetus was likely born with congenital rickets as a contributory source of the fractures. Reflux problems almost certainly perpetuated multiple nutrient deficiencies, including vitamin D. Skull fractures may have originated at birth but also extended by the fatal fall. This study is provided in the hope that future cases of this nature may be more thoroughly examined in service of justice. “SBS Theory is irreconcilable with the weakness of the human infant’s neck. . . . [and] gross deficiencies in establishing a differential diagnosis of other possible sources . . .”
This study is provided in the hope that future cases of this nature may be more thoroughly examined in service of justice.
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