Tuesday, August 9, 2011

DR. JOHN PLUNKETT / 593

Dr. John Plunkett
I am pretty impressed with the caliber of medical and bio-mechanical experts, pathologists and lawyers who served as presenters at the recent Evidence Based Medicine and Social Investigation Conference held in Surrey last weekend. Paul and Zabeth Bayne deserve applause for envisioning this conference and making it happen.

One example is a forensic pathologist Dr. John Plunkett, a leading critic of shaken baby syndrome and a thorn in the side of child abuse prosecutors.

His topic was ‘The differential diagnosis for subdural hemorrhage and retinal hemorrhage in children under the age of two.’ It was during the 1970s, that “shaking” was advanced as a theory to explain a triad of findings (subdural hemorrhage, retinal hemorrhage, and/or brain swelling) when it appears in infants or children who have no signs of trauma. The idea was that when there are no signs of abuse, the bleeding can be explained immediately by slapping the SBS label on the case. The theory was that shaking caused these findings by rupturing bridging veins and tearing the axons within the brain. His categorical censure of SBS is “You can’t cause the injuries said to be caused by shaking.” Plunkett’s work and opinions were among the many that began to change thinking in the medical community. He authored a widely cited 2001 scientific article on short distance falls that called into question the whole theory behind shaken baby syndrome. Now you find steadfast adherents of SBS have added trauma to their definition. In recent years and current cases, judges view SBS as itself a theory undergoing tests and it has not reached acceptance in the scientific community. Some judges are beginning to bar the use of the term “shaken baby syndrome” on the basis that it is a possible prejudicial influence on jurors. Of course the same insinuations against parents can be made using different labels and the latest I have heard is 'Inflicted childhood neurotrauma.' 

It is bewildering that our own Children’s Hospital still permits physicians to diagnose SBS with no other evidence of manifest injuries and thereby to empower the physician to diagnose a legal conclusion. That’s precisely what MCFD and Fraser Valley regional staff and director employed as the foundation for their allegations against Paul and Zabeth Bayne in 2007 and all the way to March 2010 when Judge Crabtree put the SBS claim on ice.

Plunkett was a compelling witness for the Baynes during their 2010 Continuing Care hearing, which was more like a criminal case because the Ministry Director was seeking to have the court believe that one or both Baynes maliciously injured their seven-week old daughter on autumn of 2007. Dr. Plunkett has testified in hundreds of cases over the past ten plus years because he is one of the early courageous practitioners who challenged shaken baby syndrome in cases where prosecutors were seeking to nail innocent hides to the veritable wall.

ABA Journal.com is the website of the flagship magazine of the American Bar Association. Mark Hansen is a senior writer for the ABA Journal and he wrote an article about Plunkett in 2005. Plunkett was such a crusader for the truth about the injuries that were categorically being diagnosed as SBS and people were being tried, convicted and imprisoned unjustly. Because he was somewhat of a pioneer among the opponents of comprehensive SBS accusation and prosecution, he became a target. I couldn’t begin to copy Hansen’s informative story so I provide the link to ‘Battle of the Expert’. 

After reading the Hansen article you will be impressed with the substance of this man who has continued to endure assaults upon his integrity, reputation and bank account. Fortunately, he has been joined in these last years by a strong contingent of other voices not afraid to stand up and be heard. It’s hardly a malevolent intent. This has been a long term effort to urge the medical profession to sit down in discussion in order to develop a calm, rational and evidence-based approach to pediatric head injury and child death.

Some Online Data:
  1. July 5, 2011, a CBC article entitled, ‘Boy could have been injured twice, Tippett trial told’ highlights Plunkett’s work in another Canadian case where a father is on trial for manslaughter.
  2. Plunkett at the Tippett Trial
  3. Studies Split on Shaken Baby Syndrome
  4. On Shaky Ground
  5. Has Sally Clark’s case changed attitudes to infant death?

5 comments:

  1. I cannot resist a word about the medical evidence in the Bayne case and the way Judge Crabtree handled it. What he did was to virtually discount all the medical evidence in the case for both prosection and defence. He rejected the claim that the Bayne girl had been shaken. This was the main plank in the case for the director. However, he could have done that half way through the trial, when he ruled that one could not infer cause from injury alone. Had he accepted the shaking claim it would be automatic proof of non-accidental injury. Then he went through all the defence medical evidence and picked nits from it and quibbled, until he finished up discounting it altogether, except for one point. The crux. You cannot infer cause of injury from medical symptoms alone. All that time in court and it amounted to nothing.
    In spite of much expert testimony and much research filed with the court, which included the Goudge report, the judge carefully avoided making any reference to the shaken baby syndrome hypothesis in general and thus avoided setting any precedents for future cases.
    So what did he finish up with? He did not decide the case on medical evidence and he did not decide the case on any of the testimony of non medical witnesses. He decided tha case on his perception of Mrs. Bayne on the witness stand under cross examination. He scraped the bottom of the barrel in order to make a protection finding. She was under merciless cross-examination by Finn Jensen for a day and a half. The judge found that there was some inconsistency in her recall of events on a certain day three years previously. Well let me tell you, you could grill any one of us about events on a day three years ago and we would be inconsistent. If he had not let the case drag on so damned long, maybe her recall would have been clearer. He dug into precedents and in general he did what could only be a desperate attempt to find some rationale for a protection finding. When he did that he saved the bacon of the director and saved himself from major embarrassment and made sure the new Bayne baby would not get breast milk. Having gone to all that trouble he shot himself in the foot by making an illegal order, which he had to retract and rewrite. Great stuff from the head judge.

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  2. The emphasis at the conference is that it is very difficult to determine the difference between and accidental and non-accidental head injury.

    A connecting story ( http://www.cbc.ca/news/canada/newfoundland-labrador/story/2011/06/21/nl-tulk-tippett-trial-621.html ) has investigators lying to the girlfriend telling her that Mr. Tippet confessed, when it was not true.

    So, instead of trying to find supporting diagnosis, looking at opposing diagnosis objectively and social workers doing a proper investigation, talking with character witnesses and such, the focus seems to be deciding someone is guilty first, and then gathering only evidence to support that decision and disregarding the rest.

    I think the Baynes can certainly sympathize with this. At least a Jury is looking at this case and would be in the best position to make a decision.

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  3. Having watched several days of trial and after reading through the judgment, I was shocked at the omissions in the judgment of the indiscretions of the prosecution and their witnesses. And we thought the judge, quiet, pensive and studious looking was going to be fair and impartial. It is truly Mind boggling.

    Although I wholeheartedly agree with Mr. Ferris' assessment, it does not go far enough and must include the contributing players in this debacle of needless state intervention.

    The only way this affair can be properly communicated to the public is to get a copy of the trial transcripts, and write a book that documents the incredible efforts of the establishment to vilify the Baynes family.

    The fact that this family persevered under this onslaught is the real story. That is the stuff of legends that the rest of us can draw inspiration on, and I hope there is an author out there that can due justice to this story.

    Before signing off on this blog, I would advise each page and all the comments be archived. Who knows, it could be worth something some day. The Bayne's children might want to read it when they grow up.

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  4. I wish to express my gratitude for all of your comments from so many people, sometimes appreciative, supportive, sensitive, informational. These are always welcome. Of course there is a bias to this blog. We want this family to come together and to stay together. Thank you. There is still time to tell stories and provide links.

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  5. What the "investigation" of the Baynes has done for our family is shown us that little is credible in the courts and judiciary of Canada.
    The avoidance of charges; the civil law approach - where accused proves he is not guilty as accused rather than police lay charges and the onus is on the prosecution to prove charges - is unbelievable and, apparently, being increasingly practised around the world.


    The lying, the back room deals with judiciary and lawyers, the false convictions, the utter disregard for proper - or in some cases, any - investigation to gather evidence is appalling. We listened, at the EBMSI conference, to people who, firsthand, experienced abuse by their legally appointed protectors who, instead, protected a powerful bureaucracy, a powerful judiciary and many,sadly, dishonest medical practitioners.

    People used to expect trial by a jury of their peers but it is rare to see such "extravagant" practise any longer in Canada. Instead, we are stuck with pompous, political appointments where one person plays around with some other peoples' lives as though so clever, a judge doesn't need any other opinions but his own or those fomented in the back office or on the phone.

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