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Shocking: How Faulty Science Lands Innocent People Behind Bars as Accused Child Murderers

Medical examiners and coroners have repeatedly mishandled cases of infant and child deaths, helping to put innocent people behind bars.

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There is a growing awareness among medical practitioners of "mimics": ailments that can cause the kind of bruising and bleeding once assumed to be telltale indicators of child abuse. A 2006 textbook on head injuries in children listed literally dozens of afflictions -- including some fairly common illnesses -- that can produce hemorrhaging in the brain.

This is just one way that the science of how children die has evolved in recent years. The most notable -- and controversial -- exle of this is the intense debate over "shaken baby syndrome," which has played out in scientific journals and mainstream outlets such as the New York Times Magazine.

Based on studies dating back to the 1960s, many forensic pathologists -- as well as other physicians -- came to believe that a signature trio of symptoms provided definitive proof that someone had violently shaken a child. Under the theory, certain patterns of bleeding and swelling of the brain, and hemorrhages of the retinas came to be seen as conclusive evidence that a child had been assaulted with terrible force, even if there were no other signs of trauma.

But many experts now view the diagnosis with increasing skepticism. In Canada and Britain, official reviews have uncovered nine cases in which people may have been wrongly convicted based on the shaken-baby theory.

Dr. Case, the Missouri medical examiner, said the controversy is a "sideshow": Typically, children who've been shaken have also suffered other serious injuries from being battered. "Yes, there is a scientific debate," she said. "I personally believe that you can shake a child and kill it."

The thinking of other doctors has undergone a radical change. Dr. Patrick Barnes, a pediatric radiologist at Stanford University, was a key prosecution witness in what is arguably the most famous shaken-baby case of all, the trial of Louise Woodward. Woodward was a 19-year-old nanny charged in 1997 with shaking an 8-month-old baby to death, hitting his head and causing fatal bleeding. With Barnes' help, the jury found Woodward guilty of second-degree murder. (She was ultimately released after serving less than a year in prison, when a judge reduced her charge to manslaughter.)

Barnes said he wouldn't give the same testimony today. There's been a "revolution" in the understanding of head injuries in the past decade, in part due to advances in MRI brain scanning technology, he said. "We started realizing there were a number of medical conditions that can affect a baby's brain and look like the findings that we used to attribute to shaken baby syndrome or child abuse," Barnes said.

The case of Melonie Ware shows how profoundly a closer reading of medical evidence can affect the outcome of a child death investigation.

Ware was convicted in 2004 of murdering a 9-month-old boy she was babysitting, based in large part on the testimony of a local forensic pathologist, Dr. Gerald Gowitt. Gowitt said someone shook the child violently, damaging his brain, and slammed his head, causing three near-identical bruises beneath the scalp.

Ware was sentenced to a life term in a Georgia prison.

After an extensive legal battle, a judge granted Ware a new trial in 2009. This time, her attorneys produced evidence from the baby's medical records overlooked in her first trial: Hospital staffers had tried multiple times to insert a probe into the child's skull, as part of their attempt to save his life. The bruises under the baby's scalp, experts for Ware testified, were likely caused by those failed attempts.

Two prominent physicians testified that shaking had nothing to do with the boy's demise. The child had died from sickle cell anemia, said the doctors, both specialists in the disease, which is known to cause cerebral bleeding.