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S H A K E N
S C I E N C E

A DISPUTED DIAGNOSIS IMPRISONS PARENTS

PART ONE
SECTION ONE

Prosecutors build murder cases on disputed Shaken Baby Syndrome

diagnosis
By Debbie Cenziper, Published: March 20, 2015
Six years ago, in a tidy home day care on the edge of a cornfield, with angel figurines in the flower beds and an American flag
over the driveway, 9-month-old Trevor Ulrich stopped breathing. He had contusions on his scalp and bleeding on the surface of
his swollen brain.
Within weeks, day-care owner Gail Dobson was charged with killing the baby in a fit of frustration at the business she had run for
29 years along a rural stretch of Marylands Eastern Shore. The Sunday school teacher and grandmother of three was convicted
of second-degree murder in 2010, eight months shy of her 54th birthday, and sentenced to 20 years in prison.
To me, she is a monster, Trevors mother told a local television reporter in 2013. She is a cold-hearted killer.
But what prosecutors called a clear-cut case of child abuse is now mired in doubt. Two doctors working on Dobsons appeal last
year argued that the scientific testimony used against her was fundamentally flawed. A judge overturned the conviction and
ordered a new trial, finding that a jury hearing that argument could have had a reasonable doubt about her guilt.
Doctors for the prosecution said Trevor had been a victim of Shaken Baby Syndrome, a 40-year-old medical diagnosis long
defined by three internal conditions: swelling of the brain, bleeding on the surface of the brain and bleeding in the back of the
eyes. The diagnosis gave a generation of doctors a way to account for unexplained head injuries in babies and prosecutors a
stronger case for criminal intent when police had no witnesses, no confessions and only circumstantial evidence.
It has also led to more than a decade of fierce debate: Testing has been unable to show whether violent shaking can produce the
bleeding and swelling long attributed to the diagnosis, and doctors have found that accidents and diseases can trigger identical
conditions in babies.
Challenges to the diagnosis have spilled into courts on two continents. In 2005, Britains Court of Appeal found that the head and
eye injuries alone were not absolute proof of abuse and, in Sweden last year, the Supreme Court ruled that the scientific support
for the diagnosis had turned out to be uncertain.
In the United States, 16 convictions have been overturned since 2001, including three last year. In Illinois, a federal judge who
recently freed a mother of two after nearly a decade in prison called Shaken Baby Syndrome more an article of faith than a
proposition of science.
Despite the uncertainty, prosecutors are still using the diagnosis to help prove criminal cases beyond a reasonable doubt
against hundreds of parents and caregivers.
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against hundreds of parents and caregivers.

You cant necessarily prove [Shaken Baby Syndrome] one way or another sort of like politics or religion, said forensic
pathologist Gregory G. Davis, the chief medical examiner in Birmingham, Ala., and the board chairman of the National
Association of Medical Examiners. Neither side can point to compelling evidence and say, Were right and the other side is
wrong. So instead, it goes to trial.
The Washington Post, in partnership with journalists at Northwestern Universitys Medill Justice Project, carried out the first
systematic examination of dispositions in Shaken Baby cases since doctors started disputing the science behind the syndrome.
Reporters used court records and newspaper reports to track down murder or abuse cases involving shaking that have been
filed or dismissed since 2001. The year-long study unearthed about 1,800 resolved cases nationwide, finding some of the
heaviest concentrations in counties in Ohio, Pennsylvania, Wisconsin and Nebraska.
About 1,600 cases resulted in a conviction, a rate that is higher than that for other violent crimes. In hundreds of cases, there
were reports of shaking along with more obvious forms of violence that left extensive bruises and broken bones, with prosecutors
alleging that babies also had been slammed, thrown or beaten.
The study for the first time identified about 200 cases in 47 states that ended when charges were dropped or dismissed,
defendants were found not guilty or convictions were overturned.
Among them: a 39-year-old software entrepreneur in California who mourned his infant son while locked in an isolation cell; a 13year-old babysitter in Washington who was charged with second-degree murder; and a 46-year-old grandmother in Arizona who
spent nearly 2 years facing capital murder charges.
Kelly Kline, acquitted in 2012 of shaking a baby to death in her home day care in rural Ohio, met her 6-year-old daughter for a
parents lunch at school the day her mug shot flashed on the local news.
If I wasnt married and didnt have kids, I would have committed suicide because of the hell, the embarrassment, said Kline, a
mother of three.

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Kelly Kline at home with her family April 20 in Shreve, Ohio. Kline was charged with killing a child by shaking. Kline was found not guilty. (Photo by Bonnie Jo
Mount/The Washington Post)

In four of the cases, doctors who had diagnosed shaking later revised their opinions, saying they were uncertain about the timing
or cause of the injuries. One of the revisions helped free a Sacramento father after 3 years in jail.
In four other cases, new medical examiners found that their predecessors had made mistakes by diagnosing shaking in babies
who likely died from conditions that had nothing to do with violence. One doctor in Tennessee found a 10-week-old diagnosed
with shaking appeared to have suffered from a series of strokes while he was in the womb.
Forensic pathologist George Nichols is among the doctors who once diagnosed Shaken Baby Syndrome and no longer believes
in the science.
Doctors, myself included, have accepted as true an unproven theory about a potential cause of brain injury in children, said
Nichols, who was the chief medical examiner of Kentucky for 20 years before retiring in 1997. My greatest worry is that I have
deprived someone of justice because I have been overtly biased or just mistaken.
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I didnt think it could be any worse than being where I was at in prison.
Gail Dobson

About this investigation

Although federal health officials have long considered Shaken Baby Syndrome a serious public health threat, no regulatory body
or advocacy agency has tracked the number of alleged incidents.
In a year-long study, The Washington Post, in partnership with journalists from Northwestern Universitys Medill Justice Project,
used court records and news media accounts to track the dispositions of about 1,800 cases nationwide since 2001 that
reportedly involved shaking. Information was also obtained from the National Registry of Exonerations at the University of
Michigan Law School and from bloggers Sue Luttner and Susan Anthony.
Court dockets in more than 800 U.S. counties, accounting for 75 percent of the nations population, were reviewed. In several
dozen of the dismissed cases, reporters examined thousands of pages of court and police records, including medical and
autopsy reports.
Interviews were conducted with families, lawyers, imprisoned defendants and doctors on both sides of the scientific debate. The
Post also commissioned a study from Design Research Engineering, an engineering firm outside Detroit, to compare the
acceleration in shaking to falls.
Contributors to the investigation include Post database editor Steven Rich, Post researchers Alice Crites, Magda Jean-Louis
and Jennifer Jenkins; Lauryn Schroeder, Manini Gupta, Dan Bauman, Jessica Floum, Mark Olalde, Megan Thielking, Sophia
Bollag, Anna Zambelli, Blake Bakkila, Anna Bisaro, Ellen Schmitz, Amanda Westrich and Alec Klein at Northwestern University;
Paige Blankenbuehler, Josh Benson, Joe Guszkowski, Fran Webber and James Gordon at the University of Missouri; Elizabeth
Koh and Cathaleen Qiao Chen with American Universitys Investigative Reporting Workshop; Elyssa Pachico, Mariam Baksh
and Pietro Lombardi with American University; Julia Glum, Kelcee Griffis and Katherine Kallergis from the University of Florida;
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Rachel Leingang from Arizona State University; and Carolyn Crist and Lee Adcock from the University of Georgia.
Debbie Cenziper
Contributors
Part 1: Lauryn Schroeder, Jessica Floum, Manini Gupta, Dan Bauman and Mark Olalde of Northwesterns Medill Justice Project;
Cathaleen Qiao Chen of the Investigative Reporting Workshop at American University; Post video journalist Zoeann Murphy,
photographer Bonnie Jo Mount, database editor Steven Rich and researchers Alice Crites, Magda Jean-Louis and Jennifer
Jenkins.
Part 2: Dan Bauman with the Medill Justice Project at Northwestern University, Cathaleen Qiao Chen and Elizabeth Koh with
American Universitys Investigative Reporting Workshop, and Washington Post researchers Alice Crites and Magda Jean-Louis.
Videos by Zoeann Murphy.
Photos by Bonnie Jo Mount.
Design & development by Seth Blanchard, Emily Chow and Shelly Tan.

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