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 Satawa Law, PLLC

Our firm has a significant amount of experience handling Shaken Baby Syndrome and Abusive Head Trauma cases at both the trial and appellate levels. We have successfully defended these cases at the trial court level. We have successfully won appeals and post-conviction collateral reviews, too.

It’s important to start the conversation of these matters with an understanding of what we are talking about when we discuss Shaken Baby Syndrome (SBS) or Abusive Head Trauma (AHT).

First of all, everyone should understand that these terms both refer to the same concept. Abusive Head Trauma is a new terminology coined by child abuse pediatricians and child abuse protection teams to replace SBS, because judges and juries were frequently found to be too caught up in the idea of shaking being a necessary component. This was especially true because the average person views some shaking to be closely associated with normal behavior, such as burping and bouncing an infant.

Abusive Head Trauma is the new nomenclature for the forensic medical-legal diagnosis of SBS. Therefore, whether you call it AHT or SBS, the term is defined by an attempt to explain what happens when a person causes a set, or “triad,” of injuries, to an otherwise healthy infant, by shaking or otherwise, without breaking the child’s neck or causing an external impact injury.

When child victims of AHT show up at a hospital, they usually have a trial of injuries: (1) a Subdural Hematoma, which is bleeding under the Dura level of the brain; (2) retinal hemorrhaging, or bleeding behind the eyes; and (3) edema, or brain swelling.

In these cases, there is no external evidence of the injuries. There is no bruising to the scalp, no skull fracture, no cuts or abrasions, and no damage to the neck by fracture, strain, or ligament damage. So how does that happen? Shaken Baby Syndrome is a medical concept that was developed to try to explain that phenomenon.

SBS posits that a person can shake an infant with enough force to cause a subdural hematoma, retinal hemorrhaging, and edema without damaging a baby’s neck and without causing any external injuries to the baby’s head or skull. This is what we mean by the terms SBS or AHT.

Individuals can show up to an ER with a child who has crashed (meaning that they had a negative change in their state of consciousness) quite suddenly. This typically means the child had a seizure, difficulty breathing, become limp, and is non-responsive. In the classic AHT or SBS case, there is no obvious explanation for the baby to have crashed.

Over the past 20 years, the child abuse pediatric community has theorized and then “accepted” that such a situation is most likely caused by SBS. Additionally, it is widely assumed that the adult who was caring for the child at the time the child crashed is the person who committed the abuse.

The reason for this assumption is that child abuse pediatricians, without any medical evidence to support the idea, have long advanced that a child with a subdural hematoma, edema, and retinal hemorrhaging extensive enough to cause the child to arrest and have seizures cannot have a period of a “lucid interval “in which the child is acting and behaving normally. In other words, as soon as a child is injured and sustains trauma that has enough force to cause subdural hematoma, retinal hemorrhaging, and edema, the child seizes immediately. Therefore, they cannot act normally for any period of time longer than a few minutes or even a few seconds. Because of this, the person who is in charge of caring for the infant when the child arrests are almost always seen as the primary suspect of a charge of AHT.

At Satawa Law, our experience and expertise in SBS and AHT cases goes back 20 years, to the early 2000s. We have learned the biomechanics behind the alleged injury causation. We have learned the investigative techniques employed by law enforcement, and the strategies employed by the prosecutors to secure these convictions. Our firm employs a multi-disciplinary approach to fighting these cases.

This is done via attacking the timing of factual allegation by asking:

  • “Who was watching the child, and when?”
  • “Could someone other than our client been the person that caused these injuries, if they were intentionally caused?”

We attack biomechanics, what really caused these injuries, by asking:

  • “Is this a chronic subdural hematoma that is weeks if not months old that just happened to re-bleed at the time that our client was in charge of the infant?”
  • “Is this an accident?”
  • “Is this a short-distance fall?”
  • “Is this the result of a violent reaction to a vaccine?”

We assault the facts, we assault the biomechanics, and we assault the medical diagnosis.

We challenge the idea that short-distance falls cannot cause a subdural hematoma or retinal hemorrhaging.

We challenge the idea that there cannot be a period of lucid interval between the time the trauma takes place and the time the child arrests or seizes.

We challenge the idea that chronic subdural hematomas can, and frequently do, re-bleed. In fact, very minimal force (or even no force at all) is necessary to cause a chronic subdural to re-bleed.

We do all of these things because it is not necessary to challenge the diagnosis of SBS or AHD itself in every case. SBS or AHT could be a valid diagnosis that is only misapplied to this particular defendant’s case. The tenets and rules for SBS or AHT cases may not apply to a particular defendant’s situation. However, if necessary, we do ultimately take on SBS and AHT as a diagnosis.

The idea of a person being able to shake an infant with enough force to cause a subdural hematoma has been shown by biomechanical studies to be absurd. Biomechanics have shown that a short distance fall of even two feet produces a far greater force of impact than an adult can cause by simply shaking an infant.

Additionally, there is significant medical literature to suggest that a subdural hematoma itself can cause an edema, which in turn can be the cause of retinal hemorrhaging. In other words, retinal hemorrhages and edema can be secondary to, and a result of, the subdural hematoma, and not independent of each other at all.

The diagnosis of SBS has been shown frequently to be a “garbage can diagnosis,” which is a term medical professions use to refer to situations in which no other option appears to be relevant, so SBS is ultimately resorted to. It has been studied that lucid intervals can and do happen, that chronic subdural hematomas can and do re-bleed with little to no force, and that short distance falls can and do cause these injuries.

Our experience and expertise allows us to perform cross-disciplinary examinations of your entire case. Did the child have a chronic subdural hematoma that re-bled? Maybe someone did abuse the infant, but it wasn’t the person who was watching the infant at the time. Did the child experience a short-distance fall? Maybe the infant wasn’t injured from SBS but fell onto their head standing and holding onto a coffee table. Did the child have chronic subdural hematoma? Maybe the child has had a chronic subdural hematoma for six months that had continued to bleed, causing continually greater intracranial pressure which lead to edema and retinal hemorrhaging.

We work with biomechanics, radiologists, ER doctors, neurologists, head trauma doctors, and private investigators to provide the best alternative explanation for what may have happened to the infant. We seek to find reasons for the injury, other than SBS, that caused the child to arrest.

These methods have been proven effective at both the trial and appellate post-conviction stages, and this multi-disciplinary approach is the most effective and useful way to properly go about defending an accusation of SBS or AHT.

For more information on Shaken Baby Syndrome/Abusive Head Trauma Cases, a free initial consultation is your next best step. Get the information and legal answers you are seeking by calling (248) 509-0056 today.

Mark Satawa

Call Today For Your Free Case Strategy Session
(248) 509-0056