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Paul D. Cramm

Any Time a Child Is injured under an Adult’s Care, the Authorities Involve Child Protective Services and Hospital Staff to Determine If the Injuries Were Intentional


Interviewer: What we wanted to talk about today is shaken baby syndrome. Let’s get an overview on that.

Paul Cramm: In recent years, any time a child is injured while under an adults care it’s almost a reflexive reaction to have child protective services involved. Also involved is the cooperation of a pediatrician from the local children’s hospital, to try to determine whether or not any of the injuries the infant or a child has suffered, were intentionally inflicted.

It seems as though more and more cases of what are purely accidental injury, are being evaluated and prosecuted as criminal cases wherein the the authorities allege intentional injury or abuse.

Adults Can Face Charges Ranging from Abuse of a Child or Aggravated Battery to Homicide

Interviewer: What are they charged with? Is it seen more as like a domestic violence, a criminal act or child abuse?

Paul Cramm: There is a specific crime of child abuse. Other jurisdictions will simply charge these cases as battery, aggravated battery cases. Certainly, if the infant does not survive the injuries, the charge would be a manslaughter or homicide charge.

In Kansas, if an Infant Dies as a Result of the Injury, the Charges Depend on the Circumstances of Death

Interviewer: What could someone be facing as far as prison or jail time with that? Do you know?

Paul Cramm: In Kansas, if a child dies as a result of alleged abuse, the charge would depend on the degree of intent that occasioned the harm.  If the prosecutor believes that he person acted intentionally and with premeditation, the charge would be first degree murder, carrying a statutory mandatory sentence of life in prison with no opportunity for parole for a term of 20 years.   Of course, if a child dies as a result of reckless – but unintentional conduct – like leaving a child unattended on a changing table, and the child falls, or leaving a child unattended in a bath and the child drowns – there are less serious manslaughter charges available for the prosecutor to consider.

Interviewer: To get a better perspective of this would you share some cases to give me an example of how you dealt with these situations?

The Term Shaken Baby Syndrome Originated in the 1970s and Is Attributed to Hemorrhages Resulting from Violent Movements of an Infant’s Head

Paul Cramm: The origins of shaken baby syndrome arise from the early ’70s when a researcher, at the time, believed that rapid or violent movement of the head, without impact on any other surface, but just movement back and forth, would cause injury to the brain tissue and circulatory system of the infant. The primary injuries this particular researcher was examining were retinal hemorrhage, subdural hemorrhage and cerebral edema.

This Charge Can Be Leveled Any Time an Infant Is Observed to Have This Type of Hemorrhage

The theory was that shaking alone could cause these injuries. Now, any time a pediatrician or physician sees a child or infant in the emergency room with any sort of retinal hemorrhages, any sort of cerebral edema, it’s almost a knee jerk diagnosis or accusation that the child was shaken violently to cause these injuries.

In my practice, we have had cases where the client was left at home to care for the child, the client fed the child, put the child down for a nap, went about his business, went about his ordinary business while the child’s napping. Then, noticed that it was just too long since he heard anything from the child’s room. When he checked on the child, the child was not breathing and was turning blue – or cyanotic.  Also, there was some vomit or vomit material in the child’s bed and the child’s not breathing

When a Child Is in the Emergency Room with Injuries, Does Law Enforcement Most Always Assume They Were Intentionally Inflicted?

Immediately the client calls 911 and the first responders arrive. The child was taken to the emergency room and immediately law enforcement begins questioning and interrogating that father, suspecting that he must have done something to have caused these injuries.

Interviewer: How many of these kinds of cases have you had over the years?

Paul Cramm: I’ve had several of these cases in recent years. One involving death of the child and one where the child did survive with some significant brain injury from what we believe was hypoxia, due to choking. Nothing to do with violence or trauma of any kind.

Interviewer: I guess when it comes to shaking the baby it’s suggest a sort of malicious intent in the situation.

Paul Cramm: Sometimes the theory of the prosecution is that the caregiver lost his temper with a child who was crying or fussy.

Interviewer: Are these kinds of cases common or becoming more common?

Paul Cramm: They certainly are more common in recent years. I’ve seen several more of these cases charged in both Kansas and in Missouri.

Paul D. Cramm

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