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Paul D. Cramm

Case History: Shaken Baby Syndrome


Interviewer: Can you tell us about some of the recent cases involving shaken baby syndrome that you have handled recently?

Can Shaken Baby Syndrome Be Incorrectly Diagnosed? Is This a Way Expert Medical Testimony Benefits the Defense?

Paul Cramm: I had one case where the father was at home alone with the infant. Again, he discovered the infant was not breathing and immediately called 911. There was a wash of suspicion over him that he must have done something wrong. We came to find out that that infant had been demonstrating symptoms of internal brain bleeding, which does not require trauma. It does not require physical injury.

There can be a subdural brain bleed from a weakened blood vessel. It’s common in the childbirth process, because of the forces that are exerted during the birthing process.

We found out that this little infant had significant brain bleed. The forensic evidence was able to establish the condition long predated the date of this infant’s sad death. We discovered through forensic examination this infant had absolutely no injury whatsoever to the bony or connective structures of the neck. There was no injury to the spinal cord and no injury to the cervical spine. No injury at all to the muscles or ligaments of the neck.

Knowing those two things, which we only knew from our own independent forensic examination, it was very difficult to believe that these injuries were caused by violent or aggressive shaking.  The initial diagnosis did not make sense when the neck structure itself is completely intact, with no injury and we have injury of bleeding within the brain that predated the date of death by days if not weeks. That’s an example of the value of qualified forensic and medical participation in these cases.

What Questions Can You Expect to Be Asked by the Police?

Interviewer: In this type of case, what are some of the questions that an alleged child abuser will be asked by the police?

You May Be Given One Only Opportunity to Relay the Sequence of Event before the Child was Injured

Paul Cramm: The police officer is just going to ask the person to reconstruct the timeline of events. This is a lot different to do when a police officer is interrogating you and you have no opportunity to review your work. The police officer is going to ask the person to relay what has happened. This person has one time and one time only with no pen, no paper and no opportunity to ask a spouse or a husband, wife, “Is this the way you remember it? Am I remembering this correctly or incorrectly?”

They are sitting down in an interrogation room answering one time with no pen and paper, to walk through a timeline. That timeline is poured in cement, legally speaking. If days or weeks later the person remembers, “Wait, I forgot the phone rang and I stepped out of the room and it was my brother in law.” If they remember that at a later date and bring that up, immediately they’re going to be accused of fabricating or some such as that.

Any good faith, honest addition to or amendment of the story or timeline they provide to law enforcement on day one, when they’re already in an emotional state, is going to be seen as deception or dishonesty. That’s a big problem.

The Officers May Ask Direct Questions of a Suspicious Nature

Additionally, officers will question people in a very directive and suspicious way. They will say, “Now come on, we know that you shook this baby. The doctors told us you shook the baby. We just need to hear it from you.” When the doctor may have said no such thing.

Those are the types of things people will face when they agree to speak with law enforcement about these types of events.

Paul D. Cramm

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