The Science Behind Shaken Baby Syndrome (SBS)

This doctor’s testimony has helped put people in prison. Some say he doesn’t always get it right.

By Isabelle Taft; February 28, 2023

Benton’s testimony was a key factor in preventing two Mississippians convicted of shaking a baby to death from getting new trials. And although he claims to approach his work with scientific objectivity, a Mississippi Today review of his testimony found inconsistencies and a claim directly contradicted by medical literature.

This story is the second part in Mississippi Today’s “Shaky Science, Fractured Families” investigation about the state’s only child abuse pediatrician crossing the line from medicine into law enforcement and how his decisions can tear families apart. Read the full series here.

At Jeffrey Havard’s trial in 2002, medical examiner Dr. Steven Hayne testified the Adams County man had shaken 6-month-old Chloe Britt to death. Her injuries — bleeding in both her brain and retinas — were “consistent with a person violently shaking a small child.”

More than a decade after Havard was convicted and sentenced to death, Hayne changed his mind. 

At a hearing in 2017 to determine whether Havard would receive a new trial, Hayne said he believed the science had evolved, and that Chloe could not have died by shaking alone, though he still thought her death was a homicide. The claim that had put Havard on death row — an injury to her rectum meant he had sexually assaulted the baby — disintegrated, as three different experts and Hayne himself now said there was no evidence of sexual abuse. 

Havard had long maintained he had been giving Chloe a bath when she slipped from his arms and her head hit the toilet. He put her to bed, and not long after, her mother found her “blue and not breathing.” She died at Natchez Community Hospital on Feb. 21, 2002. 

Three defense experts testified in that 2017 hearing that the autopsy findings were consistent with the short fall onto a hard surface Havard had described…

Read the entire story >>

Statement of the Innocence Network On Shaken Baby Syndrome/Abusive Head Trauma

December 2019, By The Innocence Network

Shaken baby syndrome (SBS), now more frequently known as abusive head trauma (AHT), is a medico-legal diagnosis that has served as the basis in thousands of cases where children have been separated from their parents and caretakers have been sent to prison. Until recently, no independent scientific agency had reviewed the evidence basis for the diagnosis. The first to do so published its results in 2016, and it found the evidence for SBS “insufficient” and unreliable.

The Innocence Network is very concerned that, despite several developments that undermine core SBS/AHT tenets, including the findings of this independent review, prosecutions and family separations continue and there has been no systematic attempt to identify and correct wrongful convictions.

The SBS/AHT hypothesis has never been validated. The unproven hypothesis allows
doctors to infer abuse from a “constellation of findings” that we now know appear in a wide
array of situations, both accidental and natural. The independent review has shown that there
has never been a reliable basis to infer shaking or other abusive trauma from these findings.
This has led and continues to lead to incorrect accusations of abuse and wrongful convictions…

Recommendations:

In order to identify and correct wrongful convictions, prevent the future conviction of innocent parents and wrongful separation of families, and to improve the reliability of the legal process in these complex cases, the Innocence Network recommends the following:

1) Convictions in which the prosecution’s experts provided testimony now known to be false, such as rejecting an accidental fall or testifying that retinal hemorrhages are caused only by abuse or major trauma equivalent to an automobile accident, should be identified, evaluated, and vacated if that testimony was potentially material to the outcome.

2) Prosecutions should not be based on disputed medical evidence. Expert testimony
purporting to “diagnose” SBS/AHT or any form of abuse based on the presence of
retinal and/or subdural hemorrhage should not be admitted because it is unreliable…

Review the entire statement by The Innocence Network:

Shaken Baby Syndrome Hypothesis Has Never Been Scientifically Validated

May 3, 2019, by Jenna Little, California Innocence Project

For years we have known that the diagnosis of Shaken Baby Syndrome (SBS) is flawed. Yet too many innocent parents and caretakers remain wrongfully incarcerated and face wrongful convictions based on this false evidence. In a statement released by the Innocence Network on April 30, the Network explains that although the SBS hypothesis was popularized in the early 2000s, it has never been scientifically validated.

As outlined in the statement, in 2001, the American Academy of Pediatrics’ (AAP) Committee on Child Abuse and Neglect issued a “Technical Report” on SBS citing hypotheses from the 1970s that certain symptoms, including subdural hemorrhages and retinal hemorrhages, were indicative of violent shaking resulting in an infant’s death. The medical community then quickly adopted the hypotheses from the AAP report as established fact, despite lack of scientific support. In 2012, Dr. A. Norman Guthkelch, whose hypothesis was cited in the AAP paper, essentially argued against the positioning of the AAP paper as medical fact. He clarified that, “SBS and AHT are hypotheses that have been advanced to explain findings that are not yet fully understood. There is nothing wrong with advancing such hypotheses; this is how medicine and science progress. It is wrong, however, to fail to advise parents and courts when these are simply hypotheses, not proven medical or scientific facts.” Despite Dr. Guthkelch’s clarification, accusations of SBS remained – and still remain – rampant. Whilst most people take perfectly fine care of their children by taking them to a respectable clinic (such as Southwest Care), others find themselves under this scrutiny…

Read the entire story >>

Jeffrey Havard’s Story Told In ‘The Cadaver King and the Country Dentist,’ by Radley Balko and Tucker Carrington, with a foreword by John Grisham

A startling and thoroughly researched examination of the ongoing issues of institutional racism and flawed forensic science within our criminal justice system, highlighting its catastrophic impact on the lives of innocent individuals.

After two three-year-old girls were raped and murdered in rural Mississippi, law enforcement pursued and convicted two innocent men: Kennedy Brewer and Levon Brooks. Together they spent a combined thirty years in prison before finally being exonerated in 2008. Meanwhile, the real killer remained free.

The Cadaver King and the Country Dentist recounts the story of how the criminal justice system allowed this to happen, and of how two men, Dr. Steven Hayne and Dr. Michael West, built successful careers on the back of that structure. For nearly two decades, Hayne, a medical examiner, performed the vast majority of Mississippi’s autopsies, while his friend Dr. West, a local dentist, pitched himself as a forensic jack-of-all-trades. Together they became the go-to experts for prosecutors and helped put countless Mississippians in prison. But then some of those convictions began to fall apart.

Here, Radley Balko and Tucker Carrington tell the haunting story of how the courts and Mississippi’s death investigation system — a relic of the Jim Crow era — failed to deliver justice for its citizens. The authors argue that bad forensics, structural racism, and institutional failures are at fault, raising sobering questions about our ability and willingness to address these crucial issues.

The following are a couple of excerpts from Jeffrey’s story as told in this book by Radley Balko and Tucker Carrington (starting on page 215):

The SBS [shaken baby syndrome] conviction of Jeffrey Havard demonstrates as well as any other how without DNA testing, it can be nearly impossible to overturn convictions based on faulty forensic testimony…

While it now seems clear that Chloe wasn’t sexually assaulted, [Dr. Steven] Hayne’s latest attempt to rehabilitate his role in the case is hard to comprehend. Although it’s true that he never explicitly testified that Chloe Britt had been sexually abused, his testimony did plenty to help prosecutors convince the jury she had…

It took Havard’s jury less than two days to deliberate, convict him based on bad scientific evidence, hear evidence on appropriate punishment, deliberate again, and sentence him to death. It took thirteen years for the court to admit that a small portion of the bad evidence might have been scientifically unsound. It took another fourteen months for the trial court judge to agree to hold a hearing on the matter…

The Havard case is also illustrative of the way Mississippi state officials have neglected their duty to look into Hayne.

To read the entire story, purchase the book.

Changed opinions, new sentence: Ex-death row inmate in Mississippi gets life in baby death

December 18, 2018, by Jeff Amy, Associated Press

A judge ruled Monday that a Mississippi man should spend the rest of his life in prison after the state Supreme Court ordered a review of evidence that he shook an infant to death. 

Adams County Circuit Judge Forrest Johnson resentenced Jeffrey Havard to life in prison without parole. The move came after Johnson overturned Havard’s death sentence in September but refused to order a new trial, disappointing lawyers who say evidence of a murder is weak.

Havard, now 40, says he accidentally dropped his girlfriend’s baby, 6-month-old Chloe Madison Brittin 2002, causing her to hit her head on a toilet. His lawyers said that since Havard was convicted, physicians have changed their opinion about such injuries.

One of the state’s witnesses in the original trial was pathologist Steven Hayne, whose autopsy work and testimony has been the subject of repeated challenges across Mississippi.

During a 2017 hearing, Hayne testified that he still believed Britt’s death was a homicide, but he also testified that he’d now describe the death as “abusive head trauma.” In 2009, the American Academy of Pediatrics advised physicians to describe certain head injuries to infants. Other experts, though, testified during the 2017 hearing that they didn’t believe shaking alone could cause death.

Read the entire story >>

‘Shaken Baby Syndrome’ Diagnoses Discredited, Convictions Questioned

May 15, 2018, by Matthew Clarke, Criminal Legal News

The term “junk science” does not quite cover the revolution in our understanding of the diagnosis of shaken baby syndrome. Medical experts now know that their belief in how to diagnose a clear sign of child abuse based upon a determination of shaken baby syndrome was mistaken. This new understanding may cast doubt on hundreds of murder, assault, and child abuse convictions…

[O]ver the past two decades, newer scientific research has proven that accidents, diseases, and genetic conditions can cause the damning triad and other symptoms associated with shaken baby syndrome. This has undermined faith in the credibility of a shaken baby syndrome diagnosis to the point that, in 2009, the American Academy of Pediatrics (“AAP”) recommended that doctors cease using the term, especially in light of the potential legal, both criminal and civil, ramifications of such a diagnosis. The AAP explained that “advances in the understanding of the mechanisms and clinical spectrum of injury associated with abusive head trauma compel us to modify our terminology to keep pace with our understanding of pathologic mechanisms.”

But what does that mean for the people who have been convicted of assault or murder based on the triad? In 2015, the Medhill Justice Project in the Journalism Department at Northwestern University complied data covering the previous 20 years. The data showed that over 3,000 criminal cases in the U.S. involved shaken baby syndrome. A Washington Post investigation turned up 1,600 shaken baby syndrome convictions of parents and caregivers since 2001, 16 of which were subsequently overturned. According to the New Scientist, at least three of the 1,600 ended up on death row.

Zavion Johnson was one of the 1,600. The then-18-year-old Sacramento, California, father called an ambulance on the afternoon of November 21, 2001, and reported that his daughter had stopped breathing. At the hospital, doctors found internal head injuries and a fractured skull. Suspecting abuse, they called police…

Although the ordeal cost Johnson 15 years of his life and so much more, he was eventually vindicated and set free. That’s the good news. The bad news is there are certainly more factually innocent men and women just like Johnson who are still in prison.  

That is all good for Johnson, but what about the thousands of other shaken baby convictions? Dr. Norman Guthkelch had said that it’s “high time every case of a parent in [prison] for this had his or her case reviewed” because “we went badly off the rails … on this matter.”

We at CLN couldn’t agree more. An automatic determination of abuse based on the presence of the so-call triad has been discredited by the medical community. Anyone convicted based upon the triad and in prison today should reach out to an innocence project, conviction integrity unit, or similar resource. In light of the medical and legal communities’ current understanding of shaken baby syndrome/abusive head trauma, people are listening and working to right the wrongs of the past. 

Read the entire story >>

Shaken Baby Syndrome As a Controversy in Wrongful Conviction Cases

Spring 2018, by Eza Bella ZakirovaGale Academic OneFile

Shaken Baby Syndrome (“SBS”) is a controversial medical diagnosis that has led to wrongful convictions. Since 2001, there have been about 2,000 cases where defendants were charged with SBS (1) and out of those, in 213 cases “charges were dropped or dismissed or convictions were overturned” when secondary analysis showed that the victim has suffered from something other than SBS. (2) One of the primary causes for misdiagnosis of SBS, which potentially leads to a wrongful conviction, is the misconception of signs and symptoms which, when present all at once, are considered to fall under the umbrella of SBS. (3) Often, when a defendant is suspected of shaking the infant to death, the medical expert checks whether the victim has the following three symptoms, also known as the “classic `triad’: retinal hemorrhages (bleeding of the inside surface of the back of the eye); subdural hemorrhages (bleeding between the hard outer layer and the spongy membranes that surround the brain); and cerebral edema (brain swelling).” 

Read the entire story >>

Controversial medical examiner backs off ‘shaken baby’ claim in death penalty case

This week, the controversial former Mississippi medical examiner Steven Hayne testified at a hearing for Jeffrey Havard. Havard was convicted in 2002 of sexually assaulting and shaking to death Chloe Britt, the 6-month-old daughter of Havard’s live-in girlfriend. Havard has always maintained that the infant hit her head on the toilet after he dropped her while giving her a bath. 

Read the entire story >>

Mississippi and New York Shaken Baby Convictions Tossed

December 17, 2014, Innocence Project

Two Shaken-Baby convictions were overturned this week, with judges citing changing medical opinion regarding the controversial diagnosis. 

On Monday, the Mississippi Supreme Court ordered a new trial for Leevester Brown, who was convicted of murder in 2003 for the death of his 6-month-old son. At the trial, Medical Examiner Steven Hayne testified Brown’s son died of Shaken-Baby Syndrome. During his career, Hayne attracted significant controversy surrounding his medical practices and testimony in criminal trials.  His testimony contributed to the wrongful convictions of Innocence Project clients Kennedy Brewer and Levon Brooks, who were exonerated after DNA evidence in Brewer’s case identified the real perpetrator who subsequently confessed to the rape and murder in Brooks’ case.  

Brown’s is the second case in recent months where the Mississippi court has questioned a Shaken-Baby Syndrome conviction involving Hayne. In August, the court ordered the trial court to conduct an evidentiary hearing.

In the case of Mississippi Innocence Project client Christopher Brandon after the Mississippi project revealed that Hayne supported his testimony by relying on a study that doesn’t exist.   Since 2000, at least 11 Mississippians have been convicted in Shaken Baby Syndrome cases, two of whom were sentenced to death.

Read the entire story >>

Judge reverses shaken-baby conviction

December 16, 2014, by Steve Orr and Gary Craig, Democrat & Chronicle

In a ruling that could have statewide significance, a Monroe County Court judge has reversed the 2001 murder conviction of a Greece woman who was accused in the shaken-baby death of a toddler in her care.

In a decision released Tuesday morning, Judge James Piampiano ruled that the science used to convict René Bailey has changed significantly since her trial.

The ruling marks the first time a shaken-baby conviction has been overturned in New York on the basis of changing science. Lawyers have won a handful of reversals in other states in recent years.

“The newly discovered evidence in this case thus shows that there has been a compelling and consequential shift in mainstream medical opinion since the time of the defendant’s trial,” Piampiano wrote in his 28-page decision.

He concluded that the evidence was compelling enough “as to create a probability that it would change the result if a new trial was granted.”

A motion such as the one brought by Bailey’s attorney must show that new evidence has arisen that was not available at the time of the trial. Piampiano ruled that the changes in science constituted such new evidence.

“This would be the first time in New York that we have a head-on, squarely-facing decision saying that a major change in the science qualifies as newly discovered evidence,” said Bailey’s attorney, Adele Bernhard.

Read the entire story >>

Mississippi Supreme Court overturns conviction involving Steven Hayne, Shaken Baby Syndrome

December 16, 2014, by Radley Balko, The Washington Post

In May and July of this year, I wrote about the case Brandon v. Mississippi, in which defendant Christopher Brandon was convicted of killing his girlfriend’s 15-month-old son. The case involved dubious testimony from the discredited, longtime Mississippi medical examiner Steven Hayne as well as the controversial Shaken Baby Syndrome (SBS) diagnosis. Brandon was also denied funding to hire his own medical examiner. Over the summer, the state then filed a remarkable brief that would require one to believe that Hayne is capable of traveling through time. In August, the Mississippi Supreme Court ruled in Brandon’s favor on all of his claims but ordered an evidentiary hearing on Hayne’s credibility instead of granting him a new trial.

But last week, the Mississippi Supreme Court overturned a conviction in a remarkably similar case that could be a good sign for Brandon. Leevester Brown was convicted in 2002 of killing his infant son. The conviction was based entirely on Hayne’s diagnosis of SBS. Brown, too, was denied funding to hire his own medical examiner to review Hayne’s work. (Hayne was hired by Coahama County Coroner Scotty Meredith. For more on Meredith, read the transcript of my amusing phone conversation with him from a few years ago.)

Read the entire story >>

A Look at Exonerations in Shaken Baby Syndrome Cases

August 15, 2013, by Monica Alonzo, Phoenix New Times

Drayton Witt of Tucson spent 10 years behind bars after being convicted in 2002 of shaking to death his girlfriend’s 4-month old son, Steven Holt. 

And he likely would have served 10 more years for the murder of Steven had the Arizona Justice Project — along with retired British pediatric neurosurgeon Norman Guthkelch and several other medical experts — not stepped in to re-examine his case.

Guthkelch is credited with developing the medical theory in 1971 that laid the groundwork for what later would became known as shaken baby syndrome. He apparently was dismayed by what he read in 2008 when he was asked to review Witt’s case…

Medical professionals pointed to the triad of symptoms in the deceased child as a clear case of shaken baby syndrome, or non-accidental head trauma. The Justice Project’s strategy was, in part, to point to new medical evidence that demonstrates that other conditions can mimic symptoms long considered to be present only in cases of abuse…

Similarly, forensic pathologist John Plunkett cites in one of his studies that even short falls have caused those exact symptoms on young children…

Read the entire story >>