Elena Burnett, BS

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Erika Petersen

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Binenbaum G, et al. JAAPOS: 2016. 

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Joelle Moreno and Brian Holmgren. Utah Law Review. July 2016

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Lawrence R. Ricci, MD

Angel was then, and is even now, one of the most beautiful babies I have ever seen and I have seen many in my thirty years as a child abuse pediatrician. Yet, to look at her today, asleep against her foster mother’s shoulder, one could never guess at the devastation wrought upon her.

I first met Angel, then only a few months old, in the pediatric intensive care unit just before Christmas. She had been admitted unresponsive the night before. Her father had told the hospital staff that he had picked her up from her crib tochange her soaked diaper and as he did so she slipped from his grasp and fell back into her crib. He said she went limp and stopped breathing. He rushed her into his car and drove wildly to the local hospital. Eventually, Angel ended up in my hospital.

I was called in to see her after a CT scan showed subdural hematomas. Later, an MRI found evidence of parenchymal injury. An ophthalmology exam found such severe hemorrhages retinal hemorrhages that they were visible on the MRI.

Angel’s mother was at work when the injury occurred and only found out about it after Angel was rushed to the hospital. She told me what her boyfriend had told her, that Angel had fallen from his grasp into the crib. She said she had no reason to believe otherwise.

I finished the interview with Angel’s mother then spoke with her father. He was anxious and somewhat furtive. He told me that Angel had “peed everywhere,” on her clothes, in her bed. When he went to pick her up, she slipped from his grasp and fell onto the mattress. She immediately lost consciousness.

I ended the interview after a few more questions about the fall, and we both went back into the ICU, he to his baby’s side, me to the computer workstation to type my note. As I typed, Angel’s mother came up to me and said that she now knew what had happened. Her boyfriend had just then confessed to her that he had shaken Angel and that he wanted to talk to me.

I went into Angel’s hospital room. Her father was sitting on the cot with his head in his hands, Angel’s mother by his side consoling him. He didn’t look like a bad person; perpetrators rarely do.

Before I could speak he offered, “I’m sorry Doc. I lied. I shook her.”

I asked him why he had shaken her. “I picked her up from the crib. She was screaming and kicking and scratching at me, and I just lost it. I shook her.”

“Did the fall happen?”

“No, Doc. She didn’t fall. I shook her.”

And finally “What happened after you shook her?

“She went limp and stopped breathing. She looked dead. I know what I did was wrong. I’m sorry Doc.”

So there it was. I thanked him for telling me the truth. I told him it was the right thing to do and left to notify the police.

Months later, Angel’s father pled guilty to assault. He said at his sentencing that he had shaken Angel and that he was sorry. He is serving several years in prison.

All of that was yet to pass. Here was Angel in the ICU, profoundly brain damaged, never to awake, a victim of devastating violence, and for all the world she looked like a healthy, beautiful, three-month-old girl about to experience her first Christmas. Having seen too many shaken babies, it always astounds me how normal many of these babies look, few if any bruises, no obvious fractures, nothing to suggest the violence that had been perpetrated on them. To look at her in her hospital bed, surrounded by beeping instruments and tubes, intubated, not breathing, to look at her face and body, she looked fine, not a scratch, cherubic.

I saw her one last time several months later accompanied by her foster parents. Her functioning at a year was that of a one month old. Her existence, like that of a light switch without nuance, flipped between screaming/arching and deep sedation. She was quadriplegic, blind, and deaf. Her foster parents attend to her every day and every night, ceaselessly, religiously. I am myself not religious and have never said to anyone “God bless you.” I did to them. My eyes filling, I told them they were saints who deserved a special place in heaven.

There is something of a “debate” within the legal community and on the fringes of the scientific community about the existence of shaken baby syndrome. One argument offered is that confessions are always coerced. Another is that shaking cannot cause these injuries. Those who would say such things should talk to Angel’s father.

Yet, for Angel, none of this matters. Words and events orbit around her like so many errant planets: shaken baby prevention, child protective custody, termination of parental rights, grand jury, criminal prosecution, plea bargain, prison. Unknown and unknowing, immutably beautiful, she spins silently within her own dying sun.

God bless you Angel and may flights of angels sing thee to thy rest.

Re-posted with permission from Dr. Lawrence Ricci. 

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First International Conference

The First International Conference on Shaken Baby Syndrome was held at the Little America Hotel & Towers in Salt Lake City, Utah. The leadership committee included co-directors Marilyn Sandberg, SSW, Executive Director, Child Abuse Prevention Center, Jacy Showers, EdD, Director, SBS Prevention Plus and sixteen other national experts in the field of child abuse.

Conference Highlights

The First International Conference on Shaken Baby Syndrome/Abusive Head Trauma drew over 750 attendees from a variety of disciplines, including medical, legal, investigative, prevention and parents. This conference included 89 of the leading experts on shaken baby syndrome. 

Many agencies, both local and national, supported this landmark event including: National Center on Child Abuse and Neglect, Independent Order of Foresters, Intermountain Health Care, National Network on Shaken Baby Syndrome Prevention, Child Abuse Prevention Center, Utah.

The Period of PURPLE Crying was implemented in the University of Arkansas for Medical Sciences Nurseries (UAMS) and in the Arkansas Children’s Hospital (ACH) Nursery in Little Rock Arkansas in early 2013. Since then the program has been made accessible in the Emergency Department, and in the Infant/Toddler Unit of the Arkansas Children’s Hospital. It also has been made available to all the Pediatric Residents and Resident Physicians from other services via the ACH Intranet. The program has been evaluated by surveys completed by the parents of newborns admitted to the nurseries and by the nursing staff.

The Period of PURPLE Crying program is introduced in the pre-partum and post-partum units of the Obstetrics Units at UAMS, and as part of follow-up, the information is reviewed with the parents again as part of the discharge education. The UAMS nursery Education Team is working on creating an information packet about safety (Period of PURPLE Crying will definitely be included).

In the prenatal classes that are taught by 4 educators on the UAMS campus, the Period of PURPLE Crying is being mentioned in each one of the classes. The topics that are being taught include: preparing for birth, infant CPR and safety, breastfeeding, and newborn care. In the newborn care class, parents watch the Period of PURPLE Crying video! Prenatal classes are taught as well at the 12th Street Community Clinic. The Period of PURPLE Crying program is mentioned in those classes as well.

The Injury Prevention Center at Arkansas Children’s Hospital has been promoting the Period of PURPLE Crying as part of their Out-Reach Programs throughout the State of Arkansas.

In 2013, the Arkansas State Legislature assigned the Arkansas Department of Health with the task of creating brochures and other literature about Shaken Baby Syndrome that will be distributed in more than 100 hospital maternity wards, birthing centers and child-care centers across Arkansas. The Arkansas Department of Health makes information on the Shaken Baby Syndrome available on its website.

Our goal is to eventually have the Period of PURPLE Crying program in all the hospital maternity wards, birthing centers, and child care center across the state of Arkansas.

Contacts

• Maria Teresa Esquivel, M.D.:  
• Pamela Tabor:  
• Rebecca P. Sartini, MSN, RNC-NIC, Clinical Services Manager, NICU:  

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Updated December 3, 2014.

Dontshake.org Privacy Policy

We recognize that visitors to dontshake.org (the “Site”) may be concerned about the information they provide to us and how we treat that information. This privacy policy addresses those concerns. Your privacy on the Internet is important to us. As part of the National Center on Shaken Baby Syndrome’s (NCSBS) operation, we may gather certain types of information about users of the Site, and we would like to explain the types of information we gather, what we do with it and how to correct or change the information.

Information Collected by the National Center on Shaken Baby Syndrome

The NCSBS collects two types of personally identifying information from users: personal data (such as names and e-mail addresses); and aggregated data (such as information about traffic patterns on the Site, or how many users log into the Site on a daily basis).

Personal Identifying Data

In the event you establish an account and receive a password, register for a conference, or make a charitable contribution, the NCSBS will only collect personally identifiable information that you voluntarily provide through our web site or e-mail correspondence. Any information supplied to the NCSBS will be used for, but not limited to, supporting content delivery, creation, scoring, assessment, reporting and analysis. The NCSBS may use such personally identifiable information to provide user access, to supply services, and to report scoring and course progress to organizations using dontshake.org for professional development of staff. You are responsible for any content, including images and comments that you upload to the site. Inappropriate, illegal or improper content will be removed without notice by NCSBS staff.

The NCSBS will take appropriate, commercially standard steps to keep all personally identifiable information confidential. We use the information we collect through our web site to provide the services you request. We do not sell, rent, or lease our subscriber or client lists to third parties.

Aggregated Information

Aggregated information, such as information on traffic patterns within the Site, is collected through various methods.

IP Addresses

We collect IP addresses through the Site. An IP address is a number that is automatically assigned to your computer whenever you're surfing the web. Web servers, the computers that “serve up” web pages, automatically identify your computer by its IP address, and when you request a page from the Site, our servers log your IP address. The Site does not link IP addresses to anything personally identifiable, so although your session will be logged, you will remain anonymous to us.

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Dontshake.org also uses “cookies” to collect information. A cookie is a small data file that most major web sites write to your hard drive for record keeping purposes when you visit them. Cookies allow us to measure activity on the Site and to improve your user experience, for example by remembering your passwords and viewing preferences. Cookies are used by NCSBS to measure activity on the Site and make improvements and updates based on which areas are popular and which are not. NCSBS does not use cookies to retrieve information from your computer.

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NCSBS uses both the personal and aggregated information we collect for multiple purposes. The information is used to improve the content of the Site, to customize the content and/or layout of the Site for each individual user and to notify users about updates to the Site. We may send you solicitations for the purchase of materials, resources, donations or invitations to fund-raising events. As applicable, we will share credit card information with financial institutions as needed to process donations or purchases made through the Site.

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Dontshake.org includes links to other web sites that we think may be useful for our users. When you enter other web sites, they will be operating under their own privacy policies. We encourage you to carefully review the privacy policies of the web sites you visit.

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NCSBS protects your personal information in a variety of ways. For certain services, such as our online training modules, only minimal personal information is required, such as names and email addresses. Personal information provided for purchases made through our online store is encrypted. We also protect that account information by placing it on a secure portion of our site that is only accessible by authorized personnel. In addition, IP addresses are not linked to personally identifiable information. Unfortunately, no transmission of data over the Internet is guaranteed to be completely secure. It may be possible for hackers or other third parties not under the control of NCSBS to intercept or access transmissions or private communications unlawfully. While we strive to protect your personal information, NCSBS cannot ensure or warrant the security of any information you transmit to us. Any such transmission is done at your own risk.

USE OF THIS SITE SIGNIFIES YOUR AGREEMENT TO THE TERMS OF USE AND THIS PRIVACY POLICY.

NCSBS reserves the right to change this policy at any time. Since any changes will be posted on this page, we encourage you to check this page regularly. Your continued use of the Site will constitute your acceptance of such changes. If you have any further questions regarding this privacy policy or the use of your personal information under this privacy policy, you can contact us at the following postal address:

Information and Resource Specialist
National Center on Shaken Baby Syndrome
1433 North 1075 West, Suite 110
Farmington, UT 84025

This privacy policy was revised December 3, 2014.

Sabah Servaes, et al. Pediatric Radiology. 2016

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