SBS 101
Subdurals
Retinal Hemorrhages
Fractures
Anatomy of an Autopsy
Neuro-Anatomy 101
Biomechanics 101
SBS Myths
Alternate Explanations
Annotated Bibliography
Glossary
False
Assumption #2:
Short distance falls do not cause subdural hematomas in infants or toddlers.
Truth:
Medical research and case studies indicate that children can and do die
from short falls.
The third prong of
the SBS triad is a history inconsistent with the degree of damage seen in
the baby upon hospital admission. This prong relies on the belief that short
falls do not kill children. Prosecutors and child abuse advocates argue
that the amount or degree of injuries found on admission, could not have
been incurred through accidental trauma or a short fall. At trial, the State's
experts generally testify that the force needed to cause the type of injuries
seen in these babies is akin to that of a 35 mph unrestrained motor vehicle
accident or a 2-3 story fall.
These commonly held assumptions are factually incorrect and are disputed
by the biomechanical and medical literature on short falls, and by cases
observed in the legal literature. There is ample scientific evidence within
the biomechanics literature, that a short fall with rotational components
produces a greater degree of force at impact than a translational fall or
a motor vehicle accident. The medical literature on short falls shows us
that the combination of retinal hemorrhage and subdural hematoma can be
found in accidental as well as intentional traumas.
A 2001 study by John Plunkett analyzed the Consumer Product Safety Commission's
database on playground equipment falls between January 1988 and June 1999.
In this study there were 18 deaths from falls of less than 10 feet. Thirteen
of the children had subdural hematomas, and twelve had lucid intervals ranging
from five minutes to forty-eight hours. Four of the six that had funduscope
examinations had retinal hemorrhages. The article is seminal in the study
of childhood head injuries because it supports many of the previous studies
on short falls and refutes some of the fundamental myths upon which SBS
cases have been charged and convicted.
Furthermore, the theory that says short falls cannot kill children assumes
that none of the children possess any intervening factors that would make
the child more fragile. There are many underlying medical conditions that
can lessen the degree of force necessary to cause the injuries found in
"SBS" cases. Because more than 70% of the babies in our data set
have preexisting subdural hematomas, we believe that infants should be screened
for chronic subdural hematomas, coagulopathies and other disorders that
make them more vulnerable to minor head trauma or spontaneous hemorrhaging.
| Fatal
Fall from a Hospital Changing Table HEADLINE:
ROANOKE HOSPITAL SETTLES LAWSUIT IN INFANT'S Published: Sunday,
September 18, 1994 BYLINE: The
Associated Press TEXT:
A hospital has settled a lawsuit filed by the mother of a newborn
girl who died seven months after falling from a nursery table. Roanoke
Memorial Hospital agreed to pay an undisclosed amount to settle the
$1 million medical malpractice
Copyright. MediaStream, Inc., a Knight-Ridder Inc. company. |
Citations
1. Plunkett,
John. Fatal pediatric head injuries caused by short distance falls. American
Journal of Forensic Medicine and Pathology 2001; 22, No. 1-12.
2.
Gurdjian, E.S., Roberts, V.L., and Thomas, L.M. Tolerance curves of acceleration
and interracial pressure and protective index of experimental head injuries.
The Journal of Trauma 1966 6(5): 600-604.