Did Baby Alan Die of Shaken Baby Syndrome?
by Harold E. Buttram, MD
(An edited version of a talk given at the February 16, 2002 fund-raiser to free Alan Yurko)
Contributing editor, Peter G. Tocci, BA, MT

Dr. Harold Buttram:
hbuttram@woodmed.com

Alan Yurko has been incarcerated since he was arrested and jailed in November, 1997 for causing the death of his infant son, Alan, by what is known as shaken baby syndrome (SBS). In Februray, 1999, he was convicted and imprisoned for life, without parole. Very strong evidence has since arisen that medical misdiagnosis brought the jury conviction, and an appeal has been filed. The story will be profiled here, but first, some pertinent information about immune function.

A Brief Look at Immunity
Immune function comprises two major classes: cellular (cell-mediated) immunity and humoral (antibody-mediated) immunity. Cellular immunity utilizes phagocytic activities (ingesting foreign agents) and cytotoxic activities (poisoning foreign agents). Each class is identifiable by a biochemical signature it produces in the form of substances called cytokines.

Major medical journals state that in healthy people, there is a "bias" toward cellular immunity, while people with allergies, asthma, and autoimmune diseases have immune response "skewed" toward the humoral. There is now significant evidence suggesting that vaccines disturb immune balance, thereby contributing profoundly to allergy and other illness, and to their current, alarming increase, especially in infants and children. Dr. H. H. Fudenburg, a world renowned immunologist with hundreds of publications to his credit, made the following comments: "One vaccine decreases cell-mediated immunity by 50%, two vaccines by 70% . . . all triple vaccines (such as MMR, DTaP) markedly impair cell-mediated immunity, which predisposes to recurrent viral infections, especially otitis media, as well as yeast and fungi infections."

An Ominous Health Trend
I recall attending summer camp for several seasons during the 1930s. No boy was ever sick, had allergies, or was on medication. It was much the same in the schools I attended. Compare that with today. To my inquiries years ago, school teachers replied emphatically and unanimously that they were seeing more hyperactivity, more learning disabilities/behavioral problems, and more patterns of general sickness among school children.

In 1999, full realization of this adverse health trend hit me with a severe jolt. Were vaccines playing a significant role here? While in this frame of mind, I received my first letter from Alan Yurko. It seems my thoughts and experiences had "set me up" for his letter, because, on the first reading, a sense of great injustice overwhelmed me. I suspected that studying baby Alan's medical records would reveal the facts of injustice. That review largely confirmed for me that death occurred in a delayed manner following a combination of vaccines--violence of a different order.

A Reign of Terror
I have since come to know the pioneering work of Australian physician Archivedes (Archie) Kalokerinos, MD, who has testified in defense of parents in over 30 SBS cases. Other pioneers in Australia and New Zealand have been working in this field for many years. Of twenty-two cases I have reviewed, all but one show clear evidence, exemplified below, of defendant innocence. In the opinion of those veteran physicians and researchers, and in mine, many cases closely resemble the Yurko scenario: delayed onset, following vaccines, of signs and symptoms conventionally accepted as the definitive criteria for SBS. Most doctors dismiss this correlation as coincidental. Although coincidence might be expected occasionally, at the frequency being observed, such conclusion is unreasonable.

The ominous suggestion follows that if a large portion of SBS accusations and convictions are the result of subsequent misdiagnosis, we are witnessing a rapidly growing reign of terror against home and family. There is no other term for it. An excerpt of a letter written from prison by Alan Yurko conveys the potential of this terrorism:

". . . our four-year-old daughter was taken by the authorities to 'protect her' from me--the accused who was in a maximum security facility without bond. She was used by the police and authorities to threaten and blackmail my wife to help them fabricate evidence and testify against me. This she adamantly refused to do. She was charged as an accessory to murder, and our daughter was placed in extended custody. Here she was sexually battered and molested when her 'protectors' left her unsupervised with two boys who had a history of deviant behavior. My wife's charges were dismissed after great effort and cost, and our daughter was returned. They both fight every day to bring our family back together and have been fighting since 1997."

The Birth Experience
Now to the medical specifics of the baby-Alan case. Importantly, the pregnancy was complicated with constant nausea such that the mother was unable to take vitamins. She lost 10 pounds after conception, and barely regained it before parturition. Additional complications included group B Streptococcal vaginal infection, E coli urinary tract infection, and gestational diabetes.

At 35 weeks, on September 16, 1997, labor was chemically induced due to lack of amniotic fluid. Although medical records showed Apgar scores of 8 and 9 (standard of newborn condition--10 being the highest), a video of the birth taken by the father tells a much different story: clear respiratory distress, with marked rib and sternal retractions, and bluish-grey skin color. Hypoxia (oxygen deficiency) was confirmed by arterial blood gasses. The baby was sent immediately to pediatric intensive care, put on a ventilator, and administered Survanta®, a lung surfactant (surface-active) rescue drug. Three daily chest X rays showed bilateral pulmonary infiltrates interpreted as "respiratory distress."

While still presenting the symptoms of respiratory distress, including raspy breathing and grunting, the baby was sent home on his seventh day. Parents and grandparents continued to observe these problems, along with brief periods of apnea (breathing cessation). On November 11, at approximately eight weeks (43 days true post-partum age), baby Alan was given the DTaP, Hib, OPV, and Hepatitis B vaccines despite the breathing difficulty and length/weight factors in the 3 percentile range. Within 24 hours, low grade fever, irritability, and diarrhea developed, all of which continued for about ten days until the morning of November 24. The father was at home with the baby and his 4-year old sister when the baby's breathing stopped and did not resume. While attempting mouth-to-mouth breathing, the father rushed to a nearby hospital where the baby was only temporarily resuscitated.

Autopsy and Trial
Autopsy findings comprised retinal hemorrhages, subdural hematomas (blood-filled swellings on the brain), brain changes interpreted as diffuse axonal injury (axon: nerve impulse conductor), and four rib calluses on the left interpreted as the result of prior fractures. The father was therefore accused, and subsequently convicted by a jury, of murdering his son by physical violence. As mandated by Florida law, a life sentence was imposed. Anyone familiar with the medical/legal procedures in SBS cases is aware that these pathology findings have been deemed exclusively diagnostic of SBS. However, investigation has revealed a significant body of medical literature, much of it by pathologists and specialists in the United States and Great Britain, criticizing this interpretation and showing that these conditions can, and commonly do, arise from a number of other causes.

There were four state witnesses with a total of six appearances before the trial jury, in contrast to one appearance for the single defense witness. This witness was H. Douglas Shanklin, MD, FRSM, Professor of Pathology and of Gynecology and Obstetrics, Division of Neuropathology, University of Tennessee, Memphis. I'm told he is held in the highest professional regard by his peers. Lacking prenatal and birth records at the trial, and having only pathology slides to go on, Dr. Shanklin attributed death to "natural causes" including failure-to-thrive, bilateral pneumonia (confirmed at autopsy), and meningitis.

In a letter summarizing the case, Dr. Shanklin states that either pneumonia or meningitis might or might not have caused death, but together they almost certainly would have. Without prenatal and birth records records, Dr. Shanklin could not corroborate his interpretation of the pathology slides; and the state witnesses went unchallenged with the fact of pregnancy/birth complications, for example.

Perhaps the most significant factor working against the defense was the medical complexity of the case, which even doctors have had difficulty grasping. Thus, inequity and confusion led to conviction.

Why were there no prenatal and birth records in court? Unfortunately, no one knows the whole story. Unquestionably, some subterfuge and incompetence were involved. The defense attorneys probably did make a gesture at requesting them, but meeting delay or obstruction, did not persist. The medical examiner was compelled to admit under oath that he neither sought nor examined these records before or after autopsy. In any case, in my opinion, a lack of pertinent medical records should be, indeed, should have been, grounds for calling a mistrial.

Evidence of Innocence
Further complicating the scenario were the rib calluses. In the early stages of review they were quite puzzling. A rational explanation came from a later, voluminous report by Archie Kalokerinos, MD, previously mentioned. In the 1970s, Dr. Kalokerinos made a major contribution to medicine by proving that post-vaccinal death of Aboriginal babies (nearly a 50% rate in some geographical areas), especially if colds or respiratory infections were present, was caused by vaccinal aggravation of a condition he diagnosed as "subclinical scurvy."

Edward Yazbak, MD, a retired pediatrician who has been following the case, informed me that any one of the pregnancy complications would put a baby in a high-risk category. With the multiple complications noted, severe nutritional deficiencies were probable, and Dr. Shanklin reported definite retardation in kidney development. We know that vitamin C is necessary for production and maintenance of connective tissue; that spontaneous fractures and hemorrhages (from bleeding capillaries) characterize classical scurvy; and that the most common site of bleeding in scurvy is subperiosteal (under the fibrous covering of bone). In ribs, as clots from such bleeding develop and calcify, they are indistinguishable on X-ray from healing fractures. Also common in scurvy, slippages of the ribs in locations near the spine may also appear on X-rays as healing fractures. Based upon the medical literature, this is detailed in the Kalokerinos report.

More recently, Alan received a report from an Australian hematologist, Michael D. Innis, MBBS, DTM&H, FRCPath, FRCPA, Honorary Consultant Haematologist, Princess Alexandria Hospital, Brisbane, Australia. He cites a highly likely contributory cause of death as intracranial hemorrhage resulting from failure of the liver to synthesize clotting factors in adequate amounts (although the causative connection between insufficient clotting factors and hemorrhage might not be immediately apparent, Dr. Innis has expertise in this area resulting from extensive research). He also emphasizes that bone underlying subperiosteal hemorrhage would become necrotic from loss of it's blood supply, and that a healing necrosis looks identical to a healing fracture at autopsy. Because appropriate post-mortem tests were not done, precise determination of all morbidity factors and their interactions is impossible. But the Innis report alone should be sufficient for Alan's vindication.

Finally, the DTaP vaccine in question is known to have come from a from a batch which ranks number one in deaths, number one in non-recoveries, and fourth in total events reported. Such batches are called "Hot Lots." One might wonder why, if batches can be so identified, SBS suspects aren't given some benefit of the doubt. One challenge is that such identification is based upon clinical observation, which courts will not accept. This seems odd, since the Vaccine Adverse Events Reporting System (VAERS) plainly indicates, as does the 1986 Congressional Childhood Vaccine Injury Act, that vaccine injuries are a fact of life. When people try for compensation under this Act, the court disallows VAERS information, asking for objective evidence, such as laboratory tests. Another challenge is, of course, that the requisite tests are nonexistent (see Addendum).

Alan Yurko could have plea bargained and received a lesser sentence. His refusal spoke to me of a man secure in his innocence. Also remarkable was the immediate and continuing loyalty, under soul-testing circumstances, of his wife, Francine. Following the trial, her diligent efforts secured complete medical records. Based on these records, there are, at this writing, 28 medical professionals willing to testify to Alan's innocence (and the number will grow). The disciplines represented at this writing include board-certified specialists in the fields of pathology, bone pathology, toxicology, hematology, ophthalmology, pediatrics, Ob/Gyn, and forensics, with some practitioners having dual specialties including pathology. As noted, an appeal has been filed.

Extreme Importance of This Case
Due to Alan's tireless effort at hand writing literally thousands of letters, the case has gained significant attention and status internationally. Its critical implications for parents and caretakers falsely accused and imprisoned, and the life-and-death questions it raises concerning medically advised and mandatory vaccine programs, rank it high among the most important legal/health issues. To illustrate further, in my experience it is common in hospital emergency rooms that, once suspicion of shaken baby syndrome arises, all thought of further diagnostic investigation ceases. I know of no other situation in medicine where the usual diagnostic thoroughness one finds in such centers is abandoned.

Finally, public confidence in America's health care system and in the medical profession in particular is already eroding. Sooner or later, it will become publicly obvious that many SBS defendants have been falsely accused and convicted through deplorable misdiagnosis pertaining to pathologies that could one day become regarded as the result of malpractice--the indiscriminate administration of childhood vaccines. Further adverse backlash is sure to ensue in the US and abroad unless this case, as a prime example, is brought to light now with plentiful and reliable support for the defense. Having also witnessed outright viciousness behind the scenes in legal proceedings (such as that, described earlier, used against Francine Yurko), I now feel that the SBS debacle is a potentially fatal malignancy in the integrity of medicine.

The Yurko case is eminently winnable. Its particulars make the likelihood of another equally propitious opportunity remote. Based upon what we can only imagine the post vaccinal suffering of that small, fragile life to exemplify, not to mention the misery visited upon his loving family, we--professionals and lay persons alike--must not relent in our insistence upon measures to prevent such tragedy. To this end, the Yurko case must be won. No other outcome is thinkable.

ADDENDUM:
To this author and many other professionals, the role of medical misdiagnosis in a significant portion, possibly a majority, of SBS accusations and convictions seems to be the result of inadequate investigation in at least three areas, listed below. To avert more tragedy, the following minimal screening is recommended as mandatory before considering charges of child abuse/shaken baby syndrome:
(1) serum ascorbate and histamine to rule out subclinical scurvy;
(2) prothrombin time, partial thromboplastin time, fibrinogen level, platelet count, and D dimer test to rule out bleeding diatheses;
(3) when there is callus or fracture, bone densitometry to rule out the recently described temporary brittle bone disease, as well as tests to rule out classical brittle bone disease and all conditions, such as rickets, that predispose to spontaneous fracture. (See Minimal Recommended Screening Where Shaken Baby Syndrome Is Suspected for more complete information and references.)

Caveat:
The suggested panel is not intended to be comprehensive, but only a starting point for screening purposes where child abuse is suspected. Changes and/or additions are likely as we learn more about these areas. Such information will be added to the website.

Obviously, the panel does not include tests for vaccine reactions. As noted earlier, no suitable post-licensing diagnostic protocol for vaccine reactions has ever been officially established. There is no basic science in this area worthy of the name, and this seems to be no accident, based upon my experiences at court hearings. There are two important avenues:
1) systematic before-and-after testing for vaccinal effects on the immunological and neurological systems, not to mention their potential effects on genetics;
2) meaningful, long-term epidemiological surveillance of a significant number of vaccine recipients and controls (this implies, of course, that people be informed, and not bullied into vaccinating babies and children, so that there will be controls).
These tests would hold up in court, which is why an iron curtain of official resistance surrounds them. In my opinion also, within a reasonable degree of medical certainty, vaccines and vaccine reactions very frequently trigger subclinical scurvy and its complications, as well as bleeding complications from deficiencies of clotting factors.

Note:
This article is endorsed by Roy B. Kupsinel, MD; Susan Kreider, RN; Catherine J. M. Diodati, MA, Vaccination & Biomedical Ethics Researcher and Author; and C.A.B. Clemetson, Professor Emeritus, Tulane University School of Medicine.

As of this writing, a court date has not been set. Your help, professional, financial, or both is welcome and needed. Please explore the Yurko website for more information.

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The appeal document itself can be viewed here.

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