Getting Away With Murder – Part 4

Winner of Pulitzer Prize in National Reporting
SIDS sometimes used to cover up child-abuse deaths
Gannett News Service Series
Marjorie Lundstrom and Rochelle Sharpe

Getting Away With Murder: SIDS sometimes used to cover up child-abuse deaths

Sudden Infant Death Syndrome is so hard to distinguish from murder that some medical examiners say they rely on the Three Baby Rule.

If they find no cause for a baby’s death after a thorough autopsy, they declare the case SIDS. The second unexplained infant death in a family is “undetermined.” The next, they suspect, is homicide.

“You wait until they kill the third kid,” said San Antonio medical examiner Vincent DiMaio. Then the exhumations and the accusations begin.

It is a crude way to deal with a delicate problem, but one that circumstances and statistics almost demand. SIDS, a perplexing condition that kills about 5,000 seemingly healthy babies each year, is the most common cause of death for infants one week to 1 year old.

It is also the most common alibi used by parents who murder a child.

Two of every three child-abuse deaths that go undetected are labeled SIDS, speculates Dr. William Sturner, Rhode Island’s chief medical examiner and a specialist in child-abuse deaths.

While the vast majority of suspected SIDS cases are legitimate, some murders are discovered only by chance – years after they occur.

Carla Porritt, 30, of Alexandria, Va., who had pretended for three years that SIDS had killed her 2-month-old son, confessed in October she had suffocated her child by pinching his nose and covering his mouth. Porritt, who is now pregnant, will be sentenced for first-degree murder in January.

Sandra Pankow, a babysitter in Wisconsin, came under suspicion only after three children died mysteriously in her care. She even joined a SIDS support group and spoke about the children’s tragic deaths before she was convicted in 1986 of two of their murders. She is serving a 40-year prison sentence.

Before Marybeth Tinning was suspected of murdering any of her nine children in Schenectady, N.Y., she masqueraded as a SIDS mother, requesting contributions for the SIDS Foundation in one daughter’s obituary. Tinning, whose children died between 1972 and 1985, claimed six had died of the mysterious disease. She was convicted of smothering her ninth child and sentenced to 20 years to life in prison.

To distinguish between SIDS, where babies suddenly stop breathing, and deliberate suffocation, Dr. Sturner has devised an elaborate system.

First, he compares observations made at the death scene with the parents’ description of events, making sure there are no discrepancies. Then, he autopsies the child, ruling out all diseases.

These steps are essential since SIDS is an official medical mystery, defined as a sudden death that remains inexplicable after autopsy.

But Sturner goes beyond these basics. He checks the bladder, which is almost always empty in SIDS infants. He also searches for telltale spots on the lungs and heart, pinpoint hemorrhages that usually appear in SIDS babies but not in victims of suffocation.

“You’d better look very carefully,” he warned. “For SIDS, you have to exclude everything and anything.”

Yet almost one of every 12 deaths classified as SIDS is not even autopsied, according to a Gannett News Service analysis of all 1987 death certificates nationwide for children under age 9.

The South is particularly derelict. Eleven of the 14 cities with the worst records were Southern.

While 128 of the nation’s 305 largest cities autopsied all their SIDS cases, Athens, Ga., and Lynchburg, Va., autopsied only 20 percent, the lowest rates of the cities surveyed. Athens and Lynchburg each had five cases attributed to SIDS in 1987, but each autopsied only one. By comparison, Los Angeles managed to autopsy all 212 of its SIDS cases.

Across the country, several counties appeared to have chronic lapses investigating SIDS. Davidson County in Tennessee, which includes Nashville, had 15 suspected SIDS cases but did not autopsy eight – the highest number of unautopsied SIDS cases in any single county. Adams County, in the metropolitan Denver area, did not autopsy seven of its 15 suspected SIDS cases that year.

Although the National Institutes of Health dictates that all suspected SIDS cases be autopsied, only 11 states have laws that mandate the practice, according to Dr. Cyril Wecht, who published a 1989 survey of autopsy laws. They are: California, Illinois, Iowa, Louisiana, Maine, Minnesota, New Hampshire, New Jersey, South Dakota, Utah and Wisconsin. States and counties that routinely failed to autopsy SIDS offer a variety of explanations.

Clark County, Ga., coroner Tom Lord, who handles Athens’ deaths, said he does autopsy all suspected SIDS cases. But sometimes, he said, the local hospital does not refer cases to him.

In Virginia, which autopsied 86 percent of its suspected SIDS cases in 1987, officials readily acknowledged they sometimes disregard the scientific community’s directives for investigating SIDS.

“I’ve been here 13 years and, and it’s always been our policy that we don’t do an autopsy without the family’s wishes – unless, of course, there’s foul play involved,” said Richard Delpiere, spokesman for the medical examiner’s office that handles Lynchburg cases. “A lot of people, they just hate the thing of going in and having their baby cut up.”

Virginia state medical examiner David K. Wiecking, who says he autopsies 90 percent of his suspected SIDS cases, said he can diagnose SIDS without an autopsy. He said he sometimes relies on “external examination” and by reviewing his checklist of “sociological factors” – clean home, loving family, good hygiene, no history of child abuse, and “intelligence of the parents.”

Many medical examiners were flabbergasted by Wiecking’s remarks.

“That’s outrageous. It’s unethical and improper,” said Sturner of Rhode Island.

No one can tell by looking at people if they’re capable of murder, he said. “We’re not in the guessing business.”

Babies who are smothered don’t struggle, so their bodies aren’t bruised. If they are shaken to death, the tiny rib fractures and hemorrhages often can only be seen through comprehensive X-rays and thorough dissection.

Then there are the children whose deaths do not arouse suspicion because their mothers are clever at cloaking abuse. These women, who suffer from a bizarre psychiatric disorder called Munchausen Syndrome by proxy, induce illnesses in their children to get attention and sympathy for themselves. Such women have injected feces into their children’s arms, blocked their infants’ breathing, even fed them loads of poison.

“Nobody comes in and says, ‘My child is dead and I shook the heck out of it two hours ago,” said Dr. Harry Bonnell, chief deputy coroner for Hamilton County, Ohio, whose office is known for its careful investigations. Of the 30 cases of suspected SIDS he sees each year, four or five turn out to be homicide, he said.

But in the zeal to detect these cases, some investigators have trampled on the feelings of parents whose children really died of SIDS.

“This is very hurtful to SIDS parents,” said Phipps Cohe, spokeswoman for the Columbia, Md. National SIDS Foundation. “Not only do they have to suffer the grief of (losing) the baby they loved and wanted, but then they have to suffer the suspicion that maybe they did something wrong. It’s a double whammy.”

It took the death of a prominent family’s baby in New York City some 30 years ago to lead to the discovery of Sudden Infant Death Syndrome, said Dr. John Smialek, Maryland’s chief medical examiner. When the New York medical examiner found a skull fracture and accused the parents of abuse, they were outraged, Smialek said. An investigation revealed that the baby had been dropped on a concrete floor while being transported to the autopsy table.

The parents discovered others with similar experiences and founded a support group, which pressured doctors nationwide to study why so many babies were dying unexpectedly.

In 1969, doctors from across the country convened in Seattle and defined Sudden Infant Death Syndrome. It was an unusual condition – one that could only be determined after an autopsy. Unlike other syndromes, which consist of a cluster of symptoms and findings, SIDS was defined as a constellation of no symptoms and no findings. The designation allowed researchers to isolate such cases into one group to search for a possible cause. No one yet knows what triggers the syndrome, although scientists now believe fetuses may be subtly handicapped while still in the womb.

But over the years, some coroners and medical examiners began to use the SIDS category as a dumping ground, throwing in cases they could not figure out. It became a convenient wastebasket for those who were too busy or lazy to tackle the toughest cases.

After a while, said Ohio coroner Bonnell, his colleagues became so skeptical of the classifications they developed a new axiom:

“The only difference between SIDS and suffocation is a confession.”

As child abuse became the topic of the ’80s, SIDS parents found themselves under increasing – and sometimes devastating – scrutiny.

“It’s been a witch hunt in some areas,” said Gayla Reiter-Scott, president of the California SIDS Council, who lost a child to SIDS. “You are presumed guilty until you are found innocent.”

One grieving SIDS mother in Massachusetts, who had rushed out of her house hysterical when she found her baby dead, discovered police on her doorstep when she returned home, said Mary McClain, project coordinator for the state’s SIDS chapter. “They read her her rights on the sidewalk, and refused to let her go back in,” she said.

Michelle Rosancrans of Northumberland, Pa., was so devastated by her experiences after her baby died of SIDS that she is now crusading for a mandatory autopsy law. When her 7-week-old son died, her local coroner reassured her that an autopsy was unnecessary. But two hours after the funeral, police knocked on her door, telling her they had received a tip that the baby may have been abused. The body would have to be exhumed.

Rosancrans was eventually exonerated, but not until she’d hired three lawyers and undergone two more burials of her son. She called her state legislator and asked him to introduce a bill mandating autopsies for all sudden infant deaths. It is one of several bills nationwide that the SIDS Foundation plans to support next year.

“There has to be a line between guilty and innocent,” Rosancrans said. “The only way you’re going to know is by doing an autopsy.”