The jury chosen to decide the fate of Andrew Goldston got a crash course in medical analysis Wednesday as doctors brought in by the prosecution and defense offered greatly contrasting explanations for the fatal injuries suffered by his 1-month-old son.
Dr. Lynn Sheets, medical director of the child abuse program at Children’s Hospital of Wisconsin in Wauwatosa, said she can say with “no hesitation” that Leander died of “abusive head trauma.” She examined the boy during the nine days he remained hospitalized before dying of his injuries.
“Absolute abuse – no hesitation,” Sheets told the jury. “You have severe rotational injuries, and that’s very different from straight-line or falling injuries.”
The jury also saw a picture of Leander for the first time, as Sheets displayed a picture of the boy in head restraints at Children’s Hospital. She said Leander had slight facial twitching immediately after he arrived but soon stopped responding and breathing on his own. . . .
But Dr. John Plunkett, a forensic pathologist who specializes in infant head trauma, testified with equal vehemence that Leander’s injuries could have occurred in the fall Goldston described. . . .
Plunkett said the injuries Sheets cited as too extensive for a simple fall could have occurred as a cascading effect, with one causing the other in the aftermath of the fall. . . .
Sheets said Leander suffered what is commonly called shaken baby syndrome, with bleeding in numerous areas of the brain indicating the back-and-forth motion of shaking or slamming a child. She said either action, which an infant’s neck is too weak to protect against, could have caused the bleeding, but Leander also had several bruises consistent with impact.
“I don’t know if he was shaken, but I know he was slammed,” Sheets said.
Plunkett said Leander landed on the worst possible point in his head, causing his pliable skull to put pressure on the brain. That then pushed on the brain stem causing the boy to stop breathing.
He said the ensuing pressure and swelling caused the retinal bleeding observed in Leander. Leander also suffered bleeding throughout the brain, which Plunkett said could be due in part to blood being forced through the brain during the minutes Leander had no pulse and was not breathing immediately after the fall. The remaining bleeding he attributed to a condition existing at birth that previously resulted in no symptoms.
Sheets had said many children have such bleeding at birth, but such a condition was not noted by doctors on any of Leander’s medical reports. She cited the extensive bleeding as evidence of shaking or slamming the child.
On cross examination, Assistant District Attorney Joel Urmanski challenged Plunkett’s conclusions and credibility, leading to an acknowledgement from Plunkett that most pediatricians would diagnose child abuse given Leander’s injuries.
“I would also be suspicious this was an inflicted injury,” Plunkett said. “I’m not saying it’s not. I’m saying you can’t tell from the medical evidence.”
Urmanski also noted Plunkett, unlike Sheets, was paid to be there and had testified in more than 30 states as a consultant. Urmanski implied Plunkett testified frequently for defense attorneys because he was willing to offer testimony contrary to the general consensus among pediatricians and other experts, but Plunkett defended his conclusions as consistent with other pathologists.
When pressed by Urmanski, Plunkett acknowledged his testimony was disproven in a similar case in Montana. Plunkett had testified that injuries on a young child who died could not have been caused by shaking, but the father later admitted to shaking his daughter to death.