Portia - Helen's Trial

Helen's Trial?
by Tom Watkins

A review of the trial of Helen Stacey based on the summing up, questions from the jury, pathology reports and written statements by physicians.

The judge, Mr Justice Blofield has been thorough and consequently given us a lot of extra information. The first point of interest is his statement that a person commits murder if they have intent to kill or cause really serious harm.

Later he says, “The Crown have expressly made it clear that they do not say that there is evidence that she intended to kill Joseph.”

So why is the charge murder?

It was accepted by the defence that shaking was the cause of death.

My comment. Why? Why has not all the other possibilities been explored? The Defence’s only strategy was to argue that shaking took place before Helen was in charge of the child so forcing the jury to choose between Helen and the child’s parents. A tactic that we know was later fully exploited by the prosecution giving this as an ultimatum to the jury. Choose one or the other.

The case is based on circumstantial evidence said the judge.

My comment. That just means that something may have happened in the way described, not that it did happen.

The judge gives us the birth date of Joseph as 20th November 1996 and that at his death he was just under 6 months old. He was 5 weeks premature when he was born.

At the end of December 1996 he fell ill. His parents took him to a hospital. We are told he was in there for four days suffering from bronchiolitis. The judge said he made an excellent recovery.

My comment. This episode was used by the judge to demonstrate that his parents cared. No mention was made that the child died twice while there and had to be revived and kept on oxygen. No mention was made that his parents were told he must not be left alone during his first year of life and must be kept out of a smoky atmosphere. Why not! Later in this transcript we find that lack of oxygen causes the brain to swell. Both Helen and her husband smoke.

The judge mentions that the child’s mother is a trained nurse. (What relevance has this?)

The judge draws attention to Helen’s age of 40 and that she has had 4 children in her life. He states she is not an untrained, immature 17 year old.

He said as training to become a childminder Helen did a first aid course on which it was emphasised, that if in doubt seek advice, call a doctor.

At the time of Joseph’s death his mother said he was teething and therefore slightly fretful.

The first child taken on by Helen was Caroline Hibbs who was two years old. Helen looked after Caroline on 20-30 occasions to the perfect (the judge’s words) satisfaction of Caroline’s parents.

The judge mentioned that Mrs Mackin visited Helen to see if she was suitable and then went back again with her husband. He is emphasising Mrs Mackin’s care in making a decision.

Reference was made to forms filled out with details of Joseph, his local grandparents and the telephone number of the Mackin’s doctor.

Joseph and Samantha went to Helen for the first time on Thursday 8th May. The judge says, unsurprisingly it may well be that Joseph was a little difficult. On Friday the children went again.

On Sunday 11th May Joseph was christened. The judge describes it as obviously a happy occasion.

On Monday the children were dropped off by Mr Mackin’s parents who were on their way back to Scotland. The judge pointed out that this was when these people left the scene. The children’s father collected them at 5pm. The judge drew attention to this time.

Tuesday 13th. (1997)

4 - 4.30am. Joseph awoke and was given a bottle by his parents he then went back to sleep.

5.30am. Mr and Mrs Mackin arose. Mr Mackin dressed Joseph. Both parents say he had a little more milk from the bottle, around 2 oz.

6.20am. Mrs Mackin left for work. Mr Mackin gathered together food for his two children and bottles of milk, juice and water for Joseph to be given to Helen. Both parents say they saw no problems with their children that morning. Mrs Mackin said Joseph had rosy cheeks because he had started teething. Both were asked whether they had shaken, dropped or thrown Joseph down and said they had not.

Mr Mackin said if Joseph had been unwell he would not have taken him to Mrs Stacey’s. As a Civil Servant all he had to do was ring his employers and say he was not coming in. The judge commented, “one of the blessings no doubt, if you work for the Civil Service.”

Mr Mackin said to Helen that he might be later than the previous day in picking the children up. He denied he had said Joseph was unsettled.

The judge says that Mrs Stacey’s evidence is different. What we know about what happened to Joseph between 7am and 5pm comes from interviews and the evidence of the defendant.

Helen’s evidence 7am. Joseph was delivered to her. Her recollection is that Mr Mackin said, “I’ve just given him a 7oz bottle of milk”.

Helen’s evidence 7.30am. After Mr Mackin left, Joseph was crying a lot so she gave him about 3/4 of his rusks with milk. He consumed most of the bottle leaving some 2oz of milk. Joseph was still grizzling so she picked him up and walked him around the room. Looking out of the window, looking at the fish, looking at various things and talking to him. Showing him the fish seemed to make him more settled, he definitely paid attention to his rattle. His eyes were watching it. He also gripped the handle of the rattle.

Helen’s evidence 10.30am. He had another bottle and he took 5ozs of milk, then he went to sleep. She thought, oh good I’ve got him settled.

11am. Mr and Mrs Pomphrett live close to Mr and Mrs Stacey. He described her as a decent, friendly person. On the 13th of May he went round to exercise their dog. He got there around 11am. He saw Samantha there and Monique and a younger child sleeping in a low children’s chair. He was with Helen about half an hour, she seemed entirely normal in manner. As they chatted Joseph woke up and started to cry. He thought it was a normal cry. Helen commented that she was used to babies crying and he thought it was not bothering her much.

Helen’s evidence 11.30am. Joseph woke up and he was grizzly. She took him out of his chair and got him to do various things.

My comment. This ties in with Mr Pomphrett’s evidence.

Helen’s evidence 11.50am. He was still grizzly so she thought maybe he is hungry again, she changed his nappy and got his dinner. She fed him his firsts, the Heinz tin and then offered him his chocolate pudding. He ate a bit but did not want any more. He carried on crying so she gave him another bottle. He dozed for a bit and then woke up.

He kept grizzling, grizzling, grizzling. She said she was not over happy with the situation.

Helen’s evidence 1pm. Joseph fell asleep and slept for quite a while. Monique also slept, waking at 2.30pm and Joseph slightly after. Again he was crying so she tried him with more juice. He carried on crying, and crying and crying and crying. Helen carried him around and he was slightly sick on her shoulder. “He had been in my ear hole for all of ten minutes, this was beginning to go through me. I’m saying come on Joseph, what’s up, what’s the matter”. The Crown suggests, “beginning to go through me” means she lost control.

2pm approx. Mr Pomphrett returned with the dog. He didn’t go into the house.

Helen’s evidence 2.30pm. Joseph started grizzling again. Monique had gone to sleep and it woke her up. My mother-in-law telephoned.

3 - 3.30pm approx? Helen’s mother-in-law, Mrs Stacey senior called. She stayed for around 20 to 30 minutes. She looked at Joseph and said he was grizzly, he looked as if he wanted to go off to sleep. Helen said he had been grizzly all day, she did not know what was a matter with him. Helen picked him up, patted him, loved him, walked him around the room and said she had been doing this all day.

Mrs Stacey snr. said, “I thought Joseph was teething”. She didn’t think it necessary to call a doctor. Helen told her she expected Joseph’s father at 4pm. Helen was a little concerned by the baby. Mrs Stacey snr. said, “I didn’t think there was anything wrong with him. There was no lengthy discussion about calling a doctor to see Joseph. Helen said she hoped Joseph’s father would take him to a doctor when he picked him up.”

The judge said the jury would want to consider that evidence and compare it with Helen’s account of her mother’s visit.

Helen’s evidence 3.30pm. My mother-in-law came in. Helen said she noticed Joseph getting more and more grizzly and she said to her mother-in-law, “please take Monique home with you because Joseph is upsetting Monique”.

The judge make reference here to Helen giving a different reason at a later stage (grandpa was longing to see his grandchild). The judge says that maybe there was more than one reason of course.

Helen says she continued to say to her mother-in-law, “I’m not very happy with Joseph, look at this eyes, they have just started to roll, I’m not particularly happy.

Helen’s evidence 4.10pm. After her mother-in-law had left Helen proceeded to try and give him a bottle and he did consume just about all of it. She was expecting his dad to be there at 4pm. She said she was concerned about Joseph but not overly worried, if she had been really, really worried she would have called a doctor. His father did not turn up until 5pm. By this time she had noticed Joseph had not got control of his head.

In further questioning Helen said Joseph had gone off to sleep about 3pm and then for some unearthly reason started to whinge, like a cry. Helen made a sound like a sharp intake of breath twice. She said she thought he still looked as if he was asleep, his eyes were shut and he was shivering from the chest upwards. That was shortly before her mother-in-law arrived when he did wake up crying.

My comment. So this paragraph was about happenings while the child was asleep. Not unusual, we all often make funny noises in our sleep, including sharp intakes of breath and shudders.

The judge however draws attention to this by telling the jury they have to consider whether the picture she is painting supports the defence contention that shaking may have taken place before 7am or whether it supports the prosecution case. (Why not HAD taken place?)

4.27 to 4.39pm. Helen was speaking to North Walsham Cottage Hospital. She was on the phone for 12 minutes. She had rung-up to enquire about a friend in there and they took a long time to put her through. An act of kindness, hardly a deed by someone who had done something wrong?

4.40 to 4.46pm. Mrs Pomphrett telephoned Helen. The call lasted approximately 6 minutes. Mrs Pomphrett could hear a baby crying strongly in the background throughout her call. She mentioned the child crying. Helen said she had had the child since 7am and she thought there was something wrong with it because it keeps crying. Helen commented that she wished the child’s father would come. The judge points out that this is important evidence and to remember the comments by the Defence.

My comment. I have not seen the remarks by the Defence but the judge is absolutely right, this proves the child was awake and able to cry strongly up to 4.46pm. Just 14 minutes before the child’s father arrived. This corroborates Helen’s evidence that the seriousness of Joseph’s condition was only really apparent to her just before Mr Mackin arrived. Note also that in this last paragraph is the third reference to Helen expecting Mr Mackin at 4pm.

The two telephone calls combined ran from 4.27 to 4.46. Almost 20 minutes.

Before the judge came to the police interviews with Helen he said, “bear in mind that being interviewed in the police station is a very stressful matter for anybody. ..don’t weigh every precise word”. (This is extremely important advice).

He states that he is going to go through not all, but different parts of the interviews.

The police interrogation (parts picked out by the judge from 17 tapes made during the 3 days and nights Helen was in custody being questioned over and over again, becoming more and more tired and less coherent as time went on. The remaining time would have been spent in a cell, alone, tired and worrying. A terrifying ordeal).

Q = question. A=answer.

Helen. I thought to myself that doesn’t look right, something here looks a bit funny. That’s when I first started noticing....bells started ringing. I wouldn’t say alarm bells but getting concerned.

Officer. Mother-in-law still there?

A: Yes, he opened his eyes and I went over to him to start talking to him. His eyes were not straight like yours or mine looking at me. He was kind of rolling his eyes a bit. I pointed this out to mother-in-law. She said what’s a matter with him and we discussed at length whether we should call a doctor out.
Q: Did she seem alarmed at his eyes?
A: She wasn’t happy because of the signals she got from me. I was upset, anxious, I went into the kitchen and washed my hands because I wanted to put my finger in his mouth to make sure he had not got his tongue caught.
Q: Was the eyes doing the same thing?
A: When they were open.
I stuck one of my fingers into his mouth gently; I could see his tongue was there. I didn’t know whether he was asleep, dreaming or what. His arms were not like....
Q. His arms weren’t tense, rigid but they weren’t floppy?
A: They were in between.
Q: How did his breathing appear?
A: Very shallow.
Q: More shallow than normal?
A: A fraction but not a lot.
Q: Was he having difficulty in breathing.
A: Not that I could see, but I had checked that his tongue was not caught.
I lifted him out of his chair; laid him on the changing mat.

I am trying to think whether I had done that before mother-in-law went home, I can’t remember

My comment. This is the most important part of this sequence. Did all this happen when her mother-in-law was there? My guess is not. The judge said being questioned at the police station is stressful, an understatement, Helen would have been panic stricken, she had been already told the doctors were claiming that Joseph had been shaken. Had she done all that she had been taught? Confused, under pressure she is rambling on, desperate, tired, she feels she must say something. We all have difficulty in remembering things clearly. Try thinking of everything that happened to you 4,5,6,7 days ago and see how much you can remember. That would also apply to her 78 year old mother-in-law too of course. During the 3 days and nignts Helen spent in custody being interrogated she wore the same clothes throughout, washing facilities were a small basin in the cell and the in-cell lavatory was only partly hidden from anyone who looked in. Do you think she got any sleep? How rational would you be after going without sleep for this period?

Samantha was watching TV at 3.30pm so I could concentrate on Joseph. When I had finished giving him his bottle it was somewhere around 4.10pm. I thought, where the hell is Tony. I lifted up Joseph to wind him, he did not have so much control of his head. He was sitting on top of my thigh, moving my hand down slightly to start giving him a few taps to wind him, I found the head had not got much control.

Q: So what happened to show you that?
A: It kind of fell forward like. Then I was worried, something here was very wrong.
Q: What were his eyes doing at this stage?
A: They were still rolling.
Q: Did the eyes and pupils disappear?
A: No

I couldn’t get any wind.

My comment. I couldn’t get any wind!!! She is still going through a pattern of feed the baby, wind the baby. Something she has been doing all day, she believes this to be the remedy for the child’s crying.

Before mother-in-law went home I did discuss with her do you think I should call the doctor out.

My comment. She is blaming herself for not having called the doctor and trying to show here that she should have thought about it. This is shown by the next statement.

It was kind of 3.45pm when she (mother-in-law) left and after great discussion (thought?) I decided his dad would be here shortly. Tony unfortunately did not arrive until 5pm and I blame myself......I should have phoned the doctor at 4.10pm but I kept thinking his dad will be here in 5 minutes.

The judge then said that what she actually did, we know from the telephone schedule......she did not get on the phone to the doctor, she phoned the Cottage Hospital to find out about Mr Clarke and then had a 6 minute conversation with Mrs Pomphrett. So you can now fit those telephone calls into context.

My comment. The judge here is blaming her but none of this shows evil intent, she still has not recognised how serious things are.

Helen said, “I classed Joseph with the utmost care and love as if he was my own child”, she did not feel that looking after 3 children had been too much for her or that she was out of her depth.

The judge next says she was taken through the events of the previous day and repeated what she had said in the previous interview......

Helen denied the crying had got on her nerves. She explained that when she comforted Joseph his crying gave her a slight headache but she was still trying to be calm because she is a great believer; if you get emotionally upset with children they will be upset even more. You have got to stay calm and carry on the best you can. She explained that “beginning to go through me” in the previous interview meant it was beginning to give her a headache.

Helen said that the conversation about whether Monique was getting jealous of the attention she was lavishing on Joseph was not the case. She again said she classed Joseph with the utmost care and love as I would my own child.

She denied when Mr Mackin picked-up Joseph describing him as a bit snuffly and unwell.

The conclusions of the pathologists were read out to Helen, that death had occurred as a result of shaking or whiplash injury.

Helen accepted that during the day he had been responsive to the rattle and fish and he took in food and milk on several occasions. Helen repeated; nothing whatsoever happened. He certainly was not dropped forcefully on a cot, mattress or settee. The only person apart from her in the room was his sister who certainly would not have shaken him. At that time she could not remember the Clarke telephone call.

She said she did not shake or throw Joseph down. She did nothing to cause injury to him. There was no accident, no other adult was with Joseph while he was in her care, Mr Pomphrett had nothing to do with Joseph and her mother-in-law had nothing to do with him.

She had decided to become a childminder because we needed the money. I didn’t want to leave my child with anyone else. She knew one or two other childminders and she enjoyed children. Mrs Boddy was a childminder, she played a part in her decision, “I enjoyed helping Mrs Boddy.”

Mrs Boddy’s evidence was read out, she said Helen was extremely good with Kimberley and she gave a very high recommendation of Mrs Stacey for looking after Kimberley and looking after Monique whom she described as “the apple of her eye, as most mothers think their children are.”

Each day’s events leading up to Tuesday the 13th were gone over again with approximately the same answers as previous interviews.

The judge asked Helen what she meant by grizzling, she replied “not a strong cry.”

Tuesday 13th. Helen said, “when Mr Mackin arrived I said I want to talk with you about Joseph, I have noticed something, I have not got a doctor’s number.” I had totally forgotten I had it.

My comment. Totally in character with Helen. Talk to her, a lovely, bubbly personality but a little scatterbrained perhaps.

She agreed Mr Mackin came into the house and was out of the house in one minute and left shouting “ring the doctor so he is ready for when I am there”. She rang saying Mr Mackin and Joseph were on their way.

My comment. Experts were asked by the police if a fast car journey could have caused the haemorrhage of the brain. They all answered no, but surely if the child had no control over his head then movement of the head must have made matters worse.

The judge remarked that certainly from the moment Mr Mackin came to the house it is clear that he spotted that his child was very seriously ill. He then said, that is what I call the factual evidence and you add what your findings are on that evidence to the doctor’s evidence.

The judge continued, the doctors are giving evidence on medical matters and on medical matters only ....they are looking at matters they are expert in and very expert all these doctors were. All the doctors are at the top of their profession. Nobody has criticised another doctor on the basis that he or she does not know what he or she is doing. Everyone accepts that you could not have had more competent doctors in any case. (Wow!)

My comment. Getting a medical expert to criticise another is near impossible as anyone who has tried to bring a medical malpractice case to court knows. This judge was certainly in awe of these people. They could not be wrong in his eyes and he was certainly making that opinion known.

Dr. Coleman, he comes from Addenbrookes Hospital at Cambridge, he’s a consultant pathologist.

The post mortem was started at Norfolk and Norwich Hospital. It is not suggested that anything took place which interfered with the findings of all the other doctors but it stopped before any conclusion was reached.

My comment. So what did happen there? The start of a post mortem examination surely requires an incision into the scalp. I found in a written statement by Dr. Carey that the Consultant Pathologist at the Norfolk and Norwich Hospital identified a possible intracranial bleed on the basis of blood staining of the cerebrospinal fluid. I am told that the incision will have been through not only the scalp but also the skull to expose the coverings of the brain. When the pathologist decided to close up she will have lifted the flaps of bone which will have been folded downwards to put them into their proper position as near as possible, she will have then repeated this with the scalp and then put in a stitch to hold the scalp into place. I understand that blood clots over the surface of the brain were discarded and not examined under a microscope. It is not enough that it was new clot. If they had looked they might have found evidence of ‘organisation’, i.e. recognisable changes that happen within blood and could have proved that whatever was wrong with the child must have started before 7am. Helen was denied a chance of useful evidence of timing.

The body was transferred to Addenbrookes. Dr. Coleman was with Dr. Carey when the post mortem examination was carried out. Dr. Coleman’s role was to decide whether in his opinion death was by natural causes. He came to the conclusion it was not. (They had already decided that at the Norfolk and Norwich according to newspaper reports, they told the parents so before they left).

He found food in the stomach which had been eaten soon before death, within 4 hours. (Helen had given evidence of feeding at around 4.10pm). Time of death was approximately 5.30pm, it is not precise. (It could be as late as 6.30pm as claimed in some written medical statements).

The history is the child was taken to the doctor’s surgery. The GP tried to resuscitate him. The child was slightly sick because he was blowing into his lungs. The ambulance came, the paramedics lent him tubes so that they could put (push) a tube into his lungs to artificially make him breath. They got little response so he was rushed to hospital.

My comment. Slightly sick! The child was very sick. Vomit in the trachea (windpipe) will have contributed to death. No mention has been made of the ambulance stopping to give electric shocks twice on the way to the hospital and any other resuscitation attempts on route. There is a belief that resuscitation can be the cause of retinal bleeding especially if there is raised intracranial pressure caused by haemorrhage.

Consider the following:-
Taylor’s Paediatric Ophthalmology - “it is most important that retinal haemorrhaging not be taken as pathagnomic (unique to) Non-Accidental Injury; they occur in a wide variety of other causes of raised central venous pressure.”

Dr. Coleman, (prosecution) examined the brain. He told you that the brain of a child of this age is not fully formed and is of a jelly like consistency. Throughout the brain there are a vast number of blood vessels which supply oxygen through the blood to the brain. Without that oxygen the brain ceases to function and swells. That further disrupts the blood supply and the baby dies.

My comment. So once however started, it is a self perpetuating sequence.

Around the brain over the jelly like consistency there is a thin layer of skin, then there is a slightly thicker skin called the arachnoid. There is a gap between the arachnoid and the brain. Above the arachnoid there is another gap, that gap has fluid in it and there are a number of connecting blood vessels from the arachnoid through this gap to the dura. The dura is a thicker covering inside the skull. Between the dura and the skull there is another layer of liquid.

The dura can move and the brain can move within the skull backwards and forwards if the head is moved violently. As the baby’s head is of a softer substance it is easier for it to be damaged than it is for an adult.

My comment. That also proves true of accidental injury as well as an intended injury.

He (Dr. Coleman) found no evidence of natural disease, he gave no evidence about the time of shaking.

Dr. Carey, Home Office Pathologist (prosecution) who was present did further examination. He did deep dissection of the relevant parts of the body and found two bruises in the root of the neck; one on the right and one on the left, those were consistent with fingers gripping the baby.

My comment. The most probable cause of these is resuscitation attempts. If you push an endo-tracheal tube down the throat is this not where you would hold the head while tilting it backwards. This is not the place where you would hold a child in order to shake it. Dr. Carey’s police statement gave details of the bruises as 0.8cm (8mm) maximum on the right with blotchy bruising of 2cm (20mm) maximum on the left.

He (Dr. Carey) also found a one centimetre, (faint) bruise in the middle of the forehead for which no-one has an explanation.

My comment. Fallen forward after being propped up? His head has hit something, but when?

He found that death was a direct result of an injury to the head caused by shaking. It was a classic instance of what he called Shaken-Baby-Syndrome; shorthand for either shaken and thrown down or just thrown down hard ....not just gentle shaking, violent shaking. If the baby was thrown it would have been on a cushioned surface otherwise you would expect to find bruising on the outside of the body and there was none of sufficient size to indicate that. He was satisfied that he could rule out accidental injury by one child to another.

My comment. Any form of sudden deceleration can surely have the same effect as thrown down hard on a cushioned surface, without any bruising this is just a figment of someone’s imagination. Pure supposition.

He said he had seen the neuro pathological report prepared by Dr. Smith. He said that indicated there were haemorrhages in the sub arachnoid and deeper inside the brain. His view was that with a baby with deep brain injuries you expect symptoms to appear quickly ..... injuries would have been caused by shaking some hours before the baby died. In his view deep brain injury was the key to this case....the baby would show something more obvious than just whinging.

The timing of the shaking depended on the level of deep brain injury. Asked what he would consider to have been the timing of the shaking if there had only been subdural haemorrhage - he said it was difficult to assess. Sometimes the ability of the blood to clot stops the bleeding for a period. If clotting does not take place and prevent death that is broadly the difference between subdural and deep brain damage.

Next Dr. Smith (prosecution) who is a consultant neuropathologist in Leeds which is a centre of excellence in the north of England and accepted as such by everybody.

My comment. The judge is in awe again. Pity though that Dr. Smith comes from The Royal Hallamshire Hospital at Sheffield (still in Yorkshire though). The judge could have also added that the north and north east of this country are a hot-bed of accusation where harm to a child is suspected.

She examined the brain which had been sent to her. She was aware that there was possibility of artefactual damage. She found that there was bleeding in the sub arachnoid area and some bleeding in the ventricular systems inside the brain. She also found a small tear, very small, in the central part of the brain between the two hemispheres. These injuries had caused swelling to the brain that would lead to death. She said that those injuries would have been caused a relatively few hours before symptoms were seen in the baby. She would not have expected a baby in this condition to have had a normal lunch.

She would have expected symptoms of eye-rolling and head flopping. She said she found symptoms of neuronal hypoxia (changes in nerve cells), these changes occur some 2-3 hours after an injury. In view of the severe injuries to the brain she would have expected the shaking to have occurred after a shorter rather than a longer period but she did not think one can be 100% sure about any injury.

Questioned by the defence she said that the tear she had concentrated on was a pinprick in size and agreed it could have been as small as 1/100th of an inch. She said she was of the opinion that this was an ante-mortem tear but she could not say it is impossible it was not caused after death.

She found blood in the ventricular system and considered that had taken place during life.

Professor Green, Home Office Pathologist (prosecution) is a specialist in examining the eyes of children and babies in particular those who may have suffered death in the way that Joseph had suffered; from shaking. (The judge has made up his mind, once again no consideration of other possibilities).

By the time he had received the eyes the outside shape had altered (swollen?) because they had been preserved in liquid formalin. He took account of this and that they had been removed from the body for two days so that there had been some degenerative, decomposition changes. (It was three days not two and did this really make no difference at all?)

There is no dispute between him and Professor Luthert for the defence about his findings. He found small pinprick haemorrhages in front of the retina, through the various levels and behind the retina. These are consistent with a shaking injury. He said from his research he would have expected deep brain injury. He said his feelings were that the injuries were suffered later in the day rather than sooner. The possibility of Joseph behaving normally and taking a normal lunch with this degree of brain injury was extremely remote. He regarded it as extremely likely that the injuries occurred after he had had his lunch but he added, in medicine all things are possible.

Dr. Dickson (prosecution) a retired Clinical medical Officer and former designated Child Protection Doctor for Sheffield Health Authority thought it unlikely a child with these injuries could have taken in objects like a rattle or fish, or taken the usual lunch. The judge said she is not an expert in these matters, I would therefore advise you not to place much reliance on her because she has not got the specialist knowledge of the other doctors. (Another example of the judge’s veneration of the experts).

Dr. Harding (defence) a consultant neuropathologist at St. Ormond Street Hospital described by the judge as the leading hospital for children in the country and some say the world. He saw the slides prepared by Dr. Smith; he had no complaint in the way they had been prepared. He was satisfied that death was by shaking but he believed it not unlikely that this shaking took place before 7am. He referred to the tiny tear in the centre of the brain and said that only one of the ventricles had red corpuscles of blood in it, on balance he had found this to be a post-mortem tear. Blood could have come from a nearby blood vessel or surface blood as the brain was carried up to Dr. Smiths laboratory.

He said that if shaking was severe enough to produce a subdural haemorrhage but no other symptoms the baby might not show any signs that could be recognised for a considerable period.

He worked on the basis that the baby was shaken, some of the blood vessels attaching the brain to the dura were torn and blood leaked into the cavity. this put pressure on the brain and the brain began to swell. This compressed other blood vessels and these in turn may have burst and eventually cut off the blood supply to the nerve cells. The absence of blood to the nerve cells can after 2 or 3 hours be detected under the microscope as neuronal hypoxia. Some of that blood may have found its way into the ventricular system. The blood in the ventricular system may also have come from blood on the surface of the brain. He considers there is a possibility that there was no deep brain injury of any sort.

He agreed there was extensive retinal bleeding which would have occurred shortly after shaking but there is still a possibility that this happened before 7am.

Professor Luthert (defence) has equal expertise to Professor Green. He does not disagree with anything Professor Green reported about the eyes. He emphasised that you can have badly damaged eyes in shaking cases without deep brain injury. He said that Dr. Harding's interpretation that this may have been only a subdural haemorrhage is a possibility.

The defence say that the defendant giving evidence in a case where you are charged with murder is a nerve wracking business, Mrs Stacey was a good witness and that you can rely on her evidence. The same goes for her police interviews. They do not indicate that she is guilty of murder or manslaughter. The differences between her account and her mother-in-law’s is a good thing. If two people said the same you would be suspicious.

The defence say that they rely on the contents of Mrs Pomphrett’s telephone account to indicate that there was nothing very wrong with Joseph at that time. The defence say that the medical evidence is inconclusive and that Dr. Harding's evidence is to be preferred coming from such a distinguished man. Coupled with Professor Luthert’s evidence it indicates you can place little reliance on the prosecution evidence.

The prosecution say that their medical evidence is convincing, that Dr. Smith had an advantage that Dr. Harding didn’t have of seeing the brain and being able to assess it with her eyes and that she is a convincing witness. Her evidence indicates that you can be satisfied there was deep brain injury. Coupled with the remaining evidence of how the baby was behaving as disclosed in the interviews from 3.15pm or thereabouts. So that they say all that points to an injury by shaking a little earlier around lunchtime. They say that her behaviour in not contacting anybody to get help is incomprehensible unless it be for the reason that she knew she had done something terribly wrong.

My comment. Mr Pomphrett saw the child just before lunch, Helen’s mother-in-law saw the baby later that afternoon and the baby was crying loudly just 14 minutes before his father arrived. There was food in the child’s stomach eaten within 4 hours of death which was put at 5.30pm. proving he had been fed at 1.30pm or later.

The time was around 12 noon when the jury retired. The judge said that they would be given lunch and then continue their deliberations until 5pm. If they had not reached a verdict they could return the next morning, a Saturday, or continue on Monday. They were not to think or talk about the case during the weekend (an impossibility). At the end of the afternoon the jury chose to return on the Monday. (Why did they not continue through the weekend, was the life of the accused and her family of no consequence - one mustn’t inconvenience anybody, what a blasé attitude!)

The jury was instructed that they could return a verdict of guilty of murder (why when the prosecution accepted there was no evidence of intent) or guilty of manslaughter. if they did not reach a unanimous verdict they would be instructed that a majority verdict of ten or more would do.

The Court reconvened on Monday morning at 10.15am. The judge started by answering questions asked by the jury on the Friday afternoon. The judge had gone through these questions with counsel for the prosecution and the defence before the trial restarted.

Q. = Jury. A. = Judge

Q. Does the sub arachnoid damage tell us anything about timing?
A. It doesn’t tell you anything about timing ..... it does not indicate deep brain injury. The deep brain injury alleged by Doctor Smith is the bleeding in the ventricular system and the small tear. Dr. Harding came to the conclusion that was post mortem not ante mortem and he also came to the conclusion that it was more likely that the blood in the ventricular system came from loose blood during transportation.

Q. Can we hear the written evidence from the doctor’s surgery practice manager and the nursing sister.
A. Tina Hibbs, the practice manager said that at 5.10pm. on the 13th May she received a telephone call from a female who said she was a childminder for Joseph Mackin, he was having difficulty breathing, she asked if he could be seen straight away. Joseph was being brought by his father. Around the time Tina Hibbs phoned for an ambulance (5.22pm) she received another call from the childminder who then identified herself as Mrs Stacey. She said she wanted to give details of how Joseph had been throughout the day in case it was of help. Mrs Stacey said he had been fretful throughout the day and restless. He had had a normal feed but had not taken much of his last feed.

Betty Lacey who is the practice nursing sister was in the nurse’s treatment room when Mr Mackin came in and informed her that Dr. Young wanted her. She said she saw a baby lying on the treatment couch partially undressed. She could see by the baby’s feet that it was seriously ill. She then dealt with the details of attempts to resuscitate the baby. The ambulance arrived between 5.35 and 5.40pm.

Shortly after, Betty Lacy went through to the reception area where Tina Hibbs was speaking on the telephone. Tina said the childminder was on the telephone and wanted to know what was happening, Betty Lacey agreed to speak to her. The female voice on the other end of the telephone said if the baby is being admitted to the hospital then there must be something seriously wrong. She continued by saying to her, he has been a bit off colour all day but he has taken his bottle, he’s such a lovely boy. Betty Lacey asked her to look after the other child until the parents returned from the hospital. She described Helen as concerned but not upset for the child.

My comment. Helen still does not realise how ill the baby is, surely that is obvious. Up to here she did not think the baby would have to go to hospital, this has come as a surprise, it is only just starting to dawn on her that things are really serious. Concern is the right word.

The judge continued by saying next we had the evidence of the paramedics which I needn’t refer to, who took the child to the hospital - doing all they could.

Next was the evidence of Sister Birt at the Norfolk and Norwich Hospital. She said the ambulance crew arrived still resuscitating Joseph. She said, I got Joseph’s father to speak with Joseph’s mother and tell her to come to the hospital .... I turned to look at Joseph and saw the staff had stopped trying to revive him. He was pronounced dead by Dr. O’Neill.

Shortly afterwards I received a telephone call from a woman who told me she was Joseph Mackin’s childminder. She sounded concerned and asked how Joseph was, I told her things were not good. She asked if it would have made any difference if she had taken Joseph to the Doctor’s earlier. I was non-committal, I then said that Joseph had died. At this she appeared shocked. The caller then briefly told her Joseph had not been well all day, he had had his lunch and she was about to call a doctor when his father had called to collect him.

My comment. Certainly Helen was shocked, this she can not believe, she obviously had no idea that this was a possibility.

The judge then went through the evidence given by Helen in court once more, once again this shows it was not until the very end of the day that she had cause for concern. Helen insisted she had not shaken Joseph. The judge then asked how long the jury had been deliberating, the Clerk of the Court said about 4 hours. Deciding he could now dispense with the need for a unanimous verdict the judge said he was now allowed to give instruction on a majority verdict. He said the law required only two hours as a minimum and they had gone twice that. He told them that from that point he could accept a verdict from just ten of them.

The jury retired on that Monday morning at 10.52am and returned at 2.23pm. (including their lunch?) The Clerk of the Court said, My Lord, it is now 7 hours and 35 minutes that the jury have been considering it’s verdict. The Foreman of the Jury was asked for the verdict and replied, guilty of murder by a majority of ten.

The judge sentenced Helen to life imprisonment (and also consequently her husband, her child, parents and everyone else who loves her).

MY SUMMARY.
British justice had been done, the game had been played and the crown had won, but this trial had nothing to do with fairness and a real search for truth. Helen’s conviction is based on a theory referred to as shaken-baby-syndrome. This along with other sudden-infant-death harm theories have been a life long obsession by some doctors. In late 1997 I saw one of the main proponents on a Newsnight programme claim there was now a 95% consensus. Well, history shows that so-called experts are rarely as expert as they are supposed to be, and anybody who studies other miscarriages of justice will find it is the evidence of pathologists that is often found at fault.

Shaken-baby-syndrome is the diagnoses if the child is found to have a brain haemorrhage and haemorrhaging of the retina but there are other reasons for these conditions. No attempt during this trial was made to investigate these. This makes me extremely suspicious, did these people collude, meet before the trial and decide that only SBS would be considered? Is this why they all seem to have had one track minds?

Meningitis and Chicken Pox are two common diseases that cause the brain to swell, there must be several more, the world is awash with viruses. Why was the evidence suppressed that the child had died twice in the Norfolk and Norwich Hospital the previous December? Lack of oxygen almost killed him then. We learned during this trial that once the brain starts to swell it is a self perpetuating sequence. It cuts of the blood supply causing more swelling and it also causes blood vessels to burst. How much more vulnerable is a child with a swollen brain to ordinary deceleration forces. I am told a baby born prematurely is even more at risk, particularly around 6 months old. What other medical conditions had been considered, not even as the whole cause but even as contributing. The judge does not mention any bleeding tendency, e.g. von Willebrands disease or certain metabolic diseases. No steps seem to have been taken to rule them out.

Here is an extract from a letter in the eBMJ by John Heptonstall, has this got any bearing on this case?

A comentator above cites intracranial haemmorhage; this has been mentioned as a sign of possible parental abuse both in 'shaken baby syndrome' cases and SIDS - it can also be a sign of vaccination abuse as it is a RECOGNISED effect induced by some vaccines, indeed that very effect is induced in animals in experimental research with vaccines yet when it occurs in a child it is deemed a 'mystery'! Jacod and Mannuo (1979) described bulging fontanelle due to brain swelling as a direct reaction to DPT vaccine. Delayed reactions are the norm, not the exception, and is explained as a consequence of an immunological intravascular complexing of particulate antigen (Wilkins 1988) - yet vaccinators seem to have great difficulty with this stating reactions ought to occur within 24 hours! The convulsions that follow 1 in 1750 cases of DPT vaccine (Cody et al 1981) can result in unexplained falls in bigger children who can sit or stand that can cause linear fractures. With 3 doses per baby of DPT and OPV the risk is 1 in 350 therefore a great number of children develop vaccine-related convulsions between the ages of 2-6 months, 18 months, and 5 to 6 years. The parent or carer may not be aware of the child's fall or convulsion. Bruising and easy bleeding are the characteristic sign of blood clotting disorder thrombocytpaemia - a recognised side effect of many vaccines - which may result in brain and other haemorrhages (Woener et al 1981).

I enquired about resuscitation which went on for an hour or so and what that involves. A doctor told me the following.

No reflection on the GP; and we can all go on refresher courses (I do regularly up at our hospital). He may have been on a recent course or he may have been fresh from a paediatric job in hospitals; but unless you are resuscitating 5 month old babies all the time (and lets face it, that equals nobody) it is very hard to do it just right. Most common problem with children is to be too vigorous. You have to extend the head. that means with the person lying on their back you have to get the head, neck and body in a straight line; and then you have to tilt the chin upwards so the head tilts backwards. And you have to feel for pulsation in the neck ... frequently by pressing with your fingers. You also have to blow air from your mouth into theirs (or in the case of babies, into their nose and mouth, or just their nose.) and do frequent fast external cardiac compressions by pressing up and down on the sternum (breast bone). Such manoeuvres shake a baby around a bit too. Resuscitation will have been kept up for about an hour or perhaps more. There will probably have been 100 chest compressions per minute - or more. That is a total of 6000, many of them will have been done in the ambulance; a moving vehicle. I guess that is what you are thinking about and it may be in reality more violent than we see on TV especially in the desperation of the moment.

I can remember seeing a television programme where it was said that after resuscitation attempts on an adult it is not unknown to find that their ribs have been broken. It is also quite common for the heart to be bruised and fluid or blood to appear in the pericardium (membrane around the heart). The bruising found in the neck muscle of baby Joseph was almost certain to have been caused during resuscitation or from movement of the head while being transported. Was the retinal bleeding also?

Now according to the judge the prosecution claimed that shaking was around lunchtime. Dr. Smith (prosecution) said she would not have expected the baby to have had a normal lunch. professor Green (prosecution) said the possibility of a normal lunch was remote. Dr Dickson (prosecution) said she thought it unlikely Joseph would have taken the normal lunch.

However, Dr. Coleman (prosecution) said that food WAS EATEN reasonably soon before death, certainly WITHIN 4 hours. So the child had to have been fed AFTER 1.30pm or later. Helen gave evidence that the child ate lunch at around noon. He ate his firsts, the Heinz tin and then a bit of his chocolate pudding. He was seen to be normal by her mother-in-law for a period between 3pm and 4pm. Helen again said around 4.10pm she gave him a bottle and he consumed just about all of it. So surely this supports Helen’s account of events. It was not until the end of the afternoon that it was obvious that something was really wrong, and remember the child was heard crying strongly just 14 minutes before 5pm.

Dr. Young, the G.P. who tried so hard to save Joseph, in a written statement says, almost as soon as I started to put breaths into the child he started to vomit what looked like the remains of a RECENT meal. Joseph vomited so much that it impeded our attempts at resuscitation. Throughout the time we were trying to resuscitate Joseph, which was about sixteen minutes, I had to keep stopping giving mouth to mouth whilst Joseph was sick. I would estimate that Joseph vomited in the region of 300 millilitres of undigested food whilst he was at the surgery.

What more evidence is needed to show Joseph was fed when Helen said he was and that he was capable of feeding? Note a baby’s bottle holds 240ml.

The claim by Dr. Smith that there was deep brain injury is based on a pin prick just 1/100th of an inch in size, the obvious explanation for this is a prick from the tip of a scalpel, probably when the brain was being removed. I am also told that the brain, as the judge said, really is like jelly. If not supported between cupped hands when being moved, damage will have easily been done. The brain was removed from the skull sometime during the day of Friday 16th May and placed in formalin fixative. Dr. Smith received the brain at 1.30pm on the 10th June, 28 days after the death of Joseph.

In her police statement she states; “cerebral swelling as indicated by formalin fixed weight of 946gms, expected weight 600gms approx”. A massive increase of 58%. I am told that formalin will account for 8% of this (so the pin prick was even smaller when made) but what about the other 50%? In a medical paper on haematomas I find symptoms peculiar to infants less than 6 months old listed as, ‘fontanelles - bulging, increased head circumference, and sutures - separated.'

With an increase of 50% in brain weight why aren’t these present?

Dr. Harding is right when he says that the pin prick is post mortem and the blood claimed to be in the ventricular area has seeped there during transportation. Remember the brain was taken from Addenbrookes in Cambridge to Sheffield in Yorkshire, it didn’t get there floating on air. Dr. Smith said she could not say it was impossible it (the pin prick) was not caused after death.

Helen is supposed to have shaken this child but how? According to Dr. Carey the force used was equal to a fall from the first storey of a building or a motor vehicle accident and Joseph Mackin's head injuries were consistent with being violently shaken backwards and forwards as hard as you possibly can. Yet all internal organs were normal. There was no compressive neck injury, no injuries to the strap muscles or cartilages, no other injuries apparent in the neck, back, all four limbs, no rib fracturing, no skull fracture, no bruising to the scalp. The only injuries found was the 1cm (10mm) maximum size, faint (note faint, no great force here, possibly old?) bruise in the middle of the forehead and the two very small bruises that were not visible, but found after dissection in the root of the neck.

These bruises said to be 8mm and a blotchy 20mm maximum in diameter and according to Dr Carey were consistent with fingers gripping the baby. According to Dr. Coleman Joseph’s body weight at autopsy was 8.5kg (19lbs). Try it, it is impossible to shake an object of that weight, holding it with just finger and thumb, let alone with the force described and something as soft as a baby. Even if it was possible the injuries to the neck would be massive. (Try shaking a 20lb bag of potatoes with this amount of force while holding it between forefinger and thumb). If the body was also held with the other hand where are the marks. The fact that according to Dr. Carey, there were no cyanosis and no petechial haemorrhages on the eyes or face prove that no real pressure has been applied to Joseph’s neck. (Helen Stacey is not a big woman, slight in stature she takes dress size 12).

So that leaves throwing down hard on a soft surface. This reasoning would get people convicted of witchcraft. If this was a serious consideration surely there would be some bruising to the neck, arms, chest or back and damage to internal organs. (Remember; force equal to a fall from a first storey or a vehicle accident is claimed.).

There is no evidence whatsoever of the force described being used on this child.

This child had as Dr. Harding and Professor Luthert indicated just a bilateral subdural haematoma that was older than 7 hours. It could have been started in a number of ways including by genetic disorder, virus or by accident.

The judge has gone to a lot of trouble to pick out parts of the evidence that he thinks were relevant. I am told that other judges stick to just explaining points of law and leave the rest to the jury. The one thing the judge does not seem to have done is to tell the jury their real purpose and that is they are not there to solve a puzzle but to decide only whether the prosecution has proved their case WITHOUT REASONABLE DOUBT (another judge in another case I have just read about used the word ‘sure’, the jury should be sure the defendant was guilty).

This was not the case and the verdict of two of the jury shows this. This conviction is another product of our abysmal, adversarial justice system. A contest which the prosecution is 90% sure of winning, where even the jury is rigged so that those capable of rational thought and compassion are of no consequence unless they number more than two.

This verdict is unsafe and should be overturned.

Postscript.
On Channel 4 News (7-8pm) Tuesday 13th July 1999, I watched Jon Snow interview someone from the University of Birmingham. They were doing research into Shaken Baby Syndrome. That person stated their research indicated that a haemorrhage of the brain in a 5 month old baby could be started with just one or two shakes. He demonstrated this with a closed jar containing an egg and a fluid. If the jar was struck the movement of the egg was cushioned by the fluid, to break the egg the jar needed to be hit so hard the glass would break, however just two shakes and the egg was broken. Earlier in this review we found that once started bleeding of the brain could be self perpetuating.

Without bruising, tearing of muscles or broken bones this surely is a most likely explanation for any subdural haemorrhage. The original damage having occurred well before the time when the effects become apparent and probably unknown to the perpetrator (It does not have to be done with intent either). The person blamed is the person who is with the child when the injury is evident. The severity of the subdural haemorrhage is because it has grown over a period of time. The only reason the so-called experts exagerate the force required is to persuade the jury to convict the accused.

SURELY THIS IS PLAIN COMMON SENSE.

People who think evil, see evil
In the London Times Sept. 10, 1999, Professor Green who appeared for the prosecution in this trial is reported to have claimed that up to 40% of babies registered as cot deaths may have been killed by their parents or another adult. He says, "The advice given in a Canadian investigative protocol to 'think dirty' although a little graphically expressed for my liking, sums it up." He urges pathologists who are looking into suspected sudden death syndrome cases to take a careful look at the family history.

My comment. God help any person who has a baby die while in their care with people like this around. In spite of his excuse for "thinking dirty," this man's agenda is very apparent.

I learned while visiting Helen in prison that the police during their investigations into this case had Helen's baby daughter medically examined and bone scanned. Helen, indignant, told me that of course they found nothing. The thought of causing harm to her daughter or baby Joseph was utterly repugnant to her.