A former Atlanta-area medical examiner who’s now a consultant in death cases testified Wednesday that babies simply can’t be shaken hard enough to cause the brain injuries that led to 8-month-old Alexander Cabanayan’s death in 2012.
Testifying for the defense in the murder trial of Cabanayan’s father Shane Eric Hinkson, Dr. Joseph Burton told the jury that recent research has shown “pure Shaken Baby Syndrome” does not exist, because adults can’t produce the force needed to rupture veins in an infant’s skull to cause a subdural hematoma, or internal bleeding between the brain and skull.
Burton is not alone in that contention, as forensic pathologists and other physicians lately have expressed doubts about the diagnosis, saying other conditions can mimic the medical evidence once considered indicative of inflicted head trauma.
What neither they nor Burton doubt, though, is that if a baby being moved violently hits a surface that abruptly stops the motion, it can cause such sudden deceleration that the child suffers head trauma.
“You have to stop the head during the process,” Burton said, acknowledging also that the baby’s head needn’t hit a hard surface to sustain the injury: Slamming an infant down on a bed would do the damage.
Doctors who treated Cabanayan saw no external signs of the severe head trauma that was revealed by a brain scan. They noted only two small bruises under the baby’s jaw, one on each side.
During Burton’s defense testimony, he and attorney David Wolfe used a doll to demonstrate shaking an infant. In cross examining Burton, prosecutor William Hocutt IV used the doll, too.
With one hand under the doll’s chin, his thumb on one side and two fingers on the other, Hocutt demonstrated hurling a baby boy onto his back on a bed, and asked Burton if that could have caused Cabanayan’s injuries.
Burton agreed that it could have.
Hocutt has told jurors Hinkson, who was engaged to the baby’s mother and caring for the child on Jan. 1, 2012, became frustrated when Cabanayan would not stop crying and lost his temper, fatally injuring the infant. The mother said Hinkson called her at work at 1:55 p.m. that New Year’s Day to tell her “something bad had happened” and she needed to come to his Antietam Drive apartment to get their son.
The mother testified she arrived to find Hinkson standing in the kitchen with a gun to his head and the baby lying on the bed in the bedroom, moaning. The infant’s right eye was nearly shut, and one eye looked up while the other looked down, she said.
She rushed the baby to the emergency room at St. Francis, where records show she arrived at 2:55 p.m.
Wolfe has maintained the child would have survived had he gone straight to a level-1 trauma center, which Columbus does not have. He said St. Francis was not staffed or equipped to handle the child’s brain injury.
Burton testified that having reviewed the hospital records, he concluded the baby at first appeared reasonably healthy. “In photographs he looks like a normal well-developed 8-month-old child,” Burton said.
But over time the hematoma or “mass of blood” building in the child’s brain would have caused his condition to deteriorate, he said. The trauma to the brain’s right side would cause it to swell and push into the left hemisphere.
The baby was flown by helicopter to the Scottish Rite children’s hospital in Atlanta, a level-1 trauma center, where surgeons removed a patch of skull to relieve the pressure within. The child died there the following Jan. 6.
Had the child gone to Scottish Rite first, he might have survived, Burton said, contradicting physicians who Tuesday testified the boy likely would have died regardless of his initial treatment.
Had the infant got level-1 trauma treatment right away, “he would be neurologically damaged, but could have survived,” Burton said.
Both the defense and the prosecution rested their cases Wednesday, and Judge Frank Jordan Jr. set closing arguments for 9 a.m. today in his Government Center courtroom.
Hinkson declined to testify in his own defense. Wolfe on Wednesday morning tried to get Jordan to dismiss one of the charges against Hinkson, a count of malice or intentional murder. Hinkson also faces two counts of felony murder for allegedly killing Cabanayan while committing the underlying felonies of aggravated assault and first-degree child cruelty.
Wolfe said the court had heard not “an iota of evidence” showing Hinkson intended to kill his son. The defendant obviously had no “intent to kill” as shown by his remorse at thinking he had injured his son, even contemplating suicide.
Physicians testified to the extent of the baby’s injury, “but nobody said it was an apparent attempt to end the child’s life,” the attorney told Jordan.
Hocutt countered that whether Hinkson acted maliciously was for the jury to decide: Intent can be inferred by the evidence, and the jury must consider “the totality of the circumstances.”
“I’m going to defer a ruling at this time,” Jordan told the lawyers.