Child abuse testimony

In April 2017, six-week-old J.M. slept most of the day and vomited “a lot” that evening. Mother noticed that J.M.’s arms began shaking at various times. Assuming it was a stomach issue, Father went to the store to buy tea for J.M. Meanwhile, J.M.’s condition worsened. J.M. turned pale, started moaning, could not fully open her eyes, and her arms became stiff. After Father returned from the store, Mother and Father took J.M. to an urgent-care center where they waited more than 40 minutes for the doctor to evaluate her. Upon examination, the doctor told Mother and Father to immediately take J.M. to Phoenix Children’s Hospital (“PCH”). At PCH, a scan revealed that J.M had a large subdural hemorrhage on the left side of her brain and a smaller subdural hemorrhage on the right. She also had significant midline shift and herniation of her brain, meaning there was so much pressure in the brain that it started to shift out of its normal position. J.M. required emergency neurosurgery to relieve the pressure because it had become so great that her skull could no longer contain the brain and its contents without threatening her life. She also had diffused retinal hemorrhages (or bleeding) in all quadrants of the retina and all layers of the retina. Her head injuries negatively affected a multitude of systems in her body. Post-trauma, doctors diagnosed her with cerebral palsy because she had significant motor impairment. She also suffers from regular epileptic seizures and is blind. She now requires occupational therapy, feeding therapy, and 24-hour monitoring. After surgery, Dr. Melissa Jones, a pediatrician with a specialty in child abuse pediatrics, evaluated J.M. After reviewing the family’s medical history and J.M.’s birth records, Dr. Jones determined the injuries resulted from abusive head trauma and Mother and Father provided no alternative explanation for the cause of J.M.’s injuries...

Dr. Jones testified for DCS, opining that J.M.’s injuries resulted from nonaccidental trauma. She
added that J.M.’s lack of external injuries did not rule out abuse. Dr. Ruth Bristol, J.M.’s pediatric
neurosurgeon, testified that J.M.’s injuries were most likely caused by recent trauma. She also
testified that J.M. will likely require long-term, full-time care for the foreseeable future.

Mother and Father’s expert, Dr. Joseph Scheller, a pediatric neurologist with specialties
in pediatric neurology and neuroimaging, disagreed with the Department’s experts. He testified
that J.M.’s injuries resulted from a subdural hematoma at birth that began spontaneously rebleeding some weeks later, which in turn caused her retinal hemorrhages. He conceded that this occurrence would be “an unusual complication” and that no other non-traumatic medical condition could have caused J.M.’s injuries.

In turn, Drs. Jones and Bristol opined on Dr. Scheller’s conclusion, testifying that such 
an occurrence under the circumstances present with J.M. would be “very, very rare.” Dr. Jones
testified that “children [who] have spontaneous re-bleeding [also] have some other complicating
factor with their brain.” Dr. Bristol testified that in her experience as a pediatric neurosurgeon she
had “not seen a spontaneous re-bleed to that degree.” Dr. Jones opined that J.M.’s presentation
and injuries did not correspond to Dr. Scheller’s theory, particularly the diffuse nature of J.M.’s
retinal hemorrhages, which was consistent with “massive trauma with acceleration and
deceleration.” Regarding J.M.’s eye injuries, Dr. Jones stated that:

[T]here had to be [a] significant force that led to that pattern of retinal hemorrhages.
You can get retinal hemorrhages from many different causes, but the only times we see
[J.M.’s] pattern of retinal hemorrhages in the pediatric population is from abusive head
trauma, severe motor vehicle collisions or there’s some case reports of children who
have fallen out of two or three story windows onto concrete.

Dr. Jones specifically distinguished Dr. Scheller’s theory, testifying that “when the pressure is
high in the brain, you can get retinal hemorrhages,” but they are typically “in the . . . most 

recessed part of the retina . . . surrounding the optic nerve,” which was “not the same pattern
that [J.M.] had.”

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