Reporting Highlights
- A Highly effective Physician: Dr. Nancy Harper is a number one little one abuse pediatrician primarily based in Minnesota. She testifies in prison trials throughout the Midwest, nearly at all times for the prosecution.
- Casting Doubt: Protection attorneys and judges have referred to as Harper’s testimony into query. Two households have filed federal lawsuits in opposition to Harper.
- A New Overview: Prosecutors in Hennepin County mentioned they’re conducting a “remaining, thorough overview” of certainly one of Harper’s circumstances that may embody an analysis of the “medical conclusions.”
These highlights had been written by the reporters and editors who labored on this story.
In court docket, Dr. Nancy Harper comes throughout as skilled and authoritative. Usually she begins her testimony by explaining her subspeciality: little one abuse pediatrics, which focuses on the analysis and documentation of indicators of kid abuse. Her function, she usually reminds judges and juries, is solely medical. Whether or not or to not take away a baby from their dwelling, terminate the father or mother’s rights or, in essentially the most severe circumstances, cost a caregiver criminally is lower than her.
In accordance with Harper’s testimony, she and her workforce on the Otto Bremer Belief Heart for Secure and Wholesome Youngsters in Minneapolis deal with about 700 circumstances of suspected abuse annually. She has testified that 10% to twenty% of these wind up confirmed for bodily abuse, though it’s troublesome to find out if these figures are correct since little one safety circumstances usually are not public.
When Harper, the middle’s director, and her workforce diagnose abuse, dad and mom and caregivers usually battle to problem these opinions. By Harper’s personal estimation, she’s by no means been mistaken.
“I don’t suppose I’ve ever had a case the place I believed it was abusive head trauma and the opposite specialist didn’t,” Harper testified in 2023, within the case of a day care supplier charged with the demise of a kid in her care.
The protection lawyer within the case pressed her: “Have you ever ever incorrectly recognized a baby with abusive head trauma?”
“Not at the moment to my recollection,” she answered.
However in a handful of circumstances, judges and juries have discovered day care suppliers and oldsters not responsible of crimes after Harper has testified that abuse occurred, although a verdict can’t essentially be interpreted as a repudiation of Harper or every other skilled witness’ determinations or credibility.
Moreover, two federal lawsuits filed just lately accuse Harper of ignoring and even concealing different explanations for youngsters’s accidents. And, extra broadly, medical and authorized consultants are more and more questioning a number one little one abuse analysis, shaken child syndrome, which is also called abusive head trauma.
Harper didn’t reply to requests for remark. She has but to reply to both lawsuit. In previous court docket testimony, Harper has mentioned that each shaken child syndrome and abusive head trauma are thought-about scientifically legitimate diagnoses by the mainstream medical group. Any controversy, she has mentioned, exists primarily within the authorized world reasonably than the medical one.
Kathleen Pakes, a former prosecutor who now specializes within the forensics of kid abuse circumstances for the Workplace of the Wisconsin State Public Defender, mentioned Harper’s declare of by no means making an incorrect analysis strains credulity.
“There isn’t any different specialty in drugs that has zero error charge. None,” she mentioned.
Beneath are 4 circumstances through which Harper concluded there was abuse however courts or juries decided in any other case.
On July 12, 2017, an 11-month-old boy named Gabriel Cooper collapsed in his excessive chair on the day care that Sylwia Pawlak-Reynolds operated in South Minneapolis. Paramedics took him to Hennepin County Medical Heart, the place he was declared mind lifeless a day later.
Harper reviewed Cooper’s medical data and wrote that “within the absence of a well-documented constant extreme unintended harm, non-accidental trauma or abusive head trauma stays the first diagnostic consideration.” The kid, she wrote, was basically shaken to demise. Earlier than any prison expenses had been filed, Pawlak-Reynolds boarded a airplane for her native Poland to take care of her ailing father, in response to her lawyer. In February 2018, prosecutors charged Pawlak-Reynolds with two counts of second-degree homicide, citing Harper’s analysis.
In accordance with her husband, Will Reynolds, they didn’t notice Pawlak-Reynolds was pregnant when she boarded her flight to Poland. She remained there to provide start to their third little one, who’s now 6, whereas Reynolds remained in Minnesota with their two older kids, who at the moment are 13 and 16. Reynolds mentioned he and his spouse don’t have any confidence that she is going to get a good trial, and that she fears she is going to lose custody of their youngest little one if she reenters the nation. The household has now been separated for eight years.
Early within the case, Pawlak-Reynolds’ attorneys obtained the identical copy of Cooper’s hospital data that had been offered to Minneapolis police, which included the paramedics’ report. The doc had been printed out at a considerably lowered scale, shrinking the textual content to the purpose that some fields had been illegible. Two years later, they obtained a second copy, printed at regular measurement, which revealed a doable alternate clarification for the accidents: “Mother remembers [patient] did fall 2 days in the past, hanging the again of his head.”
“That was the form of proverbial silver-bullet proof that we’re at all times in search of in each case and often by no means discover,” mentioned Brock Hunter, Pawlak-Reynolds’ lawyer.
Polish courts, together with an appeals court docket, have denied extradition requests from the U.S. 3 times, and the nation’s minister of justice has affirmed the rulings. The denials are significantly vital of Harper’s evaluation. Polish forensic consultants evaluated the case data and took word of a discovering by a neurology skilled employed by Pawlak-Reynolds, who wrote that Cooper carried a gene tied to a blood clotting dysfunction.
The ambulance report, the Polish judges wrote, “was hid from the protection.”
“Then, after the very fact was made public, it didn’t have an effect on the actions of the American authorities in any manner,” a Polish district court docket choose wrote in 2022.
The Hennepin County Medical Examiner’s Workplace licensed Cooper’s method of demise as “undetermined” and the date and place of harm “unknown,” a tacit disagreement with Harper’s opinion that Cooper would have collapsed “shortly after infliction of the trauma.”
The Hennepin County Medical Examiner’s Workplace declined to remark.
Then in 2023, Hennepin County Legal professional Mary Moriarty wrote to Pawlak-Reynolds’ attorneys after assembly with them: “We agree that to resolve the present deadlock concerning Ms. Pawlak-Reynolds, the perfect course for all concerned is to dismiss the pending expenses with out prejudice, and for her to return to america.”
However months later, Moriarty modified her thoughts.
In a press release to ProPublica, a spokesperson for the Hennepin County Legal professional’s Workplace wrote that the workplace is finishing a “remaining, thorough overview” of the case that may embody an analysis of “considerations concerning the medical conclusions and the general energy of the case.”
Gabriel’s dad and mom, Joseph and Samantha Cooper, didn’t reply to requests for remark. In a tv interview in June, they denied that Cooper struck the again of his head two days earlier than his collapse. They mentioned that they need justice for his or her son.
Pawlak-Reynolds declined to remark by means of her lawyer. In late February, her husband filed a federal lawsuit in opposition to Harper that claims she “knowingly and deliberately falsified, modified and erased exculpatory info” from her analysis of Cooper, and she or he recognized abusive head trauma to “promote her personal private, educational, reputational and monetary wants.”
Harper has but to reply to the lawsuit. A spokesperson for Hennepin Healthcare, which operates Hennepin County Medical Heart, declined to touch upon the case or the lawsuit.
“There isn’t any oversight,” Reynolds mentioned. “It’s the factor they’re most resistant in opposition to and the factor that’s most important to cease this legacy of brutality, that leads to children being taken away from harmless caregivers and harmless caregivers going to jail.”
In August 2017, Kathryn Campbell referred to as 911 after a 4-month-old woman at her day care appeared torpid and was “respiration mistaken.” First responders didn’t take the infant to the hospital, however her mom finally did. On the hospital, MRI scans confirmed fluid within the child’s mind and medical doctors famous small bruises.
Dr. Barbara Knox, a baby abuse pediatrician then with the College of Wisconsin, instructed police it was “apparent little one abuse.” The Dane County district lawyer charged Campbell with bodily abuse of a kid. Campbell pleaded not responsible.
However earlier than the 2021 trial, Knox left the College of Wisconsin after she was positioned on go away for “unprofessional acts that will represent retaliation” and intimidation of her personal workers. A Wisconsin Watch investigation solid doubt on Knox’s judgment in a number of circumstances of alleged abuse.
Knox didn’t reply to the Wisconsin Watch collection or to ProPublica’s requests for remark. After two households in Alaska sued her in 2022, alleging she had wrongly concluded their kids had been abused, Knox wrote in an affidavit that she has no management over whether or not police and little one safety companies employees take kids away from dad and mom, that she didn’t “conspire” with police or anybody else on custody points, and that she didn’t personally consider one of many kids. The lawsuit was dismissed in 2024 after the households agreed to drop the matter.
Knox moved on to a job on the College of Florida. In accordance with a spokesperson for the college, Knox resigned as a pediatrician with the Youngster Protecting Group in late June, efficient Aug. 15. He declined to touch upon the circumstances.
At Campbell’s trial, Knox’s identify was by no means talked about. As a substitute, Harper stepped in as an skilled witness. When Campbell heard Knox had been changed, she was initially hopeful.
“I’m like, oh, nice, new eyes,” Campbell mentioned. “They’re going to take a look at it and go, ‘That is nuts, I don’t agree with this.’ And I positively was mistaken.”
Harper’s evaluation affirmed Knox’s analysis of abuse. She instructed the jury that the bruises had been possible attributable to squeezing by an grownup’s hand. A medical skilled employed by Campbell’s protection argued that the kid’s bleeding couldn’t be exactly dated and {that a} preexisting medical situation may have triggered it.
After simply two hours of deliberation, the jury returned a not responsible verdict. Campbell mentioned she is grateful to have the case concluded, although she mentioned she remains to be haunted by the accusations in opposition to her.
“That was the toughest factor too, going dwelling after this case was finished, and being like, ‘Am I allowed to be alone with my kids now?’” she mentioned. “It’s all due to the quote-unquote consultants not doing their due diligence and looking out additional into underlying points that these children may have.”
In a press release to ProPublica, Dane County District Legal professional Ismael Ozanne expressed confidence in each Harper and Knox, saying “their testimony had been in line with many various medical professionals and consultants in their very own areas of follow.”
“It is very important word {that a} not responsible verdict by lay jurors hardly invalidates the widespread acceptance of abusive head trauma as a analysis within the medical group nor would it not trigger us to have considerations about Dr. Harper’s {qualifications} or information within the subject,” he added. “Jurors usually are not sure to simply accept any skilled testimony as correct.”
Within the winter of 2022, a 4-month-old boy started respiration abnormally at his day care in Mineral Level, Wisconsin. His dad and mom took him to a hospital, the place he died days later. A police investigation decided that his day care supplier, Joanna Ford, left him and a number of other different kids alone in her dwelling for over an hour whereas she went to a tattoo and piercing parlor.
Prosecutors used Harper as an skilled witness within the case. After evaluating the kid’s medical data, she concluded that his accidents had been “clinically diagnostic of abusive head trauma,” or, put one other manner, Ford shook the infant violently. She was charged with first-degree reckless murder. Ford pleaded not responsible.
Ford’s protection legal professionals efficiently petitioned the choose within the case for a listening to to find out whether or not Harper’s skilled witness testimony could be scientifically legitimate and admissible at trial. In response to questions, Harper defined why the kid’s signs — mind swelling, blood beneath his cranium, injury to his eyes — pointed to abuse, and why, regardless of the controversy surrounding it, the analysis of abusive head trauma was scientifically sound. She additionally defined that, as a result of the infant was not strolling or crawling, the truth that none of his caregivers may clarify his accidents indicated abuse.
“Folks ought to know what occurred,” she testified.
On cross examination by Ford’s legal professionals, Harper mentioned she couldn’t say for sure what time the abuse would have occurred, precisely how Ford had injured the infant and that there are not any “nice biomechanical fashions” for shaken child syndrome.
A bit over a month later, Decide Lisa McDougal delivered a extremely vital ruling that barred Harper from telling the jury that the kid died as the results of “abusive head trauma, non-accidental harm, little one abuse or homicide.” She additionally took difficulty with the concept that an absence of clarification for accidents is indicative of abuse, calling it a “leap in logic.”
“Providing a conclusive opinion as to how an harm might have occurred crosses a line and doesn’t match throughout the dictionary definition of what analysis is,” McDougal mentioned. The choose additionally mentioned that Harper views herself as an advocate, and that that casts doubt on her “constancy to the scientific validation of abusive head trauma diagnoses, particularly when it’s a shut name.”
The homicide cost was dismissed. For leaving the kids alone, Ford pleaded responsible to the lesser cost of neglect of a kid the place the consequence is demise. She is serving a 10-year jail sentence. Ford, by means of her lawyer, declined a request for an interview. The Iowa County district lawyer additionally declined to remark.
On Feb. 4, 2022, Paul and Sarah Marshall hosted a dinner for her dad and mom and a household good friend at their dwelling in Hudson, Wisconsin. Afterward, their 7-week-old son, Fox, grew to become fussy. Paul Marshall carried him into the mother-in-law unit on the decrease stage of the home, which was cool and darkish, to attempt to calm him. He emerged minutes later in a panic, yelling that the infant spit up and stopped respiration.
Paramedics rushed Fox to Youngsters’s Minnesota, a hospital about 25 minutes throughout the state border in St. Paul. Medical doctors ran checks, and a scan confirmed Fox had a cranium fracture with fluid pooling on each side of his mind. He died days later.
Harper examined Fox, in addition to his twin sister, Liana, and located “cranium fractures, possible rib fractures, metaphyseal fractures.”
“This constellation of findings in a nonambulatory toddler is clinically diagnostic of inflicted harm or little one bodily abuse possible occurring on multiple event,” she wrote.
However the Marshalls mentioned that wasn’t true. They instructed Harper that Sarah Marshall had skilled a troublesome being pregnant with gestational diabetes and extreme anemia, and that Liana had a vacuum-assisted supply. Each twins had been to their common pediatrician over well being considerations. Whereas Liana’s well being improved, Fox’s had not.
A spokesperson for Youngsters’s Minnesota declined to touch upon the case.
As a result of he was the final individual alone with Fox earlier than he stopped respiration, Paul Marshall was charged with first-degree reckless murder. He was additionally charged with bodily abuse of a kid for hurting Liana. Sarah Marshall mentioned there was no proof that her soft-spoken husband had damage their kids.
“The state wished to solid me as a naive fool,” she mentioned. “I selected to not consider it due to the logic and information in my face. I had no purpose to consider the accusation.”
At Paul Marshall’s 2023 trial, his protection lawyer, Aaron Nelson, cross-examined the opposite medical doctors who handled or evaluated Fox and Liana, and was capable of spotlight factors of medical disagreement. A physician who examined Liana for genetic issues mentioned she couldn’t rule out rickets as a doable explanation for her bone fractures. A neuropathologist didn’t agree with Harper that Fox had a trauma-induced blood clotting dysfunction. By Harper’s personal admission on cross-examination, figuring out the age of the cranium fractures in kids Fox and Liana’s age was troublesome. Nelson referred to as six of his personal medical consultants to recommend that the troublesome start or a vitamin deficiency may clarify the twins’ accidents.
“How many individuals must be mistaken for Dr. Harper to be proper?” Nelson mentioned in closing arguments.
After an 11-day trial, the jury discovered Marshall not responsible.
In a press release to ProPublica, St. Croix County District Legal professional Karl Anderson identified that Harper was not the one treating doctor who was involved that Fox and Liana had been abused.
“A not responsible verdict doesn’t imply that the jury concluded that the kids weren’t abused,” Anderson mentioned. “Moderately, it implies that they didn’t conclude that the State proved that Paul Marshall triggered the demise, past an inexpensive doubt.”
Six weeks after the trial, the household moved three hours away right into a century-old farmhouse that’s removed from the group that they felt wrongfully villainized by.
One of many cruelest impacts of the abuse analysis, they mentioned, got here after it was clear that Fox would die and the hospital workers started making preparations for his organs to be donated. Sarah Marshall mentioned she had hoped to sometime hear her son’s coronary heart beating in one other little one’s chest. As a substitute, a court docket order put a halt to the process.
“They had been already treating him as proof,” she mentioned.
The expertise of going from a grieving father or mother to an accused assassin, her husband mentioned, has given the couple post-traumatic stress. Paul Marshall mentioned he’s grateful to be along with his spouse and kids, however what he calls a “damaged system” has left them not sure whether or not or to not have one other child and even be left alone with certainly one of their daughters.
“You get pregnant. You go to all your appointments. You voice all your considerations. You do all the things you’re purported to do as a father or mother and your little one nonetheless dies. And the state tells you it’s your fault,” Sarah Marshall mentioned. “I don’t perceive why I reside in a world like that.”
Mariam Elba contributed analysis.
