Medical examiner says Palm Harbor infant's death was not 'shaken baby syndrome'

LARGO — A 1-year-old girl who died after her first stay in a Palm Harbor day care home in 2008 was killed by "blunt head trauma," Pinellas-Pasco Medical Examiner Jon Thogmartin testified on Thursday

But he didn't say Maria Harris died of "shaken baby syndrome." Thogmartin said he's not even sure there is such a thing.

Thogmartin's testimony showed that the murder case against former day care owner Stephanie Spurgeon will rest on some highly technical medical testimony .

But it also revealed the increasing controversy over shaken baby cases in general.

Nationwide, experts have been re-evaluating the science behind the diagnosis of shaken baby syndrome, and some no longer consider it valid. The American Academy of Pediatrics now favors the term "abusive head trauma" to describe such injuries.

This doesn't mean anyone doubts that shaking a baby can be harmful, even fatal. But in traditional shaken baby cases, babies are said to have been shaken so much that they suffer severe brain injuries, even when there are no additional symptoms such as a snapped neck or a bruise to the head. Now, some doctors question whether it would be possible to shake a baby so violently without also causing the other symptoms.

Thogmartin, the top forensic pathologist for Pinellas and Pasco counties, is a key witness for the prosecution of Spurgeon, who would face life in prison if convicted.

But defense attorney Ron Kurpiers led Thogmartin into the nationwide controversy by asking: "Ever heard the phrase 'shaken baby syndrome?' "

"I've heard it," Thogmartin said.

"Do you believe in it?"

"No," Thogmartin said. He later clarified, saying common sense would tell you that shaking a baby is bad. But shaking a baby violently enough to create severe brain injuries probably also would create other injuries to the child's neck or torso, he said.

Maria didn't have those kinds of injuries.

Kurpiers asked Thogmartin if he recalled giving an interview on the PBS show Frontline, but dropped the question after Assistant State Attorney Holly Grissinger objected.

In an online version of the interview, Thogmartin said, "I am not saying that shaken baby doesn't exist; I have never seen one." Having investigated so many deaths over the years, without ever seeing a case that matches up exactly to the shaken baby diagnosis, he added, "After a while, you start becoming a little cynical about it and skeptical about its existence."

What's not clear yet is whether the uncertainty about shaken baby syndrome as a diagnosis will bolster Spurgeon's defense. Thogmartin stated firmly that Maria died from "blunt head trauma" and that the death was a homicide.

Kurpiers has previously told jurors that no one "saw or heard or witnessed Stephanie Spurgeon harm Maria Harris. Not one."

But prosecutors also have laid out the circumstances behind Maria's death. The girl's pediatrician gave her a one-year check-up just days before she went to the day care in 2008, and she was fine. Her grandmother Patricia Harris said the girl was normal when she dropped her off at the day care, but seemed as limp as "a bag of rice" after she picked her up that afternoon.

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After relatives called 911, the girl was hospitalized and eventually put on life support, which was removed a week later.

Another medical examiner, Dr. Stephen Nelson, also testified on Thursday that Maria's death was because of "blunt trauma."

Dr. Sally Smith of the Pinellas County Child Protection Team said, "It was not accidental, it was an abusive injury."

How could any child die from head trauma without injuries to the outside of their head? Smith said a child could receive such injuries if they were thrown repeatedly onto a soft surface such as a bed, damaging the brain inside the skull.

But so far, no prosecutor or witness has attempted to explain exactly what they think Spurgeon did to the girl.

Other doctors also testified for the prosecution on Thursday before the state rested its case. Defense experts will begin presenting their side Friday. The trial is expected to continue into next week.

Curtis Krueger can be reached at ckrueger@tampabay.com or (727) 893-8232.