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Reporting Highlights
A Highly effective Physician: Dr. Nancy Harper is a number one youngster abuse pediatrician primarily based in Minnesota. She testifies in felony trials throughout the Midwest, virtually at all times for the prosecution.
Casting Doubt: Protection attorneys and judges have known as Harper’s testimony into query. Two households have filed federal lawsuits in opposition to Harper.
A New Assessment: Prosecutors in Hennepin County mentioned they’re conducting a “remaining, thorough evaluate” of one among Harper’s circumstances that may embrace an analysis of the “medical conclusions.”
These highlights have been written by the reporters and editors who labored on this story.
In courtroom, Dr. Nancy Harper comes throughout as skilled and authoritative. Usually she begins her testimony by explaining her subspeciality: youngster abuse pediatrics, which focuses on the analysis and documentation of indicators of kid abuse. Her position, she typically reminds judges and juries, is solely medical. Whether or not or to not take away a toddler from their residence, terminate the guardian’s rights or, in probably the most critical circumstances, cost a caregiver criminally is less than her.
In accordance with Harper’s testimony, she and her workforce on the Otto Bremer Belief Middle for Secure and Wholesome Youngsters in Minneapolis deal with about 700 circumstances of suspected abuse every year. She has testified that 10% to twenty% of these wind up confirmed for bodily abuse, though it’s tough to find out if these figures are correct since youngster safety circumstances are usually not public.
When Harper, the middle’s director, and her workforce diagnose abuse, mother and father and caregivers typically battle to problem these opinions. By Harper’s personal estimation, she’s by no means been fallacious.
“I don’t assume 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 dying of a kid in her care.
The protection lawyer within the case pressed her: “Have you ever ever incorrectly recognized a toddler 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 fogeys 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 another skilled witness’ determinations or credibility.
Moreover, two federal lawsuits filed not too long ago accuse Harper of ignoring and even concealing various explanations for kids’s accidents. And, extra broadly, medical and authorized specialists are more and more questioning a number one youngster abuse analysis, shaken child syndrome, which is also called abusive head trauma.
A Physician Challenged the Opinion of a Highly effective Little one Abuse Specialist. Then He Misplaced His Job.
Harper didn’t reply to requests for remark. She has but to answer both lawsuit. In previous courtroom testimony, Harper has mentioned that each shaken child syndrome and abusive head trauma are thought of scientifically legitimate diagnoses by the mainstream medical neighborhood. Any controversy, she has mentioned, exists primarily within the authorized world somewhat 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 fee. None,” she mentioned.
Beneath are 4 circumstances by 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 Middle, the place he was declared mind lifeless a day later.
Harper reviewed Cooper’s medical information 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 primarily shaken to dying. Earlier than any felony fees have been filed, Pawlak-Reynolds boarded a aircraft for her native Poland to look after her ailing father, based on 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 understand Pawlak-Reynolds was pregnant when she boarded her flight to Poland. She remained there to provide delivery to their third youngster, who’s now 6, whereas Reynolds remained in Minnesota with their two older kids, who are actually 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 youngster if she reenters the nation. The household has now been separated for eight years.
Sylwia Pawlak-Reynolds’ husband, Will Reynolds, stays in Minnesota with their two older kids.
Early within the case, Pawlak-Reynolds’ attorneys obtained the identical copy of Cooper’s hospital information 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 have been illegible. Two years later, they obtained a second copy, printed at regular dimension, which revealed a attainable alternate rationalization for the accidents: “Mother remembers (affected person) did fall 2 days in the past, placing the again of his head.”
“That was the kind of proverbial silver-bullet proof that we’re at all times searching for in each case and normally by no means discover,” mentioned Brock Hunter, Pawlak-Reynolds’ lawyer.
Polish courts, together with an appeals courtroom, have denied extradition requests from the U.S. thrice, and the nation’s minister of justice has affirmed the rulings. The denials are significantly essential of Harper’s evaluation. Polish forensic specialists evaluated the case information and took notice 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 actual fact was made public, it didn’t have an effect on the actions of the American authorities in any approach,” a Polish district courtroom choose wrote in 2022.
Hennepin Nation Medical Middle
The Hennepin County Medical Examiner’s Workplace licensed Cooper’s method of dying 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, one of the best course for all concerned is to dismiss the pending fees with out prejudice, and for her to return to the US.”
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 evaluate” of the case that may embrace an analysis of “issues concerning the medical conclusions and the general energy of the case.”
Gabriel’s mother and father, 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 data” from her analysis of Cooper, and she or he recognized abusive head trauma to “promote her personal private, tutorial, reputational and monetary wants.”
Harper has but to answer the lawsuit. A spokesperson for Hennepin Healthcare, which operates Hennepin County Medical Middle, 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 crucial to cease this legacy of brutality, that ends in children being taken away from harmless caregivers and harmless caregivers going to jail.”
An previous {photograph} reveals Pawlak-Reynolds and one among her kids
In August 2017, Kathryn Campbell known as 911 after a 4-month-old woman at her day care appeared torpid and was “respiration fallacious.” First responders didn’t take the child to the hospital, however her mom ultimately did. On the hospital, MRI scans confirmed fluid within the child’s mind and medical doctors famous small bruises.
Dr. Barbara Knox, a toddler abuse pediatrician then with the College of Wisconsin, instructed police it was “apparent youngster 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 employees. 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 youngster safety providers staff take kids away from mother and father, 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 Little one 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 have a look at it and go, ‘That is nuts, I don’t agree with this.’ And I undoubtedly was fallacious.”
Harper’s evaluation affirmed Knox’s analysis of abuse. She instructed the jury that the bruises have been doubtless brought on by 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 might 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 continues to be haunted by the accusations in opposition to her.
“That was the toughest factor too, going residence after this case was accomplished, and being like, ‘Am I allowed to be alone with my kids now?’” she mentioned. “It’s all due to the quote-unquote specialists not doing their due diligence and looking out additional into underlying points that these children might 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 keeping with many various medical professionals and specialists in their very own areas of observe.”
“You will need to notice {that a} not responsible verdict by lay jurors hardly invalidates the widespread acceptance of abusive head trauma as a analysis within the medical neighborhood nor wouldn’t it trigger us to have issues about Dr. Harper’s {qualifications} or information within the subject,” he added. “Jurors are usually not certain 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 mother and father 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 several other different kids alone in her residence 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 information, she concluded that his accidents have been “clinically diagnostic of abusive head trauma,” or, put one other approach, Ford shook the child 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 underneath 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 child was not strolling or crawling, the truth that none of his caregivers might 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 child and that there are not any “nice biomechanical fashions” for shaken child syndrome.
Just a little over a month later, Decide Lisa McDougal delivered a extremely essential ruling that barred Harper from telling the jury that the kid died as the results of “abusive head trauma, non-accidental harm, youngster abuse or homicide.” She additionally took subject with the concept an absence of rationalization 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 inside 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 dying. 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 mother and father and a household pal at their residence in Hudson, Wisconsin. Afterward, their 7-week-old son, Fox, turned fussy. Paul Marshall carried him into the mother-in-law unit on the decrease degree of the home, which was cool and darkish, to attempt to calm him. He emerged minutes later in a panic, yelling that the child 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 exams, 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, doubtless rib fractures, metaphyseal fractures.”
“This constellation of findings in a nonambulatory toddler is clinically diagnostic of inflicted harm or youngster bodily abuse doubtless occurring on multiple event,” she wrote.
However the Marshalls mentioned that wasn’t true. They instructed Harper that Sarah Marshall had skilled a tough 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 issues. 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 harm their kids.
“The state wished to solid me as a naive fool,” she mentioned. “I selected to not imagine it due to the logic and details in my face. I had no purpose to imagine 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 health care provider who examined Liana for genetic issues mentioned she couldn’t rule out rickets as a attainable 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 tough. Nelson known as six of his personal medical specialists to counsel that the tough delivery or a vitamin deficiency might clarify the twins’ accidents.
“How many individuals must be fallacious 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. “Fairly, it signifies that they didn’t conclude that the State proved that Paul Marshall triggered the dying, past an inexpensive doubt.”
Paul and Sarah Marshall with their kids at residence, which is adorned with recollections of their son, Fox
Six weeks after the trial, the household moved three hours away right into a century-old farmhouse that’s removed from the neighborhood 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 employees 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 youngster’s chest. As a substitute, a courtroom order put a halt to the process.
“They have been already treating him as proof,” she mentioned.
The expertise of going from a grieving guardian to an accused assassin, her husband mentioned, has given the couple post-traumatic stress. Paul Marshall mentioned he’s grateful to be together with his spouse and kids, however what he calls a “damaged system” has left them uncertain whether or not or to not have one other child and even be left alone with one among their daughters.
“You get pregnant. You go to your whole appointments. You voice your whole issues. You do every thing you’re speculated to do as a guardian and your youngster 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.
