Analysis of causes that led to rib and skull fractures, sudden illness, intracranial bleeding, and death in the case of toddler

A male toddler suffered from cardiac arrest on May 26, 1988 after receiving amoxicillin. His stepfather, Daniel Childs, performed cardiopulmonary resuscitation (CPR) and called 911. The child was brought to the hospital, resuscitated, and given epinephrine 0.8 mg endotracheally and IV. He had a blood pH of 6.82, infection, and kidney and liver damage. The child was given sodium bicarbonate, antibiotics, and IV fluids. He died 4 days following admission. An autopsy was performed and the medical examiner (ME) found separation of the coronal suture in the child’s skull, a subarachnoid hemorrhage, brain edema, five healing rib fractures, and one acute rib fracture. It was alleged that the child died as a result of blunt trauma. However, the paramedics, physicians, and nurses at two hospitals did not observe any injury caused by trauma on the child’s body. His X-rays and a CT scan of the head did not show skull fracture. Daniel was accused of killing his stepson. He was convicted and sentenced to life in prison. The medical evidence presented in this report indicates that 1) the child’s cardiac and respiratory arrest, pulmonary edema, and liver damage were caused by an allergic reaction to amoxicillin; 2) his subarachnoid bleeding was caused by epinephrine, liver injury, infection, and vitamin K deficiency; 3) the separation of the coronal suture was caused by the increased intracranial pressure which resulted from bleeding and edema; 4) the causes of the healing rib fractures were vitamin K and protein deficiency; 5) the acute rib fracture was caused by CPR; and 6) Daniel is innocent. © Copyright 2008, Medical Veritas International Inc. All rights reserved.