On Friday, I wrote about the sort of case that outrages me every bit as much as cases of cancer quackery that lead to the death of patients. I'm referring to the case of Amanda Sadowsky, a four month old infant who died after suffering traumatic brain injuries that appeared consistent with shaken baby syndrome (SBS). As I've pointed out before, what I've found to be one of the most disturbing antivaccine claims of all is the assertion that SBS is a "misdiagnosis for vaccine injury." As you might recall, SBS is the name originally given to a triad of findings consisting of subdural hemorrhage, retinal hemorrhage, and encephalopathy. More recently, because the syndrome is more complex than the original description suggested, these days the syndrome is more properly referred to as non-accidental head injury or abusive head trauma. This particularly vile antivaccine lie is currently being used by Tonya Sadowski to try to exonerate her husband Elwood Sadowsky, who is currently in prison for having killed their baby. In addition to a passel of contradictory and dubious arguments, Mrs. Sadowski is claiming that vaccine injury was a major cause of Amanda's death. As I learned in the comments of my post from Friday, she even maintains a web page she calls the Amanda Truth Project. If you think the arguments in the original article that brought the Amanda Sadowski case to my attention were bad, you need to check out this website.

Before I start, let me just say: I understand why Mrs. Sadowski might behave this way and might grasp at straws. She lost her baby. That's horribly traumatic loss for anyone to endure. Worse, to add to her trauma, she truly doesn't believe that her husband did it, at least not intentionally. (By her own story, there's really no doubt that at the very least Mr. Sadowski dropped the baby.) She might even have a valid argument; it's hard to know, although Elwood Sadowski does have a criminal background not unlike that of Alan Yurko. Be that as it may, and no matter how much sympathy I might have for her, Tonya Sadowski is doing great harm by using the Alan Yurko defense ("vaccines and other nasty stuff done it"). She begins by invoking the claim that, just because there is a lot that's not known about sudden infant death syndrome (SIDS) and shaken baby syndrome (SBS), her husband has been unjustly accused. While it's true that there is a lot that is not well understood about both conditions, it does not follow from that ignorance that vaccines could be a cause. That doesn't stop Sadowski from writing:

Babies have died and been diagnosed with SIDS when doctors couldn't figure out why. Now the "I don't know" syndrome has been termed: SBS (and often times, usually in the UK, MSbP - see MSbP Myth for more information). Only this time loving parents and caregivers are accused of horrible acts including child abuse, shaking infants and toddlers, striking their heads against objects, etc. (Though this happens, the injuries themselves do not indicate the mechanism for their presence and the bias of SBS is used to diagnose). While it is true that there are those out there who have abused their children, it is also becoming quickly just as true that there are a lot of falsely accused people sitting in jails and prisons, and caregivers' good names are raped in their communities.

And:

Science will catch up eventually, as it always does. [1] the earth is not the center of the universe nor does the sun revolve around the moon, [2] infants do indeed feel pain and therefore most doctors do not operate without anesthesia any longer, [3] FDA recalls drugs every year because they are found too dangerous for the benefits, [4] new studies in the NFL right now are discussing closed head injuries such as that of Natasha Richardson, the actress who died after a skiing accident in 2009, [5] new methods of observation, experimentation and measuring have altered the way scientists believe (such as is Pluto a planet? are there other solar systems and universes? PET scans and fMRIs lead to more knowlege of the brain), [6] new sciences were discovered such as biochemistry, [7] germ theories stopped childbirth fever simply by having physicians wash their hands (a wild idea and it received much scoffing), etc, etc, etc.

This latter argument is known as the "science was wrong before" canard. I mean, jumpin' Jesus on a pogo stick, she even invokes the "demotion of Pluto" canard. The "demotion" of Pluto from being considered a planet is not really evidence that "science was wrong before"; it's more of a case of correcting nomenclature to be more consistent. She also doesn't understand germ theory. Ignaz Semmelweis discovered that requiring practitioners to wash their hands when going from the morgue to the delivery room greatly decreased the incidence of puerperal fever decades before Louis Pasteur demonstrated germ theory to the point where physicians and scientists started to accept it. In fact, part of the reason why Semmelweis encountered so much resistance from his colleagues was because at the time he made his observations, there was no known scientific mechanism to account for his observations. In fact, his observations actually conflicted with the dominant concepts of the time, namely that diseases were due to imbalances of the four humors or caused by miasmas ("bad air"). In fact, it's not unreasonable to speculate that if germ theory had been developed before Semmelweis, his observations would likely have been rapidly accepted as evidence supporting germ theory.

But is it really true that there is an epidemic of false or mistaken accusations of shaking babies to death, with all sorts of innocent parents sitting behind bars for crimes they didn't commit? Certainly no compelling evidence is presented to suggest that this might be true. Worse are the reports on Sadowski's website prepared by Michael Innis and Harold Buttram. They're recycling the same sorts of arguments used to try to get Alan Yurko off, but they're not doing a particularly good job of it given the very evidence that they have posted right there on Sadowski's website.

For example, there are things there like this CT scan report from the hospital to which Amanda was first taken (Fairview Hospital), which found:

Bilateral temporoparietal and right occipital skull fractures. Hemorrhage is seen adjacent to the falx, in the dependent portions of the occipital horns, and in a subtle area of parenchymal hemorrhage in the left parietal lobe. There is an area of decreased attenuation in the left posterior parietal region compatible with a remote injury and focal encephalomalacia.

Note that Amanda presented to Fairview Hospital in full arrest, was resuscitated, and then was flown to Rainbow Babies & Children's Hospital in Cleveland, where from Buttram's report it is not clear whether the following represent a new head CT or an interpretation of the head CT done at Fairview:

Multiple skull fractures. Bilateral cephalhematoma. intraparenchymal, subdural, subarachnoid, and intraventricular hemorrhage. Diffuse loss of sulci and cisterns as well as gray-white differentiation consistent with global edema. Downward herniation cannot be excluded.

This is some major trauma. It is not subtle. The most likely explanation for such massive trauma is, well, trauma. What do Buttram and Innis claim? Dr. Innis claims:

I conclude that Amanda suffered from undiagnosed Neonatal Hepatitis as shown by the abnormal Liver function Tests and as a consequence developed Vitamin K Deficiency Disease which caused her death. An Adverse Vaccine Reaction resulting in a fall in the level of Vitamin C cannot be excluded.

Which is a common theme among conspiracy theorists who think that SBS is in reality some combination of vaccine injury and nutritional deficiencies. Buttram, in particular, likes the idea that vitamin C deficiency is a cause of SBS and that vitamin C deficiency is caused by—you guessed it!—vaccines:

Returning to the importance of vitamin C in relation to vaccines, one of the prime roles of vitamin C in the body is its action as an antioxidant in donating electrons to quench free-radical and inflammatory damage from toxins and/or infections, with our consideration here being vaccine toxins. In the process of donating electrons, vitamin C necessarily becomes depleted. Once the level is reduced to the point that it can no longer protect the brain, which is unduly susceptible to toxic and infectious damage, it (the brain) may become subject to free-radical damage.

This is, of course, utter nonsense. It's also utter nonsense that vaccines commonly cause encephalopathy so severe that it can be mistaken for SBS/abusive head trauma. With this as a way of background, it's not surprising that Buttram does what he does best in his report for the Sadowskis. He Gish gallops. It's vitamin K deficiency that caused bleeding! It's a vaccine reaction! It's rickets making the baby's bones brittle! It's birth trauma! It's liver dysfunction! It's nutrient deficiencies caused by Amanda's mother having been given ampicillin (I kid you not):

The mother did attempt breast-feedings supplemented with formula but ultimately abandoned breast feedings, primarily because of the infant’s difficulty in sucking. Under normal circumstances, breast-feeding establishes a prevalence of highly beneficial and protective Lactobacillus bifidis in the infant’s intestinal flora, but the mother was administered 2 grams of ampicillin intravenously during her labor with Amanda, which would have largely eliminated the L. bifidis. This in turn would have opened the way for yeast infestations, later manifesting as cradle cap, “yeasty” neck folds, and intestinal yeast overgrowth, the true source of the intractable colic and reflux problems. These in turn in all likelihood would have led to unrecognized nutrient mineral and vitamin deficiencies including calcium, magnesium, zinc, and vitamins A, C, and D.

The ridiculousness of this claim speaks for itself. Such are the sorts of arguments used by antivaccinationists who have drunk the Kool Aid that vaccines somehow contribute to a syndrome that is frequently mistaken for SBS/abusive head trauma. I don't know if Elwood Sadowski really did kill his daughter. Maybe he did fall accidentally while carrying her, resulting in fatal injuries. I suppose it's possible (although the story given is not convincing). However it happened, Tonya Sadowski's grief at the death of her daughter does not excuse her abuse of science and embrace of the worst kind of antivaccine pseudoscience in order to exonerate her husband.

Alan Yurko was the prototype for a defense against SBS that fuses antivaccine conspiracy mongering with copious pseudoscience to try to exonerate parents and caregivers accused of SBS. Indeed, if you peruse the website of Mohammed Al-Bayati, the "expert" who wrote a fallacy- and pseudoscience-laden report designed to win Alan Yurko a new trial, you'll see several reports trying to prove that babies thought to have died due to SBS were in fact killed by other causes, many of which find their way into Buttram's and Innis' reports for Tonya Sadowski. Al-Bayati, you might recall, is the same "expert" who produced a particularly risible and nonsensical report that tried to "prove" that Eliza Jane Scovill, daughter of prominent HIV/AIDS denialist Christine Maggiore, didn't die of the HIV encephalitis or Pneumocystis carinii pneumonia found on autopsy, but rather of an allergic reaction to amoxicillin. (I'm tellin' ya, ya can't make stuff like this up).

The bottom line is that the claim that SBS is in reality due to "vaccine injury" ignores the wealth of clinical data indicating that SBS (now more frequently and formally referred to as "abusive head trauma") is a distinct clinical entity that has been well-studied and is probably underdiagnosed. Although there is controversy over the pathophysiology of SBS, how much force is necessary to produce it (hence the additional term to describe it), and whether it's underdiagnosed, whatever controversy there is over the symptoms and findings in SBS, there is no controversy that SBS is not "vaccine injury." When antivaccinationists insist that it is, they abuse science, reason, and morality by using such a myth to exonerate baby killers.