Western Morning News                                                                            February 14, 2003

Convincing case against 'expert'

Professor Sir Roy Meadow was regarded as a respected authority on cot deaths in this country. It was his evidence that helped to persuade the jury that solicitor Sally Clark had killed her two baby boys, Harry and Christopher. His work led to "Meadow's Law" - the loss of one baby to cot death is tragic, two is suspicious and three is murder. He was convinced - and what's more he managed to convince others - that the chances of two cot deaths in
the same family are 73 million to one.

John Sweeney's sensitive and impressive essay on the issue compared the way mothers of cot death babies had been subjected to the equivalent of a modern day witch-hunt.

Professor Meadow's evidence was dismissed every step of the way. The mathematical equation he used to calculate the chances of more than one cot death in the same family was fundamentally flawed.

The chances of having a second cot death are dramatically increased after one child is lost because doctors are now identifying genetic links.

Forensic pathologists discovered that some cot death victims had no way of fighting infection because a vital part of their immune system was missing.

When the immunity they inherited from their mother disappeared at about 12 weeks, they were vulnerable to infection.

Sally Clark now appears to be the lucky one amongst Professor Meadow's "victims". Her husband and father - who both contributed moving interviews to this programme - is free after an appeal dismissed the professor's evidence in the original trial.

Sally was in prison with Westcountry mother Angela Cannings who lost three children to cot deaths. She was convicted last April for killing two of them, despite genetic evidence that should have cleared her.

There was also the outrageous example of a couple from the West Midlands. There first child, a boy, was taken to hospital when he was taken ill.

He made a reasonable recovery but was kept in hospital. After his parents had left, he suffered a heart attack and consequently died.

Sir Roy's opinion - in a closed family court - was that the boy had been killed by his parents. No criminal proceedings were brought, but the mother, who was pregnant at the time, was forced to hand over her second child, a daughter, to social services when the baby was 25 minutes old.

The little girl has now been formally adopted. The parents - who cannot be named - cling on to the fact that maybe one day she will want to come and find them.

In the meantime, they cherish boxes of toys and clothes from the two children they have lost.

Sally Clark has vowed to fight on for Angela Cannings. The evidence that John Sweeney presented seemed clear. She is in jail on the strength of a now discredited witness. Let's hope that the authorities take note.

http://www.westernmorningnews.co.uk

 

Sunday Telegraph Magazine                                                                   February 16, 2003 

BACK FROM HELL

 

By: Bob Woffinden

Sally Clark was another Lindy Chamberlain, branded a monster mother and sent to rot in jail for murdering her babies. But then her husband uncovered the evidence that would bring her

It's almost impossible to imagine Sally Clark's pain. To imagine the utter anguish of a mother who lost a son when he was just 11 weeks old to sudden infant death syndrome. To imagine what it would then be like if the nightmare happened to a second baby boy, this time found inexplicably slumped dead in his bouncy chair eight weeks after his birth.

The sudden death of not one, but two babies is a tragedy almost beyond comprehension. But for Sally, a 34-year-old British solicitor, it was only the beginning of a horror story of unimaginable proportions in which she was accused of murdering her babies, branded as a psychologically disturbed and unloving mother, convicted of infanticide and, in November 1999, sentenced to life in jail. The case turned on complex medical evidence and statistics
that, after the trial, were shown to be spurious - in particular, one prosecution witness made headlines by claiming that the likelihood of two such deaths occurring in one family was 73 million to one. It involved a couple who, in their own eyes, were hardworking, decent young professionals, making their way up in the world. But in the aftermath of the conviction
Sally was portrayed as a selfish, grasping, depressive career-obsessed woman who liked pretty clothes, and who first abused and then murdered her children because they ruined her figure and stood in the way of her lucrative future. According to which paper you read, for instance, on the day she murdered Harry she had twice popped out to her local bottle shop to
buy, in total, seven, eight - or was it nine? - bottles of wine.

It was a compellingly sordid tale that the British press, and to a lesser extent Australian newspapers, covered with a mix of relish and horror. As Australia's Lindy Chamberlain could attest, there is no figure more reviled than a mother accused of the ultimate evil - murdering her baby. But two weeks ago we learned that, just as with Lindy Chamberlain, it had all been a
terrible, terrible mistake. On January 30, Sally was released after three years in prison, when the British Court of Appeal found vital medical evidence had been withheld during her trial. Sitting in the dock of the packed courtroom, Sally, now 38, cried as the verdict was read. Her husband, Steve, clasped his hands to his face as though in prayer.

Outside the court, looking pale and gaunt, with eyes haunted by pain, Sally's voice faltered as she thanked her husband for his unswerving support. "He has stood by me and supported me through the whole nightmare, not through blind love or unthinking loyalty, but because he knows me better than anyone else and knows how much I loved our babies."

It was Steve, a fellow lawyer, who finally unearthed the vital medical evidence that convinced the appeal court judges to overturn Sally's conviction. Throughout the five-year ordeal he never wavered in his insistence of his wife's innocence. He had to sell their $900,000 home to
pay legal fees and lost a lucrative partnership at his law firm when he moved to be near the prison. And he campaigned for two years to get the medical records of his second son, Harry, which revealed he probably died due to lethal bacterial infection, not from being shaken by his mother, as the jury had decided.

One British MP has described the case as "one of the biggest miscarriages of justice in recent British history". The government pathologist who carried out the post-mortem on both babies and was a crucial expert witness for the prosecution is facing investigation by Britain's General Medical Council and lawyers predict Sally will receive hundreds of thousands of pounds in
compensation for loss of earnings, false imprisonment and the shattering damage to her reputation. But nothing - no apology, no amount of money - can ever return her life to what it was before.

Sally describes her childhood as "quite idyllic". She was born in Wiltshire in 1964, the only child of a hairdresser, Jean, and a senior policeman. Her father, Frank Lockyer, said of Sally: "She wasn't naturally brilliant, but she was a very hard-working girl. She carried the cross at school that all policemen's daughters carry: that they're expected to be a little bit better than everybody else in their behaviour, same as the parson's daughter."

After graduating from Southampton University, she joined Lloyds Bank and then Citibank in London, where she met Steve, a financial lawyer. The couple married in 1990, and three years later decided to move out of the capital so they could buy a house large enough for a family. Both got jobs with leading law firms in Manchester and in 1995 they moved into Hope Cottage, a comfortable house in Cheshire. Their first son, Christopher, was born on September 22, 1996. Apparently healthy, he was voted "best-looking baby" in Sally's post-natal class. Pam Grieve, her local visiting nurse, said Sally was an excellent mother.

On December 13, Steve went to his office Christmas dinner. His wife was alone at home with Christopher. After feeding him at 7.30pm, she put him down to sleep in the couple's bedroom. At about 9:15, she went to the kitchen to make a cup of tea. When she returned, she saw that the baby - who was, she says, in his Moses basket - had turned grey. She phoned emergency
services at 9.35pm and an ambulance arrived within two minutes. Sally, though, was hysterical, and unable to let the crew in; the front door was deadlocked and she couldn't find the keys. Finally a neighbour who had a key heard the commotion and let them in. Despite attempts at resuscitation it was too late. Christopher was taken to hospital and pronounced dead at
10.40pm.

A post-mortem was conducted on December 16 by Dr Alan Williams, the local government pathologist; photographs were taken by police. Williams' report referred to "a small split and slight bruising in the inner lip and some bruising on the legs", injuries which he decided were consistent with the resuscitation attempts of hospital staff. Dr Jane Cowan, the hospital
consultant pediatrician who had first seen Christopher, agreed. Dr Williams certified that the child had died of a lower respiratory tract infection.

Sally Clark had been distraught over her son's death - suspiciously so, according to the prosecution; as distraught as might be expected, according to Dr Cowan. The Clarks decided the best way to overcome their grief was to have another child. Harry was born on November, 29 1997, three weeks premature, but apparently healthy.

The Clarks participated in a support program offered to parents who have lost a child through cot death. Like all children in the scheme, Harry had a full medical examination at 12 days. The parents were given resuscitation training, growth charts to record the baby's progress and a thermometer to ensure correct room temperature. They were also given an apnoea alarm to
monitor respiration, which would sound if the baby stopped breathing. (Harry's alarm seems to have been faulty. Sally says it often sounded even when there was no apparent problem.) Regular support was provided by health visitor Elizabeth McDougall, who visited the home weekly. In her statement to police, McDougall said she found Harry to be well and making steady progress, and described Sally as "coping well with breast-feeding (and)
happy and delighted with her new baby".

On the morning of January 26, 1998, Sally took Harry out to nearby shops. At about 2pm she rang McDougall and told her the apnoea monitor had repeatedly sounded; at 3.35 McDougall arrived with a new one. Later Sally took the baby to the health centre, where he was vaccinated against diphtheria, pertussis, tetanus and polio. Sally was given a post-natal check by Dr Kathleen Case, who later told police there "were no problems" and that Sally appeared
"cheerful".

Steve arrived home from work at about 8pm. Almost 90 minutes later, he was in the kitchen preparing a bottle for the baby, when his wife screamed from their upstairs bedroom. Harry was slumped forward in his bouncy chair and had turned blue. An ambulance arrived nine minutes after Sally's 9.27pm emergency call and found Steve attempting resuscitation, following advice being given over the phone by emergency services. Harry, though, did not
respond; he was taken to hospital and pronounced dead at 10.41pm. That the two children died at almost exactly the same time was something the prosecution made much of.

In view of this second death, Dr Cowan told police it was essential the post-mortem be conducted by a specialist pediatric pathologist. However, it was again carried by the general pathologist, Dr Williams, in the presence of police. He found tears in the brain, "severe injuries" to the spine, one dislocated rib and what he described as a "possible old fracture" of another. He concluded that "the spinal injuries and lesions in the brain and eyes are those that would be expected from non-accidental injury" and that Harry had been shaken on several occasions over several days.

When police arrived at Hope Cottage on February 23, 1998, Sally Clark assumed they had information about the cause of Harry's death and began making them cups of tea. Instead they had come to arrest her and Steve on suspicion of murder. Taken in for questioning, both were naive enough - and shocked enough - to waive their rights to a solicitor. The answers Sally
gave during three 40-minute sessions that day provided police, and later the media, with material that was used against her - material the Clarks say was wilfully misinterpreted.

For example, she told police she had been "a wee bit apprehensive" about a business trip to Glasgow Steve had planned for January 27, the day after Harry's death. The prosecution used this remark to claim she was unable to cope with the prospect of her husband's absence and had murdered Harry to prevent him going; in fact she was worried Harry might suffer an adverse reaction to his vaccinations.

She also spoke to the police about her drinking. She told them she had become depressed after the move to Hope Cottage, where she felt isolated. She explained: "I got very low and cried an awful lot during that period." She began drinking to alleviate her loneliness - she says "two or three gin and tonics on a Saturday afternoon." In '96, she admitted, she had "a couple
of binges" during the early stages of her pregnancy with Christopher and her drinking frequently got out of control. Indeed, in April 1997, four months after Christopher's death and two months into her next pregnancy, she sought psychiatric help. But she was not, she told police, drinking by the end of the pregnancy, nor in the weeks prior to Harry's death.

This, though, was peripheral: Dr Williams' post-mortem report spoke of "non-accidental injury" and on February 27, he took slides of Harry's eyes to Michael Green, emeritus professor of forensic pathology at Sheffield University. Williams believed he had detected retinal haemorrhages in both eyes; Green confirmed this finding. Together with the tears in the brain and the spinal injuries, these haemorrhages were crucial evidence the baby had been shaken to death.

Green and Williams then re-examined preserved tissue taken during Christopher's post-mortem. They found there was extensive fresh bleeding and old bleeding in the lungs. This, combined with the damage to the lip, led them to the new conclusion Christopher had been smothered, and these findings were passed to police. On July 2, 1998, Sally Clark was charged with the murders of both children. On November 29, while the case against her was in preparation, she gave birth to a third son, now four. The boy, who cannot be named for legal reasons, was taken from his parents at birth and spent his first year in foster care before Steve successfully fought to get him back. 

At the committal hearing on May 24, 1999, a difference of opinion between Dr Williams and Prof. Green, both of whom were appearing for the prosecution, emerged. Although Williams maintained there had been fresh blood in Christopher's lungs, Prof. Green now disagreed. If there was, as he said, "no evidence of recent significant haemorrhage", then smothering was an
unlikely cause of death.

However, the damage to the prosecution's case was soon repaired by another expert witness, Sir Roy Meadow, emeritus professor of pediatrics at St James University Hospital, Leeds. He said he knew of other proven cases of smothering in which there had been no fresh blood in the lungs and agreed to provide the defence with his research data on these cases. He also said the chances of two deaths like those of Christopher and Harry occurring naturally in a family were one in a million - he was later to produce the even more damning statistic of 73 million to one. The magistrate decided Sally Clark had a case to answer and committed her to trial on October 11, 1999.

Just three days before the trial, the defence team finally obtained the vitally important slides that supposedly showed retinal haemorrhages of Harry's eyes. The defence called on expert witness Prof. Philip Luthert, consultant histo-pathologist at the Institute of Ophthalmology, and Prof. Green to examine the slides. They could find no sign of haemorrhage. Green rang the crown's QC, Robin Spencer, and told him this. By this stage another prosecution expert, Dr Christine Smith, a consultant neuropathologist, had also examined the slides and found no sign either of tears in the brain or of damage to the spinal cord. The crown's crucial evidence of the so-called "classic triangle" of injuries in baby shaking cases: spinal damage, tearing in the brain and retinal haemorrhages, had evaporated; shaking was not the cause of Harry's death. Prof. Luthert expected - naively he told one journalist - the charges would be dropped.

But Robin Spencer opened his case on the basis that Harry had been either shaken or smothered. By the end of the trial he was asserting that both boys had been smothered, and that both had also been the victims of assaults prior to death. He may have been encouraged by some new evidence from Prof. Meadow, who, a week before the case was due to start, had ridden to the prosecution's rescue once again, making a statement to police that, on the
basis of a new, then-unpublished government report on deaths in infancy, the risk of these two deaths having occurred by chance was one in 73 million.

Amid the long, complicated evidence about intra-alveolar haemorrhages, haemosiderin-laden macrophages and other abstruse medical arcana, Meadow's one-in-73-million statistic seemed luminously clear, and the figure was cited in every British newspaper. Meadow further told the court that, put another way, this meant that a British family would suffer by chance an
unexplained double child death "about once every 100 years".

This was certainly easier to take in than the arguments about death by smothering. The overriding problem with trying to ascertain death by smothering is that both the presence and the absence of a variety of physical signs can be consistent with smothering. Indeed, Meadow maintained in his paper Unnatural Sudden Infant Death, that one of the characteristics
of death by smothering is that "the corpse appears normal". Certainly in Harry's case, no signs of smothering were discerned by medical staff or at post-mortem.

Another difficulty arose from the fact that all medical evidence in both cases was based on the post-mortems carried out by Dr Williams, and the tissue sample and slides he had prepared. Much doubt was cast upon his findings from both sides - for example that the tears in the brain, the subdural haemorrhage in the spine and the retinal haemorrhages had never existed. Defence witness Jem Berry, professor of paediatric pathology at the University of Bristol, told the court: "I have never before been involved in a case where so many of the original findings either failed to exist or crumbled to dust upon critical examination."

Williams' post-mortem, on which the prosecution was basing its assertion that Harry had suffered earlier episodes of abuse, also referred to one "possible" fractured and one dislocated rib. However, other expert witnesses noted the absence of damage to the surrounding tissue - which would have been expected if previous abuse had taken place. One eminent consultant
pediatrician said she "could not exclude the possibility" that the rib damage was caused by the dissection of the body during post-mortem. As well, there had been no visible sign of abuse to either child during his short life. No one ever witnessed Sally harming or ill-treating her children. No one who saw her with them suggested she was anything other than an ordinary,
caring, devoted mother. When taken to hospital, both children were seen by medical and nursing staff, ambulance men and police officers. None saw any marks or bruising on either child. Photographs of supposed bruises on Christopher's body were of poor quality and the lip tear could have resulted from the use of a laryngoscope during attempts to resuscitate the child at hospital; in fact that was the explanation originally given to police by Dr Cowan, the hospital pediatrician.

With the medical evidence in such disarray, the prosecution put great weight on more circumstantial evidence. An important part of their case revolved around the similarities in the two deaths. Robin Spencer argued that both children were found by Sally in the same room, in the same bouncy chair, at approximately the same time of day, a time when, statistically, babies are less likely to die natural deaths. (Most sudden natural deaths of infants occur between midnight and 11am). Both were about the same age. On each occasion she was alone with the child. On the first her husband was away; in Harry's case he was about to go on a business trip; the implication was that she was so fragile she murdered the children to ensure Steve's presence. The defence countered that these alleged coincidences were either meaningless or simply wrong - Christopher, for instance, was in his Moses basket.

Yet the prosecution still had that towering piece of evidence: Prof. Meadow's one-in-73-million statistic. Summing up, the judge, Mr Justice Harrison, advised the jury that the statistics appeared "compelling" and that they should "attach some significance" to the figures. He reiterated Meadow's remark that "there is a chance of two SIDS in the same family
happening every 100 years". To the jury, it must have seemed as if innocence was a statistical impossibility. Sally Clark was convicted on each count of murder.

Alas, Meadow's statements were not as solid as they seemed. He never did provide the data on the absence of blood in the lungs in other proven cases of smothering he had promised the defence; after some delay, he said that his secretary had mistakenly shredded it. Nor did his famous statistic survive. When the report on which he had based the 73 million figure was
published, it stated that a family suffering one unexplained death was at greater risk of a second, and that there had been five double "unascertained" child deaths in Britain in the previous three years.

Though the damning statistic had been discredited by the time of Sally's first appeal in 2000, her lawyers could still offer no explanation for the deaths and her convictions were upheld. It wasn't until November 2001 - three years after Harry's death and two years after his wife's conviction - that Steve finally obtained a copy of Harry's medical records. Within the piles of notes he found a document which at last provided some support to his conviction that his wife was innocent. "At first I didn't understand the significance of them," he said. "But when I showed them to the experts, they said 'Eureka'. We knew we had new evidence which was crucial. But it took another 15 months in which my wife stayed in prison before we were able to put it to the Appeal Court."

The results of blood tests on Harry, spelled out in the newly discovered document, showed his body was riddled with potentially lethal staphylococcus aureus bacteria, suggesting he had died from natural causes. Dr Williams, who carried out both post-mortems, had seen the report but it was never disclosed to the defence, even after he was asked specifically about such
tests. As had happened with the spurious identification of foetal blood samples in the Chamberlain case, the testimony of a key prosecution expert witness had been thrown into doubt.

The Criminal Case Review Commission referred the matter back to the Court of Appeals, which described the new evidence as "devastating". Lord Justice Kay said the courts had reached conclusions "wholly unaware of this aspect of the matter", adding that Dr Williams had failed to share "information that a competent pathologist ought to have appreciated needed to be assessed before any conclusion was reached". Given that Dr Williams' evidence had been
discredited, Clark's lawyers argued the whole process of the police inquiry and trial had gone awry. The judges agreed. Sally Clark could go free.


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