MN Physician Challenged Baby Abuse Specialist Dr. Nancy Harper’s Opinion. Then He Misplaced His Job. — ProPublica

On a February afternoon in 2022, Dr. Bazak Sharon logged right into a distant video assembly from his house workplace in Minneapolis. He propped up his cellphone subsequent to his laptop computer and hit file on a video app.

There have been a number of folks within the assembly with Sharon, who on the time was a pediatrician with the College of Minnesota. Two hospital leaders, Sharon’s boss and a lawyer had been there, too. However the particular person Sharon was most cautious of was within the lower-right nook of the grid of faces: Dr. Nancy Harper, the director of the kid abuse workforce at College of Minnesota Masonic Kids’s Hospital in Minneapolis.

Sharon suspected that the dialogue, in regards to the care of a 3-month-old named Hank, was going to be contentious. He apprehensive that sometime, even perhaps in court docket, he may want proof of his function caring for Hank. He was ready to argue with Harper if she challenged his scientific judgment, but it surely was rapidly obvious that the standard of the care he offered was not at situation.

Hank was born small and was not consuming effectively or gaining sufficient weight; typically, based on his mother and father, he simply gave the impression to be in ache. (ProPublica is utilizing a nickname for the kid on the mother and father’ request.) At an appointment in January, a health care provider ordered an endoscopy, a process the place a tiny digital camera is threaded via the physique, and in addition recommended an MRI.

The scans of Hank’s mind confirmed fluid pooled underneath each side of his cranium. The blood was previous, probably months previous, and Hank was admitted to the hospital. Sharon met him the subsequent day.

A member of Harper’s workforce named Dr. Caroline George additionally evaluated Hank that day. In her opinion, based on court docket data, the bleeding was “in keeping with abusive head trauma.” Sharon had recommended different doable causes, together with an damage from beginning, an an infection and even spontaneous bleeding. Sharon wrote within the baby’s medical file that it’s “probably we’ll by no means establish the precise mechanism that brought on his damage.”

Three days after Hank was admitted, Sharon stated he discovered {that a} county baby safety companies employee was making ready to come back to the hospital to take custody of the infant, in addition to his 2-year-old brother, William.

Sharon stated that he was shocked that nobody had spoken to him since he was Hank’s main physician. So he did one thing that appeared to place him at odds with George, Harper and hospital management: He instructed Hank’s mother and father, CPS and police he didn’t suppose the bleeding alone was sufficient proof to say this was abuse.

Sharon was additionally involved that separating a sick toddler from his mother and father based mostly solely on a suspicion of abuse would trigger extra hurt to Hank. Working with the detective assigned to the case, he admitted William, although the older boy was not sick, in order that the entire household might keep within the hospital underneath the supervision of a nursing assistant whereas docs continued to deal with and monitor Hank.

However 4 days later, based on Sharon, his supervisor instructed him that he was being faraway from Hank’s care workforce, and that he shouldn’t talk additional with the mother and father. When Sharon requested why, he stated he was instructed it was at Harper’s advice. “The care,” he stated, “modified the second she obtained concerned.”

In lower than 48 hours, a choose decided that Hank and William had been in want of kid safety companies and their mother and father had been pressured to depart the hospital with out them. The identical day, Sharon stated, he was summoned to the primary of two conferences with hospital management and Harper. When his supervisors scheduled the second assembly — titled “Evaluate of CPS Affected person” within the emailed invitation — lower than a month later, Sharon got here ready to file it.

Earlier than all this, Sharon had an appreciation for Harper’s formidability and for her affect on the earth of kid abuse pediatrics. She started her profession as a pediatrician within the U.S. Navy earlier than main a baby abuse workforce at a hospital in Texas. In 2014, she turned the director of the College of Minnesota’s Heart for Secure and Wholesome Kids.

An authorized baby abuse pediatrician for nearly 16 years, the 56-year-old Harper consulted on suspected circumstances of abuse for a number of Twin Cities hospital methods, testified as an professional witness in baby abuse trials throughout the U.S. and lectured on diagnosing indicators of abuse. She was additionally the vp of the Ray E. Helfer Society, a nationwide nonprofit group for physicians who work on the medical facets of kid abuse and neglect, and he or she turned its president in 2023.

Sharon, now 53 years previous, was additionally well-respected. Initially from Israel, he got here to the U.S. in 2003 to proceed his medical research. He started as a fellow on the College of Minnesota in 2006 and had been on school for 12 years. Specializing in infectious illnesses, he turned medical director of the college’s pediatric COVID-19 clinic and was a contributing member of the state Well being Division’s Lengthy COVID Guiding Council. Sharon was additionally a hospitalist, which means he directed the take care of admitted sufferers like Hank, coordinating with different docs and specialists.

As the net February assembly progressed, it turned clear to Sharon that, in a face-off with Harper, his medical experience and the truth that he thought-about most of the folks on the decision to be associates counted for little. The lawyer famous that differing medical opinions might open the hospital or the docs themselves as much as a lawsuit. George added that the variations in opinions had additionally “made issues troublesome for notably regulation enforcement.”

“I’m not a baby abuse professional,” stated Dr. Sameer Gupta, the chief medical officer of the hospital, on the decision. “However, you understand, my expertise is that this: Attempt to be fully aligned. That’s one story that’s coming from the medical workforce as a lot as doable, to keep away from the potential for, one, litigation, two, to let the specialists actually drive the ship.”

Sharon turned more and more agitated throughout the name, shaking his head. He was offended that the dialog had revolved round protocols and the hospital’s authorized liabilities, reasonably than Hank’s care.

“I feel I did the most effective any physician can do at that time in ensuring that my affected person is getting the most effective care whereas I’m not making an attempt to cover any potential abuse,” he stated throughout the assembly, the video of which he shared with ProPublica. “I felt very uncomfortable that CPS are displaying up unannounced and taking two youngsters away from the mother and father with out having a dialogue with the docs who handle this affected person. I hope nobody expects me to not say one thing when that occurs in entrance of me.”

However Harper appeared to counsel that Hank may need been seen by too many docs, and that Sharon had interfered together with her workforce’s capability to “body” the case to CPS and regulation enforcement. She stated she didn’t think about it her function to be involved about what might occur to a household after a prognosis.

“Sadly,” she stated, “if I spent all of my time worrying about … what’s going to occur with baby safety and foster care or the associated fee for the authorized stuff afterwards, I wouldn’t be capable to do my job.”

Sharon started to protest. He stated he had been studying the scientific literature on abusive head trauma and located it unconvincing, a conclusion an increasing number of docs had been coming to. Harper reduce him off. “If I spent two weeks studying the literature on COVID, would you think about me as certified as you might be?” she requested. “I’ve been doing this for many years.”

Gupta abruptly shut down the dialog. He stated that Sharon’s plan to maintain the household within the hospital was the “flawed resolution and can by no means, ever occur once more,” after which he ended the decision.

Because the display screen went clean, Sharon set free an extended, deep sigh. Although disturbed and annoyed, he didn’t but understand his actions on behalf of Hank and his household would have an effect on his profession. Over time, Sharon got here to see Harper as the principle driver of a marketing campaign to get him to fall according to the kid abuse workforce.

“She’s very black and white, proper and flawed, no grey space,” he stated, “which isn’t the way in which to do medication or pediatrics.”

Harper didn’t reply to requests for remark. She and a spokesperson for College of Minnesota Physicians, which is the scientific apply for the college’s medical college school, additionally didn’t reply to an in depth checklist of questions. However the spokesperson wrote that the Otto Bremer Belief Heart for Secure and Wholesome Kids, as it’s now known as and which is led by Harper, supplies “trauma-informed medical care and psychosocial assist whereas addressing analysis, prevention, advocacy, coverage and training.”

“When healthcare suppliers and neighborhood organizations refer sufferers to CSCH, the workforce solely makes selections about diagnoses and subsequent medical care based mostly on professional evaluation of medical proof (e.g., medical historical past, bodily examination, lab and radiological findings, enter from different medical specialists and data offered by caregivers),” the spokesperson added. “Additional investigations and authorized determinations are exterior of our workforce’s scope.”

A spokesperson for Fairview Well being Companies, which owns Masonic Kids’s Hospital, stated in an announcement that though Harper is an worker of College of Minnesota Physicians, “we clearly take these issues critically and are actively reviewing the matter.”

“Our highest precedence is the security, dignity, and wellbeing of our sufferers and households — particularly in moments of disaster. We’re conscious of issues being raised relating to the conduct of a College of Minnesota Physicians (UMP)-employed supplier who practices in a UMP-led clinic throughout the M Well being Fairview Masonic Kids’s Hospital,” the spokesperson added. “We’re in shut communication with our tutorial companions and are evaluating any steps we might must take to protect the belief our sufferers and households place in us.”

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Harper’s arrival in Minnesota coincided with the fallout of a high-profile tragedy: the 2013 demise of 4-year-old Eric Dean.

Dean lived together with his household in sparsely populated Pope County, in west-central Minnesota. In line with an investigation by The Minnesota Star Tribune, lecturers and caregivers reported indicators that Dean was being abused to baby safety employees no less than 15 instances earlier than his stepmother threw him throughout a room, inflicting accidents that might kill him. She is in jail serving a life sentence.

In response, then-Gov. Mark Dayton signed an govt order in 2014 creating the Governor’s Process Power on the Safety of Kids. The subsequent yr, together with a slew of different reforms, the state Legislature created a $23.35 million grant to present counties cash based mostly partially on the variety of open baby safety investigations.

She’s very black and white, proper and flawed, no grey space, which isn’t the way in which to do medication or pediatrics.

The variety of baby abuse circumstances soared. For example, in Hennepin County, the place Minneapolis is situated, circumstances of bodily abuse greater than doubled from 2015 to 2016, earlier than dropping over the subsequent a number of years. Baby abuse specialists attributed the rise to what Joanna Woolman, a regulation professor who makes a speciality of baby abuse regulation, known as “a second of hyper-awareness round medical baby abuse and baby abuse basically.”

“We had been convening a job drive that was closely made up of individuals with the view that we wanted to do extra, have extra eyes on, be extra conscious,” added Woolman, who can also be the manager director of the nonprofit Holding Households Linked Minnesota, which supplies free authorized companies to households going via baby safety proceedings.

A subspecialty of pediatrics first acknowledged by the American Board of Pediatrics in 2006, baby abuse pediatrics focuses on the prognosis and documentation of indicators of abuse. A prognosis may also help decide whether or not a mother or father loses custody of their baby or faces felony investigation. In circumstances the place youngsters die, it may well imply homicide fees. Harper was one of many first licensed baby abuse pediatricians within the nation — the board counts over 350 subspeciality certifications nationwide — and is one in all seven at the moment licensed in Minnesota.

“Physicians with much less coaching on baby abuse and neglect each over- and under-identify accidents in youngsters, whether or not they’re bodily abuse accidents, sexual abuse accidents,” she testified in a 2019 trial. “A toddler with a missed damage might come again later with a extra severe damage and even die. And so these are type of points the place we understand that we wanted experience.”

Harper was employed as director of the Heart for Secure and Wholesome Kids by the College of Minnesota the identical yr as Dayton’s govt order. In line with testimony she gave in a 2019 felony trial, the college recruited her to construct up the middle and create a regionwide baby abuse session system.

“After I’m on name, I may be protecting as much as six completely different locations the place youngsters may be seen,” Harper testified.

In 2016, the Otto Bremer Belief, a personal charitable group based mostly in St. Paul, introduced a $2.5 million grant to fund Harper’s ambitions to increase the middle, which is predicated at Masonic. Harper can also be program director for the college’s Baby Abuse Pediatrics Fellowship, a three-year coaching program, giving her affect over the subsequent technology of kid abuse pediatricians. A spokesperson for the belief added that it doesn’t have any “function within the day-to-day operations of the Heart.”

Hennepin County has a contract with Harper’s employer, College of Minnesota Physicians, to offer medical session, professional witness testimony and case session with county attorneys. In line with testimony Harper has given up to now, she and her workforce deal with about 700 circumstances of suspected abuse annually. She has testified that 10% to twenty% of these wind up confirmed for bodily abuse, though it’s troublesome to find out if these figures are correct since baby safety case data will not be public. She has given completely different solutions on the witness stand when requested if she has ever testified for the protection; in 2021, she stated she’d testified for the protection in a “half dozen or a dozen” circumstances. In 2023, she stated she’d achieved so twice.

In 2018, Harper’s heart started cohosting an annual Baby Abuse Summit with the Hennepin County Legal professional’s Workplace. In 2022, she obtained an introduction throughout a panel dialogue from Dan Allard, senior assistant Hennepin County legal professional, that illustrated the shut relationship between Harper and her workforce and county prosecutors.

“Should you haven’t heard Dr. Harper testify, she does an exquisite job. She is aware of her stuff,” Allard, who can also be the pinnacle of the county legal professional’s baby abuse workforce, stated on the summit. “We simply barely attempt to sustain understanding what she’s speaking about. So we simply sort of let her go.”

In response to an in depth checklist of questions, Daniel Borgertpoepping, a spokesperson for the Hennepin County Legal professional’s Workplace, wrote, “Since our workplace represents Hennepin County in CPS issues, we’re unable to remark.”

Earlier than Sharon’s encounter with Harper, he hadn’t given a lot thought to her workforce’s practices, which included evaluating and treating among the worst circumstances of bodily and sexual abuse of youngsters. Whereas he stated he had referred a dozen or so circumstances of suspected neglect to her workforce, he considered their work as a bleak aspect of pediatrics. He was comfortable to keep away from it.

“I had plenty of respect for the kid abuse docs, like, ‘Thanks for doing that for us,’” he stated.

However for roughly 15 years, the world of kid abuse pediatrics has been roiled by criticism of the prognosis as soon as generally known as shaken child syndrome and now categorized underneath the umbrella time period abusive head trauma. A triad of signs — mind bleeding, mind swelling or damage, and blood within the retina — was as soon as thought-about proof {that a} baby had been violently shaken, even when there have been no different accidents and even bruising.

In court docket testimony, Harper has stated that each shaken child syndrome and abusive head trauma are thought-about scientifically legitimate diagnoses by “the mainstream medical neighborhood,” and that the controversy is extra of a authorized one than a medical one. She has acknowledged there are medical situations that mimic doable indicators of abuse, together with bruises, bone fractures and head trauma signs, however she stated that her assessments take all of that into consideration in live performance with specialists like neurosurgeons and radiologists.

“We take a really detailed historical past from the household. We do a bodily examination, take a look at previous medical historical past, different medical situations, the preliminary laboratory and X-ray studies,” she testified in 2023.

Sharon readily concedes that he wasn’t an professional in baby abuse medication. However as he and the opposite docs tried to know the bleeding in Hank’s mind in addition to his lack of weight acquire, he spent his evenings studying the scientific and authorized literature about shaken child syndrome and abusive head trauma, scribbling notes to himself. He learn a key American Academy of Pediatrics assertion reaffirming its perception within the diagnoses; he additionally learn research that challenged the science underlying them.

“It’s flawed to fail to advise mother and father and courts when these are merely hypotheses, not confirmed medical or scientific info,” Sharon wrote on a duplicate of 1 regulation assessment article.

He examine how the primary neurosurgeon to posit the speculation of shaken child syndrome stated in an interview years later that he was “disturbed that what I meant as a pleasant suggestion for avoiding damage to youngsters has develop into an excuse for imprisoning harmless mother and father.” In line with the Nationwide Registry of Exonerations, over 40 folks convicted in circumstances associated to the prognosis have been exonerated because the Nineties, typically over rising doubts that the three signs may be interpreted so definitively.

Sharon additionally discovered that the subspecialty of kid abuse pediatrics itself has additionally been underneath rising scrutiny. Maybe probably the most well-known baby abuse pediatrician case turned the idea for the Netflix documentary “Take Care of Maya,” by which a 10-year-old woman’s ache syndrome was recognized by a baby abuse pediatrician as Munchausen syndrome by proxy. A jury discovered the hospital answerable for medical malpractice and awarded the household over $200 million; the hospital has appealed. A number of households are suing a Pennsylvania hospital for what they are saying are false diagnoses of abuse by Dr. Debra Esernio-Jenssen, who led its baby abuse workforce. A collection of allegations of overzealous diagnoses of abuse have adopted Dr. Barbara Knox from her job main a baby abuse workforce on the College of Wisconsin to related positions in Alaska and on the College of Florida.

The kid abuse pediatrician neighborhood is tightknit. After Knox left Wisconsin, Harper changed her as an professional witness in some felony circumstances. Esernio-Jenssen wrote Harper a nomination letter for a Ray E. Helfer Society award, calling her “an unstoppable drive.”

Esernio-Jenssen and Knox, in addition to the Helfer Society, didn’t reply to requests for remark. In a response to the lawsuit, attorneys for Esernio-Jenssen and her former hospital community wrote that they “are being attacked and demonized for shielding youngsters from abuse and following the regulation,” and that the allegations of bad-faith abuse investigations are “clearly unfaithful.” The lawsuit is ongoing.

Knox was sued by two households in Alaska who accused her of leveling false accusations of abuse towards them. In response, Knox stated in an affidavit that she has no say over whether or not baby safety takes youngsters away from their mother and father, that she didn’t “conspire” with police or anybody else on custody points or felony prosecution, and that she didn’t personally consider one of many named youngsters. The lawsuit was dismissed in 2024 after the households agreed to drop the matter.

In line with a spokesperson for the College of Florida, Knox resigned her job there as a pediatrician with the Baby Protecting Workforce, efficient Aug. 15. He declined to touch upon the circumstances.

From the beginning, Sharon thought what was taking place to Hank — a baby battling consuming and weight acquire, with irregular outcomes on his endoscopy and weeks-old, unexplained cranial bleeding with out some other signs of abuse — match into his wheelhouse treating advanced and even mysterious circumstances greater than it match into Harper’s. After poring via the literature on abusive head trauma, he was much more satisfied.

Sharon adopted his supervisor’s instruction to not communicate to Hank’s mother and father. However after the couple’s legal professional approached him, he offered a five-page account of Hank’s medical remedy. He included a number of potential various diagnoses.

“It’s clear to me that lacking baby abuse is as severe as lacking bacterial meningitis and ought to be thought-about as malpractice,” he wrote. “But in addition, as a hospitalist, who often handle youngsters with out clear definitions of their prognosis, I’m used to ambiguity.”

Dr. Matthias Zinn, Hank’s neurologist, agreed with Sharon that the fluid in Hank’s mind, what he known as “subdural collections,” couldn’t be definitively tied to abuse. He offered a letter to the couple’s legal professional as effectively. Zinn, who stated he’s consulted on tons of of circumstances of suspected abuse, stated Harper’s baby abuse workforce was by far probably the most aggressive he’s labored with.

“It was simply loopy,” he stated. “I bear in mind talking to them and saying, ‘What proof do you have got, aside from the subdural collections?’ And so they made it clear that they didn’t respect my opinion.”

Zinn has since left the College of Minnesota for a place in Florida.

Each a CPS investigator and a police detective spoke to Sharon repeatedly, and based on Hank’s mother and father, in addition they relayed Zinn’s opinion and begged CPS to speak to him as effectively. However the CPS petition alleging Hank was a sufferer of abuse solely cited George’s evaluation. There’s no point out of Sharon or Zinn.

George didn’t reply to requests for remark.

A spokesperson for Hennepin County declined to touch upon particular person circumstances or to answer an in depth checklist of questions. However she offered an announcement from Kwesi Booker, the director of Hennepin County Kids and Household Companies, which oversees baby safety companies. In that assertion, Booker stated “baby safety social employees appropriately depend on the subject material experience of educated medical professionals in conditions involving advanced medical points.”

Unable to let the matter go, Sharon wrote letters to the hospital’s management council about what he known as “harmful overreach” by Harper’s baby abuse workforce. In response, Gupta stated he referred the letter for assessment to the hospital’s Committee for Skilled Enhancement. Citing privateness legal guidelines, hospital directors wouldn’t inform Sharon the result of the committee’s assessment.

Individually, Gupta wrote Sharon a “peer assessment” letter informing him that, in a number of of his circumstances, there have been issues about his conduct, professionalism and a disregard for hospital protocol. Sharon stated he was conscious of his fame for being strong-willed and, at instances, dismissive and even impolite to colleagues. The letter warned him towards doing something that could possibly be seen as “retaliatory” towards different members of the workers. Gupta gave three examples associated to Sharon’s purportedly improper procedures for prescribing medicines for pediatric COVID-19 sufferers; he additionally referred to Sharon’s interplay with the kid abuse workforce.

“Your documentation within the chart and communication with regulation enforcement was opposite to what was being acknowledged by the kid abuse workforce,” Gupta wrote within the peer assessment letter. “This created confusion with the neighborhood employees and with the household in a scenario by which consistency is essential.”

Gupta didn’t reply to repeated requests for remark or to an inventory of questions.

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Hank’s household had a restricted view of what was occurring behind the scenes at Masonic Kids’s Hospital, though Hank’s mom, Kay, labored within the neonatal intensive care unit there. She acknowledged Sharon and knew of George, although she hadn’t labored intently with both. As a result of Hank’s mother and father each work within the pediatric discipline and for the privateness of their youngsters, they requested that ProPublica not use their full names.

The day after Hank’s admission, Kay and her husband, Ross, defined to George in regards to the child’s issue with breastfeeding, his inexplicable ache and his incapacity to tolerate formulation. When George requested her about doable accidents or accidents, the one factor Kay might consider was a time when she was driving and slammed on the brakes with Hank in his automobile seat.

After she learn the CPS petition alleging her youngsters had been victims of bodily abuse, Kay stated that she got here to suspect that George had been making an attempt to gather data to make use of towards her and her husband, to not deal with Hank.

“I feel she was sitting there hoping that I used to be simply going to admit or inform her that I assumed my husband may need achieved it,” Kay stated. “And I used to be simply hoping that she was going to assist me.”

Whereas Hank and William had been in foster care, police confiscated the couple’s cellphones, laptops and child displays, and interviewed numerous relations and associates. In April 2022, Hennepin County determined to not pursue felony fees.

CPS discovered no extra proof of abuse, and after almost 4 months, a choose ordered each boys returned to the couple, although it was on the situation {that a} grandparent dwell within the house full time as effectively. In June, simply earlier than a trial to find out if Hank had been abused, CPS agreed to start the method of dismissing the matter, although the company nonetheless made a “discovering of maltreatment” by an “unknown offender.”

In late July, the Hennepin County Legal professional’s Workplace signed off on the dismissal. It had been almost seven months since Hank was first admitted to the hospital.

Across the similar time, Kay and Ross took Hank for genetic testing, which confirmed he carried an irregular gene duplication with unknown results. He was additionally placed on treatment that resolved his abdomen sensitivity points and elevated his urge for food. Considered one of Sharon’s theories was that the bleeding underneath his cranium was resulting from poor feeding, dehydration or vitamin deficiency, although nobody has been in a position to establish a definitive trigger.

“He’s simply been our little thriller child, however he’s a stupendous, wholesome, thriving little 3-year-old,” Kay stated.

William, she stated, nonetheless has nightmares about being taken from his mother and father. At 5 years previous, he insists on sleeping of their mattress each evening. Defending themselves, Kay stated, plus the price of extra caregivers amounted to roughly $100,000 for the household.

Kay by no means met Harper and solely later got here to know the function she performed. As a result of there was no trial, she by no means had the prospect to confront Harper or George, or lay out any of the arguments that she and her husband had been falsely accused of abuse.

However simply earlier than the case closed, Kay noticed an commercial for the 2022 Baby Abuse Summit, with Harper as a featured panelist. She purchased a ticket to the occasion and sat proper in entrance of Harper.

“They do this stuff and possibly by no means need to see the folks once more, exterior of locations the place they’re in cost,” she remembered pondering. “You’re going to need to see me.”

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Sharon didn’t comprehend it on the time, however he was removed from the one particular person struggling in recent times to maintain a household from dropping their youngsters after Harper’s involvement. In his job as an legal professional for indigent mother and father at Hennepin County Grownup Illustration Companies, Scotty Ducharme has handled horror tales and seen circumstances of utmost baby abuse up shut. However when allegations have arisen virtually completely from a medical prognosis from a baby abuse pediatrician, which he calls a “CAP,” he has additionally seen indicators that not all of the docs on the kid’s remedy workforce are in lockstep.

“Should you learn the medical data written by the CAPs versus the common docs within the circumstances I’ve labored on, you’ll be able to see the breadcrumbs by the common docs who don’t imagine what the CAPs are saying,” he stated. “I’ve solely caught, on the file, docs straight contradicting one another a number of instances.”

Within the spring of 2023, Ducharme met María Alejandra Ramírez Rodríguez and her husband, Cristian Andrés Guzmán de la Ossa, a pair of their 20s. Latest arrivals from Colombia who spoke no English, they introduced their 4-week-old son to Hennepin County Medical Heart in Minneapolis after noticing bruises on his thighs, again, brow and face. They’d taken pictures of earlier bruises as effectively, which they shared with docs. (ProPublica will not be naming the kid to guard his privateness.) The couple additionally introduced him to the hospital when he was 12 days previous as a result of his umbilical stump wouldn’t cease bleeding.

Harper examined the infant and reviewed X-rays of his skeleton. The outcomes had been alarming; he had 14 therapeutic rib fractures, in addition to fractures in his legs and arms in numerous states of therapeutic. Harper wrote that the infant was “at grave danger for additional damage, morbidity and mortality,” and the Hennepin County Legal professional’s Workplace filed an expedited petition to completely sever the mother and father’ rights. The infant was positioned in foster care with a lady who labored as a nurse.

When Ducharme appeared on the medical data, he noticed that the infant had gone via quite a lot of blood exams, together with ones to test for clotting issues. A number of metrics had been marked barely exterior of the traditional vary, together with a studying for a protein tied to a genetic clotting dysfunction known as von Willebrand illness. Ducharme zeroed in on a selected word, maybe a “breadcrumb,” written by the pediatrician who noticed the infant earlier than Harper; he wrote that the infant would wish extra observe up from the hematology division “if extra bruising develops.”

Whereas within the care of the foster mother or father, the infant developed new bruises and Harper evaluated him once more. A brand new abuse investigation was opened towards the foster mother or father, and he was moved to a second foster household — on this case, a pediatrician and her husband. As soon as once more, the infant developed new bruises, based on his visitation supervisor.

“That is medical, one thing bizarre is happening right here,” Ducharme remembered pondering.

However based on notes from the CPS investigator, Harper declined to alter her willpower or to carry out extra blood clotting dysfunction exams as the primary physician had suggested: “Wouldn’t be any completely different now so they didn’t repeat these exams,” he wrote. He added that in Harper’s opinion, whoever bruised the infant in April was the most certainly offender in subsequent incidents.

In her notes, Harper additionally questioned whether or not the marks seen on the infant whereas he was residing together with his second foster household had been true bruises. As a substitute, prosecutors posited a brand new principle within the case: that Ramírez and Guzmán had been surreptitiously abusing their son throughout visits, though the visits had been supervised by a lady who works as an observer in CPS circumstances. To Ducharme, that strained credulity. He turned involved that Harper was too unwilling to alter her diagnoses, and that prosecutors had been reluctant to problem her.

“She has this degree of cachet with prosecutors, it’s like a trauma bond. I’m certain she’s proper greater than 90% of the time,” he stated. “They’re unwilling to see her failures.”

However not everyone seems to be. In a number of circumstances in recent times, judges and juries have discovered Harper’s diagnoses unconvincing. In 2024, a Wisconsin choose barred Harper from telling the jury {that a} baby died as the results of “abusive head trauma, non-accidental damage, baby abuse, or homicide.”

“Dr. Harper sees herself as an advocate, no less than partially, and this blurs her function as scientist and clinician with the function of advocate towards baby abuse, additional calling into query her constancy to the scientific validation of abusive head trauma diagnoses, particularly when it’s a shut name,” the choose stated.

In one other Wisconsin case, Paul Marshall was discovered not responsible in 2023 of shaking his 7-week-old son, Fox, to demise. Harper examined the boy at Kids’s Minnesota, a hospital in St. Paul. A spokesperson for Kids’s Minnesota declined to touch upon the case.

“We had been put via the grinder,” Marshall stated. “We don’t get our son again, and we don’t get plenty of the closure that we must always have had as a household. That was robbed from us.”

After Ducharme turned satisfied that there was a medical clarification for Ramírez’s child’s accidents, he ready a memo that identified quite a lot of doable contributing components, together with that Ramírez had gone days with out consuming whereas she was pregnant and touring throughout the U.S.-Mexico border from Colombia and had a troublesome supply in Minneapolis. Ramírez obtained her personal medical data from Colombia which confirmed that, as a baby, she’d additionally skilled unexplained bruising.

To problem the prosecutors’ principle that the infant’s new bruises had been from additional abuse by the mother and father, Ducharme spoke to their visitation supervisor. She offered a sworn affidavit saying that she didn’t witness any abusive conduct from the mother and father, and that she’d develop into so confused partially from the strain to say she had witnessed abuse that she requested to be taken off the case. She additionally wrote that CPS employees had been mendacity to and in regards to the couple, claiming that the foster mother and father spoke Spanish, which they didn’t, and that Ramírez and Guzmán had been unreliable about preserving visitation appointments.

“The mother and father attended each go to. They by no means cancelled,” the supervisor wrote. “Even when their tire popped on the way in which to their first supervised visitations, they obtained an Uber and had been solely about 5 minutes late.”

A choose dominated that there was “no proof” that the mother and father had been abusing their child at visits and ordered a second medical opinion. However earlier than that would occur, the county agreed to drop the termination of parental rights petition after Ramírez and Guzmán agreed to acknowledge that their son “sustained severe damage” whereas residing with them, with out admitting guilt. The case was transformed to a daily baby safety matter, which allowed the couple to have house visits. They ultimately regained custody, and the case was closed in April 2024.

“There’s no accountability. There’s no discovering of truth,” Ducharme stated. “You suppose: ‘You get your child again. None of the remainder of it issues.’ Nevertheless it issues.”

The couple discovered the complete expertise bewildering and traumatic. Though they’re now reunited, they missed six months of their new child son’s life. Ramírez didn’t have the prospect to breastfeed after the primary foster mother or father started feeding her son formulation as an alternative of the breast milk she was pumping.

“We didn’t see him crawl. We didn’t see him flip over —” Guzmán stated.

“We didn’t see him sit up,” Ramírez stated.

Though they fear about doing something that may draw consideration from immigration authorities, in late Could they filed a federal civil lawsuit towards Harper and the establishments she works for. Ducharme, who left his job at Hennepin County and is now in non-public apply, is representing the couple within the lawsuit, which alleges that Harper acted in “dangerous religion,” and that due to her actions there was no “real investigation” into the infant’s medical situation.

In line with a spokesperson for Harper’s employer, College of Minnesota Physicians, they haven’t been served with the lawsuit but and haven’t responded to the allegations.

“Why, after they didn’t discover any bodily abuse, did the hospital not maintain doing exams to see if there was one thing medically flawed with him?” Guzmán requested. “They robbed us of our baby with none actual clarification.”

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In late Could 2023, a yr and a half after Hank’s case, Sharon was on his approach house from work when he obtained a cellphone name. A brand new case had come into the emergency room at Masonic Kids’s Hospital that wanted his session: a 3-month-old boy named Daniel. An MRI had proven fluid on his mind. CPS was already investigating whether or not this was abuse.

“Not once more,” Sharon recalled pondering. He turned his automobile round.

On the hospital, he discovered the bizarre circumstances that had introduced Daniel to the hospital: His mom, a pediatric nurse, had volunteered her son for a tutorial research that wanted the MRIs of wholesome youngsters as a baseline. Somebody on the analysis workforce famous fluid in Daniel’s mind, and a report was made to baby safety companies.

After assembly with the mother and father, analyzing Daniel and reviewing the MRI report, Sharon wrote up a one-page word. Amongst different issues, he really helpful that CPS proceed assessing Daniel for doable abuse. However after what had occurred with Hank’s case the yr earlier than, Sharon additionally put his views on the file.

“One ought to apply excessive warning attributing remoted intracranial fluid assortment to abusive head trauma when no extra scientific indicators or signs are discovered,” he wrote, “because the proof to assist that is controversial and has been questioned by many authorities (medical in addition to authorized).”

After a day within the hospital, Daniel and his mother and father, Grace and Paul, had been allowed to go house collectively, though they stated the CPS investigation remained open for a month. George, the identical physician concerned in Hank’s case, requested Daniel’s mother and father to convey him again two weeks later, the place Grace stated he screamed as he was pinned down for extra X-rays and to test for bruises. In line with medical data, George decided that Daniel had skilled an “unintentional trauma” however didn’t attribute the cranial fluid to abuse.

However, based on Sharon, his supervisor known as to inform him that, as soon as once more, Harper was involved in regards to the authorized legal responsibility created by his word, and that his opinion in regards to the bleeding was “past the scope” of his apply. Struck by the similarities in Daniel’s and Hank’s circumstances, Sharon wrote one other letter reiterating his issues from the convention name in February 2022. He stated that he’d spoken to many colleagues on the hospital who shared these issues, and that he strongly believed “our group should acknowledge and tackle these issues in a clear method.”

In late June, College of Minnesota data present that three complaints had been filed inside days of each other towards Sharon. As a result of the complaints had been closed with out self-discipline, they’re protected personnel information underneath Minnesota regulation.

The primary grievance was filed the identical day he stated he obtained an invitation to a gathering with Dr. Joseph Neglia, head of the College of Minnesota Medical Faculty’s Division of Pediatrics, physician-in-chief at Masonic Kids’s Hospital and one of many folks included on the February 2022 name. The second grievance was filed a number of days later, whereas the third got here the day earlier than the assembly occurred.

In line with Sharon, an legal professional for College of Minnesota Physicians on the assembly instructed him he was “weaponizing” his notes. Every week and a half after that, Sharon stated, Neglia introduced him in once more and gave him a alternative: resign or be terminated on the spot. Sharon was shocked. He in the end resigned.

Below an settlement with College of Minnesota Physicians, Sharon stayed on the job for a number of months with strict tips, together with that he was prohibited from working with the infectious illness division. Neglia warned Sharon in a letter to “keep a excessive degree of professionalism and decorum” and to not interact in “any conduct that could possibly be perceived as retaliation,” echoing the language in Gupta’s peer assessment letter to Sharon.

“You’ll chorus and take away your self from involvement in any circumstances of suspected baby abuse or potential non-accidental trauma,” Neglia wrote. “This contains any interactions with or communication with mother and father or guardians of a affected person in such a case.”

Neglia didn’t reply to requests for remark.

On the time of his departure, Sharon was one in all solely a small variety of docs within the nation who handled an advanced immune illness with behavioral signs in youngsters identified by the acronym PANDAS or PANS. Dad and mom of Sharon’s sufferers had been so upset by information of his resignation that they went to the native newspaper.

The protection prompted an investigator from the Minnesota Legal professional Common’s Workplace to achieve out to Sharon, and Sharon stated he took the chance to share his issues in regards to the baby abuse protocols at his former office. He stated he has but to listen to again. A spokesperson on the legal professional normal’s workplace declined remark.

On a current April afternoon, Sharon arrived at a restaurant in a suburb of Minneapolis. Tucked in a again nook desk was Daniel, now a blond-headed 2-year-old, Grace, Paul and Grace’s mom. Sharon had not seen them since that day within the emergency room two years in the past, and the household wished to thank him for what he’d achieved. (As a result of Grace is a pediatric nurse and since she desires to guard her son’s privateness, ProPublica agreed to withhold the households’ full names.)

Grace nonetheless feels traumatized by the 24 hours she spent at Masonic Kids’s Hospital, undecided if she’d be allowed to take her son house. She remembers that the one one that gave the impression to be in her nook was Sharon and the way it felt to learn that single line in her son’s medical report which will have value Sharon his job.

“That was the sunshine within the darkness at that time,” she stated.

Because the incident, Grace stated, she has needed to work with George on circumstances of suspected baby abuse and stated she has develop into extra understanding of how mother and father are handled.

For his half, Sharon characterizes the complete expertise as “surreal.” He commutes from Minnesota to Colorado and Wyoming for momentary hospitalist and scientific work, however he’s nonetheless on the lookout for a full-time job. He desires to get again to treating infectious illnesses and excited about pediatric immunology, and he worries that he could possibly be hurting his personal fame by talking out about how hospitals cope with circumstances of suspected baby abuse.

On the similar time, he stated he feels that he has to push again towards the try and get him, and different physicians like him who might disagree with a baby abuse pediatrician, to “fall in line.”

After leaving his job, Sharon obtained a tattoo on the within of his left forearm, a quote attributed to Albert Einstein he stated displays his pondering and his actions at Masonic Kids’s Hospital: “Unthinking respect for authority is the best enemy of reality.”