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"There are now competing medical opinions as to how Natalie's injuries arose," the court said, citing a "legitimate and significant dispute" within the medical community about the triad.
Edmunds, now 51, works at a convenience store in a St. Paul suburb. A book about her prosecution, It Happened to Audrey: A Terrifying Journey from Loving Mom to Accused Baby Killer, came out Nov. 15.
The Montana Innocence Project began investigating Wilkes' case in spring 2011. Innocence Project Executive Director Jessie McQuillan says her staff was struck by Wilkes' consistent and simple account of what happened the night Gabriel first got sick, as well as the prosecution's reliance on the triad.
"A few things caught our eye off the bat," she says. "The fact that (Wilkes) had been accused of child abuse, and there were no external signs of abuse, and the fact that there was no history of abuse."
In addition, the science behind non-accidental head trauma has changed significantly since the triad diagnosis emerged more than 40 years ago. In 1971, pediatric neurologist Norman Guthkelch warned colleagues that the triad alone presented reason to suspect abuse. Since Guthkelch's findings, doctors have proved that the triad can stem from various other ailments, including viral and bacterial infections, blood-clotting disorders and liver disease.
These evolving medical discoveries have complicated child abuse prosecutions. The debate over non-accidental head trauma constitutes one of the most contested issues in forensic pathology today. Some doctors say that it's impossible to shake an infant severely enough to cause life-ending injuries and leave no other signs of abuse. Others say to discount the diagnosis only provides shelter for child abusers.
While the debate continues, courts are reconsidering SBS cases nationwide. During the past 15 years, judges and juries have taken new science into account when reversing SBS convictions in Michigan, Wisconsin and Iowa. In October, an Arizona judge tossed out SBS-related murder charges against Drayton Witt, who was convicted in 2002 of killing his 4-month-old son. Witt is the second Arizonan since 2010 to have an SBS-related murder conviction reversed.
At the beginning of this year, the Montana Innocence Project asked five medical experts from across the nation to undergo a comprehensive medical review to find what could have caused Gabriel's death. Forensic pathologist Peter J. Stephens discovered that Gabriel suffered from a rare liver disease that caused the triad. Northwestern University School of Medicine pediatrics professor Peter Whitington also found liver abnormalities. Armed with the new evidence, Innocence Project attorneys in September asked Missoula's Fourth Judicial Court to hold another trial for Wilkes.
"There's another whole side of this story," McQuillan says, "that wasn't told, that wasn't even explored."
When DePaul University College of Law professor and former prosecutor Deborah Tuerkheimer heard about Wisconsin homemaker Audrey Edmunds' case, she imagined there had to be others like her.
"If the science had changed enough to warrant a new trial for Audrey Edmunds, then it seemed to me there were likely lots and lots of other cases that fell into the same category, that should at the very least be revisited," Tuerkheimer says in a recent phone interview with the Independent.
The problem is that scientists' opinions run the gamut, but the legal system deals in black and white. Tuerkheimer says that Canada and the United Kingdom have initiated reviews of triad-based prosecutions, but the United States has not. She believes that new science calls into question thousands of convictions.
"Notwithstanding these rather seismic shifts in medical thinking, the criminal justice system haswith only rare and recent exceptionbeen unyielding to new thinking about a diagnosis that proves a crime," Tuerkheimer says.
High-force trauma cases such as Edmunds' and Wilkes' almost always boil down to a battle of the experts, and a doctor's time doesn't typically come cheap. That means the accused who get new trials, those who are acquitted, are the fortunate ones, Tuerkheimer says.
"Those are cases where people have really good experts, and they either do because they've got the money to hire a good lawyer and get good experts or because they're fortunate enough to have an Innocence Project with the resources and the smarts to do these cases right," she says. "There is an inequality that tends to run through all of this."
In Wilkes' case, the Innocence Project's petition alleges that the prosecution relied on antiquated science and that the defense badly erred when failing altogether to mention the long-raging debate surrounding SBS. Kaplan, one of the prosecution's expert witnesses, says he's following up on the Innocence Project's findings. He has sent a sample from Gabriel's liver to a colleague and awaits the results.
Wilkes' public defender, Scott Spencer, said in an affidavit on file with the Innocence Project that he saw no way to cast doubt on the prosecution's expert testimony.
"This was a very difficult case for me as the defendant insisted that he did not harm the child," Spencer says in the affidavit. "Yet nothing could be found to overcome the medical opinions, both from the state and from our expert. If there was a different line of attack on the medical testimony, I was not able to find it."
Prior to the trial, Spencer consulted with Thomas Bennett, a Billings-based forensic pathologist. Bennett examined Gabriel while the child was hospitalized in Spokane and he agreed with the prosecution's medical experts that it appeared the infant had been abused.
Bennett has extensive experience with SBS. In 1999, The Los Angeles Times published a lengthy article detailing his work diagnosing the syndrome while serving as Iowa's chief medical examiner. Between 1989 and 1997, Bennett autopsies identified 17 SBS-related cases. Three caregivers prosecuted with his findings were later cleared.