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Doctor Was Asked Tough Questions in Infant’s Death

Yolo-Count-Court-Room-600by Antoinnette Borbon, Jane Fitzsimmons

 Sara Stone, mother of baby Stone and the defendant’s wife, took the stand again Thursday to resume giving her testimony. Defense attorney Monica Brushia would ask her to describe the events leading up to the day of October 3, 2012, when her husband made the 911 call.

Quentin Stone, 40, faces child endangerment and abuse charges resulting in death. The trial stated last week after three-month-old Samuel Stone died from injuries that included bleeding on his brain and rib fractures that were in the process of healing.

A weeping Sara, often hanging her head, told the jurors that she had gotten a text from her husband on September 5, 2012, telling her to get home. She said he told her the baby had fallen and he was worried. Sarah arrived home shortly and, after consulting the neighbor, a fireman, they decided it was best to take the baby into the ER to be examined.

She said she stayed home with the other children while Quentin took baby Stone to see a doctor. She stated the doctor told her husband that the baby appeared normal but to watch him. She said it was over a period of 24 hours that the baby began vomiting.

Both she and her husband were concerned, so they took the baby back on the 7th of September, when she said they had informed the doctor at Kaiser that the baby had been projectile vomiting and had an episode of going limp for about 3 to 5 minutes.  But, once again, the doctor told her husband the baby was normal but may just have acid reflux.

She said they told her about his limp episode and she did consult with a neurologist out of Kaiser in Roseville. However, after a quick exam, and no injury noticeable to the doctor, they were sent home. No CT scan was ordered.

The defense asked her about the days after this second visit. She said on the 10th of September they took the baby for his well-baby visit, where doctors once again saw no alarm or cause to order a CT Scan, even after they told their pediatrician that the baby had more vomiting and another limp episode.

Dr. Otame, the baby’s pediatrician, still felt it okay to go ahead and give the baby his immunizations and, when telling the doctor about his tracking trouble with his eyes, the doctor’s only response was, “Don’t compare them, it’s different for each child.”

Defense Attorney Brushia asked, “And how did that make you feel?” A weeping Sara replied, “Um….um…I felt scared, upset when he went limp, but she kept giving us reassurance that everything was okay.” “Did she do any blood work or a CT Scan after telling her the baby had now 3 episodes of going limp, possible seizures? Did she say anything about it being a seizure?”  Sara, hanging her head and weeping, said, “Um…no…she didn’t seem concerned, she just kept assuring  us everything was okay.”

Sara said when the baby would have the episodes, she would put him on her shoulder to bring him around and rub his back.  But she stated, “ I was upset, he didn’t feel right and we emailed the doctor again.”

Brushia exclaimed, “She never told you to bring him in, did she? And did she order any tests?”  Weeping…Sarah said, “Um…No, she didn’t, she said the medicine for acid reflux would help him but he could still vomit.”

Defense then turned to the day of October 3, 2012. Sara said the babies were home alone with Quentin when, while in the swing, the baby once again went limp, but this time he was unresponsive so Quentin called 911.

She said she met Quentin at the hospital, where he was distraught over the baby. She said they were both emotional and scared but were still able to give Woodland Memorial all of the Kaiser information and tell them about the fall back in September. It was there at Woodland Memorial that the couple was told the baby had bleeding on the brain.

Defense attorney Brushia asked, “Did they say he was having seizures?” “No,” replied Sara. She said they were told he would have to be transferred to UCD.

“Did you notice his eye?” asked Ms. Brushia. “Yes, but no redness or bruising around the eye, noticed it was shut.”

Sara said it the doctors at the UCD Med Center told them that the baby may be disabled but it was not until three days later they were told he would not recover. She said they had hope and were fine with him being disabled because they were both strong enough to handle it.

A lot of family members were with them at the hospital and some present when the doctors consulted with her and Quentin.

On October 8, Sara and the family said their goodbyes. In a statement to  baby Stone, she said, “You didn’t deserve this,” which would later be an alarm for Det. Jamison who questioned the couple at the hospital. Sara stated, when she learned that Dr. Coulter felt the child had possibly been abused, she lost all faith in the doctors and was angry. She said when she learned the CPS took their other children, “I was mad!” stated Sara.

She said they donated the baby’s organs. “I wanted to be able to help other kids,” expressed Sara.

Brushia, raising her voice, asked, “Did at any time, you feel that Quentin would have hurt the baby? Did you ever see him abuse drugs, alcohol or be quick tempered? No history of violence?”

Sara asserted, “Never, never!” “Did you ever see him lash out at anyone? Would you still be with him if he had?” exclaimed Brushia.

“NO! never!” Sara replied.

Deputy DA Steve Mount objected, telling the judge that the defense was talking about his case and it is not her business. The judge ruled in his favor and sustained the objection. Brushia vehemently stated, “Your Honor, the Deputy DA is trying to say, he snapped!” It was still sustained.

Mr. Mount came back in direct with asking questions about the day of October 4, 2012. “You didn’t know your child was dying on the 4th, correct?” Sara, appearing bold, said, “Yes, that is correct.”

“When you changed his diaper, is that the only time you saw him go limp?” asked Mount. “Yes,” replied Sara.  “So…your instincts were to soothe him?”  “Yes,” answered Sara.  “And when his breathing was labored, you didn’t have concern to call 911?” Mount asked.

Mr. Mount asked about the form filled out by Sara at the well-baby visit. He asked her why she had said in testimony earlier that she told the doctor about the visual tracking being off, but marked on the form it was okay. Sara stated she did not recall saying doing that or testifying to it.

Mount brought to her attention that, in a previous testimony, Sara had said that her toddler had fallen on the baby with complete body but never told the defense until today. She stated, “I don’t recall.”

“And you testified to the Grand Jury that your toddler was occasionally jealous, or jealous all the time?” Mount asked. “It was a typical 2 ½ year-old jealousy,”  she replied.

The deputy DA’s next witness was Dr. Coulter, Chief of Pediatrics at UCD. Dr. Coulter told jurors he had been called to examine the baby once he was brought into the ICU. He testified that, from his years of experience with abused children, he felt the fractures accompanied with the brain injury were suspect of non-accidental trauma.

He said they ordered testing on the brain but it was not right away. He said in the CT Scan done by Woodland Memorial, it was found that the brain had blood in both hemispheres and in the subdural and subarachnoid areas, and other fluid, possibly spinal fluid, on the brain. He stated that the brain tissue had abnormalities also, but that could be due to seizures. He stated the “soft spot, or Fontenela “ was bulging.

Dr. Coulter said, “We wanted to get the seizures under control first, but we never really did, we were hopeful but they were difficult to control.”

He stated, “He had a visible seizure involving his left hand.” Deputy DA Robin Johnson asked, “But you can put a needle in the head to drain the fluid, right?” “Yes, we can, but we didn’t do that,” stated the doctor.

“Why not?” Johnson asked. “Neuro felt it was unnecessary?” “You can do an MRI, can’t you?” Johnson asked. “Yes, but he was too unstable to move, we didn’t do the MRI until later,” replied Dr. Coulter.

Dr. Coulter said when he questioned the defendant about what preceded the hospital ER visit at Woodland Memorial, Quentin told the story about the fall. “He was forthcoming and helpful with the information.”

Dr. Coulter explained that, in a fall, you will not have bleeding on both sides of the brain typically, but it can be possible if a person loses oxygen or blood to the brain. However, in his experience, he has seen many more cases of abused children exhibiting the same injuries as baby Stone. But the doctor ran several tests to rule out blood disorders and metabolic causes, and consulted with two other hospitals.

He said he called the Children’s Hospital in Oakland and the University of San Diego to consult with them. Coulter also stated that he sent blood work to a special diagnostics lab to test for copper deficiencies. He stated he ran tests for rickets, a vitamin D deficiency and a few other tests.

Dr. Coulter stated, “Copper deficiency can fool you, make you believe the child has been abused, but his levels were fine, only low on the vitamin D levels.”

He said he consulted with Dr. Patel and had him run a special series of skeletal xrays that show more details. In the MRI done, he stated it showed the blood fluid and the skull’s bones to have wider spaces than normal, which indicate swelling and fluid on the brain.

About the injuries he stated, “In general, brain injury occurs by impact,”  He stated, “The MRI showed injury to both sides and lower part of the brain which is called the cerebellum.”

He said he wanted to run tests to rule out suspicion and conclude his report.

Dr. Coulter stated, “We don’t normally run this many tests but in this case we did.” But he stated, “Conversations with Quentin were going well as expected, this was a horrible event, a horrible event and they were appropriately upset.”

The defense vehemently objected to the doctor’s answer about the state of mind of the Stone couple.

Defense will cross-examine in the morning.

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12 comments

  1. Elizabeth Bowler

    since the Vitamin D level was low according to Dr. Coulter’s testimony, I certainly hope that the defense will have an expert in infantile (not childhood) rickets testify!

  2. Elizabeth Bowler

    Drs David Ayoub (Springfield IL) and John Cannell (the Vitamin D Council in SLO CA) both have extensive experience with these types of cases. Even the neurosurgeon who originally came up with Shaken Baby Syndrome in the early 70s has stepped away from it due to numerous wrongful convictions of parents and other caregivers. SBS theory has no place in our modern criminal justice system!

  3. Elizabeth Bowler

    http://www.slate.com/articles/news_and_politics/crime/2012/03/when_babies_die_are_doctors_too_quick_to_blame_it_on_shaken_baby_syndrome_.html

    The case that eventually caused the originator of Shaken Baby Syndrome, neurosurgeon Dr Norman Guthkelch, to abandon his theory, has many similarities to the Stone case.

  4. Wow..interesting, Elizabeth, have to read it.

    What I find so heartwrenching is why they chose not to remove the fluid, or blood acvumilated in the brain. He may have had a fighting chance at surviving! I know, my son had a subdural empyema, which is infection filled in subdural at 13, UCD Surgeon did an immediate MRI to find it and rushed him to surgery where he had a crsniotomy. It saved his life! After surgery, he was in a coma for about five days, had seizures lasting 2 hours in front of staff, caused from swelling. Several other things happenef begors he made a full recovery and we walked out of the hospital togethet, 38 days later. Last July, he nearly died again for about the fourth time from seizures that resulted in aspirating and spent a week on life support in Woodland Memorial before they would listen to me and transfer him to UCD. Another wrrk or so,.he recovered, thankfully. To date he has had several different types of seizures. I watched him have awake type onrs while having an awake EEG at UCD. Over the ladt couple years he has suffered with them and finding the right mefs. The cause? Our Nuerologist showed us in the MRI it stemmed from the scar tissue.

    I feel so lucky we had great doctors, but it did take me being a bit forceful and never accepting some of their advice as golden, and even risked my own freedom when Woodland Memorial would not let me get him transferred out of there. They overdosed him and caused a blot clot in my sons arm, which now for the rest of his life he will be on a blood thinner. I know they thought I was craxy…but my son may be alive because of that motherly instinctual behavior…sure we all have it…

  5. Reading this thus far makes me think the incompetence of some of the involved physicians is equally as appauling as the incompetence of their defense attorney. God help you if you blindly trust your physician’s judgement and never fail to question a plan of care or treatment.

    In a American Association of Justice report (http://www.justice.org/cps/rde/justice/hs.xsl/8677.htm) …… “The Institute of Medicine’s (IOM) seminal study of preventable medical errors estimated as many as 98,000 people die every year at a cost of $29 billion. If the Centers for Disease Control were to include preventable medical errors as a category, these conclusions would make it the sixth leading cause of death in America.

    Further research has confirmed the extent of medical errors. The Congressional Budget Office (CBO) found that there were 181,000 severe injuries attributable to medical negligence in 2003.3 The Institute for Healthcare Improvement estimates there are 15 million incidents of medical harm each year. HealthGrades, the nation’s leading healthcare rating organization, found that Medicare patients who experienced a patient-safety incident had a one-in-five chance of dying as a result.

    In the decade since the IOM first shined a light on the dismal state of patient safety in American hospitals, many proposals for improvement have been discussed and implemented. But recent research indicates that there is still much that needs to be done. Researchers at the Harvard School of Medicine have found that even today, about 18 percent of patients in hospitals are injured during the course of their care and that many of those injuries are life-threatening, or even fatal. The Office of the Inspector General of the U.S. Department of Health and Human Services found that one in seven Medicare patients are injured during hospital stays and that adverse events during the course of care contribute to the deaths of 180,000 patients every year.

    Even errors that the government and private health insurers have classified as “never events,” events that should never happen in a hospital, are occurring at alarming rates. Recently the Joint Commission Center on Transforming Healthcare reported that as many as 40 wrong site, wrong side and wrong patient procedures happen every week in the U.S.8 Similarly, researchers in Colorado recently found that surgical “never” events, such as operating on the wrong patient or wrong site or performing the wrong procedure, are occurring all too frequently.

    Yet despite these numbers, the American public remains unaware of just how pervasive the problem is. Even though one in three Americans say that they or a family member has experienced a medical error, and one in five say that a medical error has caused either themselves or a family member serious health problems or death, surveys show that Americans vastly underestimate the extent of medical errors. About half of respondents believe the annual death total from medical errors to be 5,000 or less—nearly 20 times lower than the IOM’s estimate.

    People have been led to believe that there are hundreds of thousands of medical negligence lawsuits every year and only a handful of genuine medical errors. In reality, the reverse is true. There are very few medical negligence lawsuits, and hundreds of thousands dying from preventable medical errors. As University of Pennsylvania law professor Tom Baker puts it, “We have an epidemic of medical malpractice, not of malpractice lawsuits.”

    • Elizabeth Bowler

      Agree with you on this, Wes. A friend of mine has written a book detailing this and more, “Death by Modern Medicine”, that is a good read on the topic. This particular case is so disturbing because SBS has been so thoroughly debunked by experts that it is surprising to see it even raised as an issue at trial. I keep expecting the defense to produce experts of their own to debunk it, but so far not a hint of anything along those lines.

  6. Elizabeth Bowler

    It sounds like your maternal instincts may very well have saved your son’s life. In the Stone case, the parents repeatedly took the baby to the doctor because of various problems but were told everything was fine. Apparently the parental instincts were right after all. This case and cases like it are so tragic, it’s heartbreaking.

  7. Yes…..ultimately the glory belongs above, he.is the great physician, he just gave me the strength to keep pushing for the right things to be done. We have little understanding as to why he allows such tragedy but for any who love him, there will bear goid fruit one day…

    Defense does not begin their case til next week…sure they have experts.

    • Elizabeth Bowler

      I’m very much looking forward to the defense case. I thought the baby’s mother would be a defense witness thus my confusion about where they were in the trial.

  8. I believe she may be…not sure?

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