Law, Child Abuse, and the Retina

There is a longstanding, widespread belief in pediatric medicine that a finding of retinal hemorrhages in an infant or young child is strong evidence of child abuse. This belief originated decades ago as a cornerstone of the Shaken Baby Syndrome (SBS) or the Abusive Head Trauma (AHT) diagnosis. Most debate in the case law about the forensic reliability of retinal hemorrhages is embedded in a broader discussion about the SBS/AHT diagnosis. Pathologist Evan Matshes and defense attorney Randy Papetti urge, however, that the beliefs about retinal hemorrhages need to be addressed distinctly and head-on in the courts. Beliefs about retinal hemorrhages began to falter in the 2000s. Given the present understandings and uncertainties, courts performing their gatekeeping duty under Daubert and its state law progeny should not permit testimony about the supposed forensic value of retinal hemorrhages.