Fifteen Experts
00:01 True Story Media. And this case was first reported Monday by NBC News, and it revolves around Dr. John Cox. He told NBC, he accidentally fell asleep while cuddling his one-month-old in bed in May and must have turned on top of her. The infant was taken into custody at that point. Mike Hicksenbaugh is a national investigative reporter for NBC News. He's based in Houston. Mike, welcome to the ideas network. Good morning.
00:34 As you probably know if you've been listening to this show for a while, journalist Mike Hicksendbaugh lives rent-free in my brain, as the kids say. Actually, do the kids say that anymore? I don't know. I'm in my 40s. Cut me some slack. But Mike is taking up that real estate, not just because I have a personal grievance against him for his irresponsible and damaging coverage of my sister Megan Carter's case. Mike Hicks-in-bah who presents as very progressive has, in my opinion, propagated more anti-science abuse denialism than perhaps. any other journalist in recent years. He has a lot to answer for. Whether he will ever answer for those things, or answer any of my detailed requests for comment, is another matter. But I digress. When I first saw the Do No Harm series, I thought that he was probably right about some of these cases, because of course false allegations of child abuse do happen. And it's something we should
01:28 take seriously. No family should be unjustly separated. I thought it was very possible that this Peabody Award-winning journalist with the resources of NBC at his disposal, had actually done the lakework to find a case in which parents had really had their children wrongly removed. Such a case, I thought, might illuminate my kicks and boss. Why? Sometimes an experience, whether it's something that happens in our own lives or a story we report on, can really color how we see the world. Maybe if he'd found one family that had genuinely suffered the injustice of being wrongly accused of child abuse, it had caused him to see the phenomenon elsewhere where it wasn't happening. But the more I looked into the individual cases in his series,
02:10 as well as Mike's methodology for covering them, which we unpacked in detail in episode 8 of last season, link in the show notes, the more I have become extremely dubious that he's found even one story of an actual false allegation. And while the entirety of his Do No Harm series for NBC got a lot of eyeballs and therefore did a lot of damage, Mike Hicks and Boaz's John Cox coverage had a particular
02:33 devastating impact. So today, we're going to take a closer look at Mike Hicksendbaugh's arguments for John Cox's innocence and see how they hold up to scrutiny. Here's how Mike described the situation in an interview with Wisconsin Public Radio that aired immediately after John Cox was arrested, and Mike Hicksendbaugh's original NBC story dropped. Well, so the doctor, as you mentioned, brought his baby into his pediatrician because he was concerned that he had injured her collarbone. He's an ER doctor. he knows how to assess these kinds of things. And what's happened in this case is the child abuse specialists are saying they've concluded this was abuse,
03:13 but more than 15 other physicians who've examined the child, including several at Children's, Wisconsin, who are subspecialists in other areas of medicine, have said they've made mistakes in analyzing the child. A dermatologist said, who saw the girl, said those aren't bruises, those were birth marks. a hematologist who evaluated the medical record said the child abuse team misread test results that seemed to point to a potential bleeding disorder that would explain easy bruising. Orthopedic surgeons have looked at the case and said that broken collarbone matches exactly the story that Dr. Cox told. But in the end, the DA and CPS has sided with a nurse practitioner and the child abuse team.
03:56 Listening to Mike here and reading his NBC coverage, I see why this story got people, including some listeners of this show who are very well versed in the flaws in media coverage of child abuse. 15 experts is a lot of experts. And unlike in many of the cases we've touched on last season, most of these experts aren't what DA Matthew Torbenson refers to as frequent flyers, people like Dr. Joseph Scheller, who've made a career out of being defense expert witnesses. As far as I can tell, these experts are mostly regular practicing physicians. So what's going on here? According to my Kixenbaugh, this is the yet another example of an abuse of power from a child abuse team.
04:34 So why is it that 15 medical experts are saying there's no proof of abuse here? Well, because they've evaluated the records. And, you know, this story that I've, this story is part of a larger series of reports I've done about the work of child abuse medical specialists. And there have been concerns that when mistakes happen or when these physicians overstate the evidence, which can happen in end. any field of medicine, that law enforcement and CPS no longer are listening to other evidence, that these physicians' reports are kind of paramount. Speaking of overstating the evidence, Hicks and Boz claims of abuses of power by child abuse pediatricians are, as far as I can tell, after many, many hours of research, entirely
05:21 baseless. Again, see Season 7 for more. And as in all of his stories, there's a built-in asymmetry to his reporting, which was based on John Cox and his wife Sadie DeBrosi's accounts of events and on whatever cherry-picked documentation they chose to provide Hicksimbaugh. We reached out to Children's Wisconsin State Child Protective Services and Milwaukee prosecutors for comment. They all declined to comment.
05:45 And Milwaukee prosecutors said a gag order prevents any party right now from commenting on this case. What can you tell us about this gag order? Well, the gag order was requested by the deputy district attorney within an hour or so of me emailing him requesting comment last week. And then on Tuesday, a judge formally granted that request citing concerns, you know, for the child's privacy and the fact that NBC had already been working on the story. These entities can't comment ethically or legally on a case. Mike Hicks and Bogg claimed in a Twitter post that the families he'd interviewed for the series
06:29 all signed HIPAA releases. But number one, we don't know exactly what those alleged releases covered. As we've pointed out before, a HIPAA release can only apply to certain records or doctors. It does not have to be a blanket release. And the doctors I ran this by said there isn't a hospital in the world that would let a doctor speak to a journalist about a child who's the subject of an active abuse investigation, record release or no. And Hicksenbaugh knows this.
06:54 It also wouldn't have mattered what permissions John Cox gave in this particular case, because he had no legal rights to the child in question. Her adoption was still pending when she sustained her injuries. I asked Matthew Torbenson about why he took the extra step of issuing a gag order. I believe the courtroom in this day and age is one of the last areas where truth prevails. I call it the last bastion of truth. And I filed a gag order in this particular case, not because I didn't want information to be out publicly about this case,
07:24 but I wanted to come out the right way. I wanted to come out through the legal proceeding. If Dr. Cox chose to have a trial, then all of it would be aired publicly in that trial. If not, then the confidential information would remain exchanged with him. He had all the information, I had all the information, and he could make a choice on whether or not he wanted to resolve the case or not resolve the case based on that information. But when you leak only certain portions of information that are beneficial to you,
07:50 that's not airing the facts publicly. That's not coming to a conclusion based on having all of the information one party has. And that's what was done in this case is prejudicial information was leaked in a way that made it seem as though there was a witch hunt for Dr. Cox and charging Dr. Cox for child abuse. When Hicksenbaugh's story aired on January 27th, Dr. John Cox had just been criminally charged. The trial, if it came to that, wouldn't happen for months. But with Mike Hicksendbaugh bringing the story to a national stage, the hospital's trial in the court of public opinion was well underway. You can join in with your questions 800, 600, 6-4-2-1-2-3-4. Mike, what does this particular instance say about how child abuse investigations are handled right now?
08:44 I'm Andrea Zunlop, and this is part two of Nobody Should Believe Me's special report on the case of Dr. John Cox. If you are a subscriber on Apple Podcast or Patreon, you can binge all four parts of the series right now ad-free. Over there, you will also get two extra episodes each month. of our subscriber exclusive show, nobody should believe me after hours, as well as add free listening to our complete archive. And if monetary support is not an option, reading and reviewing the show on Apple and Spotify really help us out. Thanks as always for listening. We'll be right back. Visit BetMGM Casino and check out the newest exclusive. The Price is Right Fortune Pick. BetMGM and GameSense remind you to play responsibly, 19 plus to wager. Ontario only. Please play responsibly.
09:38 If you have questions or concerns about your gambling or someone close to you, please contact connects Ontario at 1-866-531-2,600 to speak to an advisor, free of charge. BetMGM operates pursuant to an operating agreement with Eye Gaming, Ontario. The investigation into John Cox, had begun after he brought LG, the four-week-old infant he and his wife were in the process of adopting, in to see the family's pediatrician, Dr. Pomerance, on May 9, 2019. John told the doctor that he was concerned that he'd fallen asleep on the baby while cuddling her in bed and broken her clavicle. During this visit, Pomerant's noticed several small bruises on the baby and reported his concerns to the hospital's child abuse team and to CPS.
10:28 A child abuse specialist named Dorita Ventura evaluated the baby on May 10th and determined that the injuries were diagnostic of abuse, a diagnosis that was confirmed in a blind review performed by a child abuse pediatrician from Children's of Wisconsin, and then later, by a cap from out of state who was hired to evaluate the case by CPS. It would appear that everyone had gone the extra mile to be sure about this case, and for good reason. Because John Cox and his wife worked at Children's, this situation was a bitter fight from the jump, with Cox filing an official grievance days after Rita Ventura's initial evaluation. But John was ultimately charged with child abuse, and then Hicks and Boz reporting through fuel on the fire, A fire ADA Matthew Torbenson tried to tamp down.
11:14 I filed for a gag order. The judge agreed with the gag order because, like I said, the demonstration of the information from Mike Hickens, Hicksonbaum's article, is that he had confidential information. And that either came from the defense attorneys, which I didn't believe happened, or it came from Dr. Cox or his wife. And so a party to the action was sharing information. And so the court ordered that there was no additional. sharing of information, put a gag order on any of us talking to the media outside of what happened in the courtroom or sharing any information with the media. Shortly after that, the defense filed a motion to dismiss. That turned into a show, again, for the media, I believe,
11:57 is for the media because the case law is quite clear, and that was denied pretty handily by the judge. The 15 experts' argument that Mike Hicksonbaum makes in his reporting pretty much mirrors what's in the motion to dismiss that was entered the same day as the NBC story ran. In addition to outlining the expert reports that Cox submitted to the DA's office, which the motion presents as exculpatory, as in proof of John's innocence, the motion also does some very lawyerly hair splitting about Matthew's paraphrasing of the battered child syndrome, a landmark article from 1962, and Dr. Naomi Sugar's research on bruising. Cox's legal team argued that the child abuse experts who determine abuse in this case were, for various reasons, wrong. And a close read of this complaint reveals that rather than simply
12:44 making a case that these specific child abuse doctors were wrong in this specific case, it's making an argument that their entire profession is illegitimate, that because doctors cannot prove that John intended to hurt LG, that the abuse allegations are nothing more than a theory. This is a cornerstone of the abuse denialist argument, and one that was expanded upon in the defense's oral arguments, as Matthew recalls. Essentially, this is a nonverbal child, and we're relying on an expert opinion to say that these injuries are diagnostic for abuse, and how can we rely on a medical expert opinion as being the sole basis for saying something's abuse or not abuse?
13:26 And if you accept that argument, then we would never be able to prosecute a child abuse case involving a nonverbal child ever. That's a wild argument to make for an. emergency room physician who has had training about identifying abuse. So basically the argument is unless a child can disclose that they're being abused, there's no, or was witness in some way. Or was witness, right, which is like zero percent of the cases, right? It's extremely rare. And, you know, actually that piece is really telling because I think like what gets very obscured in these media stories is,
14:06 Hey, you have these critiques, salient or not, but what are you suggesting should be done instead? And in fact, I believe, after spending many hours of my life with unpacking these, that they are suggesting that we just shouldn't be reporting child abuse. Yes. The motion to dismiss names and identifies the subspecialties of each of the numerous experts who gave the so-called exculpatory. reports. First up is Dr. Albert Pomerantz, pediatrician to Dr. Cox's other two young children and the first to report the suspicion of abuse. He was close to John and his wife's AD, also a pediatric physician, as he had trained both of them during their residences. According to John, Dr. Pomerantz was his second phone call on the morning of May 9th, after his check-in with his wife about the
14:59 baby's decreased movement of her arm. And initially, Dr. Cox says that Dr. Pomerantz doesn't answer the phone, there is eventually a phone call that gets through to Dr. Pomerantz, and he agrees to see the child to meet with Dr. Cox. He performs a physical evaluation of the child, and everything that he's seeing in that physical evaluation tells him that this child needs to be evaluated for physical abuse. So then at this point, Dr. Pomerantz steps away and, you know, because of his personal relationship with the parents. Is that right? Yeah, he makes a referral to the child abuse team at Children's Hospital, Wisconsin, he takes photographs to show the linear fashion of the bruising and the locations of the bruising on the child and also forge those photographs onto the
15:44 Caps team. Dr. Hilary Peska from the child advocacy team, headed by Dr. Lynn Sheets, a mentor of John's, documents the child's injuries but offers no opinion as to the question of abuse, because they all knew and worked closely with John. So they called in Dr. Rita Ventura, an outside child abuse expert. So why do John's lawyers count Pomerantz as an exculpatory witness if he's the one who originally reported the concern. Dr. Pomerantz walks back his concerns in this case, but it's clearly coming from an emotional state after he's had time to reflect on the fact that he knows Dr. Cox and he knows the repercussions of his actions of reporting based on his relationship with Dr. Cox. It's not coming
16:26 from a state, at least from my opinion, of assessing this case from logic and separating your role in your relationship with Dr. Cox. So that's one really good. example to me of that's not him changing his opinion, that's him letting a motion to invade his opinion. This walkback is detailed in the defense's motion to dismiss, where it says that Pomerant's recorded, quote, linear bruising, no clear ideology, but ones on arms may represent where father picked up the child. As a reminder, John had said that when he was awoken by the child's crying, he picked her up, quote, in a panic. Dr. Pomerantz also stated that, quote, he has been doing this work for a long time and he has seen a lot of abuse cases. And this is not usually a place
17:09 you pinch to torture. It's worth noting that while anyone who works in pediatrics is likely going to come across abuse cases, this is not the area of Dr. Pomerant's expertise. And this quote, I think, goes back to that other argument, that a parent has to intend to harm a child rather than, say, lose their temper and lash out in order for an injury to be abusive. The motion excerpts a letter from Dr. Pomerantz written on June 28th, the day the court officially ordered LG to be removed from John and Sadie's custody. Pomerant's writes, quote, I have some concerns about some discrepancies in LG's medical records between Ms. Ventura's findings and conclusions and other physician's findings, including myself. I believe these discrepancies may have led to an incorrect conclusion about suspected child abuse and therefore the removal of the child. Pomerantz hadn't officially been involved in the process since his reporting of the abuse concerns,
18:06 but John had presumably kept him apprised. And Pomerant points to expert number two in his June 28th letter, the pediatric dermatologist he'd referred John to after their visit. One of my main concerns, Pomerant's writes, is that the examination of the skin by Ms. Ventura of child advocacy is not consistent with my findings or that of the pediatric dermatologist Dr. Choo. There is no question that there were three bruises. is present that I had difficulty explaining, which is exactly why I contacted child advocacy
18:35 in CPS. He goes on to say, however, Ms. Ventura describes many more skin findings that she interprets as bruises. The pediatric dermatologist, Dr. Chu, did not feel that these were bruises and found other explanations for these findings. Considering her expertise is the skin, and I myself saw only three bruises, I consider her findings more credible. Dr. Chu did propose to other possible explanations for the bruises in her note, the upper arm bruising being secondary to the way Dr. Cox picked LG up after discovering he was partially laying on her, and the bruise on the back possibly related to the way he burps LG involving his wedding ring. There was much made of whether or not various things were bruises.
19:18 But as Dr. Pomerant says in his letter, there was no doubt about three of the bruises. The only difference is whether or not the various experts, including at least one other dermatologist, found John's explanation for the bruises plausible. And this is a question for a child abuse expert, not a dermatologist. So that's two. Number three is Dr. Craig Leach, a pediatrician John and Sadie took LG two one week after the incident. The police received a report from Dr. Leach after the visit and noted that it, quote, did not contain any new information as it relates to this investigation. There's another one where the doctor talks about observing the children to with him or the child together with Dr. Cox and says they're loving and caring.
20:03 And I don't think that this could have happened because what I'm observing in the emergency room or in the evaluation room seems to be a loving and appropriate relationship. That's the type of judgments that were being made in some of these medical records and reports. And that's not making a medical diagnosis. That's not how medicine is practiced. Days after their visit to Dr. Leach on May 24th, LG was removed from John and Sadie's care at the request of the birth parents who retained their parental rights. The decision was made final in a court order a month later, which appears to have been the impetus for Pomerance
20:39 walking back his concerns. And one can only imagine how hard this hit John's colleagues, a number of whom spoke to Hicksenbaugh and some of whom reportedly began affixing a picture of John's face to their hospital name text. We think we know what a child abuser looks like, or at very least, what it doesn't look like. And Hicksenbaugh leaned into this assumption hard, the idea that it's simply outrageous that John could ever be an abuser. On his social media, Hicks and Baugh posts angry letters to the hospital that had been shared with him. These reiterate the doubts he'd cast in his own reporting and defended the upstanding character of John Cox. Fifteen experts sounds so compelling. Fifteen experts telling people who knew and loved John Cox what they desperately wanted to hear,
21:27 that he couldn't possibly have hurt the baby. Just as Hicksenbaugh was telling his readers what they wanted to hear, that this nice man, the celebrated doctor, this guy who could be your brother, your husband, who could be you, he'd never do what these doctors said he did. Would he? Fall might be on its way, but it is still warm outside, and that is bad news for hot sleepers.
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24:34 app for app exclusive offers or go to quince.com slash believe. Get free shipping on your order and 365 day returns now available in Canada and the UK too. That's QI-N-C-E.com slash believe. You can find that information in our show notes and remember that shopping our sponsors is a great way to support the show. In the motion to dismiss, they mention the names and subspecialties of the 15 experts. They appear to count Dr. Hillary Pesca as coming down on the side of the defense. though she made no determination one way or the other because she knew John.
25:10 Beyond the four doctors who actually evaluated LG before she was removed from Savy and John, the other experts listed came from a number of subspecialties, including dermatology, hematology, and orthopedics. Notably, there was only one expert from the field of child abuse medicine, none other than Dr. Eli Newberger. This is a name you may be familiar with if you've been listening to this show for a while, and he is a fascinating figure. Newberger founded Boston Children's Hospital's Child Protection Team back in 1970, and he was a leading voice in the field for more than two decades. But after testifying for the prosecution in a high-profile 1997 case against Nanny Louise Woodward for the death of an infant in her care, he got hammered in the press,
25:56 events which many later speculated marked a turning point for him. By the time child abuse pediatrics was introduced as a subspecialty in the aughts, he'd completely turned, and Newberger rallied against the profession's existence. He subsequently showed up as a frequent and very highly paid defense witness, appearing in the Maya Kowalski trial, among others. On the subject of John Cox, he's quoted in my Kicks and Boz reporting, saying, quote, I am baffled by why there was such a rush to label and judge Dr. Cox as a child abuser. The rush to judgment is a frequent trope in these stories,
26:30 but it's hard to know what Rush Newberger is referring to here. Eight months had passed between the incident and John's arrest, during which time three child abuse experts had concurred on the injuries. So that's Newberger and we're at four. And to help me break down the others, I called in an expert of my own. I'm Mark Hudson. I'm a child abuse pediatrician, and so that's my full-time gig is doing child abuse pediatrics. So I wanted to ask as a first question, what is the role of a child abuse pediatrician in a case like this? where the injuries are appear at or do appear at first to be more minor injuries. I agree. This is a child who was not going to have injuries that were life changing.
27:16 These were all injuries that were going to heal. But really, the role of a child abuse pediatrician is similar or the same, really, regardless of sort of the amount of injury that a child sustains. I think you're right that when you think about things that hit the media, it is often the cases that are just really devastating injuries. Maybe it's even children who don't survive their injuries. But the majority of the work that we do as childhood judiatricians is with children, you don't have those catastrophic injuries. They have more minor injuries.
27:46 They have injuries that might be very important when we think about their safety, think about their ongoing well-being. But maybe that injury in and of itself isn't going to be a life-changing event. Yeah. And so can you explain to us, something that was a big part of it, this case, especially because Dr. Lynn Sheets, who is the child abuse pediatrician at Children's of Wisconsin, had done some really important work and research in this arena. Can you talk to us about what is a sentinel injury? Yeah, and Dr. Sheets did do some really important work around this.
28:21 And I think the research that I always liked best was really that the kind of research that sort of confirms what we all see in clinical practice every day. And what Dr. Sheets worked on was looking at children who presented with serious injury, comparing those children who didn't have serious injury or children who weren't abused and looked at which of those children had previous injuries. Most often those previous injuries were minor things like bruises. And out of that work, really, I think she helped to kind of coin or popularize the theorem of a sentinel injury. A sentinel injury just really means a minor injury. That is a warning that there could be, this is a child who could be at risk for more injury, increased injury, or potentially that life-altering or life-changing injury,
29:07 life-ending injury. So sentinel just really meaning it, meaning it's a signal. It's a signal injury. As part of his defense, John Cox provided a reenactment video demonstrating how he had allegedly rolled over on the baby, and his lawyers tapped a number of orthopedic surgeons to shore up his case that the layover incident he described was consistent with the clavicle injury. And so what about this story that John Cox tells about how the clavicle fracture happened? That essentially he was cuddling with the child in the crook of his arm. And then awoke to her crying and realized that he had rolled over on her. And that he thought the weight of his body essentially was what caused this clavicle fracture.
29:58 I think there's a number of things that should make this history really suspect. And just try to unpack that a little bit. So I think it's important to remember that this is a child who's about a month old. So this is a really little baby. And we certainly see kids who have bad outcomes from sleeping with adults and having roll over events. So he's essentially describing a rollover event where this infant is against his chest, theoretically then gets pinned between his arm and his chest or maybe his other arm while they're face to face and in the sort of reenactment of the doll, it's pretty clearly he's like lying on top
30:46 of the infant. And that happens. But what happens to those infants is they end up dead, right? I mean, this is not an uncommon, this is not an uncommon thing that happens is that adults who are sleeping with infants might roll. Maybe sometimes they're intoxicated or under the influence of substance or something like that, but they end up on top of an infant and that infant ends up suffocating. So we have this really odd story year where he's lying on this child hard enough in kind of, you know, providing a compressive force hard enough to cause. theoretically cause a fracture, but yet this baby is still breathing fine and in fact breathing well enough to cry and wake him from his sleep. And I think that that just doesn't make a lot of sense.
31:37 And then you get into, you can get into sort of trying to debate about, well, it's just kind is laying against the guy's soft arm and his chest against him and are we actually going to get enough compression? And I think you can sort of, you know, go down that rabbit hole and probably conclude that is probably highly unlikely. But I think you'd step back to that bigger picture of this is a hard thing to make happen without also suffocating an infant. And oh, by the way, and I think Matt Torbenson pointed this out in some of his documentation, there's data around kids who die in overlying accidents, and clavicle fractures are not something that shows up in that population. Dr. Hudson noted in a follow-up that expert reports from orthopedists are an interesting choice
32:18 because no one would refer a baby with a broken clavicle to an orthopedist, so they don't really have much relevant expertise. Dr. Hudson said there's no question that compression can cause a fracture, but that isn't the question at play here. It's whether or not John's story is plausible. Whether laying on a baby hard enough and for long enough to cause a fracture wouldn't also result in that baby being suffocated and whether or not it would result in the injuries observed, which are not orthopedic questions. And no one cites any of the baby. any relevant literature when claiming that John's history was plausible, which, as Dr. Hudson points out, they certainly would have found with this many experts if there was any. There is, however,
32:59 literature to support the idea that an overlay situation was implausible, as Matthew points out. There's a study of, it's 4,670 infants who died in a co-sleeping setting. 3,218 of those infants had a complete skeletal survey after they passed away. Not a single one of those children had a clavicle fracture as a result of co-sleeping. There were 10 cases total where there were fractured bones in the child's body, but none of them were clavicle fractures. Indeed, if this clavicle fracture resulted from an overlay, it would be the first such incident recorded ever.
33:36 Mike Kixenbaugh attempts to shore up his position about the clavicle fracture not being indicative of abuse by linking to literature about injuries that are specifically indicative of abuse by themselves, such as posterior. rib fractures. Hicks and Bob points out that clavicle injuries in infants are relatively common and not particularly concerning for abuse. But again, as Dr. Hudson explains, child abuse medicine is not just about evaluating a specific injury out of context. It is getting that history. And indeed, clavicle fractures are not fractures that we think of as highly concerning or highly specific for abuse in the general population. So if you think about where the clavicles happen,
34:16 clavicle fractures happen. We see a lot of kids with clavicle fractures at birth. So if this had been a healing clavicle fracture, I think this child was over a month old at the time. If this had been a healing clavicle fracture, no one would have thought twice about this. You know, they would have said it up. I bet this baby had a clavicle fracture at birth, didn't get noticed. Now it's healing. Who cares? We're not going to try to say, oh, it must have happened a week after birth and just attributed to birth because it's just so common. And then we also see clavicle fractures once kids get older and they get run. running around and they're moving and they have falls and they fall on an outstretched hand or fall on their shoulder or, you know, and they get these clavicle fractures.
34:53 And then they're not specific for abuse, right? Not that they couldn't be abusive, but they're not a specific fracture. A rebuse is not a fracture you say, oh, man, I'm really worried about that. But what kind of doesn't get acknowledged here is that there is this period in the middle. We're not going to, you know, just like we're not going to accept bruises in this little period in the middle, we're not going to expect a clavicle fracture, right? this is not a baby who was up and running around. This is not a baby who had a healing clavicle fracture from birth. And, you know, in this gap, actually, clavicle fractures are really uncommon. We don't see clavicle fractures, any fracture, including clavicle fractures, are really uncommon in infants, non-mobile infants.
35:34 So, yes, in general, clavicle fractures are not particularly specific. However, an unexplained or a poorly explained clavicle fracture in an infant who's not another wall, is still a concern. So what about the bruises? One of the defense's claims about Rita Ventura was that she noted more bruises on the baby when she evaluated her on May 10th than Dr. Yvonne Chu did when she evaluated LG on May 13th. We don't have either doctor's reports. But again, there was consensus from all of the doctors that there were three bruises on
36:08 LG's arms and back. Part of the public response to this case, as well as some of the defense experts, seemed to boil down to the idea that the bruises on this infant just weren't that big of a deal. Here's Dr. Hudson. Bruising is sort of the most common injury that anyone sustains, right? We could probably all sit here and search our body. We might even find a bruise that we're not entirely sure where it came from. So, you know, that is the baseline knowledge for people, for pediatricians, for physicians, for general public,
36:36 is that bruises are really common. And when we're thinking about sentinel injuries, that term sentinel injury, he specifically refers to young kids. And there's a distinct difference in non-mobile kids, kids that aren't getting up, kids that aren't getting off their butt, kids that aren't even cruising along furniture, that we're not going to expect them to have bruises. And we're certainly not going to expect them to have bruises without a clear history of, you know, trauma that's going to clearly account for that injury. Thinking about people like to think that infants don't get dropped, infants don't fall off tables, those kinds of things. But that happens all the time, right? It's a really common event. And even in those events, most times, they're not resulting in a bruise.
37:19 But if your infant has an event, falls, drops, something like that, an adult should know about it, right? Because that infant didn't climb back up on the changing table themselves, right? You didn't leave the table. You didn't leave the room. They fell off the changing table and then climbed back up and you never knew about it. So you think there's sort of two things. One is we're not going to expect bruises in infants because they aren't doing those things. They aren't running around.
37:45 They aren't smacking their shins into the coffee table. And if there are bruises, we'd really like to have a really clear history of something that is consistent with trauma that we can expect a bruise. John and his wife Sadie offer a number of different stories to explain the bruises on LG. John reported picking her up in a panic when she awoke, a possible explanation for the bruises on her arms, and burping her on the back where his wedding ring could have left the bruise there. Or perhaps it was from laying her on a pacifier. Several days after the incident, Sadie emailed CPS to offer some additional thoughts on the bruises, saying she found a stray bobby pin in the baby's bathtub.
38:24 Sadie also said she thought the concerns were premature. Were they really sure these were even bruises? Ultimately, there was no dissension that three of the markings on the baby were bruises. And as the outside cap Nancy Harper would later note in her review of the case, There is no hematologic explanation for the cutaneous trauma. Bruising has not continued with a change in placement. These injuries do not represent birth marks and are not explained by routine infant care. And as Dr. Hudson says, it's hard to zero in on exactly what plausible explanation John had given to explain the injuries.
38:58 I think as I looked through the records and looked at sort of what was attributed to other doctors having been said, it wasn't always necessarily clear whether they were trying to attribute the bruises on the arm to, to the lieover event or to the secondary picking him up. It was often just referenced as, oh, his explanation makes sense. But it wasn't really clear to me like, which explanation? We're talking about squeezing the arms because he picked him up. But I think that's maybe what they were referencing, although sometimes it seemed like they were referencing the bruises to come directly
39:30 from this lieover event. But so there's- Which that doesn't make any sense. That doesn't make any more sense. No, that makes probably less sense, right? But I agree. And some of this comes down to a little bit of common sense, right? So does this ER doctor, who is walking by a crying child, panics so much that he suffocated a crying child, that he then squeezes the infant so hard that it causes bruises. I think that it. But you know the child's not been suffocated because she's crying. She's crying, right? I mean, if someone is qualified to assess that this child has not been suffocated because of it's they're crying, I presume it should be a pediatric ER doctor, I think that it gets, you know, from the description of the bruises, could they be consistent with the squeeze around the arm
40:21 or on the chest? Yeah, I think they could be. Do I think that makes sense that he does this in a panic? I think that doesn't make a lot of sense. At best, it is highly suspect, right? And I think that that's important when you put in the context of the rest of the story. Another claim made by the defense and repeated by Hicksenbaum was that the child abuse doctors either misread or inappropriately dismissed one of LG's blood test results. Again, here's Dr. Hudson. What I'm reading is a little bit more of a fudge, right? So I didn't see any hematologist that said, this child has this disease based upon this lab result. That is not in there. Absolutely not. Right. So there's nobody saying, clearly this is diagnostic of this thing, right?
41:06 But what I did see was people sort of saying, well, this was abnormal. So there should have been more testing. Right. And so it's not that they actually came up with an alternative hypothesis or they came up with an alternative diagnosis. They came up with a suggestion that something more should have been done. And something more than could have possibly maybe resulted in some different event. Now, it's also referenced in there.
41:35 I think by sort of the outside child who is consultant of like, this child didn't go on to have more bruises, right? And, you know, I think sometimes when you get into these cases, we get all work, you know, like, oh, this lab results is the important thing. Well, it's not, you know, if we go put this child with somewhere else where they're getting normal care and handling and they don't get bruises, then they don't get bruises from normal care and handling. The reality is there are nuances to these cases that no laborable,
42:05 reporter, including myself, is really going to understand, which is why you ask someone like Dr. Hudson. So when we're talking about a lab test, you know, we can, we'll get, you know, oftentimes that you need the result and it's going to be, it's going to be reported with a normal range, okay? And, you know, sometimes for some tests, that normal range is just sort of what experts think it should be, right? Like vitamin D, there's not actually a normal. It's just based upon expert consensus. But for lots of tests, that is just sort of what is normal and the population, right? And so what's clear here is if we're talking about, people argue about this is normal or that's not, we're not talking about a massive abnormality. Okay. And so
42:47 our norms are set based on sort of what's in the population. Our norms are not set based upon one side of the line is normal and healthy. The other side of the line is severe disease. Right. So even if you have a test that even we're going to say this is an abnormal test, it's clearly not seriously abnormal. It may not be actually clinically important, okay? Because we're not talking about trying to say, hey, this child had major trauma and maybe they bled a little easier than we think. We're talking about basically a guy saying, well, I squeezed them a little bit hard. So we need not just a little abnormality. probably a significant abnormality to say that, hey, this is clinically important.
43:37 And none of these questions were actually left unanswered. They'd been resolved by the time John was charged with abuse. I think that just epitomizes a lot of my frustrations with this case. This happened back in May of 2019, and I didn't issue charges until January of 2020. I knew the blood test results. I also knew that when you look at the blood test results and you adjust them for the child's birth because the child was born premature, that they were actually normal blood test results. They were not abnormal. They were abnormal until you adjust them for the child being born premature. So that was the first thing. Oh, I see. So like if you had a full-term child who is one month old, then that test would be concerning. But because the child's sort of
44:24 biological age is less than a full-term baby adjusted for that, they're normal. Yeah, you'd have to adjust for the child's development and age. And because the child was born prematurely, she's not going to have the same results as a full-term, one-month-old child. And so that had to be taken into account. The second thing was I had the opportunity to talk with individuals who are monitoring this child closely for the eight months after this child suffered the abuse at the hands of Dr. Cox, the child had no abnormal bruises. And if a child has a bleeding disorder that's resulting in
45:03 bruising on the child, you would expect that child to have a lot of bruising from normal handling and care. We had nothing like that in this particular case. We had no additional bruising reported, no concerns from any of the caretakers after this incident took place. fall might be on its way, but it is still warm outside, and that is bad news for hot sleepers. There's nothing worse than crawling into bed after a long day and feeling sweaty and having your sheets stick to your legs, having to crank up the AC just to get comfortable. That is why I love Bull and Branch's fabulous summer bedding options. They are breathable, lightweight, and designed to keep you cool all night long.
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48:31 rather than looking at it as a whole picture. And from what we know about what's in the reports, it hardly boils down to these doctors saying there was, quote, no proof that John abused his baby. They were saying that his various explanations for the injuries could be plausible, And while child abuse physicians regularly consult specialists when they run into a knowledge gap, it doesn't make sense to look at injuries piecemeal when they happened all at once. If you go to your doctor and report half a dozen symptoms that came on all at the same time, you don't want her to look for six different isolated explanations. You want her looking for something that explains the whole picture.
49:09 And as Dr. Hudson explains, child abuse medicine is no different. If you're going to really think about a value in any case like this, you really need to look at the entire clinical scenario and how many sort of improbable or nearly impossible things have to line up before you say that clinically this doesn't make any sense. The 15 experts case only really holds up if you think that child abuse doctors are, by their nature, not experts themselves. By all accounts, Cox was taking a defensive posture. The media was on his side. There was a massive public outcry on his behalf. His defense team sent Matthew Torbenson a PowerPoint detailing additional experts they would call to the stand.
49:50 It appeared John and Sadie would, as they had told Hicksenbaugh, do everything they could for the rest of their lives to get her to come home. But then, something else came out during the course of Matthew Torbenson's investigation. The story that John Cox had repeated to the doctors and CPS and law enforcement and the press about the morning of LG's injuries was a lie. While there had already been some concerning variations in his story, the basics had always been this. John recounted bringing LG into bed with him at 5 a.m. after an ordinary night where she'd woken up for a couple of feedings. He then described nodding off and waking to her cries at around 6 a.m., at which point he called and then FaceTimed with his wife, Sadie. And then...
50:37 There's a phone call, according to Dr. Cox, initially, his first phone call to Dr. L. Pomerantz, who is the pediatrician for the child. And initially, Dr. Cox says that Dr. Pomerantz doesn't answer the phone. There is eventually a phone call that gets through to Dr. Pomerantz. The next thing John reports is going to see Dr. Pomerantz that morning at his office, after which the initial report is made to the child advocacy team. Everything seemed to corroborate at least this basic series of events until Matthew's office requested the hospital's nursing notes. It turned out that in addition to calling his wife Sadie and Dr. Pomerantz on the morning of May 9th, John had made a third phone call to the on-call nursing hotline.
51:21 And in that phone call, he describes the child as being up for 12 hours straight for being virtually unconsolable in this phone call. So it's hard to know. So he's not calling the on-call nurse about the arm. He's saying, I can't get this baby. Like, I'm just worried something's wrong because the baby has been. up all night. Correct. And his wife was out of town when this happened, right? Yes. Okay. So he's alone with a baby and because I did not see that account anywhere in the media. We found that account out after the criminal charges were issued and I actually found a motion to
51:58 amend my witness list to include the on-call nurse and to get that medical record in. And it was shortly after that that the case took a turn and seemed to move into a resolution posture. John filed a grievance against Dr. Rita Ventura for her alleged failure to take a comprehensive history. But John had told doctors, CPS, and law enforcement numerous variations of the events of the evening of May 8th and the morning of May 9th. None of them had included the call to the nurse hotline or LG being fussy all night. This was not a minor omission. That phone call he made to that on-call nurse demonstrated that this child was up crying all night, could not be consoled, could not be sued in any way, shape, or form.
52:44 We know that John Cox couldn't sleep that night, couldn't go to sleep and was up for hours and hours and hours with this child who was inconsolable, right? We can look at the pattern of injuries and know that in one moment of time he grabbed and squeezed the child's arms and squeezed in a way that there was pressure applied to the clavicle. And this story was a long way from over. So it led to a huge media storm against children. hospital led to a huge media storm against the district attorney's office, and in particular, me, I think I had a folder with my secretary that was just labeled Matt's hate mail that was,
53:21 you know, every day I would come into 10, 15 additional letters. Talking about the injustice I was carrying out by prosecuting Dr. Cox. That's next time on Nobody Should Believe Me. Nobody Should Believe Me is executive produced written and hosted by me, Andrea Dunlop. Our co-executive producer is Mariah Gossett. Our editor is Greta Stromquist. Research and fact-checking by Aaron Ajay. Additional research by Jessa V. Randall. Our production manager is Nola Karmouche. Music from Blue Dot Sessions, Sound Snap and Slipstream. Spotify, it's Jay Shetty. Are you one of those media strategy people? Scrolling through spreadsheets, searching for an audience that pays twice as much attention to your ads
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