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Nanny’s lawyer challenges diagnosed cause of child’s death

Aisling Brady McCarthy attended a hearing at Middlesex Superior Court last year.Wendy Maeda/Globe Staff/File

The defense team for an Irish nanny accused of killing a baby girl in her care last year has filed a motion challenging testimony from a specialist who diagnosed 1-year-old Rehma Sabir as a victim of abusive head trauma.

In court documents filed Wednesday, Aisling Brady McCarthy’s lawyers asserted that “an avalanche of science” has raised doubts about diagnoses of shaken baby syndrome, particularly in cases where there are no outward signs of abuse.

“At best, SBS is a highly controversial, unproven hypothesis unfit to serve as the basis for a murder prosecution,” they wrote. “At worst, SBS is junk science, a tragic hoax caused by overzealousness within the child protection community.”


McCarthy’s lawyers, Melinda Thompson and David Meier, sought a hearing on the evidence “given the present debate within the relevant scientific community as to the reliability and acceptance of shaken baby syndrome or abusive head trauma in general.”

A spokeswoman for the Middlesex district attorney’s office, which is prosecuting the case, declined to comment Thursday. The trial is scheduled to start in October.

McCarthy is accused of fatally assaulting Rehma in January 2013 while baby-sitting her in the child’s Cambridge home. Investigators found blood stains on a pillow and blanket in her crib, and prosecutors say the child suffered acute head injuries that led directly to her death.

Sabir, who authorities say was in McCarthy’s exclusive care when she was injured, was diagnosed at the hospital by Alice Newton, then the medical director of the child protection program at Boston Children’s Hospital. Prosecutors plan to call Newton as an expert witness in the case.

Newton declined to comment.

Prosecutors say Rehma Sabir suffered massive bleeding in her brain and the back of her eyes, injuries specialists say strongly indicate abusive head trauma.

“Bleeding in the back of the eye rarely happens absent abuse,” said Robert Sege, medical director of the Child Protection Team at Boston Medical Center.


Sege said abusive head trauma is a leading cause of death of infants, and its existence is a “settled scientific fact,” according to the American Academy of Pediatrics.

At least 80 infants die each year from abusive head trauma, according to government figures.

Initially, doctors told the child’s parents and McCarthy that Rehma was having a series of strokes. Child protection specialists soon suspected abuse. Newton diagnosed the child as a victim of abusive head trauma the day after she was hospitalized. She was declared brain dead the following day; life support was removed two days later.

McCarthy’s lawyers said there is no evidence that Newton or other specialists “spent any meaningful time” looking at alternative diagnoses.

“She diagnosed SBS so quickly . . . that it is difficult even to pretend for argument’s sake she engaged in any serious differential diagnosis,” they wrote.

Newton declined to comment because the case is ongoing.

The defense’s motion also asserts that the child “was sick much of her life,” and was seen by specialists for gastrointestinal problems, failure to gain weight, and a bleeding disorder. According to medical records, the child was diagnosed with malnutrition five weeks before her death, and “by all accounts bruised very easily,” the lawyers wrote.

“When [Rehma] died, her body had no bruises, grip marks, crush injuries, or acute broken bones,” the lawyers wrote. “Yet, the Commonwealth alleges that medical science proves that she died because the last person with the child, Ms. McCarthy, violently shook her or caused her abusive head trauma. Not so.”


Her lawyers also noted that prosecutors initially charged McCarthy with inflicting vertebral fractures, but later determined the injuries were mostly likely three to four weeks old. At that time, the child was traveling with her mother in Pakistan.

In a separate motion, McCarthy’s lawyers asked for evidence in a pending murder case against Geoffrey Wilson in the 2010 death of his 6-month-old son. They asserted that Wilson was indicted based on Newton’s determination that the infant died from abusive head trauma, but said the state’s medical examiner’s office recently has changed the cause of death from homicide to undetermined.

“The opinions expressed by Dr. Newton in the Wilson case are strikingly similar to those expressed by her in this case,’’ her lawyers wrote.

The spokeswoman for the Middlesex district attorney said she could not comment on the Wilson case.