Thursday, April 16, 2015
YOLO COUNTY NEWS
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Pediatrician’s testimony wraps up first week of alleged abuse trial

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From page A1 | April 27, 2014 |

WOODLAND — An entire courtroom sat in silence Friday, no one uttering a word for a full 5 minutes.

That was the amount of time that a Woodland man said his 2-month-old son went limp in his arms on Sept. 11, 2012, six days after the baby’s parents reported his fall from a bed in the family’s home.

“He was limp and just whimpering,” the father, Quentin Stone, later wrote in an email to the family’s pediatrician, Dr. Yvonne Otani, who had examined Samuel and his twin brother two days earlier at their well-baby visit. Stone noted that Samuel regained consciousness after the 5-minute stretch, at which point he appeared “exhausted.”

“Does that sound like a seizure?” Stone’s attorney, Supervising Deputy Public Defender Monica Brushia, asked Otani on the witness stand Friday in Yolo Superior Court, shortly after setting a timer to demonstrate the length of the 5-minute time span.

“It could be,” Otani replied.

“A seizure could be a potential sign of a head injury, correct?” Brushia followed up.

“Yes,” Otani whispered.

But instead of ordering radiology tests to determine whether baby Samuel indeed had head wounds, Otani said Friday she assured his parents that his symptoms — including repeated vomiting — were the result of acid reflux, a condition she said affects a high percentage of newborn babies.

The pediatrician from Kaiser Permanente’s Davis clinic testified as a prosecution witness in the trial for Stone, who is charged with felony and misdemeanor child endangerment in connection with Samuel’s Oct. 9, 2012, death. Yolo County prosecutors allege he repeatedly abused the baby, causing bleeding to his brain and multiple rib fractures.

Stone’s defense attorneys maintain that Samuel’s injuries likely stemmed from the unwitnessed fall from a 3-foot-high bed on Sept. 5, 2012, for which he was taken to the emergency room and examined again two days later, but released with assurances that he was “fine.” Stone has pleaded not guilty to the child-abuse allegations.

Otani’s testimony lasted a full day, much of it a grilling by defense attorneys who questioned her response to Samuel’s unusual behaviors.

Under direct questioning from prosecutor Steve Mount, Otani recalled examining the twins at their 2-week well-baby visit and again at 2 months, the second exam taking place five days after Samuel’s reported fall. The babies’ height, weight and head circumferences all were within normal ranges, she said.

“I did pay special attention to (Samuel’s) head,” checking for signs of increased intracranial pressure — irritability, turned-down eyes or a bulging soft spot — but finding none, Otani said. The boys’ mother, Sara Stone, reported that Samuel had vomited several times in recent days, but Otani ruled out the fall as a likely cause.

Acid reflux “is just very common at that age,” Otani said.

Sara Stone also raised the question of performing a brain scan, but with no outward signs of trauma and the potential risks involved in exposing an infant to radiation, “I said I didn’t really see any … need to do that,” Otani testified.

During cross-examination, Brushia displayed in court a series of emails exchanged between Otani and Quentin Stone, starting Sept. 7, 2012, with the report of Samuel’s fall and subsequent trip to the emergency room.

“Since we got home he’s had trouble keeping food down and seems very uncomfortable,” Stone wrote to Otani, who scheduled a follow-up visit with her partner at the Davis clinic for later that day.

A day after the twins’ 2-month checkup, Otani received Stone’s email reporting the 5 minutes of limpness, which Otani called “a little more concerning” in her response. But she also said the behavior was “exactly what babies do sometimes, especially when they are upset or stimulated too much.”

“I don’t think he’s in any pain from the fall. From what I could tell his exam was completely normal … and there was no sign of internal injuries,” Otani’s email continued. She suggested giving Samuel medication to ease the acid reflux and said an EEG — a brain-wave test — might be in order should Samuel suffer another limpness episode.

That episode happened on Oct. 3, 2012, when Samuel suffered a seizure at the family’s Woodland home that rendered him unconscious. A subsequent brain scan at Woodland Memorial Hospital showed evidence of bleeding to both sides of Samuel’s brain, and he died six days later at the UC Davis Medical Center in Sacramento.

“By then it was too late to help Sam, correct?” Brushia asked the pediatrician.

“Yes,” Otani replied.

Brushia highlighted Friday what appeared to be a drop in weight and increase in head size for Samuel between his emergency-room follow-up visit on Sept. 7, 2012, and his well-baby exam three days later, though Otani noted the baby likely would have been weighed with his diaper and possibly his clothing on during the earlier visit. The increase in head size, about four millimeters, was not cause for alarm, she added.

Otani also acknowledged that some infants are born with subdural hematomas — a collection of blood on the surface of the brain — but said they are “generally very small” and tend to heal themselves within a few weeks of birth. Asked whether they can prove fatal in the event of a fall, Otani said she had “no clinical experience” in that area.

In the end, Otani did end up ordering both CT and MRI scans — these for Samuel’s twin, Henry, “to rule out abuse” in the wake of Samuel’s death, she testified. The tests revealed extra fluid in the baby’s brain, but in Otani’s view it was “a normal variant.”

Stone’s trial resumes Monday in Judge Paul Richardson’s courtroom.

— Reach Lauren Keene at [email protected] or 530-747-8048. Follow her on Twitter at @laurenkeene

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