sponsored by VACCINATIONNEWS.COM AND REDFLAGSDAILY.COM

Analysis of Causes That Led to Baby Lucas Alejandro Mullenax-Mendez’s Cardiac Arrest and Death in August-September of 2002

By Mohammed Ali Al-Bayati
Ph.D., DABT, DABVT
Toxicologist & Pathologist

Toxi-Health International
Dixon, CA 95620
Phone: (707) 678-4484
Fax: (707) 678-8505

maalbayati@toxi-health.com
http://www.toxi-health.com

SUMMARY

Lisa Mullenax and her husband Alejandro Mendez were accused of killing their three-and-a-half-month-old Baby Lucas by blunt force trauma to the head (Shaken Baby Syndrome). The baby suffered from cardiac arrest and apnea on August 27, 2002 and his father immediately sought the assistance of a neighbor who contacted the Medical Emergency Service (MES) asking for help. The MES resuscitated the baby, treated him with epinephrine, and transported him to the Centre Community Hospital. Lucas stayed about one hour in this hospital, and then he was airlifted to the Geisinger Medical Center. Lucas was pronounced brain dead after six days following his arrival to the Geisinger Medical Center. In the hospitals, several physicians examined Baby Lucas and no evidence of traumatic injuries to the head was observed. In addition, Lucas’s head region was examined by CT scans on August 27^th and no bone fracture was found. Lisa and Alejandro were accused of killing their Baby Lucas based only on the autopsy findings of an old-healed rib fracture and bleeding in the retina of the eyes, brain, and the subdural space.

Lisa and Alejandro requested that I evaluate their case to find the factual cause(s) that led to Lucas’s cardiac arrest and death. I evaluated their case by reviewing the baby’s medical records and case history and the autopsy report; Lisa’s medical record during her pregnancy with Lucas; and the published medical literature pertinent to Lucas’s case. I used differential diagnosis to evaluate the contribution of causes and the synergistic actions among these causes that led to the baby’s cardiac arrest, apnea, bleeding in the brain and other locations, and death.

I present my review and analysis of Lisa’s medical records during her pregnancy with Lucas in Section I of this report. Section II contains a detailed description of Baby Lucas’s treatment history and his health problems from the time of birth on May 16, 2002 to the day of his cardiac arrest on August 27, 2002 along with my analysis of those events. In Sections III and IV, I describe the clinical events that took place during Lucas’s seven days in the hospitals and my analysis of those events. My analysis of the medical examiner’s autopsy report is presented in Section V. Section VI contains my conclusions and recommendations.

Baby Lucas was born at 41 weeks of gestation on May 16, 2002. He was in excellent health until the day of his vaccination on July 23^rd when he was 9 weeks of age. He was simultaneously administered seven vaccines (DTaP, Hepatitis B, Hib, IPV, and Pneumoccocal vaccine) and developed an upper respiratory tract infection within one to two days post-vaccination. He was treated with Tylenol for two to three days for fever. At seven days post-vaccination, Lucas’s mother took him to his pediatrician because he was still suffering from an upper respiratory tract infection. Also, one day prior to Lucas’s vaccination, Lucas’s mother suffered from mastitis and she was treated with a 10 days-course of Dicloxallin. She breast-fed Lucas during her treatment with an antibiotic and he developed diarrhea. Furthermore, Lisa was also treated with an eleven days-course of an antibiotic on May 20^th, when Lucas was four-days old and she also breast-fed him during her treatment (Table 1).

The clinical data collected during Lucas’s hospitalization following his cardiac arrest on August 27^th revealed that he suffered from serious health problems, which were responsible for his cardiac arrest and the bleeding in the brain, subdura, retina, and other locations. These included diabetes mellitus; metabolic acidosis, liver damage, urinary tract bacterial infection, pneumonia, vitamin K deficiency, anemia, and brain edema. Lucas’s health problems were induced as a result of his seven vaccines received on July 23^rd (Table 3), and the treatment of his mother with antibiotics during Lucas’s breast-feeding period used to treat her upper respiratory tract infection and mastitis (Table 1).

The vaccines given to Lucas on July 23, 2002 induced an upper respiratory tract infection within 1-2 days post-vaccination and I believe that this infection also caused Lucas’s urinary tract bacterial infection observed on August 28^th and his pneumonia discovered at autopsy. Lucas’s systemic infections caused hyperglycemia and metabolic acidosis, which subsequently led to the reduction of the levels of potassium in the cardiac muscle and nervous tissues and that led to cardiac arrest. Serious adverse reactions to vaccines and death in children have also been reported in the medical literature. For example, in the USA, reports to the Vaccine Adverse Event Reporting System (VAERS), concerning infant immunization against pertussis between January 1, 1995 and June 30, 1998, revealed 285 cases of death and 971 cases of non-fatal serious illnesses (II-B).

The treatment of Lucas’s mother with antibiotics predisposed Lucas to vitamin K deficiency by reducing the levels of vitamin K in her breast-milk, causing Lucas’s diarrhea, and reducing vitamin K synthesis in Lucas’s gastrointestinal tract (GIT), and vitamin K uptake from the GIT. Lucas also suffered from liver damage and other systemic problems that reduced the synthesis of coagulation factors in liver and reduced food intake. Moreover, Lucas was almost exclusively breast-fed during his life and human milk has low concentrations of vitamin K. Vitamin K deficiency was the primary cause of bleeding in the brain and other tissues in this case. I presented the clinical evidence that show Lucas suffered from vitamin K deficiency and vitamin K deficiency is the common and well-documented cause of bleeding in breast-fed infants in Section IV of this report.

Furthermore, the treatment of Lucas with epinephrine in the hospital on August 27^th and thereafter also contributed to the subdural bleeding and bleeding in other locations as shown by several brain CT scans taken on August 27^th through August 30^th. In addition, on August 28^th, the blood pH reached a critical low of 6.64 and the baby was treated with sodium bicarbonate. Unfortunately, he was treated with excessive amounts of sodium bicarbonate and the blood pH reached a critical high of 7.67 (Table 4). This treatment caused brain and pulmonary edema, hypoxia, and hypokalemia.

The radiology findings show that Lucas had an old-healed fracture of rib #11. Rib fractures have also been observed to occur during labor in babies as explained in this report (V). Lucas was born by vaginal delivery at 41 weeks of gestation with manual assistance and the force used caused his mother to suffer from vaginal laceration, severe bleeding, hypotension, and anemia that required a blood transfusion. It is likely that Lucas’s rib fracture happened during labor.

Dr. Samuel Land performed an autopsy on Lucas on September 4, 2002 (case # C-02-581) and the main objective of this autopsy was to establish the factual causes of injuries and death in this case. He stated that "after review of the clinical history and a complete autopsy, it is determined that the cause of death of this 3 _ month old male is blunt force trauma to the head and the manner of death is homicide". I find that Dr. Land’s conclusions are unsupported by the clinical data related to this case, which are described in this report. I present my arguments against Dr. Land’s methods of investigating this case and his conclusions with the supporting medical evidence in Section V of this report. The following is a list of some of the problems concerning Dr. Land’s methods of investigation and his conclusions of the causes of injuries and death in this case:

1. Dr. Land stated that Lucas’s cardiac arrest and bleeding were caused by blunt force trauma to the head. However, he did not provide any evidence that the baby suffered from trauma. In addition, several physicians examined Lucas on August 27^th and no evidence of trauma was found in the head region or any part of his body. Also, the CT scans of the head region that were taken on August 27^th did not show any evidence of trauma or bone fracture in the head region.
2. Dr. Land presented a list of lesions in his autopsy report without providing the gross and microscopic descriptions for these lesions (V).
3. The clinical data presented in this report showed that Lucas suffered from diabetes, metabolic acidosis, hypokalemia, liver damage, urinary tract bacterial infection, pneumonia, and vitamin K deficiency, which are known to cause bleeding and death in children. However, Dr. Land did not investigate the contribution of these illnesses to the causes of bleeding in tissues and death in this case.
4. Dr. Land overlooked the well-established biomarkers of vitamin K deficiency observed in this case. Lucas had a high level of PIVKA-II protein, which is a sensitive marker for vitamin K deficiency. In addition, prothrombin time (PT) and activated partial thromboplastin time (APTT) were elevated on August 27^th and the treatment of the baby with vitamin K reduced PT and APTT by 20% and 25%, respectively (Table 9).
5. Dr. Land stated in his autopsy report that the occurrence of chronic bleeding in the subdural space cannot be excluded with certainty as shown by the CT scan of the head on August 27^th. The blood products were of various ages. That means that bleeding started several days to several weeks prior to August 27^th. However, Dr. Land did not examine H & E stained tissue sections of the subdural hematoma and the meninges microscopically to evaluate the structure and the age of the bleeding.
6. Lucas’s medical chart shows that Lucas suffered from a urinary tract bacterial infection on August 28^th. However, Dr. Land did not present any description for the urinary tract in his autopsy report nor did he mention that the baby suffered from urinary tract infection.
7. Dr. Land stated that Lucas suffered from diffuse axonal injury but he did not provide the description of this injury or the method that he used to detect this injury. In addition, he claimed that diffuse axonal injury in this case was caused by blunt trauma to the head. I described several studies in this report that show axonal injuries indistinguishable from those observed in cases of head trauma that were described in cases of edema, hypoxia, hypoglycemia, cardiac arrest, and other causes (V-E). In this case, the baby suffered from brain edema, hypoxia, and cardiac arrest. However, Dr. Land did not perform a differential diagnosis in this case.
8. Dr. Land did not evaluate the contribution of the adverse reactions of medications given to Lucas in the hospital to the causes of bleeding and death. Lucas was treated with excessive doses of sodium bicarbonate that caused severe edema in the brain and lungs, hypoxia, and hypokalemia. Lucas was also treated with epinephrine, which contributed to the bleeding in his tissues.
9. Dr. Land did not evaluate the contribution of the adverse reactions of vaccines given to Lucas to the causes of bleeding and death in Lucas’s case. Lucas developed an upper respiratory tract infection within 1-2 days post-vaccination. Serious systemic injuries and death have been reported in babies who have received vaccines (II-B).
10. Dr. Land assumed that the healed-old fracture of rib # 11 observed in Lucas case was resulted from child abuse without performing a review of the medical literature to find out if rib fractures had been reported to occur during labor in infants. I presented several studies that show rib fractures occurred during labor (V-G).

The Mullenax and Mendez family have suffered from two tragedies because the physicians who treated Lucas with vaccines and those who treated his mother with antibiotics during the breast-feeding period did not take into consideration the adverse reactions of those agents on Lucas’s health. In addition, the physicians who treated Lucas during his hospitalization following his cardiac arrest and the medical examiner in charge of this case did not consider the adverse reactions of medications and vaccines given to Lucas and the adverse reaction of antibiotics given to Lucas’s mother in their investigation. The first tragedy is the loss of Baby Lucas due to adverse reactions to vaccines and medications. The Mullenax and Mendez family’s second tragedy is the false allegation, accusing Lucas’s parents of killing their Baby Lucas, which is a horrible crime that they did not commit.

I urge the doctors who are involved in this case, health care workers, and officials in the state of Pennsylvania to review the medical evidence presented in this report. It clearly shows that Lucas died as a result of the adverse reactions to vaccines and medications and Lucas’s parents are innocent. Actions should be taken to prevent similar tragedies from occurring again. The objective of the state and health care workers should be to determine the factual causes that lead to the illness and death of a child and to prevent such problems from happening to other children. Accusing innocent parents of abusing and killing their children based on unsupported theory, as it happened in this case, will not prevent the death of other children from the adverse reactions to vaccines and medications. However, it certainly puts innocent people in prison and causes great suffering. It also costs the taxpayers huge sums of money in order to pay for unnecessary trials and legal fees while destroying the lives of innocent parents and caretakers.

I believe that the following recommendations will help prevent future infant deaths from occurring as a result of the adverse reactions to vaccines and medications. Furthermore, it may prevent innocent people from wrongly incarcerated.

1. Babies who show adverse reactions to vaccines should be monitored more often. Their blood should be analyzed to check for the levels of pH, gases, glucose, potassium, vitamin K, and coagulation factors.
   
2. Breast-fed babies should be given 1 mg of vitamin K monthly to prevent bleeding in the brain and other locations. An ill breast-fed baby who has feeding problem and vomiting may require higher doses of vitamin K.
   
3. Mothers receiving antibiotics should avoid breast-feeding their babies during the course of the treatment if possible.
   
4. Babies who are admitted to the hospital with bleeding should be checked for vitamin K deficiency, liver damage, and should be given vitamin K supplementation.
   
5. The use of sodium bicarbonate in the treatment of acidosis should be avoided if possible. Children who are treated with sodium bicarbonate should be monitored closely. In addition, the standard recommendations regarding the use of bicarbonate to treat acidosis should be followed in order to prevent the excessive use of bicarbonate and the development of brain edema.
   
6. In cases similar to Lucas’s case, medical examiners and physicians should review the medical evidence and perform differential diagnosis prior to giving their conclusions that a child died as a result of a blunt force trauma to the head (Shaken Baby Syndrome).

Section I. Review of Lisa Mullenax’s Medical Records During Her Pregnancy With Lucas

Lisa Mullenax is a white female a schoolteacher. She was 27 years old (date of birth 09/25/1974) when her son, Lucas was born on May 16, 2002. Lucas was her first child.

Her pregnancy was confirmed in September of 2001. During her pregnancy, she suffered from nausea, continual painful sciatic nerve condition, and hypothyroidism. The sciatic pain prevented her from walking for at least one week. Furthermore, in December of 2001, she developed a tooth infection and she was treated with a course of penicillin [1].

She also suffered from a bacterial upper respiratory tract infection at one week prior to giving birth to Lucas and this infection continued after labor. She was treated with a course of Cephalexin at day four following giving birth (Table 1). This antibiotic inhibits the growth of bacteria that synthesize vitamin K in the intestinal tract, which leads to the reduction of vitamin K levels in milk. It is also excreted in milk and inhibits bacterial growth in the intestinal tract of the baby and reduces vitamin K synthesis. It also causes diarrhea in infants and thereby reduces vitamin K uptake from the intestinal tract as described in Section IV of this report.

On May 16^th at about 1400, Lisa felt the leakage of the amniotic fluid accompanied by severe pain. At about 1700, she was treated with Demerol into the spine to reduce her pain but its effects started to wear off at about 2000. Lucas was born at 2137 by vaginal delivery with manual assistance. Lisa remembered at one point that she was told to stop pushing because the baby needed to be repositioned. Her mid-wife moved the baby’s head around so that he would come out right. Lisa was in a lot of pain and fainted immediately after giving birth. Her blood pressure dropped and she severely hemorrhaged as a result of vaginal laceration. At the time of delivery on first presentation she had a relatively normal hematological profile with a white count of 10,400/m L, hemoglobin 12.5 g/dL, and platelets 136,000/m L. Following delivery, her hemoglobin fell to a low of 6.6 g/dL with a hematocrit of 18.9%. There was also a drop in her platelet count to as low as 108,000/m L. She was given a blood transfusion and treated with iron and vitamin B [1].

Furthermore, on May 18th, she had severe pain when attempting to urinate. Her husband discovered that part of the placenta was still not removed and a nurse, then a physician, proceeded to manually remove it. However, on May 20, 2002, an ultrasound exam of the abdomen was obtained and it showed a retained placenta. Her doctor removed the rest of placenta that day. The vagina and vulva were also inspected and two small first-degree bilateral vaginal lacerations were discovered [1].

Lisa left the hospital with Lucas on May 21^st and on that day she exclusively breast-fed him even though she was taking Cephalexin to treat her upper respiratory tract infection (Table 1). On July 22nd, Lisa came down with mastitis. Her breast was sore and her temperature was 101.2 ^oF. Her mid-wife gave her Dicloxallin (Penicillin) to treat the infection without giving her instructions about the secretion of this antibiotic in her breast-milk and the impact it could have on the baby’s health. Lisa continued to breast-feed Lucas as she did during her treatment with antibiotic two months earlier (Table 1). The use of these antibiotics by the mother during the breast-feeding period can lead to vitamin K deficiency in infant. These antibiotics inhibit bacterial growth in the intestinal tracts of the mother and the breast-fed infant, and thereby reduce vitamin K synthesis. These antibiotics were also excreted in milk and caused diarrhea in her breast-fed infant, which led to reduction of vitamin K uptake from the intestinal tract. Furthermore, Lisa was also given Synthroid to treat her hypothyroidism which she began taking in mid-August.

Section II. Review of Lucas Alejandro Mullenax-Mendez’s Medical Records From the Time of Birth on May 16^th to August 27, 2002 and Analysis of His Health Problems

II-A. Case history and health problems

Lucas was born on May 16, 2002 by vaginal delivery at 41 weeks of gestation and he was in perfect health. He was breast-fed and at his two-week check up, he was in the 95^th percentile for his weight and height (Table 2). However, he developed an upper respiratory tract infection within 48 hours following his two-month vaccinations (Table 3). He also suffered from diarrhea, vomiting, and fatigue during the 34 days following his vaccination and the treatment of his mother with an antibiotic for her mastitis (Table 1).

On July 23^rd, at approximately 9 weeks of age, Lucas was administered seven vaccines simultaneously [2]. The vaccines included DTaP, Hib, Hepatitis B, IPV and pneumococcal vaccine. The compositions of these vaccines, as reported in the Physicians’ Desk Reference [3], are presented in Table 3. In addition, to various antigens, these vaccines contain formaldehyde and phenol as preservatives in addition to aluminum.

Lucas developed an upper respiratory tract infection at one to two days following vaccination. His parents noticed that he had a cough as well as clear mucus discharge from the nose. He was given Tylenol (Acetaminophen) at a daily dose of 320 mg for two to three days to reduce fever. Fever of 38 degrees C or higher has been reported in 15% to 25% of children in the first two days following pneumococcal vaccine [4] and other vaccines [3]. In addition to fever, Lucas slept a lot on the day of his vaccination and subsequent days. His parents specifically recall that he also vomited twice on July 29^th. Furthermore, Lucas’s cough and nasal discharge continued to July 30^th and his mother took him to his pediatrician. The doctor found that the baby was suffering from an upper respiratory tract infection and she recommended the use of vaporizer and giving the baby an adequate amount of fluid.

Near the end of July, the baby’s stool became liquid. His diarrhea continued until the day of his hospitalization on August 27^th. Lucas had immediate bowel movements that followed his nursing. His parents thought that this was a normal process and they did not seek medical assistance. One day prior to the baby’s vaccination on July 23^rd, his mother came down with mastitis and her mid-wife gave her Dicloxallin to treat her bacterial infection (Table 1). This antibiotic excreted into her breast-milk and contributed to the cause of diarrhea by inhibiting the growth of normal intestinal bacteria and that enhanced the growth of chlostridia in the intestine [5]. In addition, in a study including three hundred sixty-five infants who were inoculated with Hib, diarrhea developed in 5.2% of the children at 48 hours post-inoculation [3, page 2318].

Furthermore, on August 17^th to the time of Lucas’s hospitalization on August 27^th, Lucas slept more than usual. He slept through the night (9:00-9:30 PM to 7:00-7:30 AM). In addition, in the morning of August 26^th Lucas vomited a lot after being fed. He also spit up quite a bit shortly after that. On the morning of August 27^th, Lisa had to wake up Lucas to breast-feed him before leaving for work. A few minutes after being breast-fed, Lucas vomited it all up again. His mother left home at 7:45 AM and came back at 11:15 AM. Lucas was almost asleep when she arrived home and her husband informed her that Lucas did not want to take his milk from his sippy cup. She breast-fed him and he appeared very tired. Lisa left for her meeting at 12:50 P.M. Lucas stopped breathing at about 1:30 PM and his father ran carrying him to the neighbor’s house to get assistance.

II-B. Adverse reactions to vaccines in children

Serious adverse reactions and death due to the vaccines given to baby Lucas (Table 3) have been described in the medical literature. Below are brief descriptions of selective studies that describe the incidence of illnesses associated with vaccinations in children. Some of these studies are also described in the Physicians’ Desk Reference [3]. However, neither Lisa nor her husband was informed by the medical staff of the possibility of the adverse reactions to vaccines prior to or after administering vaccines to Lucas.

The above selected studies clearly show that serious health problems and even death can result from vaccinating infants and children. The parents or guardians of a child should be given the Vaccine Information Materials prior to immunization as required by the National Childhood Vaccine Injury Act of 1986. The Physicians’ Desk Reference states that physicians should inform the parents or guardians about the potential for adverse reaction of pertussis-containing vaccines [3, page 3062]. However, when Lisa and Alejandro discussed the issue of vaccinating their baby with the pediatrician, they were never informed of the possibility that their baby could develop a serous adverse reaction to vaccines. In addition, he suffered from chronic diarrhea, vomiting, and fatigue during the 34 days following his vaccination and the treatment of his mother with an antibiotic for mastitis.

On August 27, 2002, Lucas’s father was taking care of Baby Lucas at home and he noticed that the baby stopped breathing at about 1:30 PM. The father took the baby to the neighbor’s house asking for help. The Medical Emergency Service (MES) was called and the baby was resuscitated and treated with epinephrine. The MES took the baby to Centre Community hospital for a short period and then airlifted him to the Geisinger Medical Center. The baby was pronounced brain dead after six days following his arrival at the Geisinger Medical Center.

Review of Lucas’s medical records from both hospitals revealed that, at the time of admission on August 27th, Baby Lucas suffered from diabetes and complications of diabetes (metabolic acidosis, apnea, and cardiac arrest), respiratory acidosis, bacterial infections of the urinary tract, and liver damage. He also suffered from vitamin K deficiency that caused subdural bleeding and bleeding in the brain and other locations. These illnesses were induced by the vaccines given to Lucas on July 23, 2002 and by the treatment of Lucas’s mother with antibiotics (Table 1).

Furthermore, the baby was treated with excessive amounts of sodium bicarbonate that caused metabolic alkalosis, hypoxia, cerebral and pulmonary edema, and hypokalemia. He was also treated with epinephrine that contributed to the bleeding in brain and spinal cord and other locations. A detailed description of the hospital events and my analysis of these events are presented in the next two sections (III and IV).

Section III. Review of Lucas Mullenax-Mendez’s Medical Records During His Hospitalization on August 27 Through September 2, 2002

III-A. Treatment by the Emergency Medical Services and the Centre Community Hospital

On August 27, 2002, at approximately 1330, Baby Lucas was put down for a nap after being fed. His father found him unresponsive shortly thereafter. Emergency Medical Services (EMS) was called. Upon arrival, the EMS found Lucas unresponsive with agonal respirations and mottled. Transport was begun. The infant was intubated with a 4.0 endotracheal tube and respiration was maintained by bag valve mask. The infant was placed on a monitor and was given 0.1 mg of epinephrine via an interosseous route. Just prior to arrival to the Centre Community Hospital, he was started on a Mannitol drip 7 gm in 50 cc of D5W (1 gm/Kg). This was infused over approximately one hour. Lucas’s blood glucose level was found to be 382 mg/dL.

The child arrived at Centre Community Hospital (CCH) at about 1350 with a tachycardiac and a perfusing pulse but unresponsive [9]. Dr. Clifford J. Neal examined Baby Lucas upon arrival at CCH and he found evidence of retinal hemorrhage bilaterally and the fontanel was full. However, he did not see evidence of ecchymotic lesions on skin that were observed in the Geisinger Medical Center an hour later. There was a profusable pulse and the child was in rhythum at a 175 to 180 beats per minute. The abdomen was soft and there was no evidence of obvious mass. The baby had no neurologic activity at this point and there was no reaction to even painful stimulation. Baby Lucas was transferred from the Centre Community Hospital to Geisinger Medical Center by Life Flight at about 1430 on August 27, 2002.

III-B. Treatment at Geisinger Medical Center

A physical examination on admission at the Pediatric Intensive Care Unit at Geisinger Medical Center conducted by Dr. Jamian Ryan revealed a temperature of 35^oC; heart rate of 94; blood pressure of 94/62 Hg; bulging anterior fontanel; nonreactive pupils; and pinpoint eyes. The gastrointestinal was soft, nontender, and nondistended and no bowel sounds were heard. In addition, ecchymosis on right eyelid (1-2 mm), below left eyelid (2 mm) and on the back (4 mm) and bloody endotracheal tube secretions were observed [10].

A blood analysis performed on August 27^th at 1430 revealed low blood pH (7.22); low bicarbonate level (7 meq/L), high blood glucose level (382 mg/dL); low hematocrit (26%) and hemoglobin (8.9 g/dL) levels; elevated prothrombin time of 17.3 seconds and activated partial thromboplastin time of 38 seconds. In addition, on August 28^th, Lucas’s PIVKA-11 level was 22.7 ng/mL (normal range 0.0-3.5 ng/ml). Blood glucose level increased to 415 mg/dL at 2200 on August 27^th and it was reduced to normal levels on August 31st by IV infusion of N-saline (Table 4). Baby Lucas was given red blood cells (RBC) to correct his anemia and his hematocrit and hemoglobin values reached normal levels on August 30^th (Table 5). On August 28^th at 0315, the blood pH reached a critical low of 6.64 and the baby was treated with sodium bicarbonate. Unfortunately, Lucas was treated with an excessive amount of sodium bicarbonate and his blood pH reached a critical high of 7.67 (Table 6). This treatment caused brain and pulmonary edema, hypoxia, and hypokalemia [5].

Furthermore, Baby Lucas suffered from lactic acidosis, high Anion gap, and urinary tract bacterial infection (Tables 4 and 7). He also had liver damage as shown by elevated serum liver enzymes (Table 8). The baby was give 1 mg vitamin K per day on August 28^th through August 30^th. This treatment reduced prothrombin time by 20% and partial thromboplastin time by 25% (Table 9). Lucas was also treated with potassium to correct his hypokalemia. In addition, the baby was treated with epinephrine, diuretic, and other agents. The list of medications given to Lucas on August 27^th through September 2, 2002 is presented in Tables 10 and 11.

A computerized tomography (CT) scan of the brain taken on August 27^th at 1806 showed an acute subdural hematoma along the tentorium, the posterior interhemispheric fissure and the interhemispheric fissure at the vertex. There was also a right frontotemporal parietal isodense subacute hematoma. The blood products were of various ages. The ventricles were non-dilated. No evidence of hydrocephalus or fractures was seen at this time. The CT scan of the brain taken on August 29^th at 0816 showed an increase in blood in the interhemispheric fissure and extraparenchymal hemorrhage as compared with the scan of August 27th. There were also multiple new focci of acute intraparenchymal and subdural hemorrhages. Cerebral edema and impending downward transtentorial herniation were also observed [10].

Furthermore, the CT scan taken on August 30^th showed diffuse edema of the hemispheres bilaterally. The effacement of the sulci, basal cisterns and ventricles was increased as compared with the prior exam. There was also hyperdensity along the tentorium bilaterally consistent with blood, which is seen on the prior exam and remains unchanged.

Over the 24-48 hours from the time of admission, the CT scans revealed deterioration with increased edema. The fontanel became increasingly fuller. This led the doctors to make an incision into the baby’s head and to insert a tube into the ventricles and to drain the excess fluid. On August 30^th, the patient’s head was prepped and draped in the usual sterile fashion for surgery. A small incision was made in the right frontal region. The dura was lanced and a ventricular catheter was passed into the lateral ventricular system without difficulty. Bloody cerebrospinal fluid arose under mild pressure of approximately 15-20 cm of water [10].

The chest x-ray taken on August 27^th at about 1400 showed no infiltrate in the lungs. However, an area of hazy infiltrate or edema was noted in the right perihilar region and right mid lung field in a second chest x-ray that was taken shortly after the first one. At 1620, the overall appearance of the chest was worsening when compared to the previous films. The chest x-ray showed right upper and left lower lobe consolidation.

Furthermore, the chest x-ray taken on August 28 at 0243 showed more extensive opacification of most of the left lung since the previous examination on 8/27/02. There was also more opacification of the right lung in this same interval. In addition, a chest x-ray taken on August 28 at 1058 showed evidence of increased opacity in the right upper lung field, which most likely represents patchy consolidation. The left lung base was hazy and may have been due to some atelectatic change. Evidence of complete atelectasis of the right upper lobe and also a right-sided pneumothorax was seen in the chest x-ray taken in August 28^th at 1526. Diffuse bilateral pulmonary infiltrates were also present [10].

Chest x-rays taken on August 30th at 0750 and 1950 showed evidence that both lungs appeared diffusely opacified, which is consistent with areas of consolidation or edema. In addition, the chest x-ray taken on September 1, 2002 at 0925 showed more diffuse abnormalities throughout the lung field than was present on the earlier study. The appearance would be compatible with pulmonary edema. Chest x-ray taken on August 27^th at 1620 also showed a single left posterior non-displaced healing fracture of the 11th rib. The age of the fracture cannot be determined on this single projection. The CT scan of the abdomen and pelvis taken on August 27^th at 1806 also showed a healing non-displaced rib fracture (callus formation surrounding this fracture) in the 11^th rib on the left posteriorly. The CT scan of cervical spine taken on August 27^th at 1806 showed no evidence of fracture. In addition, an x-ray bone survey taken on August 28 at 2149 showed no evidence of a fracture or abnormalities in the skull, spine, pelvis and hips, long bones, hands and feet [10].

On day six of Lucas’s hospitalization, it was determined that the baby was not breathing spontaneously. Brain death protocol was initiated and followed. Lucas was pronounced dead at 1200 on 9/2/02. An autopsy was performed on September 4, 2002 by Dr. Samuel Land and he determined that the cause of injury and death was blunt force trauma to the head [11]. However, the clinical events described above indicate that the cardiac arrest and the bleeding in the brain and other locations were caused by the adverse reactions to vaccines and medications. They caused Lucas’s diabetes, metabolic acidosis, reduction of potassium levels in cardiac muscles and other tissues, vitamin K deficiency, and bacterial infections. My analysis of these events is presented in Section IV below.

NEXT PAGE

Back to Conference

Home | Archives | Columnists | Online Conferences | Red Flags Store | Site Philosophy

Copyright ©2001-2003 - It is prohibited by copyright law to quote, in whole or in part, from any article on this site, without the expressed consent of the author of the article. Links, however, can be made to articles on this site.
site by CGR Productions