Dr. Stephen Boos, Child Abuse Pediatrician

Was it a picture or video?

And I looked at the autopsy report again today, and it talked about some notching of the inferior cerebellum down by the brainstem.

So what you have to ask the ME is, was that a sign of herniation?

Meaning the brain swelling pushes the brain down such that it starts oozing and squishing

at the base of the skull.

And the relevance to that was that the cervical spine injury, if it's primarily traumatic, in the ME's opinion, with which I have no argument, would render the child unable to do like hardly anything and rapidly die.

On the other hand, if that change in the cervical cord is the result of infarction, meaning a cutoff of blood supply due to herniation, it can be a downstream result of the trauma from before.

Okay, so that's how that fits into the one hit, two hit phenomena question.

The two steps are not a red herring.

It is absolutely the critical issue.

So what I would say at this point, if I had enough knowledge of the case to have a formal opinion, and just to be clear,

I am not satisfied that I have enough knowledge of this case to venture an opinion that people should really listen to.

This is kind of for purpose of discussion.

What I would say is that it's highly improbable that that child would have died from an event before those two steps, if you give that history credence.

Not impossible,

And I can tell you the sequence of events that might allow for that to occur physiologically, you know, but on a percentage likelihood, it's really small, right?

So the statistics are such that the probabilities are with the ME if those two steps are valid,

And then the probabilities are up in the air.

It's not like we can't disprove what the ME is asserting.

So those two steps separate, yeah, two opinions, but either one could be true, versus, yeah, two opinions, one could be true, but that's very unlikely, and the other is much more probably true.