A new look for medical malpractice lawyers at retinopathy of prematurity and cerebral palsy in intensive care nurseries
by H. Peter Aleff
The continued twin epidemics of eye- destroying retinopathy of prematurity and severe brain damage among children born prematurely gain new importance for medical malpractice lawyers in the wake of the U.S. Supreme Court’s 1993 Daubert v. Merrell Dow decision against “junk science”, and of the further rulings based on it that now forbid even highly credentialed experts to represent their unsupported opinions and “generally accepted knowledge” in their field as facts.
For the past five decades, lawyers for the victims of these still common and permanently disabling intensive care nursery diseases had little hope of prevailing over the unbroken phalanx of medical experts, nursery “heroes” shielded by “miracle- baby” propaganda, who blamed the blinding usually on high concentrations of supplementary oxygen administered with the best of intentions in an uncertain area, and who also explained the cerebral palsy and other brain damage caused by their rationing of that life- saving gas as an unchallengeable Scylla- Charybdis situation.
However, now that plaintiffs are allowed to examine the ground on which those experts stand, it turns out there is nothing to support them, except for the hot air in their self- serving and often repeated but demonstrably plain wrong assertions. Moreover, you can now puncture their pontificating with the pens of their own profession’s pundits by using the detailed documentation of research frauds, blatant disregards for science, cover-ups, and other gross ethics violations in their field which I assembled from mostly medical writings and posted at www.recoveredscience.com/medicine_index.htm.
Here is a summary of some highlights:
The long- standing doctrine of oxygen rationing to prevent baby- blinding is the core of modern intensive care nursery management, and its procedures and apparatus account for about a third of the billings in those usually most profitable departments of their hospitals.
This nursery- dominating doctrine is based on a blatantly rigged trial in the mid 1950s which was designed to eliminate the babies most vulnerable to the eye damage before they could be counted.
The group of doctors responsible for this sham had previously suggested that “defective germ plasm plays an important role” in the blinding. They recommended to prevent the disease “by selection of parents” and then said, in the discussion after the lead article in the May 1949 issue of the American Medical Association’s Archives of Ophthalmology, page 550 top:
“let ‘fate’ settle the problem of existence of these defective persons. Obstetricians and pediatricians should not be so zealous in preserving defective persons, of which the world has a sufficient quantity already.” (The quote marks around "fate" are in the original; the editor of that journal led the discussion..)
See the two series of web pages beginning at www.recoveredscience.com/Oxygenwithholding01.htm and www.recoveredscience.com/Medifrauds01.htm
Other writers in that field at the time described the oxygen supplementation for preemies as an “undeserved subsidy” for weaklings who should prove themselves worthy of survival by struggling on their own. In accordance with these then still openly expressed eugenics- minded views, the trial designers withheld all oxygen supplements from all babies for their first two days and then enrolled only the survivors, after this Draconian asphyxiating had predictably weeded out the babies with the weakest lungs.
These so killed victims were also those with the most vulnerable eyes who would otherwise have grown up blind, so the trial found less eye damage among the more resistant survivors.
Those rogue researchers then omitted to count the babies killed before enrollment and announced that oxygen withholding was a safe way to reduce the chances of blinding. This knowingly false pronouncement by a prominent panel of leading pediatric ophthalmologists and neonatologists was uncritically accepted by those who relied on them for guidance, and without further question the oxygen- starving became standard practice practically overnight in nurseries around the world.
By so restricting the breathing help for the babies who needed it most, the results of this single and blatantly rigged trial killed year after year many thousands of babies, including more Americans than the Viet Nam war.
This cynical scientific fraud is all the “science” there is behind the long unquestioned and still standard patient- harming routine of denying the babies the much needed and often brain- damage- preventing oxygen supplements.
The results of that tricked trial have never been confirmed by any scientific evidence whatsoever. To the contrary, several later studies that attempted to replicate its results failed to do so, and leading neonatologists admit among themselves that they can neither measure nor define or control in any way the oxygen concentrations in the retinal vessels where alone they would matter according to their doctrine.
One of them even wrote, shortly before the Supreme Court’s outlawing of such junk science, that the oxygen hypothesis for the blinding is “void of any scientific meaning”. (Birth Defects: Original Article Series, 1988, 24:1, pages 23 to 40, and see www.recoveredscience.com/Oxygenwithholding09.htm#The uselessness of trying to control
Yet, a slightly less drastic form of the arbitrary oxygen withholding continues today and leaves many of the so deprived preemies with cerebral palsy and other forms of permanent brain damage from lack of sufficient oxygen during their time of most critical need.
This widespread harming has never been shown to promise even the slightest benefit against the eye damage, but it often leaves the children worse off than if they had merely lost their sight.
On the other hand, there is a mountain of evidence that retinopathy of prematurity is caused directly by the overbright fluorescent lighting which the American Academy of Pediatrics recommends for those nurseries.
The epidemic started in country after country together with the introduction of these lamps. They happen to concentrate their strongest energy spike in precisely that narrow blue- violet wavelength which inflicts the most damage to mammalian retinae and to which preemies are much more vulnerable than older people or animals.
Because the preemies’ eyes are much more transparent to these most damaging wavelengths than those of older people, the typical intensive care nursery exposes their retinae in fifteen minutes or less to the amount of damage- weighted retinal irradiance which the US Occupational Safety Guidelines consider as the maximum permissible cumulative daily dose for the eyes of healthy industrial workers. The eyes of those adults are much more resistant to eye damage from light than the still developing retinae of the preemies. (See www.recoveredscience.com/Babyblindinglights01.htm and the subsequent pages in that series.)
An early 1980s study in two Washington, DC, hospitals found strong correlations between higher light levels and greater incidence as well as severity of blinding. For the group with the lowest birth weights, and thus highest risk factors, the correlation between eye damage and higher light levels worked out to less than one chance in a hundred that it might be a fluke.
For all the babies in all the groups, the chances were almost 19 in 20 that the more intense light was connected with the blinding (NEJM, 1985, 313, pages 401 to 404, and see www.recoveredscience.com/Babyblindinglights07.htm#next study).
However, the medical interpreters of this light- condemning result completely reversed the approach to risk that is normal in all other fields. The common- sense approach is to remove a suspected agent if there is any hint that it might be connected with harm, particularly if that agent is as unnecessary and obviously unnatural as bright lights for a baby that still belongs in the womb.
However, the light- defending baby- doctors quibbled about the before- and- after format of the study although it was the same as in their much touted oxygen- starving show trial.
Worst of all, the study authors as well as all their medical critics spoke of the shading as a treatment to be evaluated. None of them seemed to realize that the light exposure itself was and is the treatment, as in the common treatment for bilirubin under lamps only two to three times brighter than standard nursery lighting.
Shading the babies was actually a reduction in dosage of the low- level phototherapy treatment which the nurseries had been administering all along to all their helpless inmates under their standard lighting.
The nursery lighting prescribed by the American Academy of Pediatrics is a huge undeclared and uncontrolled experiment with a potent therapeutic agent that has known inherent dangers, as demonstrated by the need for eye patches under bilirubin lamps. That strong medicine gets imposed on the patients indiscriminately, for no discernible benefit, and with devastating effects.
This semantic confusion between a treatment and its partial withdrawal triggered in the doctors involved their conditioned reflex that a “treatment” must meet certain standards of documenting its efficacy before it can be accepted. Their dangerously mindless reaction made them ignore all normal logic which would have demanded an immediate alert against the high light levels which were so strongly associated with the blinding.
Or would you willingly expose your newborn child to those bright lights if you knew there were 19 chances out of 20 that they could harm her or his eyes?
Yet, the nursery doctors oblige all parents of preemies to accept this danger- associated exposure, but without telling them anything about its well documented risks.
To further falsely exonerate the nursery lights, a group of pediatric retinal surgeons and neonatologists staged from 1995 to 98 another rigged trial, called LIGHT-ROP.
Knowing that the damage they claimed to study typically accumulates in just a few minutes, as also discussed in several of the studies they themselves cited, the trial designers delayed the eye- shielding in their allegedly protected group for up to 24 hours and then found, predictably, no difference in blinding between the “protected” and “unprotected” babies.
I obtained through the Freedom of Information Act a copy of the Manual of Procedures for that rigged LIGHT-ROP trial and posted relevant excerpts from it in the series of web pages that begins at www.recoveredscience.com/LIGHT_ROP_Manual01.htm. I book-marked for you some of the highlighted passages, for instance those that document the authors’ knowledge of the short exposure times required for the damage.
Other bookmarked passages in that Manual ask the staff to ensure maximum exposure of the unprotected group to the agent which the authors describe as potentially and probably harmful, and to remove the blankets that parents and compassionate nurses in other nurseries often drape over the incubators to protect the babies in them at least a little from the harsh lights.
The authors wanted “greater contrast between the groups”, as if human babies were expendable guinea pigs that can be sacrificed for science.
For a detailed discussion of the scientific frauds and patients’ rights’ violations in that trial, see www.recoveredscience.com/Medifrauds01.htm as well as the “Sovereign Doctors” series of pages in that site section.
The alleged governmental watchdog agencies that are supposed to protect the public from such frauds and from the many other ethics violations in that and other trials saw nothing wrong with it.
They let the trial proceed right while President Clinton offered his much publicized apologies for earlier medical abuses of the same kind. The Congressional Research Office even lied to US Congressman LoBiondo about having conducted the investigation he had requested.
The detailed documentation of all the above, and much more, in the “Medicine” section of www.recoveredscience.com gives you now the tools to break through the stonewall the child- molesting medical priesthood has erected around its intensive care nurseries.
You can use for free any of the material I posted on these subjects, and I can give you much more if you want it. I only ask that you not accept a gag clause in any action that uses the evidence against nursery abuses which I offer, and that you please tell me about the outcome.
Thank you in advance for anything you can do to help end the routine medical maiming and blinding of preemies, and to expose the runaway medical recklessness that created and prolongs their suffering.
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