Alteration of child's death certificate is defended

Author: Dennis Cassano; Staff Writer

Hennepin County Medical Examiner Garry Peterson took the witness stand Wednesday to defend the operations of his office, which have been under attack in the trial of Janet Ostlund, who is accused of killing her daughter by shaking her.

Peterson and four physicians who cared for the child until she died at Minneapolis Children's Hospital July 15 were called by the prosecution to rebut the testimony of doctors called by the defense to testify that 2-year-old Maria Ostlund died after falling from a couch in her Robbinsdale home, not from being shaken so violently that her brain was damaged.

Janet Ostlund is charged with second-degree murder.

Peterson changed the cause of death on the death certificate two weeks ago from bleeding on the brain to swelling of the brain. He said yesterday that the main part of the autopsy and the death certificate had been completed by an assistant, Dr. Lindsey Thomas, long before he expected a consultant to finish an examination of the brain itself. He said that he signed it, but that after he got more information and questions were raised about it by defense doctors two weeks ago, he changed it.

He said the consultant, Dr. Angeline Mastri, an associate professor of neuropathology at the University of Minnesota, telephoned him recently and told him she disagreed with his conclusion that the child's brain was damaged by shaking, because it was swollen more on one side than on the other.

Peterson said he disagreed. He and other doctors who testified yesterday said it is possible that the brain of a child who has been shaken violently can be swollen asymmetrically.

An ophthalmologist at Children's Hospital, Dr. William Rodman, had testified for the defense that the child's eyes were not receiving blood, so he assumed that an artery to the eyes was blocked.

Doctors called by defense attorney Steve Meshbesher criticized Peterson's office for not examining those arteries and other vessels in the brain to see if they were blocked or if there was some other reason for the lack of blood.

When Peterson said that when he examined the retinal artery it was open, Meshbesher told him Thomas had testified that she dissected an artery near the retinal artery, but not the retinal artery itself.

Peterson said that he thought the one she dissected and he examined included the retinal artery, but that he would have to check a book on anatomy to be sure.

Prosecutor John Brink also called Dr. Richard Fox, director of the lung care and intensive care units at Children's Hospital. He said he disagreed with Rodman's conclusion, because X-rays showed there was no blood getting to the entire brain, and therefore it would be impossible for blood to reach the eyes.

Rodman had testified that he used a special instrument to examine the backs of the eyes and that he found a number of pinpoint hemorrhages. He said that means the child was not shaken, because hemorrhages in the eyes of shaken children are much larger.

Fox and Dr. John MacDonald, a pediatric neurologist, testified that hemorrhages in the eyes of shaken children take no particular form. MacDonald and Dr. David Dassenko, a pediatrician specializing in anesthesiology and intensive care, said they used a less specialized instrument than the one Rodman used to examine the eyes, and described the hemorrhages differently.

The doctors disagreed yesterday with the testimony of Dr. Robert ten Bensel, a pediatrician and expert in child abuse, who said Maria Ostlund's underdeveloped brain made her more susceptible to brain damage from head injuries.

They also disagreed with Dr. Gerald Slater, a pediatric neurologist at Hennepin County Medical Center, who said Maria's brain was more vulnerable to injury because she had fallen and hit her head eight days before she received the fatal injury.

One of the principal disputes is the significance of a small area of bleeding found under the child's scalp near the back of her head.

The doctors testifying for the defense said it could have been caused by Maria falling from the couch. They said that blow was transmitted across the skull to cause the increased swelling on the opposite side of the brain that led to her death.

The prosecution's doctors said the bleeding had no significance with regard to the brain injury. They said it could have been caused by another blow about the same time that she was shaken.

The trial is to continue today before District Judge Robert Schumacher.