Autopsies by former examiner reviewed
Several cases got a second look after questions about neutrality
By ANDREW TILGHMAN
Copyright 2004 Houston Chronicle
Gilliam's attorney, Ernest "Bo" Hopmann, contends that Moore tried to match her findings to law enforcement investigations.
"I think that once a detective on the scene or some other law enforcement officer made the original analysis that a possible crime had been committed, then she did her work from that standpoint and tried to substantiate those allegations with medical conclusions," Hopmann said.
Butting headsWhile working in Harris County, Moore had a contentious relationship with then-Chief Medical Examiner Dr. Joye Carter. In employee reviews in 1999 and 2000, Carter cited Moore for "defective and improper work."
Moore was criticized for handing in paperwork contaminated with blood and making written requests for X-rays on paper towels. One employee review calls her "headstrong."
Carter reprimanded Moore in 1999, saying she seemed biased in favor of the prosecution.
"Dr. Carter reminded Dr. Moore that our office is neutral and that we are not doing cases for the DA's office. We need to be open to both the prosecution and the defense," states a July 19, 1999, memo by Alex Conforti, the chief administrative officer at the medical examiner's office.
The remark stems from the death of 10-month-old Christina Dew. Doctors suspected shaken baby syndrome, but the precise time of the fatal injuries was unclear.
That left prosecutors unsure whether to pursue charges against the mother or the baby sitter, who said she found the child semiconscious shortly after the mother left for work.
Moore's initial report indicated that the baby must have become unconscious right after the injury, a finding that would point to the baby sitter as a suspect.
But after police said the mother had failed a lie-detector test that the baby sitter had passed, authorities focused on the mother, county records show.
Shortly afterward, Moore met with a prosecutor and other doctors. The autopsy report was then changed.
After learning of this, Carter confronted Moore.
"You stated your opinion of who the guilty party was. I responded to you at that point to say you were overstepping your boundaries," she later told Moore in a memo. "We as medical examiners should not opine as to who did what, if we are to remain neutral."
Carter followed up with a note in the case file.
"It remains impossible to gauge a thirty minute time frame as to precisely when the fatal injuries occurred to this young and unfortunate victim," Carter wrote. "So as not to impede the legal process, the new version is now signed after careful review. The prosecutor was reprimanded as to the serious risk of collusion when changes are made to a public document."
The baby sitter, Trenda Kemmerer, was tried in 2000 on a charge of injury to a child.
The jury deadlocked, but in 2001, Kemmerer was convicted and sentenced to 55 years in prison.
Assistant District Attorney Kelly Siegler, who prosecuted Kemmerer's second trial, said autopsies usually are contested in this type of case because defense attorneys often claim the child died of natural causes.
"It's always the main thing in a shaken baby case," she said.
Siegler said she had no concerns about Moore's work.
Questions about Moore's autopsy on a Fort Bend County child led prosecutors there to drop capital murder charges and give a man probation on a lesser charge.
Frank Chavez was accused of killing his 2-year-old stepdaughter, Hallie Lohner, after Moore concluded the child was beaten to death in 2000.
The Harris County medical examiner's office was providing autopsy services to Fort Bend County at the time.
After Moore testified about the autopsy at a civil court hearing on custody of another child, prosecutors decided to have an expert review the case before taking Chavez to trial in criminal court.
That expert suggested the death had resulted not from blunt force, but from illness. Prosecutors later had the capital murder charge dismissed.
The case ended in 2003 when Chavez agreed to plead guilty to failure to seek medical attention. He faced up to 10 years in prison, but got probation.
A statistical examination of Moore's work suggests a trend of finding shaken baby syndrome as a cause of death, said Dr. Jim Bromberg, a physician and defense attorney who worked on a shaken-baby case in which Moore performed an autopsy.
Based on numbers from the U.S. Department of Health and Human Services, Bromberg estimated that Houston's metropolitan area should see one or two fatal cases of shaken baby syndrome each year.
Moore, however, cited it as a cause of seven deaths in one 18-month period.
"The numbers suggest one should look into whether this is being overdiagnosed," Bromberg said.
District Attorney Chuck Rosenthal said he has worked with Moore on many cases and sees no reason to question her work.
"She acted pretty middle-of-the-road," Rosenthal said. "I thought she did them pretty much as she saw them. She didn't come across as a biased state witness on any of the trials I had."
Child fatalities that raise suspicions of abuse or neglect have received more scrutiny in recent years, said Assistant District Attorney Denise Oncken, longtime head of the district attorney's child-abuse division.
"Years and years ago, people felt so bad when somebody's kid died that nobody wanted to look for any foul play," Oncken said.
But Bromberg said the pendulum has swung too far in the opposite direction.
"This is a politically sensitive area of medicine. They all want to protect children, but they are using incomplete science," he said.
"I don't think there is malice. I don't think there is
But I do think there were scientific errors that have created legal