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Re: Destiny Jacobo case: Would Appreciate a
Little Help
Friday, July 3, 2009 1:45 PM
From:
"Mohammed Al-Bayati" <[email protected]>
View contact details
To:
[email protected]
Cc:
[email protected]
Dear Dr. Amack:
Below are the answers to your questions. Sorry for the delay to get back to you. I hope that
Destiny's mother will be released soon. She is innocent.
Best regards,
Mohammed
Q 1It would help a great deal if you could provide any specific details regarding Ribe's
procedural deficiencies, or discrepancies from the standard protocol for Destiny's autopsy,
beyond the factors (i.e., Ribe's failure to (1) take lung fluid for cytological and
microbiological evaluation, and (2) take blood samples to do a bacterial culture and
standard hematology and serum tests) that you described. I am sure that there were many
inadequacies in Ribe's methodology.
I listed the following specific problems with Ribe's evaluation of Destiny's case and I believe that
only one of the items listed below is enough to disqualify the validity of his conclusion in this
case.
1) I examined four H & E stained sections of Destiny’s lungs microscopically and found that she
suffered from severe acute hemorrhagic pneumonia (Figure 2 and Table 2). This is a fatal illness,
and septicemia causes bleeding in the lungs and other parts of the body. T
2) Ribe did not take Destiny’s lung fluid to perform cytological and microbiological evaluation.
These tests are usually conducted to identify the causes and nature of pneumonia in children as
described in section III of this report.
3) Ribe did not take blood samples in Destiny’s case to do a) bacterial culture; and b) standard
hematology and serum tests to check for anemia, thrombocytopenia, infections, and liver and
kidney problems. He also did not check for vitamin K deficiency. Prothrombin time (PT) and
partial thromboplastin time (PTT) are usually prolonged in individuals suffering from vitamin K
deficiency. Vitamin K deficiency leads to bleeding in the subdural region and other locations of
the body as observed in Destiny’s case.
4) Ribe’s allegation of sexual abuse is not supported by medical
facts. Ribe examined the retrorectal area in Destiny’s case and found two
small areas of hemorrhage in the anterior presacral fascia and behind the
rectum at the approximately S5 level. He concluded that the bleeding was
caused by forcible rectal insertion of an object.
I believe that inserting an object through the anal canal and the rectum of a child by force will
cause injury and bleeding. Ribe’s examination of Destiny’s anal canal, the rectal mucosa and the
wall revealed no injury or bleeding. The retrorectal space is one of the pelvic spaces located
outside the rectum. I believe it is not medically possible to cause contusion in the reterorectal
space with an object inserted by force through the anal canal and the rectum of a child with a
clotting problem, without causing damage and bleeding in the anal and the rectal regions.
Q 2. For example, although we may not have informed you, Ribe examined Destiny's lungs
microscopically. When you indicated that he did not "examine Destiny's lungs
microscopically to find the nature and cause of the problems," what aspects of Ribe's
microscopic examination could be characterized as deficient?
I stated that Ribe did not examine Destiny’s lungs microscopically because his findings were not
described in the autopsy report. I learned that he examined the HE stained slide when I reviewed
his testimony. Knowing that Ribe examined the slides and ignored the issue of hemorrhagic
pneumonia is making me wonder about his ability to interpret pathology data.
Q 3. Most importantly, can you conclude that the cause (or the principal cause, or merely a
cause) of Destiny's death was severe acute hemorrhagic pneumonia?
Yes.
Q 4. Also, could you please lead me to any recent studies (the more recent, the better)
indicating:
(1) That Destiny's retinal, subarachnoid, or subdural hemorrhaging could be attributable to a
coagulopathy, or
Yes, I explained these issues in more detailed in the articles that I sent to you 2 days ago.
These articles also posted in EJ site.
(2) That there are other explanations for symptoms commonly attributed to Shaken Baby
Syndrome.
Yes, I published many articles on this issue. Please check EJ site and the links below for my
reports.
misdiagnosedcases.blogspot.com
At 08:57 PM 6/25/2009, you wrote:
Dear Dr. Al-Bayati:
As you know, I am trying to exonerate Patricia Vildosola from life imprisonment after
her unjust conviction for the murder of Destiny Jacobo. Thank you very, very much
for the work that you conducted, which has been extremely valuable.
In your report dated October 21, 2006, titled "Histopathological features of Eliza Jane
Scovill’s and Destiny Jacobo’s lungs with analysis of the causes of death in
both cases" at http://www.medicalveritas.com/images/00121.pdf , you state:
"Medical examiners have a professional and legal responsibility to conduct all the
necessary medical tests and to evaluate the medical evidence thoroughly prior to
providing their opinions regarding the cause(s) of injury and death in any case. The
medical evidence presented in this report and the cited references clearly indicates that
Ribe did not meet these obligations in [Eliza Jane’s and] Destiny’s case[s]."
It would help a great deal if you could provide any specific details regarding Ribe's
procedural deficiencies, or discrepancies from the standard protocol for Destiny's
autopsy, beyond the factors (i.e., Ribe's failure to (1) take lung fluid for cytological
and microbiological evaluation, and (2) take blood samples to do a bacterial culture
and standard hematology and serum tests) that you described. I am sure that there
were many inadequacies in Ribe's methodology.
For example, although we may not have informed you, Ribe examined Destiny's lungs
microscopically. When you indicated that he did not "examine Destiny's lungs
microscopically to find the nature and cause of the problems," what aspects of Ribe's
microscopic examination could be characterized as deficient?
Most importantly, can you conclude that the cause (or the principal cause, or merely a
cause) of Destiny's death was severe acute hemorrhagic pneumonia?
Also, could you please lead me to any recent studies (the more recent, the better)
indicating:
(1) That Destiny's retinal, subarachnoid, or subdural hemorrhaging could be
attributable to a coagulopathy, or
(2) That there are other explanations for symptoms commonly attributed to Shaken
Baby Syndrome.
The reference to the Demiroren study, citation [16] in your report, was very helpful.
Thank you again for your superlative efforts.
Best Regards,
Lew Amack
California Bar #177774
President
MedicoLegal Advocates
2037 Woods
Monterey Park, CA 91754-5913
(310) 774-0000, (323) 264-1500
J.D., U WASHINGTON
M.D.-PhD. (Biol.) program, U ILLINOIS
National Boards in Medicine, 6/82
M.B.A., CAL. STATE U (CSULA)
M.A., Sociology, U IL
M.S., Psych., CSULA
Certificate, Computer Programming, CONTROL DATA INSTITUTE, 2/90
SANTA MONICA MEDICAL CENTER Consultant, Cardiac Surgery
RAND CORPORATION Fellow, Behavioral Sciences--Medical Outcomes Study, Health Care
Financing Administration
Climbed all 275 Sierra Club So. Cal. peaks in 11 mo., 1 day--record since 5/11/84
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