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MELISSA BLOCK, Host:

From NPR News, this is ALL THINGS CONSIDERED. I'm Melissa Block.

ROBERT SIEGEL, Host:

And I'm Robert Siegel.

In this part of the program, we bring you the results of an NPR investigation. It focuses on cases in which a child dies, abuse is suspected, and a parent or caregiver is accused of killing the child.

NPR's investigative unit, along PBS' "Frontline" and ProPublica, analyzed nearly two dozen cases in the U.S. and Canada.

BLOCK: They found people an alarming pattern: People accused of killing children based on flawed medical evidence. Some spent years in prison before courts overturned their convictions.

NPR's Joseph Shapiro has the story of one Texas man who is behind bars but insists he's not a child killer.

First a warning: Some of the details in this story are disturbing.

JOSEPH SHAPIRO: This is a story about the horrible death of a child - a baby girl, just six-months old. A man named Ernie Lopez was accused of slapping, shaking, and hitting her so hard that she died. A Texas jury quickly found him guilty of another appalling charge: That he'd raped the baby. Now he's serving a 60-year sentence in prison.

But this is also a story about how little agreement there is among medical experts on the science of how children die unexpectedly. One result is that sometimes innocent people get accused and wrongfully convicted of killing children.

On a Saturday morning, in October of 2000, in Amarillo, Texas, Ernie Lopez called 911.

(SOUNDBITE OF A 911 CALL)

ERNIE LOPEZ: Wait...

Unidentified Woman: What's going on? What's going on?

LOPEZ: Okay, my - we're babysitting this little baby girl for Dr. Vas.

SHAPIRO: Ernie Lopez was a mechanic. His wife DeAnn was a hairdresser. To make extra money, they did babysitting from their small bungalow. They looked after that six-month old, Isis Vas.

(SOUNDBITE OF A 911 CALL)

LOPEZ: And she stopped breathing and I have been trying to give her CPR for the last two, three minutes.

BLOCK: Okay. I need you to keep doing CPR.

LOPEZ: Can you hear her?

BLOCK: I can hear you doing it.

LOPEZ: Oh, come on, baby. Come on.

Woman: Oh, shoot.

SHAPIRO: Forty minutes before Ernie Lopez called 911, his wife DeAnn had gone shopping. Lopez was in the house with the baby and three other children.

LOPEZ: I tried to slap her on the bottom and slap her on the face, but she won't wake up. She won't do nothing.

BLOCK: Okay. I need you to keep doing it, Okay? Keep going.

SHAPIRO: This is what Ernie Lopez told the 911 operators, what he told the ambulance crew, and what later he'd tell doctors and police at the hospital. Isis had been sick, lethargic, and had eaten little ever since her mother brought her to the house three days earlier. And when the mother came with Isis, the baby had bruises on her body and about a dozen marks on her face. The mother said they were insect or spider bites.

LOPEZ: She's been acting funny ever since about Thursday or so.

Woman: Uh-huh.

LOPEZ: She's got all these bruises around her neck and on her face where she was bitten.

Woman: What kind of spider was it?

LOPEZ: I don't know.

SHAPIRO: At the hospital, nurses and doctors saw those marks. They found blood in the girl's vagina. Right away, they suspected child abuse, and that it had happened shortly before the ambulance brought the child to the ER.

That made Lopez the only suspect police would seriously consider.

An autopsy on the child found bruising and signs of sexual abuse, and listed the cause of death as multiple blows to the body. Later, at trial, one hospital nurse would testify it was the worst case of child abuse she'd ever seen.

(SOUNDBITE OF A TRAIN WHISTLE)

ROSA LOPEZ: This is the house that we lived in. And we, we have a lot of memories there. But then, of course, when this happened across the street, I just couldn't stay here anymore.

SHAPIRO: That's Ernie's mother, Rosa Lopez. Her long hair is a sunny yellow. Her face seems weary. She's come back to a street in Amarillo of small, close- together houses. She and her husband raised their three sons in one of these homes. Then Ernie moved directly across the street.

LOPEZ: I'd look out my kitchen window, you know, and see that house and it just broke my heart.

SHAPIRO: The day Rosa Lopez heard the sirens, she went outside and saw her son sitting in the ambulance, crying. When he got to the hospital with the baby, the police started asking questions.

LOPEZ: He called me a couple of times, telling me they were asking him lots of questions. And I said, tell them everything, you know. And he said, okay, I will. And then later on, my other son, Eddie, he had gone up there. And Eddie called me and, I mean, it just totally floored me. He told me that they had arrested Ernie. And then our nightmare began.

SHAPIRO: Lopez talked freely to the police. He told police that he'd slapped Isis on her face and shook her legs. He said these were gentle slaps to see if he could get a response. Later, prosecutors in court said this was really an admission of brutal, angry blows.

Lopez told police he'd briefly splashed the girl with bath water, to see if the cold water would revive her. Prosecutors later said this showed he tried to wash away evidence of rape.

Randall Sims is the district attorney for Amarillo.

RANDALL SIMS: It was a sexual assault case - aggravated sexual assault case that he was convicted of.

SHAPIRO: Lopez was indicted on murder and sexual assault charges. Prosecutors chose to go to trial on the sexual assault case first and got a conviction.

Jurors found out the baby had died only when it was time for them to determine Lopez's prison sentence.

SIMS: Sixty years was the sentence.

SHAPIRO: Last September, a Texas appeals court judge ruled that Lopez's original lawyers failed to give him an effective defense. Now a three-judge panel must decide whether he gets a new trial.

Because of the pending appeal, Sims said he could not answer specific questions about the Lopez case. But others were eager to speak out, like Lopez's former boss, Nathan Hand.

NATHAN HAND: I just think he's innocent. I think my wife thinks he's innocent. And a lot of other people think he's innocent.

SHAPIRO: One reason Nathan Hand feels so strongly is because of a conversation he overheard the day before Isis died.

HAND: I walked into the office and Ernie and my wife were talking.

SHAPIRO: Hand and his wife, Becky, run a machine shop.

HAND: And I just overheard that he was concerned about the baby because it was sick. And as I remember it, he was giving her some symptoms. And she used to be in the medical field, and she was trying to figure out why the baby was sick and trying to give him some ideas and things to do.

SHAPIRO: Becky Hand didn't want to be interviewed. But in an affidavit, she said Lopez was worried because Isis had these strange bumps on her head, and because the mother refused to take the child to the doctor.

And Becky Hand said he'd been worried about Isis for days and even weeks. That's important, because at trial, prosecutors focused on what happened in the minutes before Ernie Lopez called 911, and then until the baby died the next day in the hospital.

But pull back and look at the story of Isis Vas over days and weeks, and you get a different sense of things. The baby's medical history becomes more important. Remember, the trial focused on whether Lopez had sexually assaulted the infant. So the child's health problems didn't seem so relevant, nor did the behavior of the girl's mother.

Veronica Vas is a doctor. And she was in the middle of a bitter custody fight. Her ex-partner recorded this phone conversation four days before baby Isis was rushed to the hospital.

(SOUNDBITE OF A PHONE CONVERSATION)

VERONICA VAS: I don't need to tell you where I go, when I go, what I do. You know, if we were married, great. But we're not.

DOUGLAS SHELTON: Well, when it comes to my kids I need to know that they're being taken care of.

VAS: They are being taken care of.

SHAPIRO: Both Vas and Douglas Shelton are obstetrician-gynecologists. Vas had two children with him, a two-year old girl and a three-year old boy. The baby, Isis, was a child she'd had with another man - a married doctor. And on this weekend, she was flying off to Michigan to visit a boyfriend, also a doctor.

Only, that's not what she told her ex-partner. She said she was taking the kids on vacation.

(SOUNDBITE OF A PHONE CONVERSATION)

SHELTON: It is my business to know who takes care of my kids.

VAS: I am taking care of the kids, Doug. Me, their mother. Okay?

Dr. SHELTON. Well...

VAS: No one else.

SHAPIRO: But Vas wasn't taking care of the kids that weekend. They were staying with Ernie and DeAnn Lopez.

We tried multiple times to talk to Dr. Vas. In a brief telephone conversation, she said she had no comment. At trial, she testified that the baby just had a cold and some bug bites when she left her at the Lopez house.

The Lopezes weren't the first babysitters for Isis Vas.

LORRIE WORD: I bonded with her immediately, immediately. And I just - I fell in love with her the first time I saw her.

SHAPIRO: That's Lorrie Word. She was just 19 when Veronica Vas hired her to live and work in her house as a babysitter. Word says Isis seemed to need her. The baby was fragile and tiny but smiley and sweet. And Veronica Vas, as the babysitter tells it in court papers, was a neglectful mother.

Lorrie Word says, at the Vas house, the three children were often naked or just in diapers. There was excrement on the walls and the floor, and Vas didn't clean it up.

WORD: It was nasty. There were spiders, daddy long legs, everywhere. Flies.

SHAPIRO: There were darker problems, too. The babysitter says Veronica Vas drank heavily, even when she was pregnant with Isis. She let her other kids drink daiquiris and frozen margaritas at a wedding shower and thought it was funny. And Vas would disappear for long stretches of time.

One night, the babysitter came back at three in the morning to find the baby, then just three months old, alone in the house. Isis was in the middle of a bed, twisted in sheets and blankets.

WORD: She was soaked from the top of her head to the bottom of her feet.

SHAPIRO: There were baby bottles of milk propped up on the blankets near the baby, but they had leaked.

WORD: Her diaper looked like it hadn't been changed in a long time. And so I just grabbed her, and I held her for a long time. And then I just, I dried her off, I changed her clothes, cleaned her up and then I lay down with her.

SHAPIRO: Lorrie Word says Dr. Vas came home an hour later. Vas would claim the babysitter got the chronology wrong. She insisted she left the house for just 10 minutes, that she'd heard a baby cry in the night and that she'd gotten in her car to drive around the neighborhood to look for it. A few weeks later, Lorrie Word quit. To this day, she feels guilty about walking out on Isis Vas.

WORD: Because I loved her like she was my own. I loved her like I love my biological children. And I was supposed to protect her, and now she's gone.

SHAPIRO: The young babysitter wasn't the only one who felt guilty. There were people who worked with Veronica Vas. Dena Ammons says she and Vas were friends.

DENA AMMONS: Veronica was basically ostracized by everyone around her at that point, and instead of the medical personnel and people that really knew her and really saw what was going on, I think instead of stepping in, everyone just, they just scattered.

SHAPIRO: Ammons was a nurse at the hospital, assigned to work with Vas. She says, at first, Vas was popular with patients. She was down to earth; she was easy to talk to. But in court papers, Ammons says Vas also admitted to drinking heavily. She'd show up to work late or not at all. She got into screaming fights with other doctors. And then, the baby died.

Today, Vas lives in Michigan. She married her doctor boyfriend and had a son. Last November, the state of Michigan took emergency action to stop Vas from practicing medicine. The order cited her history of continued substance abuse. Last month, Vas signed an agreement with the state that will allow her to practice medicine again if she stays sober. The state regulatory board noted she'd dealt with multiple tragedies in her personal life.

BLOCK: Our story continues in just a moment when we visit Ernie Lopez in prison, and we'll explore this question: If Lopez did not kill Isis Vas, then how did the baby die?

(SOUNDBITE OF MUSIC)

SIEGEL: From NPR News, this is ALL THINGS CONSIDERED. I'm Robert Siegel.

BLOCK: And I'm Melissa Block.

We continue now with the story of Ernie Lopez, who is accused of killing a six- month-old baby in Texas. His story is part of an NPR investigation into the use of flawed medical evidence in child death cases.

SHAPIRO: On Tuesday nights, the three children of Ernie Lopez get together at their grandmother's house in Amarillo.

(SOUNDBITE OF TELEPHONE)

LOPEZ: Oh, I bet that's him.

SHAPIRO: It's the night their father calls from prison.

NIKKI LOPEZ: Hey Dad. Good. Guess what I got today?

SHAPIRO: Nikki, the oldest, took her driver's test today.

LOPEZ: Yeah, I passed.

SHAPIRO: Nikki just turned 16. It's been eight years since her father went to prison. Yes, she tells her dad, she knows how to check the oil. And okay, she won't drive next to trucks on the highway.

(SOUNDBITE OF LAUGHTER)

LOPEZ: I drive all the time, all the time. Yes, I drive on the highway all the time.

(SOUNDBITE OF LAUGHTER)

LOPEZ: I will.

SHAPIRO: It's been two years since Nikki last saw her father. The prison is 600 miles away. We went to see Ernie Lopez the next day at that sprawling maximum- security prison.

A guard escorts him through locked doors. Lopez wears bright white pants, shirt and sneakers. He works out with weights, but he seems small. And this afternoon, he's still thinking about Nikki driving.

LOPEZ: One of the first questions, I said: Do you know how to drive standard? And she said: No I don't. I said: Well, don't learn. Let me teach you. When I get out of here, I want to teach you that.

SHAPIRO: But Lopez is serving a 60-year sentence. We asked him directly: Did you rape and kill Isis Vas?

LOPEZ: No way. I didn't do this.

SHAPIRO: He still can't fathom that he got charged.

LOPEZ: For the worst crime that somebody can commit, sexual assault on a six-month old baby and capital murder. It's hard to explain but to have somebody to pass away in your hands, especially a baby, you feel helpless.

SHAPIRO: Lopez called Isis his little bird.

LOPEZ: Because she was so little. My heart went out to her because she was not really paid attention to, I guess is what I'm trying to say.

SHAPIRO: Amarillo psychologist Edwin Basham was hired by Texas Child Protective Services to evaluate Lopez, to see if he was dangerous and should be separated from his own children while he was awaiting trial.

Over 20 years, Basham says he's evaluated many men who injured and killed babies by shaking or hitting them violently. Usually they fit a pattern.

EDWIN BASHAM: These are immature, self-centered men who just, their tolerance for frustration is so low that the crying of a baby, the persistent illness, whatever it was that gets to them, they just snap.

SHAPIRO: Basham says none of this seemed to describe Ernie Lopez. His life was centered around his family. He was gentle and open. So, if Ernie Lopez is just a normal guy caught up in a bad circumstance, then there's got to be some other reason Isis Vas died. There's got to be something that prosecutors and a jury, doctors, nurses and a medical examiner missed.

MICHAEL LAPOSATA: So in this particular slide you see a child who has bruises on the legs.

SHAPIRO: Dr. Michael Laposata is a clinical pathologist at Vanderbilt University. And he's working, for no fee, for the Lopez defense.

LAPOSATA: So here you see scattered bruises and over on the right side, in this other child, similar bruises.

SHAPIRO: This is a PowerPoint Laposata plays for other doctors. Each slide shows pictures of two kids with almost identical bruises. One was a victim of child abuse. But the other, it was later proven, had a blood disease. It turns out that many blood disorders cause marks that mimic the bruises of child abuse. They're so similar that the doctors can't tell the difference, even Laposata.

LAPOSATA: So I've been looking at patients with bleeding problems for years, more than two decades. And if you show me the two children with the bruises on their legs, I couldn't tell you that that one is the bleeding disorder. I'd have to do the blood test to find out.

SHAPIRO: In the case of Isis Vas, hospital workers ran blood tests shortly before she died. One doctor noted the clotting problem. But the medical examiner who did the autopsy said in court, she didn't need to look at those lab results because this was such a clear case of child abuse. But Laposata says those lab results were stunning.

LAPOSATA: This child had a significant bleeding disorder.

SHAPIRO: One of those tests is called the PTT. It measures how quickly your blood clots. A testing machine spins the blood. Usually, it takes about 35 seconds to clot. For Isis Vas, after three and a half minutes, her blood still hadn't clotted.

Laposata says the girl's elevated white blood cell count shows that she had some kind of infection that had gone untreated. He thinks that infection likely triggered the bleeding that killed Isis Vas.

Prosecutors won't comment, but they say the evidence still supports their theory that Lopez snapped and, in a moment of fury, sexually assaulted and beat Isis Vas to death. And prosecutors note that a trauma like a violent blow can trigger a blood clotting problem.

But Laposata says evidence shows the baby had been bleeding for days, not just in the few hours before she died. She'd been lethargic and wouldn't eat. Lopez testified that the girl's stool had turned black, green and thick like tar. That's a sign of internal bleeding that had been going on for days.

Another defense medical expert, Dr. Richard Soderstrom, says the bleeding disorder explains why rape was suspected.

RICHARD SODERSTROM: In order for you to claim beyond a reasonable doubt or medical probability that sexual assault has occurred, you've got to find findings that are consistent with severe disruption of tissue. That was just not here.

SHAPIRO: There was no major bruising or tissue damage, no semen or pubic hair. But, at the hospital, doctors and nurses found that blood in the vagina. That's why they suspected rape.

But Soderstrom, a gynecologist with an expertise in child abuse, says they were wrong.

SODERSTROM: This child had a severe problem with her blood clotting capabilities which could, in and of itself, explain the small amount of blood in the opening of the vagina.

SHAPIRO: When the courtroom testimony was over in Ernie Lopez's trial, most of the jurors felt Lopez was innocent. Their first vote went eight to four for acquittal. But the defense had called no medical experts. So in the end, some jurors said that without medical evidence to support Lopez, they felt they had no choice but to find him guilty.

LOPEZ: And here I am, I'm in prison. I see the barbed wire. I see the chain-link fence. I see the gates. And it's not that I'm living a dream, but it feels like a dream sometimes, a bad dream, a nightmare.

SHAPIRO: Now, Ernie Lopez is arguing he deserves a new trial. And it all comes down to that medical evidence. His new lawyer has found more than a half-dozen pro-bono medical experts. If Lopez gets a new trial, they will present medical evidence that Ernie Lopez did not rape or murder Isis Vas and that it was an untreated bleeding disorder that killed the six-month old child.

Joseph Shapiro, NPR News.

(SOUNDBITE OF MUSIC)

SIEGEL: NPR's investigation continues tonight on PBS' "Frontline." And you can read more from our online partner, ProPublica, at npr.org.

Copyright © 2011 NPR. All rights reserved. No quotes from the materials contained herein may be used in any media without attribution to NPR. This transcript is provided for personal, noncommercial use only, pursuant to our Terms of Use. Any other use requires NPR's prior permission. Visit our permissions page for further information.

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