Pubdate: Sat, 07 Sep 2002 Source: Arizona Republic (AZ) Copyright: 2002 The Arizona Republic Contact: http://www.arizonarepublic.com/ Details: http://www.mapinc.org/media/24 Author: Karina Bland PRENATAL EXPOSURE TO CRACK KILLED BABY Finding By Experts Hurts Prosecution A deadly bowel condition caused by prenatal exposure to crack cocaine killed 10-day-old Anndreah Robertson, not secondhand smoke from the drug, doctors on a panel reviewing the baby's death said Friday. Prosecutors charged Anndreah's mother, Demitres Robertson, 23, with first-degree murder, saying she caused the baby's death by clouding the child with crack cocaine smoke. The doctors say that is not possible. Their conclusion could undermine the case against Robertson because prosecutors need to prove the child's death was caused by conditions created after her birth. Arizona law does not allow for prosecution of women for drug use during pregnancy. Bill FitzGerald, Maricopa County Attorney's Office spokesman, said Friday that he could not comment on a pending case. Attorney James Cleary, who is representing the baby's grandmother and primary caregiver, Lillian Butler, 44, said if prosecutors can't prove that secondhand smoke killed Anndreah, then they have no case. Butler is charged with two counts of child abuse. Drs. Ravi Gunawardene, a pediatric neonatologist at Maricopa Medical Center, and Michael Carlton, a pediatrician and medical director of the East Valley Addiction Council, said Anndreah's problems started before she was born. Anndreah died Nov. 9, 2001, 10 days after birth. Her intestines were destroyed by necrotizing enterocolitis, or NEC. Medical experts say it often shows up in premature babies and babies exposed prenatally to drugs, particularly cocaine. In drug-exposed babies, the doctors said, it is fatal in more than half of cases. "It is the assumption that all babies who get it are born with it," Carlton said. "Initially, this involves a small portion of the bowel and then spreads." Anndreah's death was ruled a homicide by the Medical Examiner's Office. Cause of death: complications of cocaine exposure and dehydration. She weighed 4 pounds. Anndreah's short life has brought a barrage of criticism on state Child Protective Services, whose caseworkers knew three weeks before Anndreah's Oct. 30 birth that crack cocaine was being smoked in her family's Phoenix apartment. Still, caseworkers let the girl stay with her mother and did not remove her brothers, ages 1 and 2. The 2-year-old also was born addicted to cocaine. A CPS investigation for possible neglect was ongoing when Anndreah died. The boys now are in a relative's care. "The bottom line is: From what we know now, there's certainly enough blame to go around," said Carol Kamin, director of the Children's Action Alliance and a panel member. Typically, babies with NEC spend at least 10 days in the hospital, are fed intravenously and given antibiotics until the intestine can repair itself. Anndreah was kept in the hospital for three days, until the cocaine cleared her system. Hospital staff told her mother the baby would die if exposed to any crack cocaine smoke and to bring her back in three days for a check- up. Anndreah was not brought back to see a doctor. Anndreah began crying uncontrollably in the two days before her death. She wouldn't eat and had foul-smelling diapers. She vomited and moaned. At dawn on Nov. 8, she was taken to St. Joseph's Hospital and Medical Center in a taxi. Surgeons opened up her tiny belly and could only stitch her back up because her entire bowel was dead. The doctors told the panel Friday that there is no evidence in medical literature that the condition can be caused by secondhand crack cocaine smoke. A 1998 Yale study found that exposure to cocaine smoke poses health risks for babies but did not cite any deaths. It's unlikely secondhand cocaine smoke could kill a child, said Detective Tom Salisbury of the Riverside County, Calif., Sheriff's Office. He is director of that county's Drug Endangered Children's Project. "Someone would have to blow the smoke directly up the baby's nose," he said. The panel will make a report to John Clayton, head of the state Department of Economic Security, which oversees CPS, within a few weeks. - --- MAP posted-by: Beth