Doctor Accused of His Baby’s Death Caught in Tragic Dilemma

That pivotal day began for Malcolm and Lois Scoon as most days do for new parents, according to the rhythm of their baby’s sleeping and eating schedule.

There were only two small complications: Lois had a toothache and 5-month-old Mariah was congested.

It was President’s Day last February and Malcolm, a doctor, had the day off. Lois decided to go see a dentist.

Before leaving, she fed Mariah, gave her a sponge bath and dressed her in a white, floral jumper. On her daughter’s feet she put a new pair of white socks that Malcolm’s mother had given Mariah for Valentine’s Day.

Then she put Mariah down for a nap and wound up a music box of lullabies. The tinkling sounds of “Jesus Loves Me” and “His Eyes on the Sparrow” filled the first-floor bedroom.

“And that is the last time I saw her with her eyes open,” Lois said months later at her kitchen table, the memory causing her to sob painfully.

Now Malcolm Scoon, anesthesiologist and born-again Christian, is charged with reckless manslaughter and criminally negligent homicide. Authorities and doctors say he shook his daughter to death.

The Scoons say he was trying to save her life.

Mariah’s autopsy produced classic symptoms of shaken baby syndrome: bleeding in the membrane around the brain, bleeding in the eyes, a hemorrhage under the right arm consistent with being grabbed tightly.

As a doctor, Scoon “unquestionably knew all too well” the consequences of shaking an infant, Queens Dist. Atty. Richard Brown said when the indictment was announced.

At home in their small house in the middle-class Cambria Heights neighborhood of Queens, on a street of red-brick houses with small, tidy lawns, Malcolm and Lois huddle together looking at a photo album that documents Mariah’s short life. They tell a very different story.

Sitting with them is Malcolm’s brother-in-law, Alvin Peters, a co-counsel in the case.

The Scoons, both deeply religious, were married in June 1993, six months after they met. Mariah was born on Sept. 12, 1995, after they spent at least $17,000 on fertility treatments. The baby was 2 1/2 months premature and weighed 2 pounds, 1 ounce.

“She was a pleasant baby, very pleasant. She smiled a lot,” Lois recalls. “She used to like to eat Malcolm’s nose. The only thing she was demanding about was her food.”

Malcolm, 38, is a placid, reserved man whose voice lacks animation--except when he talks about his work at Woodhull Hospital in Queens, which suspended him without pay after he was indicted.

Lois, 39, is outgoing and passionate. Before becoming a labor lawyer, she worked as a children’s social worker in South-Central Los Angeles--first in a hospital emergency room and later as a case investigator.

“I got a full view of child abuse,” she says.

Malcolm gives this account of what happened that morning of Feb. 19:

After Lois left, he says, he sat down at the kitchen table to open mail that had accumulated during a week they spent in Florida.

About 10 a.m., he says, he went to look in on Mariah. “She seemed to be sleeping and doing fine,” he says, so he returned to his mail.

About noon, he went to check on Mariah again; she was making cooing noises and had a dirty diaper. To make changing her diaper easier, he decided to give her a bath. He filled a plastic tub with water and brought it into the room.

“I felt [the bathwater] was a little bit warm, so I decided to leave it there,” he says. Mariah was awake, “just lying there,” when he left her and went back to the kitchen, he says.

She did not cry, even though her diaper was dirty, she had just awakened from at least a two-hour nap, and had not been fed since about 9 a.m.

Malcolm says he only expected to be gone a few minutes but “got caught in doing some things.”

“I don’t think it was very long,” he says. “I can’t say exactly. It definitely wasn’t, you know, as long as an hour or anything like that.”

Back in the bedroom, he removed Mariah’s diaper. “I noticed she wasn’t looking at me. And I picked her up like this,” he says, putting his hands around an imaginary body and holding it out in front of him.

“And I said, ‘Mariah,’ and I just jostled her a little bit.

“And she didn’t make any noises. And she looked like she was gasping for breath.” He says he checked her heart rate and it was slow.

“I didn’t really panic,” he says, noting that he had completed a course in pediatric life support two months before. But he says he decided that his daughter’s life was in danger, so he began cardiopulmonary resuscitation, giving her a couple of breaths and doing a few chest compressions with his fingers.

“She started to cry a little bit and kind of looked at me,” he says. “It looked like she was going to get better.”

Then, he says, she went limp again.

“I just said, ‘Mariah! Mariah!’ and I jostled her a little bit--holding her with my hands behind her head. And she didn’t respond. At that point, I realized I needed help.”

Malcolm called 911 and Mariah was taken to Long Island Jewish Medical Center, where she arrived pale and breathing periodically, according to a hospital affidavit.

A CAT scan “revealed evidence of severe hemorrhage and swelling of the brain,” the affidavit said. By the evening, Mariah was completely unresponsive. The hospital decided to notify the Child Welfare Administration.

Doctors pronounced Mariah legally brain dead three days later. When the Scoons objected to the hospital’s decision to disconnect her from a ventilator, citing their religious beliefs and hope for a miracle, a court battle ensued.

Legal and medical experts said at the time that critical medical evidence would deteriorate the longer Mariah’s autopsy was delayed. Counters Ronald Kuby, Malcolm’s lawyer: “We could have benefited” with fresher evidence.

But for Lois, keeping Mariah on a ventilator was, above all, about not wanting to let her go.

“Could it just be the main reason is that you don’t want to give the child up?” she says. “She doesn’t move. She lays there. Her eyes are shut. But she’s still breathing. So it’s always that hope, that things will change, that you’ll have your baby back.”

The issue was resolved a week later, when Cardinal John O’Connor intervened and had Mariah transferred to a Catholic hospital, St. Vincent’s Medical Center. She stayed there, on a ventilator, until her heart stopped March 13.

Mary de Bourbon, a spokeswoman for the Queens district attorney’s office, says the autopsy findings in total lead inevitably to shaken baby syndrome. There could be another explanation for each finding taken separately, she says, but only shaking could explain all of them.

“This case was recognized at the beginning as a terrible tragedy,” she says, “and I think that is reflected in the grand jury’s charge of reckless manslaughter. That is not an intentional killing.”

But the Scoons and their lawyers argue that the medical findings, though consistent with violent shaking, also point to other possible causes of death. Since Mariah was born prematurely, her health was vulnerable; she had been suffering from chronic nasal congestion before she died.

The Scoons say Mariah could have suffered a blood clot in the brain caused by a severe illness, or had a violent reaction to a diphtheria-tetanus-pertussis vaccination she had had a week earlier.

They also say Malcolm may have intervened with CPR just in time to prevent her from dying from sudden infant death syndrome (SIDS), which is related to an irregularity in the respiratory mechanism.

Ronald Kuby also has another suggestion for why Malcolm is a suspect: When he brought his daughter to the emergency room, he was disheveled and unshaven, wearing jogging pants and a T-shirt--and he is black.

“The good white folks at LIJ did not see an anesthesiologist cradling his grievous injured daughter,” argues Kuby, who was the late William Kunstler’s partner and has his first child-abuse case in Malcolm Scoon.

The district attorney’s office counters that the hospital staff knew Malcolm was a doctor. “I think they went out of their way to treat him with great deference and respect,” de Bourbon says.

Dr. Patrick Barnes, chief of neuroradiology at Children’s Hospital in Boston, will probably be a key witness at Scoon’s trial. Last summer, at the defense’s request, he testified before the grand jury.

In an interview, Barnes called the theory that Mariah’s death was caused by the immunization “a distraction,” though possible. But he places great weight on the theory that Mariah suffered a blood clot in a vein in the brain. That condition could not have been caused by shaken baby syndrome.

Doctors at Long Island Jewish Hospital found no signs of this kind of blood clot in its two CAT scans. Barnes, however, reviewed the scans and says he did.

The problem with this theory, Barnes concedes, is that there has never been any documentation of this kind of clot causing bleeding in the space around the brain. But he adds that Mariah’s bleeding there could have been caused by whatever caused the blood clot--perhaps encephalitis, an inflammation of the brain.

But, as medical doctors who are experts in child abuse point out, someone doesn’t get encephalitis out of the blue; they get ill and have symptoms such as a high fever. The only symptom Mariah exhibited was congestion.

The hemorrhage under Mariah’s right arm also doesn’t fit with a blood clot in the brain. But the family says it could have happened when Mariah was moved to St. Vincent’s. It was first mentioned in the autopsy report.

Another possible cause of death, the Scoons say, is that their daughter was dying of SIDS and Malcolm temporarily resuscitated her with CPR. This theory was put forward earlier this year by Dr. John Menkes, professor emeritus of neurology and pediatrics at UCLA.

On Nov. 4, the 5-week-old son of Lois’ brother died in his crib in Newark, N.J. The autopsy ruled SIDS killed the full-term baby.

“We know that SIDS can run in families” and “more often affects premature infants,” Menkes said on learning of the nephew’s death. Often, he added, the only symptom is “a little cold.”

SIDS could not have caused Mariah’s bleeding. But Menkes says the CPR could have. Other medical experts disagree.

Malcolm Scoon could get up to 15 years in prison if convicted of manslaughter and a maximum four years if convicted of criminally negligent homicide. His case is expected to go to trial in the spring. Kuby hasn’t decided if Scoon will testify.

The Scoons spend their days researching Malcolm’s case to defray the cost of his defense. They also pray, work around the house and do volunteer work at their church. Malcolm has painted the living room yellow and is building a fireplace.

And they are planning to have more children.