Analysis of causes that led to Baby Lucas Alejandro Mullenax-Mendez' cardiac arrest and death in August-September, 2002

Lisa Mullenax and her husband Alejandro Mendez were accused of killing their 3½ month old Baby Lucas by blunt force trauma to the head (Shaken Baby Syndrome). The baby suffered from cardiac arrest and apnea on August 27, 2002 and his father immediately sought the assistance of a neighbor who contacted the Medical Emergency Service (MES) asking for help. The MES resuscitated the baby, treated him with epinephrine, and transported him to the Centre Community Hospital. Lucas stayed about one hour in this hospital and then was airlifted to the Geisinger Medical Center. Lucas was pronounced brain dead after six days following his arrival to the Geisinger Medical Center. In the hospitals, several physicians examined Baby Lucas and no evidence of traumatic injuries to the head was observed. In addition, Lucas’ head region was examined by CT scans on August 27 and no bone fracture was found. Lisa and Alejandro were accused of killing their Baby Lucas based only on the autopsy findings of an oldhealed rib fracture and bleeding in the retina of the eyes, brain, and the subdural space. Lisa and Alejandro requested that I evaluate their case to find the factual cause(s) that led to Lucas’ cardiac arrest and death. I evaluated their case by reviewing the baby’s medical records, case history, the autopsy report, Lisa’s medical record during her pregnancy with Lucas, and the published medical literature pertinent to Lucas’ case. I used differential diagnosis to evaluate the contribution of causes and the synergistic actions among these causes that led to the baby’s cardiac arrest, apnea, bleeding in the brain and other locations, and death. I present my review and analysis of Lisa’s medical records during her pregnancy with Lucas in Section I of this report. Section II contains a detailed description of Baby Lucas’ treatment history and his health problems from the time of birth on May 16, 2002 to the day of his cardiac arrest on August 27, 2002 along with my analysis of those events. In Sections III and IV, I describe the clinical events that took place during Lucas’ seven days in the hospitals and my analysis of those events. My analysis of the medical examiner’s autopsy report is presented in Section V. Section VI contains my conclusions and recommendations.