In 1999, Sally Clark was convicted of murder. Her son, Christopher, had been born in September of 1996 and by all accounts, had been a healthy baby. Just three months later, an ambulance was called to the home, and the baby was dead.
The mother, Sally, said that she had just put him to bed and found him unresponsive not long after. The police were suspicious; she seemed a little cold and unemotional about the whole thing to them, but they couldn’t prove anything. After treatment for depression, Sally tried again and had another baby in November 1997. Just eight weeks later, he was dead, too. On both occasions, Sally had been alone with the babies, and there were some signs of trauma. Possibly due to the resuscitation attempts, but prior injury could not be excluded.
Sally was charged with the murder of her two infant sons. During court proceedings, she became pregnant again and had a third son. At trial, a learned professor of pediatrics, Dr. (Sir) Roy Meadow, opined that the chance of two children from an affluent British family both dying from “cot death,” what we call SIDS, was one in 73 million. During deliberations, the jury asked about blood and other tests and, in truth, Staph aureus had been found in the second baby’s CSF, but the pathologist, Dr. Alan Williams, didn’t want to confuse the jury with these inconvenient facts and testified that no, there were no significant tests.
Sally was convicted and sentenced to life in prison, and it was upheld on appeal. It was her husband, doggedly going through all the records to try to regain his wife’s freedom, that came across the truth. Then, the Royal Statistical Society stepped in. It turns out that Sir Meadow’s calculation of the odds, very persuasive to a jury, was flawed. The Society proved that you can’t just multiply risk factors together and hope to find the truth and that the one in 73 million quoted to the jury was flawed. Going on to calculate that, while double SIDS is very rare, double infant homicide is much more so.
In America, the appeals court would say, “Who cares?” but in England, they overturned the conviction, saying, “… the evidence should never have been before the jury in the way that it was when they considered their verdicts.” Sally was released in 2003, and all was well, right? Not quite. Sally had been sent to prison as a child killer and had been treated horribly by other prisoners and even the prison staff. She was an attorney herself and the daughter of a police officer, and the stress of being so publicly destroyed caused her immense stress. She drank herself to death within four years of her release. This is one of the things we do not address in the U.S. The post-traumatic stress of wrongful prosecution. And that brings us back to this country.
The DEA often quotes big numbers to reporters, who dutifully throw them into the news without context. In a DOJ press release after a physician’s arrest, it was announced that the doctor had “In the two-year period analyzed… prescribed approximately 1.2 million dosage units of opiates, including oxycodone and hydrocodone, to approximately 1,508 patients (approximately 847 dosage units per patient). That sounded like a lot to the public, each of whom is a potential juror, and even to other doctors in the area. When one doctor remarked about the “extreme” prescribing practices to a colleague who happened to be a pain specialist, he was slapped down.
You see, the pain specialist had run the numbers the right way. If a doctor prescribed 1.2 million MDE to 1,508 patients, the dosage per patient would have actually been 795.8. This should have cued any reporter with a calculator on their phone to look closer, but sadly, it did not. There would need to be 1,277,276 total MDE to result in 847 MDE per patient for 1,508 patients. But the pain specialist didn’t stop there. This was over a two-year period. Twenty-four months. Divide the 847 MDE per patient by 24 months, and you come out with an average MDE per month per patient of 35.3. Well below the 50 MDE recommended by the state and far below the CDC 90 MDE.
Why does the DEA report numbers this way? Because they trust that the U.S. media will not bother to fact-check what they are told, and the government is not often disappointed. Our patients will fall on a bell curve and the government will sift through the data, aided by unscrupulous data technicians, to identify a few out of thousands that had extreme problems or were particularly difficult to get on the right track. Out of 36,192 patient visits that would have occurred with that many patients over that period of time, the doctor was brought to trial on charges for just five visits. These five problematic patients are then held up to jury alone, without context, as indicative of criminal intent by “willful ignorance” of the risk of overdose and addiction.
That doctor was me, and I was convicted on four of the five charges. I had begged the attorneys to get a statistician, but they refused. I think because they didn’t understand statistics sufficiently themselves. Many doctors don’t. All those numbers are just too much. We don’t want to confuse the jury with facts, after all.
L. Joseph Parker is a distinguished professional with a diverse and accomplished career spanning the fields of science, military service, and medical practice. He currently serves as the chief science officer and operations officer, Advanced Research Concepts LLC, a pioneering company dedicated to propelling humanity into the realms of space exploration. At Advanced Research Concepts LLC, Dr. Parker leads a team of experts committed to developing innovative solutions for the complex challenges of space travel, including space transportation, energy storage, radiation shielding, artificial gravity, and space-related medical issues.