The flawed work of pathologist Charles Smith led to serious questions about the cases of 19 children who died in unusual circumstances.
In 2008, Mr. Justice Stephen Goudge concluded that Charles Smith was an arrogant, unqualified pathologist whose biased, inconsistent and unprofessional testimony precipitated a string of wrongful murder charges and convictions.
Judge Goudge recommended that the Ontario government look into providing swift redress for people who "through no fault of their own … suffered tragic and devastating consequences."
Here are some of the people who were charged in the deaths of children based on Dr. Smith's findings.
Oneil Blackett pleaded guilty in 2001 to the manslaughter of his 13-month-old daughter Tamara Thomas.
Tamara was in a full-body cast from a broken thigh when Mr. Blackett tried to force her to drink a bottle of chocolate milk on Feb. 8, 1999. He rammed the bottle into her mouth until the child began to vomit milk and blood, then gave up, leaving the child in her play pen.
When Tamara's mother came home, the toddler was cold and not breathing. A post-mortem by Dr. Smith concluded she died from asphyxia associated with multiple traumatic injuries. Mr. Blackett was charged with second-degree murder.
Despite concerns about the validity of Dr. Smith's testimony, Mr. Blackett agree to plead guilty to manslaughter as a sign of remorse, his lawyer said. He was sentenced to three-and-a-half years in prison, on top of the 15 months he had already served awaiting trial.
Richard Brant was convicted of aggravated assault in 1995 for the death of his two-month-old son, Dustin.
Mr. Brant was taking Dustin for a walk when he noticed red foam around the baby's nose. Dustin died two days later, on Nov. 18, 1992.
Dr. Smith concluded Dustin had been shaken to death, despite the fact that the baby's brain had rotted away after morgue staff mistakenly left it in a container of water. His findings contradicted the findings of a neuropathologist who had examined the child's brain and concluded he had likely died of pneumonia.
Mr. Brant said he felt compelled to plead guilty to aggravated assault to avoid a possible manslaughter conviction. He conceded he had accidentally jostled Dustin during a physical struggle with his wife.
In January, 2009, the Ontario Court of Appeal granted Mr. Brant permission to reopen the case and fight his conviction.
William and Mary Colville
William and Mary Colville found their three-and-a-half-month-old daughter Tiffani dead in her crib in their Kingston, Ont., home on the morning of July 4, 1993,
A pathologist at the local hospital said while the baby died of undetermined causes, there were no suspicious circumstances.
After the girl was buried, police learned that a radiologist had overlooked rib fractures on Tiffani's x-ray. Her body was exhumed and Dr. Smith performed a second autopsy. He found multiple rib fractures and diagnosed the cause of death as asphyxia.
Police charged Tiffani's parents with manslaughter, aggravated assault, and failing to provide the necessaries of life.
In 1995, the court dismissed the first two charges, and the Colvilles pleaded guilty to failing to provide the necessaries of life. Mary Colville received a suspended sentence and two years' probation. William Colville was sentenced to five months in custody.
Jane Doe, whose identity is protected by a publication ban, pleaded guilty in 1994 to the manslaughter death of her newborn baby, referred to in case files as "Baby M".
Ms. Doe was 21 when she went into the bathroom of her family's home in Pickering, Ont., with what she thought were stomach cramps. At about 10 p.m. on Nov. 8, 1992, she gave birth to a boy. She later said she didn't know she was pregnant.
Her parents found her in the early hours of the morning, covered in blood. Ambulance attendants found Baby M's body in the toilet. Dr. Smith performed an autopsy later that morning, and concluded the cause of death was asphyxia. That evening, police charged Ms. Doe with second-degree murder.
Medical reports presented to the court said there was no concrete indication to show if Baby M died in the toilet or if he'd become entangled in the umbilical cord. Ms. Doe was given a suspended sentence and three years' probation, and was ordered to perform 300 hours of community service.
Lianne Gagnon was never charged in relation to the death of her 11-month-old son, Nicholas. But she lost custody of another child during a sustained police investigation.
Nicholas lost consciousness after likely hitting his head after crawling under a sewing table on Nov. 30, 1995. By the time he arrived at a hospital, he was in full cardiac arrest.
A pathologist initially found that the cause of death was undetermined and the findings were consistent with sudden infant death syndrome. However, Dr. Smith concluded the boy had died from a non-accidental bump to the head. An independent expert later ruled the cause of death as undetermined and found that Dr. Smith had made several errors.
While no charges were ever laid, child-welfare officials apprehended Ms. Gagnon's second child and her parents had to use their life savings to get the child back.
Dinesh Kumar was 26 when he pleaded guilty in 1992 to negligence causing the death of his five-week-old son Gaurov.
Gaurov screamed in his sleep on the night of March 18, 1992, and Mr. Kumar rushed to the crib to find the boy gasping and looking bluish. When Mr. Kumar picked up his son, the boy gasped and went limp. The baby was rushed to hospital, and was confirmed brain-dead. He was removed from life support two days later.
Dr. Smith concluded the boy died from shaken baby syndrome, and Mr. Kumar was charged with second-degree murder. Mr. Kumar later agreed to plead to a lesser charge, rather than face trial testimony from Dr. Smith.
In 2008, the Ontario Court of Appeal said it was "very understandable" Mr. Kumar would make such a plea bargain, and new evidence cast doubt on Dr. Smith's findings in the case. The case is currently under appeal.
Maureen Laidley was charged with second-degree murder in the death of her boyfriend's four-year-old son, Tyrell Salmon.
Tyrell fell and hit his head on a marble coffee table while jumping on the couch on Jan. 18, 1998. The next morning, Ms. Laidley brought him to the hospital, where he died four days later.
Dr. Smith performed an autopsy and concluded Tyrell had died of a head injury, but found the injury was too severe to have been caused by a household accident.
Almost a year later, police charged Ms. Laidley with second-degree murder. The charge was withdrawn on the eve of her trial after three other pathologists concluded the bump was likely caused by falling on the coffee table.
In 1995, Tammy Marquardt was convicted of second-degree murder and sentenced to life in prison for the death of her two-year-old son, Kenneth. After spending 14 years in jail, she was freed on bail in March, 2009.
Kenneth died on Oct. 9, 1993, after Ms. Marquardt called 911 in a panic to report that she had emerged from the shower to find the boy tangled in his bedclothes, struggling for breath and calling, "Mommy." The boy had a history of epileptic seizures.
Dr. Smith concluded Kenneth had been asphyxiated as a result of smothering or neck compression. Two other pathologists, however, later found that the cause of death was undetermined.
Ms. Marquardt's two other sons - one born while she was awaiting trial, the other shortly after she was sent to prison - were seized by child-welfare authorities.
In April, 2009, the Supreme Court of Canada sent the case to the Ontario Court of Appeal to weigh fresh evidence and whether Ms. Marquardt's conviction constituted a miscarriage of justice.
William Mullins-Johnson was convicted of first-degree murder and served 12 years in prison in the death of his four-year-old niece, Valin.
Mr. Mullins-Johnson babysat Valin and her brother at the home near Sault Ste. Marie, Ont., on the night of June 26, 1993. The next morning, their mother found the girl dead in bed.
Dr. Smith was one of three pathologists who concluded Valin had been asphyxiated and sexually assaulted. The cause of her death is undetermined.
Mr. Mullins-Johnson was released in 2005 when it was discovered that Dr. Smith had lost tissue samples that could have proved Valin had died of natural causes.
Mr. Mullins-Johnson was exonerated in October, 2007, after the Ontario Court of Appeal called his conviction a "terrible miscarriage of justice."
Louise Reynolds was convicted of second-degree murder in the death of her seven-year-old daughter, Sharon. She spent two years in jail.
Sharon's body was found in the basement of her Kingston, Ont., home on June 12, 1997.
Dr. Smith concluded that 80 cuts on Sharon's body had been caused by scissors or a knife. Despite knowing that a pit bull lived in the basement, Dr. Smith ruled out an animal as the cause of her injuries.
Ms. Reynolds was exonerated after Sharon's body was exhumed, revealing at least some of her injuries were bites from a pit bull. She later launched a lawsuit.
Maria Shepherd spent two years less a day in jail after pleading guilty to manslaughter in the death of her three-year-old stepdaughter, Kasandra.
Kasandra was found unconscious on April 9, 1991. She died two days later.
The Filipina immigrant acknowledged she had hit the child in a moment of frustration, but claimed it was a minor blow that she couldn't have imagined would have led to the child having seizures and dying.
Dr. Smith concluded Kasandra died from a blow to the head. However, another pathologist later found evidence to suggest she died of natural causes, such as epilepsy.
Ms. Shepherd said her lawyer had warned her against trying to plead not guilty, saying Dr. Smith "was a force to be reckoned with."
In May, 2009, the Ontario Court of Appeal granted Ms. Shepherd's request to reopen her case and seek exoneration.
Sherry Sherrett-Robinson was convicted of infanticide in 1999 for the death of her four-month-old son after Dr. Smith testified that he found signs consistent with homicide on the body of Joshua Sherrett. She spent a year in jail.
Last December, Ms. Sherrett-Robinson was acquitted of infanticide by the Ontario Court of Appeal. The court told Ms. Sherrett-Robinson it was "profoundly regrettable" she was wrongly convicted based on errors by Dr. Smith. The court heard it was possible that Joshua suffocated in his crib after becoming entangled in bedclothes.
"The tragedy of this four-month-old child's death is compounded by the fact that his mother was wrongly convicted of infanticide, served a year in jail and she lost her other child,' Mr. Justice Marc Rosenberg said at the time.
After Ms. Sherrett-Robinson was charged, her eldest son was seized and put up for adoption. She is not permitted to seek him out until he is 18.
Marco and Anisa Trotta
Marco Trotta was convicted of second-degree murder, aggravated assault and assault causing bodily harm and sentenced to life in prison for the death of his eight-month-old son, Paolo. His wife, Anisa, was convicted of criminal negligence causing death and failing to provide the necessities of life and sentenced to five years in prison.
Paolo was found dead in his crib on May 29, 1993. A pathologist initially ruled he died from sudden infant death syndrome. But the investigation into his death was reopened a year later when Mr. and Ms. Trotta brought their newborn to hospital with a fractured femur.
The baby's body was exhumed and Dr. Smith found the cause of death was undetermined, but found multiple fractures and suspected foul play. Police charged Mr. and Ms. Trotta. However, two pathologists later discredited Dr. Smith's botched autopsy and testimony. Among other discredited findings, Dr. Smith mistook an old, partly healed skull fracture for a recent injury.
In 2007, the Supreme Court of Canada ordered a new trial for Mr. and Ms. Trotta, citing Dr. Smith's mistakes.
Brenda Waudby was charged with second-degree murder in the death of her 21-month-old daughter, Jenna Mellor.
Ms. Waudby left Jenna in the care of a 14-year-old babysitter on Jan. 22, 1997. That night, the toddler died in hospital. A pubic hair was found in her groin area.
Dr. Smith performed an autopsy and concluded the girl had died of blunt abdominal trauma. Ms. Waudby was charged in September, 1997, based, in part, because Dr. Smith determined the girl likely died at a time when she was with her mother. The Crown withdrew the charge after experts suggested the girl had suffered fatal injuries when she was not in Ms. Waudby's care.
Five years after the murder charge against Ms. Waudby had been withdrawn, and after Dr. Smith had testified that he knew nothing about the pubic hair, he found the hair in an envelope in his desk.
Jenna's babysitter pleaded guilty to manslaughter in 2006 and confessed he had punched, poked and burned the girl to the point of death. Charges of sexual assault were withdrawn because of insufficient evidence. He cannot be named because he was a minor at the time.
With a report from Stephanie Chambers
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