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On a February afternoon in 2022, Dr. Bazak Sharon logged into a remote video meeting from his home office in Minneapolis. He propped up his cellphone next to his laptop and hit record on a video app.
There were several people in the meeting with Sharon, who at the time was a pediatrician with the University of Minnesota. Two hospital leaders, Sharon’s boss and a lawyer were there, too. But the person Sharon was most wary of was in the lower-right corner of the grid of faces: Dr. Nancy Harper, the director of the child abuse team at University of Minnesota Masonic Children’s Hospital in Minneapolis.
Sharon suspected that the discussion, about the care of a 3-month-old named Hank, was going to be contentious. He worried that someday, perhaps even in court, he might need evidence of his role caring for Hank. He was prepared to argue with Harper if she challenged his clinical judgment, but it was quickly apparent that the quality of the care he provided was not at issue.
Hank was born small and was not eating well or gaining enough weight; sometimes, according to his parents, he just seemed to be in pain. (ProPublica is using a nickname for the child at the parents’ request.) At an appointment in January, a doctor ordered an endoscopy, a procedure where a tiny camera is threaded through the body, and also suggested an MRI.
The scans of Hank’s brain showed fluid pooled under both sides of his skull. The blood was old, possibly months old, and Hank was admitted to the hospital. Sharon met him the next day.
A member of Harper’s team named Dr. Caroline George also evaluated Hank that day. In her opinion, according to court records, the bleeding was “consistent with abusive head trauma.” Sharon had suggested other possible causes, including an injury from birth, an infection or even spontaneous bleeding. Sharon wrote in the child’s medical record that it’s “likely we will never identify the exact mechanism that caused his injury.”
Three days after Hank was admitted, Sharon said he learned that a county child protection services worker was preparing to come to the hospital to take custody of the baby, as well as his 2-year-old brother, William.
Sharon said that he was stunned that no one had spoken to him since he was Hank’s primary doctor. So he did something that seemed to put him at odds with George, Harper and hospital leadership: He told Hank’s parents, CPS and police he didn’t think the bleeding alone was enough evidence to say this was abuse.
Sharon was also concerned that separating a sick infant from his parents based only on a suspicion of abuse would cause more harm to Hank. Working with the detective assigned to the case, he admitted William, though the older boy was not sick, so that the whole family could stay in the hospital under the supervision of a nursing assistant while doctors continued to treat and monitor Hank.
But four days later, according to Sharon, his supervisor told him that he was being removed from Hank’s care team, and that he should not communicate further with the parents. When Sharon asked why, he said he was told it was at Harper’s recommendation. “The care,” he said, “changed the second she got involved.”
In less than 48 hours, a judge determined that Hank and William were in need of child protection services and their parents were forced to leave the hospital without them. The same day, Sharon said, he was summoned to the first of two meetings with hospital leadership and Harper. When his supervisors scheduled the second meeting — titled “Review of CPS Patient” in the emailed invitation — less than a month later, Sharon came prepared to record it.
Before all this, Sharon had an appreciation for Harper’s formidability and for her influence in the world of child abuse pediatrics. She began her career as a pediatrician in the U.S. Navy before leading a child abuse team at a hospital in Texas. In 2014, she became the director of the University of Minnesota’s Center for Safe and Healthy Children.
A certified child abuse pediatrician for almost 16 years, the 56-year-old Harper consulted on suspected cases of abuse for several Twin Cities hospital systems, testified as an expert witness in child abuse trials across the U.S. and lectured on diagnosing signs of abuse. She was also the vice president of the Ray E. Helfer Society, a national nonprofit organization for physicians who work on the medical aspects of child abuse and neglect, and she became its president in 2023.
Harper testifies for the prosecution at a 2021 trial.
Credit:
Coburn Dukehart/Wisconsin Watch
Sharon, now 53 years old, was also well-respected. Originally from Israel, he came to the U.S. in 2003 to continue his medical studies. He began as a fellow at the University of Minnesota in 2006 and had been on faculty for 12 years. Specializing in infectious diseases, he became medical director of the university’s pediatric COVID-19 clinic and was a contributing member of the state Health Department’s Long COVID Guiding Council. Sharon was also a hospitalist, meaning he directed the care for admitted patients like Hank, coordinating with other doctors and specialists.
As the online February meeting progressed, it became clear to Sharon that, in a face-off with Harper, his medical expertise and the fact that he considered many of the people on the call to be friends counted for little. The lawyer noted that differing medical opinions could open the hospital or the doctors themselves up to a lawsuit. George added that the differences in opinions had also “made things difficult for particularly law enforcement.”
“I’m not a child abuse expert,” said Dr. Sameer Gupta, the chief medical officer of the hospital, on the call. “But, you know, my experience is this: Try to be completely aligned. That’s one story that’s coming from the medical team as much as possible, to avoid the potential for, one, litigation, two, to let the experts really drive the ship.”
Sharon became increasingly agitated during the call, shaking his head. He was angry that the conversation had revolved around protocols and the hospital’s legal liabilities, rather than Hank’s care.
“I think I did the best any doctor can do at that point in making sure that my patient is getting the best care while I’m not trying to hide any potential abuse,” he said during the meeting, the video of which he shared with ProPublica. “I felt very uncomfortable that CPS are showing up unannounced and taking two children away from the parents without having a discussion with the doctors who take care of this patient. I hope no one expects me not to say something when that happens in front of me.”
But Harper seemed to suggest that Hank might have been seen by too many doctors, and that Sharon had interfered with her team’s ability to “frame” the case to CPS and law enforcement. She said she did not consider it her role to be concerned about what could happen to a family after a diagnosis.
“Unfortunately,” she said, “if I spent all of my time worrying about … what’s going to happen with child protection and foster care or the cost for the legal stuff afterwards, I wouldn’t be able to do my job.”
Sharon began to protest. He said he had been reading the scientific literature on abusive head trauma and found it unconvincing, a conclusion more and more doctors were coming to. Harper cut him off. “If I spent two weeks reading the literature on COVID, would you consider me as qualified as you are?” she asked. “I’ve been doing this for decades.”
Gupta abruptly shut down the conversation. He said that Sharon’s plan to keep the family in the hospital was the “wrong decision and will never, ever happen again,” and then he ended the call.
As the screen went blank, Sharon let out a long, deep sigh. Though disturbed and frustrated, he did not yet realize his actions on behalf of Hank and his family would affect his career. Over time, Sharon came to see Harper as the main driver of a campaign to get him to fall in line with the child abuse team.
“She’s very black and white, right and wrong, no gray area,” he said, “which is not the way to do medicine or pediatrics.”
Harper did not respond to requests for comment. She and a spokesperson for University of Minnesota Physicians, which is the clinical practice for the university’s medical school faculty, also did not respond to a detailed list of questions. But the spokesperson wrote that the Otto Bremer Trust Center for Safe and Healthy Children, as it is now called and which is led by Harper, provides “trauma-informed medical care and psychosocial support while addressing research, prevention, advocacy, policy and education.”
“When healthcare providers and community organizations refer patients to CSCH, the team only makes decisions about diagnoses and subsequent medical care based on expert assessment of medical evidence (e.g., medical history, physical exam, lab and radiological findings, input from other medical specialists and information provided by caregivers),” the spokesperson added. “Further investigations and legal determinations are outside of our team’s scope.”
A spokesperson for Fairview Health Services, which owns Masonic Children’s Hospital, said in a statement that although Harper is an employee of University of Minnesota Physicians, “we obviously take these concerns seriously and are actively reviewing the matter.”
“Our highest priority is the safety, dignity, and wellbeing of our patients and families — especially in moments of crisis. We are aware of concerns being raised regarding the conduct of a University of Minnesota Physicians (UMP)-employed provider who practices in a UMP-led clinic within the M Health Fairview Masonic Children’s Hospital,” the spokesperson added. “We are in close communication with our academic partners and are evaluating any steps we may need to take to preserve the trust our patients and families place in us.”
Harper’s arrival in Minnesota coincided with the fallout of a high-profile tragedy: the 2013 death of 4-year-old Eric Dean.
Dean lived with his family in sparsely populated Pope County, in west-central Minnesota. According to an investigation by The Minnesota Star Tribune, teachers and caregivers reported signs that Dean was being abused to child protection workers at least 15 times before his stepmother threw him across a room, causing injuries that would kill him. She is in prison serving a life sentence.
In response, then-Gov. Mark Dayton signed an executive order in 2014 creating the Governor’s Task Force on the Protection of Children. The next year, along with a slew of other reforms, the state Legislature created a $23.35 million grant to give counties money based partially on the number of open child protection investigations.
She’s very black and white, right and wrong, no gray area, which is not the way to do medicine or pediatrics.
—Dr. Bazak Sharon
The number of child abuse cases soared. For instance, in Hennepin County, where Minneapolis is located, cases of physical abuse more than doubled from 2015 to 2016, before dropping over the next several years. Child abuse experts attributed the rise to what Joanna Woolman, a law professor who specializes in child abuse law, called “a moment of hyper-awareness around medical child abuse and child abuse in general.”
“We were convening a task force that was heavily made up of people with the view that we needed to do more, have more eyes on, be more aware,” added Woolman, who is also the executive director of the nonprofit Keeping Families Connected Minnesota, which provides free legal services to families going through child protection proceedings.
A subspecialty of pediatrics first recognized by the American Board of Pediatrics in 2006, child abuse pediatrics focuses on the diagnosis and documentation of signs of abuse. A diagnosis can help determine whether a parent loses custody of their child or faces criminal investigation. In cases where children die, it can mean murder charges. Harper was one of the first certified child abuse pediatricians in the country — the board counts over 350 subspeciality certifications nationwide — and is one of seven currently certified in Minnesota.
“Physicians with less training on child abuse and neglect both over- and under-identify injuries in children, whether they’re physical abuse injuries, sexual abuse injuries,” she testified in a 2019 trial. “A child with a missed injury could come back later with a more serious injury or even die. And so these are sort of issues where we realize that we needed expertise.”
Harper was hired as director of the Center for Safe and Healthy Children by the University of Minnesota the same year as Dayton’s executive order. According to testimony she gave in a 2019 criminal trial, the university recruited her to build up the center and create a regionwide child abuse consultation system.
“When I’m on call, I can be covering up to six different places where children can be seen,” Harper testified.
In 2016, the Otto Bremer Trust, a private charitable organization based in St. Paul, announced a $2.5 million grant to fund Harper’s ambitions to expand the center, which is based at Masonic. Harper is also program director for the university’s Child Abuse Pediatrics Fellowship, a three-year training program, giving her influence over the next generation of child abuse pediatricians. A spokesperson for the trust added that it does not have any “role in the day-to-day operations of the Center.”
Hennepin County has a contract with Harper’s employer, University of Minnesota Physicians, to provide medical consultation, expert witness testimony and case consultation with county attorneys. According to testimony Harper has given in the past, she and her team handle about 700 cases of suspected abuse each year. She has testified that 10% to 20% of those wind up confirmed for physical abuse, although it is difficult to determine if these figures are accurate since child protection case records are not public. She has given different answers on the witness stand when asked if she has ever testified for the defense; in 2021, she said she’d testified for the defense in a “half dozen or a dozen” cases. In 2023, she said she’d done so twice.
In 2018, Harper’s center began cohosting an annual Child Abuse Summit with the Hennepin County Attorney’s Office. In 2022, she received an introduction during a panel discussion from Dan Allard, senior assistant Hennepin County attorney, that illustrated the close relationship between Harper and her team and county prosecutors.
“If you haven’t heard Dr. Harper testify, she does a wonderful job. She knows her stuff,” Allard, who is also the head of the county attorney’s child abuse team, said at the summit. “We just barely try to keep up understanding what she’s talking about. So we just kind of let her go.”
In response to a detailed list of questions, Daniel Borgertpoepping, a spokesperson for the Hennepin County Attorney’s Office, wrote, “Since our office represents Hennepin County in CPS matters, we are unable to comment.”
Before Sharon’s encounter with Harper, he hadn’t given much thought to her team’s practices, which included evaluating and treating some of the worst cases of physical and sexual abuse of children. While he said he had referred a dozen or so cases of suspected neglect to her team, he viewed their work as a bleak side of pediatrics. He was happy to avoid it.
“I had a lot of respect for the child abuse doctors, like, ‘Thank you for doing that for us,’” he said.
But for roughly 15 years, the world of child abuse pediatrics has been roiled by criticism of the diagnosis once known as shaken baby syndrome and now categorized under the umbrella term abusive head trauma. A triad of symptoms — brain bleeding, brain swelling or injury, and blood in the retina — was once considered evidence that a child had been violently shaken, even if there were no other injuries or even bruising.
In court testimony, Harper has said that both shaken baby syndrome and abusive head trauma are considered scientifically valid diagnoses by “the mainstream medical community,” and that the controversy is more of a legal one than a medical one. She has acknowledged there are medical conditions that mimic possible signs of abuse, including bruises, bone fractures and head trauma symptoms, but she said that her assessments take all of that into account in concert with specialists like neurosurgeons and radiologists.
“We take a very detailed history from the family. We do a physical examination, look at past medical history, other medical conditions, the initial laboratory and X-ray reports,” she testified in 2023.
Sharon readily concedes that he wasn’t an expert in child abuse medicine. But as he and the other doctors tried to understand the bleeding in Hank’s brain as well as his lack of weight gain, he spent his evenings reading the scientific and legal literature about shaken baby syndrome and abusive head trauma, scribbling notes to himself. He read a key American Academy of Pediatrics statement reaffirming its belief in the diagnoses; he also read studies that challenged the science underlying them.
“It is wrong to fail to advise parents and courts when these are simply hypotheses, not proven medical or scientific facts,” Sharon wrote on a copy of one law review article.
He read about how the first neurosurgeon to posit the theory of shaken baby syndrome said in an interview years later that he was “disturbed that what I intended as a friendly suggestion for avoiding injury to children has become an excuse for imprisoning innocent parents.” According to the National Registry of Exonerations, over 40 people convicted in cases related to the diagnosis have been exonerated since the 1990s, often over increasing doubts that the three symptoms can be interpreted so definitively.
Sharon also learned that the subspecialty of child abuse pediatrics itself has also been under increasing scrutiny. Perhaps the most famous child abuse pediatrician case became the basis for the Netflix documentary “Take Care of Maya,” in which a 10-year-old girl’s pain syndrome was diagnosed by a child abuse pediatrician as Munchausen syndrome by proxy. A jury found the hospital liable for medical malpractice and awarded the family over $200 million; the hospital has appealed. Several families are suing a Pennsylvania hospital for what they say are false diagnoses of abuse by Dr. Debra Esernio-Jenssen, who led its child abuse team. A series of allegations of overzealous diagnoses of abuse have followed Dr. Barbara Knox from her job leading a child abuse team at the University of Wisconsin to similar positions in Alaska and at the University of Florida.
Sharon began to question the scientific nature of shaken baby syndrome and abusive head trauma after his dispute with Harper’s team. “It is wrong to fail to advise parents and courts when these are simply hypotheses, not proven medical or scientific facts,” he wrote on a copy of one law review article.
The child abuse pediatrician community is tightknit. After Knox left Wisconsin, Harper replaced her as an expert witness in some criminal cases. Esernio-Jenssen wrote Harper a nomination letter for a Ray E. Helfer Society award, calling her “an unstoppable force.”
Esernio-Jenssen and Knox, as well as the Helfer Society, did not respond to requests for comment. In a response to the lawsuit, attorneys for Esernio-Jenssen and her former hospital network wrote that they “are being attacked and demonized for protecting children from abuse and following the law,” and that the allegations of bad-faith abuse investigations are “obviously untrue.” The lawsuit is ongoing.
Knox was sued by two families in Alaska who accused her of leveling false accusations of abuse against them. In response, Knox said in an affidavit that she has no say over whether child protection takes children away from their parents, that she did not “conspire” with police or anyone else on custody issues or criminal prosecution, and that she did not personally evaluate one of the named children. The lawsuit was dismissed in 2024 after the families agreed to drop the matter.
According to a spokesperson for the University of Florida, Knox resigned her job there as a pediatrician with the Child Protective Team, effective Aug. 15. He declined to comment on the circumstances.
From the start, Sharon thought what was happening to Hank — a child struggling with eating and weight gain, with abnormal results on his endoscopy and weeks-old, unexplained cranial bleeding without any other symptoms of abuse — fit into his wheelhouse treating complex and even mysterious cases more than it fit into Harper’s. After poring through the literature on abusive head trauma, he was even more convinced.
Sharon followed his supervisor’s instruction not to speak to Hank’s parents. But after the couple’s attorney approached him, he provided a five-page account of Hank’s medical treatment. He included several potential alternative diagnoses.
“It is clear to me that missing child abuse is as serious as missing bacterial meningitis and should be considered as malpractice,” he wrote. “But also, as a hospitalist, who frequently manage children without clear definitions of their diagnosis, I’m used to ambiguity.”
Dr. Matthias Zinn, Hank’s neurologist, agreed with Sharon that the fluid in Hank’s brain, what he called “subdural collections,” could not be definitively tied to abuse. He provided a letter to the couple’s attorney as well. Zinn, who said he’s consulted on hundreds of cases of suspected abuse, said Harper’s child abuse team was by far the most aggressive he’s worked with.
“It was just crazy,” he said. “I remember speaking to them and saying, ‘What evidence do you have, other than the subdural collections?’ And they made it clear that they did not respect my opinion.”
Zinn has since left the University of Minnesota for a position in Florida.
Both a CPS investigator and a police detective spoke to Sharon repeatedly, and according to Hank’s parents, they also relayed Zinn’s opinion and begged CPS to talk to him as well. But the CPS petition alleging Hank was a victim of abuse only cited George’s assessment. There’s no mention of Sharon or Zinn.
George did not respond to requests for comment.
A spokesperson for Hennepin County declined to comment on individual cases or to respond to a detailed list of questions. But she provided a statement from Kwesi Booker, the director of Hennepin County Children and Family Services, which oversees child protection services. In that statement, Booker said “child protection social workers appropriately rely on the subject matter expertise of trained medical professionals in situations involving complex medical issues.”
Unable to let the matter go, Sharon wrote letters to the hospital’s leadership council about what he called “dangerous overreach” by Harper’s child abuse team. In response, Gupta said he referred the letter for review to the hospital’s Committee for Professional Enhancement. Citing privacy laws, hospital administrators would not tell Sharon the outcome of the committee’s review.
Separately, Gupta wrote Sharon a “peer review” letter informing him that, in several of his cases, there were concerns about his conduct, professionalism and a disregard for hospital protocol. Sharon said he was aware of his reputation for being strong-willed and, at times, dismissive or even rude to colleagues. The letter warned him against doing anything that could be seen as “retaliatory” toward other members of the staff. Gupta gave three examples related to Sharon’s purportedly improper procedures for prescribing medications for pediatric COVID-19 patients; he also referred to Sharon’s interaction with the child abuse team.
“Your documentation in the chart and communication with law enforcement was contrary to what was being stated by the child abuse team,” Gupta wrote in the peer review letter. “This created confusion with the community workers and with the family in a situation in which consistency is very important.”
Gupta did not respond to repeated requests for comment or to a list of questions.
Masonic Children’s Hospital
Hank’s family had a limited view of what was going on behind the scenes at Masonic Children’s Hospital, even though Hank’s mother, Kay, worked in the neonatal intensive care unit there. She recognized Sharon and knew of George, though she hadn’t worked closely with either. Because Hank’s parents both work in the pediatric field and for the privacy of their children, they asked that ProPublica not use their full names.
The day after Hank’s admission, Kay and her husband, Ross, explained to George about the baby’s difficulty with breastfeeding, his inexplicable pain and his inability to tolerate formula. When George asked her about possible accidents or injuries, the only thing Kay could think of was a time when she was driving and slammed on the brakes with Hank in his car seat.
After she read the CPS petition alleging her children were victims of physical abuse, Kay said that she came to suspect that George had been trying to collect information to use against her and her husband, not to treat Hank.
“I think she was sitting there hoping that I was just going to confess or tell her that I thought my husband might have done it,” Kay said. “And I was just hoping that she was going to help me.”
While Hank and William were in foster care, police confiscated the couple’s cellphones, laptops and baby monitors, and interviewed various family members and friends. In April 2022, Hennepin County decided not to pursue criminal charges.
CPS found no additional evidence of abuse, and after nearly four months, a judge ordered both boys returned to the couple, though it was on the condition that a grandparent live in the home full time as well. In June, just before a trial to determine if Hank had been abused, CPS agreed to begin the process of dismissing the matter, though the agency still made a “finding of maltreatment” by an “unknown offender.”
In late July, the Hennepin County Attorney’s Office signed off on the dismissal. It had been nearly seven months since Hank was first admitted to the hospital.
Around the same time, Kay and Ross took Hank for genetic testing, which showed he carried an abnormal gene duplication with unknown effects. He was also put on medication that resolved his stomach sensitivity issues and increased his appetite. One of Sharon’s theories was that the bleeding under his skull was due to poor feeding, dehydration or vitamin deficiency, though no one has been able to identify a definitive cause.
“He’s just been our little mystery baby, but he is a beautiful, healthy, thriving little 3-year-old,” Kay said.
William, she said, still has nightmares about being taken from his parents. At 5 years old, he insists on sleeping in their bed every night. Defending themselves, Kay said, plus the cost of additional caregivers amounted to roughly $100,000 for the family.
Kay never met Harper and only later came to understand the role she played. Because there was no trial, she never had the chance to confront Harper or George, or lay out any of the arguments that she and her husband had been falsely accused of abuse.
But just before the case closed, Kay saw an advertisement for the 2022 Child Abuse Summit, with Harper as a featured panelist. She bought a ticket to the event and sat right in front of Harper.
“They do these things and probably never have to see the people again, outside of places where they’re in charge,” she remembered thinking. “You’re going to have to see me.”
Sharon did not know it at the time, but he was far from the only person struggling in recent years to keep a family from losing their children after Harper’s involvement. In his job as an attorney for indigent parents at Hennepin County Adult Representation Services, Scotty Ducharme has dealt with horror stories and seen cases of extreme child abuse up close. But when allegations have arisen almost exclusively from a medical diagnosis from a child abuse pediatrician, which he calls a “CAP,” he has also seen signs that not all the doctors on the child’s treatment team are in lockstep.
“If you read the medical records written by the CAPs versus the regular doctors in the cases I’ve worked on, you can see the breadcrumbs by the regular doctors who don’t believe what the CAPs are saying,” he said. “I’ve only caught, on the record, doctors directly contradicting each other a few times.”
“I’ve only caught, on the record, doctors directly contradicting each other a few times,” said Scotty Ducharme, a former attorney for indigent parents at Hennepin County Adult Representation Services who is now in private practice.
In the spring of 2023, Ducharme met María Alejandra Ramírez Rodríguez and her husband, Cristian Andrés Guzmán de la Ossa, a couple in their 20s. Recent arrivals from Colombia who spoke no English, they brought their 4-week-old son to Hennepin County Medical Center in Minneapolis after noticing bruises on his thighs, back, forehead and face. They had taken photos of previous bruises as well, which they shared with doctors. (ProPublica is not naming the child to protect his privacy.) The couple also brought him to the hospital when he was 12 days old because his umbilical stump wouldn’t stop bleeding.
Harper examined the baby and reviewed X-rays of his skeleton. The results were alarming; he had 14 healing rib fractures, as well as fractures in his arms and legs in various states of healing. Harper wrote that the baby was “at grave risk for further injury, morbidity and mortality,” and the Hennepin County Attorney’s Office filed an expedited petition to permanently sever the parents’ rights. The baby was placed in foster care with a woman who worked as a nurse.
When Ducharme looked at the medical records, he saw that the baby had gone through a number of blood tests, including ones to check for clotting disorders. Several metrics were marked slightly outside of the normal range, including a reading for a protein tied to a genetic clotting disorder called von Willebrand disease. Ducharme zeroed in on a particular note, perhaps a “breadcrumb,” written by the pediatrician who saw the baby before Harper; he wrote that the baby would need more follow up from the hematology department “if more bruising develops.”
While in the care of the foster parent, the baby developed new bruises and Harper evaluated him again. A new abuse investigation was opened against the foster parent, and he was moved to a second foster family — in this case, a pediatrician and her husband. Once again, the baby developed new bruises, according to his visitation supervisor.
“This is medical, something weird is going on here,” Ducharme remembered thinking.
But according to notes from the CPS investigator, Harper declined to change her determination or to perform additional blood clotting disorder tests as the first doctor had advised: “Would not be any different now so they did not repeat those tests,” he wrote. He added that in Harper’s opinion, whoever bruised the baby in April was the most likely offender in subsequent incidents.
In her notes, Harper also questioned whether the marks noticed on the baby while he was living with his second foster family were true bruises. Instead, prosecutors posited a new theory in the case: that Ramírez and Guzmán were surreptitiously abusing their son during visits, even though the visits were supervised by a woman who works as an observer in CPS cases. To Ducharme, that strained credulity. He became concerned that Harper was too unwilling to change her diagnoses, and that prosecutors were reluctant to challenge her.
“She has this level of cachet with prosecutors, it’s like a trauma bond. I’m sure she’s right more than 90% of the time,” he said. “They’re unwilling to see her failures.”
But not everyone is. In several cases in recent years, judges and juries have found Harper’s diagnoses unconvincing. In 2024, a Wisconsin judge barred Harper from telling the jury that a child died as the result of “abusive head trauma, non-accidental injury, child abuse, or murder.”
“Dr. Harper sees herself as an advocate, at least in part, and this blurs her role as scientist and clinician with the role of advocate against child abuse, further calling into question her fidelity to the scientific validation of abusive head trauma diagnoses, especially when it is a close call,” the judge said.
In another Wisconsin case, Paul Marshall was found not guilty in 2023 of shaking his 7-week-old son, Fox, to death. Harper examined the boy at Children’s Minnesota, a hospital in St. Paul. A spokesperson for Children’s Minnesota declined to comment on the case.
“We were put through the grinder,” Marshall said. “We don’t get our son back, and we don’t get a lot of the closure that we should have had as a family. That was robbed from us.”
The Marshalls at home with their two daughters. “We don’t get our son back, and we don’t get a lot of the closure that we should have had as a family. That was robbed from us,” Paul Marshall said.
After Ducharme became convinced that there was a medical explanation for Ramírez’s baby’s injuries, he prepared a memo that pointed out a number of possible contributing factors, including that Ramírez had gone days without eating while she was pregnant and traveling across the U.S.-Mexico border from Colombia and had a difficult delivery in Minneapolis. Ramírez got her own medical records from Colombia which showed that, as a child, she’d also experienced unexplained bruising.
To challenge the prosecutors’ theory that the baby’s new bruises were from further abuse by the parents, Ducharme spoke to their visitation supervisor. She provided a sworn affidavit saying that she did not witness any abusive behavior from the parents, and that she’d become so stressed in part from the pressure to say she had witnessed abuse that she asked to be taken off the case. She also wrote that CPS workers were lying to and about the couple, claiming that the foster parents spoke Spanish, which they did not, and that Ramírez and Guzmán were unreliable about keeping visitation appointments.
“The parents attended every visit. They never cancelled,” the supervisor wrote. “Even when their tire popped on the way to their first supervised visitations, they got an Uber and were only about five minutes late.”
A judge ruled that there was “no evidence” that the parents were abusing their baby at visits and ordered a second medical opinion. But before that could happen, the county agreed to drop the termination of parental rights petition after Ramírez and Guzmán agreed to acknowledge that their son “sustained serious injury” while living with them, without admitting guilt. The case was converted to a regular child protection matter, which allowed the couple to have home visits. They eventually regained custody, and the case was closed in April 2024.
“There’s no accountability. There’s no finding of fact,” Ducharme said. “You think: ‘You get your baby back. None of the rest of it matters.’ But it matters.”
The couple found the entire experience bewildering and traumatic. Although they are now reunited, they missed six months of their newborn son’s life. Ramírez didn’t have the chance to breastfeed after the first foster parent began feeding her son formula instead of the breast milk she was pumping.
“We didn’t see him crawl. We didn’t see him turn over —” Guzmán said.
“We didn’t see him sit up,” Ramírez said.
María Alejandra Ramírez Rodríguez and her husband, Cristian Andrés Guzmán de la Ossa, brought their 4-week-old son to Hennepin County Medical Center in Minneapolis after noticing bruises on his body. After an evaluation by Harper, their son was sent into foster care for months before he was returned to them.
Although they worry about doing anything that might draw attention from immigration authorities, in late May they filed a federal civil lawsuit against Harper and the institutions she works for. Ducharme, who left his job at Hennepin County and is now in private practice, is representing the couple in the lawsuit, which alleges that Harper acted in “bad faith,” and that because of her actions there was no “genuine investigation” into the baby’s medical condition.
According to a spokesperson for Harper’s employer, University of Minnesota Physicians, they have not been served with the lawsuit yet and have not responded to the allegations.
“Why, after they didn’t find any physical abuse, did the hospital not keep doing exams to see if there was something medically wrong with him?” Guzmán asked. “They robbed us of our child without any real explanation.”
In late May 2023, a year and a half after Hank’s case, Sharon was on his way home from work when he got a phone call. A new case had come into the emergency room at Masonic Children’s Hospital that needed his consultation: a 3-month-old boy named Daniel. An MRI had shown fluid on his brain. CPS was already investigating whether this was abuse.
“Not again,” Sharon recalled thinking. He turned his car around.
At the hospital, he learned the unusual circumstances that had brought Daniel to the hospital: His mother, a pediatric nurse, had volunteered her son for an academic study that needed the MRIs of healthy children as a baseline. Someone on the research team noted fluid in Daniel’s brain, and a report was made to child protection services.
After meeting with the parents, examining Daniel and reviewing the MRI report, Sharon wrote up a one-page note. Among other things, he recommended that CPS continue assessing Daniel for possible abuse. But after what had happened with Hank’s case the year before, Sharon also put his views on the record.
“One should practice extreme caution attributing isolated intracranial fluid collection to abusive head trauma when no additional clinical signs or symptoms are found,” he wrote, “as the evidence to support this is controversial and has been questioned by many authorities (medical as well as legal).”
After a day in the hospital, Daniel and his parents, Grace and Paul, were allowed to go home together, although they said the CPS investigation remained open for a month. George, the same doctor involved in Hank’s case, asked Daniel’s parents to bring him back two weeks later, where Grace said he screamed as he was pinned down for additional X-rays and to check for bruises. According to medical records, George determined that Daniel had experienced an “accidental trauma” but did not attribute the cranial fluid to abuse.
Nevertheless, according to Sharon, his supervisor called to tell him that, once again, Harper was concerned about the legal liability created by his note, and that his opinion about the bleeding was “beyond the scope” of his practice. Struck by the similarities in Daniel’s and Hank’s cases, Sharon wrote another letter reiterating his concerns from the conference call in February 2022. He said that he’d spoken to many colleagues at the hospital who shared those concerns, and that he strongly believed “our organization must acknowledge and address these concerns in a transparent manner.”
In late June, University of Minnesota records show that three complaints were filed within days of one another against Sharon. Because the complaints were closed without discipline, they are protected personnel data under Minnesota law.
The first complaint was filed the same day he said he received an invite to a meeting with Dr. Joseph Neglia, head of the University of Minnesota Medical School’s Department of Pediatrics, physician-in-chief at Masonic Children’s Hospital and one of the people included on the February 2022 call. The second complaint was filed a few days later, while the third came the day before the meeting took place.
According to Sharon, an attorney for University of Minnesota Physicians at the meeting told him he was “weaponizing” his notes. A week and a half after that, Sharon said, Neglia brought him in again and gave him a choice: resign or be terminated on the spot. Sharon was shocked. He ultimately resigned.
Under an agreement with University of Minnesota Physicians, Sharon stayed on the job for several months with strict guidelines, including that he was prohibited from working with the infectious disease division. Neglia warned Sharon in a letter to “maintain a high level of professionalism and decorum” and not to engage in “any behavior that could be perceived as retaliation,” echoing the language in Gupta’s peer review letter to Sharon.
“You will refrain and remove yourself from involvement in any cases of suspected child abuse or potential non-accidental trauma,” Neglia wrote. “This includes any interactions with or communication with parents or guardians of a patient in such a case.”
Neglia did not respond to requests for comment.
At the time of his departure, Sharon was one of only a small number of doctors in the country who treated a complicated immune disease with behavioral symptoms in children known by the acronym PANDAS or PANS. Parents of Sharon’s patients were so upset by news of his resignation that they went to the local newspaper.
The coverage prompted an investigator from the Minnesota Attorney General’s Office to reach out to Sharon, and Sharon said he took the opportunity to share his concerns about the child abuse protocols at his former workplace. He said he has yet to hear back. A spokesperson at the attorney general’s office declined comment.
On a recent April afternoon, Sharon arrived at a restaurant in a suburb of Minneapolis. Tucked in a back corner table was Daniel, now a blond-headed 2-year-old, Grace, Paul and Grace’s mother. Sharon had not seen them since that day in the emergency room two years ago, and the family wanted to thank him for what he’d done. (Because Grace is a pediatric nurse and because she wants to protect her son’s privacy, ProPublica agreed to withhold the families’ full names.)
Grace still feels traumatized by the 24 hours she spent at Masonic Children’s Hospital, not sure if she’d be allowed to take her son home. She remembers that the one person who seemed to be in her corner was Sharon and how it felt to read that single line in her son’s medical report that may have cost Sharon his job.
“That was the light in the darkness at that point,” she said.
Daniel with parents, Grace and Paul. Grace still feels traumatized by the 24 hours she spent at Masonic Children’s Hospital, unsure if she’d be allowed to take her son home.
Since the incident, Grace said, she has had to work with George on cases of suspected child abuse and said she has become more understanding of how parents are treated.
For his part, Sharon characterizes the entire experience as “surreal.” He commutes from Minnesota to Colorado and Wyoming for temporary hospitalist and clinical work, but he is still looking for a full-time job. He wants to get back to treating infectious diseases and thinking about pediatric immunology, and he worries that he could be hurting his own reputation by speaking out about how hospitals deal with cases of suspected child abuse.
At the same time, he said he feels that he has to push back against the attempt to get him, and other physicians like him who may disagree with a child abuse pediatrician, to “fall in line.”
After leaving his job, Sharon got a tattoo on the inside of his left forearm, a quote attributed to Albert Einstein he said reflects his thinking and his actions at Masonic Children’s Hospital: “Unthinking respect for authority is the greatest enemy of truth.”
Mariam Elba contributed research. Melissa Sanchez and Agnel Philip contributed reporting.
ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up for Dispatches , a newsletter that spotlights wrongdoing around the country, to receive our stories in your inbox every week.
ProPublica is a nonprofit newsroom that investigates abuses of power. Sign up for Dispatches, a newsletter that spotlights wrongdoing around the country, to receive our stories in your inbox every week.
Mariam Elba contributed research. Melissa Sanchez and Agnel Philip contributed reporting.
Mariam Elba contributed research. Melissa Sanchez and Agnel Philip contributed reporting.
