The second day of Hannah Overton's evidentiary hearing began with compelling testimony from Dr. Michael Moritz, one of the world's leading authorities on salt poisoning. As I explained in my January 2012 article on Hannah's case:
Moritz is the clinical director of pediatric nephrology at the Children’s Hospital of Pittsburgh, where he specializes in children’s kidney diseases. In 2007 he published a seminal paper on salt poisoning, in which he examined, among other things, documented cases of children who had accidentally ingested excessive quantities of salt. He found that they fit a narrow profile: they were between the ages of one and six, they had been in the foster system or were from abusive homes, and they had pica.
This profile, of course, sounds eerily like the victim in this case: Andrew Burd, the four-year-old who Hannah and her husband were in the process of adopting. My article continued:
Moritz, in fact, had been asked to testify as an expert witness for Hannah’s defense at her trial. After examining Andrew’s medical records, he had determined that the boy’s death was likely accidental. Yet the jury had never heard from him. Short on time as the trial drew to a close, the defense had asked Moritz—who needed to return to Pittsburgh—to sit for a videotaped deposition; when the deposition ran long and could not be completed, the defense was unable to enter it as testimony.
Yesterday, five years after Hannah's trial, Moritz finally had the opportunity to take the stand.
He testified that he believed Andrew had likely ingested the lethal amount of salt himself. (Evidence suggests that Andrew had an undiagnosed eating disorder called pica, which caused him to eat everything from toothpaste to cigarette butts.) That scenario, Moritz explained, was far more likely than one in which he was force-fed salt by his adoptive mother. “The reports in the literature do not show a loving parent who takes in a foster child, who wants to do well, and for no apparent reason, salt poisons the child, with no evidence of struggle,” Moritz said.
Leading him through several hours of questioning was Houston trial attorney John Raley (pictured above), of the Houston firm of Raley & Bowick, who is representing Hannah pro bono. Raley, as you may remember, waged and won a dramatic six-year-long battle with Williamson County D.A. John Bradley over DNA testing in the Michael Morton case. Morton was subsequently exonerated of his wife's murder and released from prison last year after nearly 25 years behind bars. Morton's case was the first criminal case that Raley, a civil lawyer, had ever handled. Hannah's is his second. But as a civil litigator with a background in medical malpractice defense, Raley was well-suited to the task at hand yesterday--sorting through complex, disputed facts in a case that rests on medical opinion.
Under Raley's questioning, Moritz explained that intentional salt poisoning is rare.When it does occur, he said, the victims are usually very young children whose food supply can be easily tampered with, such as bottle-fed babies, or are disabled and fed with the assistance of a feeding tube. A healthy four-year-old like Andrew, however, would be far more difficult to poison, Moritz observed, since he would likely resist if someone attempted to force-feed him a large quantity of salt. Moritz stated that there was only one documented case in which an older, healthier child was poisoned with salt, and in that case, there were obvious signs of a struggle: lacerations around the child’s mouth, salt crystals on his clothes, and so forth. Yet no such signs were seen in the Overton case, the doctor said. Typically, he added, perpetrators of intentional salt poisoning suffer from mental health or substance abuse problems. Hannah had no such issues. “So what we’re seeing in this case does not fit with any cases of intentional salt poisoning in the literature,” Moritz said. Those cases all have a well-documented history of abuse and involvement by child welfare officials, he explained. Salt poisoning, he said, “does not happen in isolation without any previous episodes of abuse.”
The doctor's fascinating and sometimes macabre testimony--which touched on everything from Munchausen Syndrome by proxy to a disorder called "psychosocial dwarfism"--undercut many aspects of the prosecution's case. During Hannah's 2007 trial, the jury found that she had "knowingly" or "intentionally" caused Andrew's death by failing to render aid quickly enough--that is, that she recognized what grave danger he was in, knew he was going to die, and then deliberately acted too slowly to save him. But Moritz pointed out that even the trained medical personnel at the emergency clinic and two hospitals where Andrew was taken when he fell ill were slow to diagnose him. They were so slow, in fact, that they administered "hypertonic saline solution and three rounds of sodium bicarbonate," he said, as they struggled to revive him. In other words, they had introduced additional sodium into his system. If these medical professionals could not recognize the danger Andrew was in, how, Moritz posited, could Hannah?
The afternoon was devoted to testimony from one of Hannah's former defense attorneys, Chris Pindeo, who suggested that the state had withheld exculpatory evidence from the defense. John MacCormack at the San Antonio Express-News, whose reporting first focused public attention on this case, described the deficiencies in Pinedo's testimony and the uphill battle Hannah's attorneys still face in making this claim:
An important example [of misconduct cited by the defense] was the prosecution's alleged concealment of Dr. Edgar Cortes, a local doctor who had treated Burd and had opinions helpful to the defense. But he wasn't called to testify at Overton's trial.
On Tuesday, after defense lawyer Chris Pinedo testified about his failed efforts to find Dr. Cortes, he was cross-examined by Assistant District Attorney Bill Ainsworth — and with one question, much of the air was taken out of that issue.
“Would it surprise you to know that this same Dr. Cortes was on your defense list of experts?” asked Ainsworth.