PRENATAL EXPOSURE TO CRACK KILLED BABY

Finding By Experts Hurts Prosecution

A deadly bowel condition caused by prenatal exposure to crack cocaine
killed 10-day-old Anndreah Robertson, not secondhand smoke from the drug,
doctors on a panel reviewing the baby's death said Friday.

Prosecutors charged Anndreah's mother, Demitres Robertson, 23, with
first-degree murder, saying she caused the baby's death by clouding the
child with crack cocaine smoke. The doctors say that is not possible.

Their conclusion could undermine the case against Robertson because
prosecutors need to prove the child's death was caused by conditions
created after her birth. Arizona law does not allow for prosecution of
women for drug use during pregnancy.

Bill FitzGerald, Maricopa County Attorney's Office spokesman, said Friday
that he could not comment on a pending case.

Attorney James Cleary, who is representing the baby's grandmother and
primary caregiver, Lillian Butler, 44, said if prosecutors can't prove that
secondhand smoke killed Anndreah, then they have no case. Butler is charged
with two counts of child abuse.

Drs. Ravi Gunawardene, a pediatric neonatologist at Maricopa Medical
Center, and Michael Carlton, a pediatrician and medical director of the
East Valley Addiction Council, said Anndreah's problems started before she
was born.

Anndreah died Nov. 9, 2001, 10 days after birth. Her intestines were
destroyed by necrotizing enterocolitis, or NEC. Medical experts say it
often shows up in premature babies and babies exposed prenatally to drugs,
particularly cocaine.

In drug-exposed babies, the doctors said, it is fatal in more than half of
cases.

"It is the assumption that all babies who get it are born with it," Carlton
said. "Initially, this involves a small portion of the bowel and then spreads."

Anndreah's death was ruled a homicide by the Medical Examiner's Office.
Cause of death: complications of cocaine exposure and dehydration. She
weighed 4 pounds.

Anndreah's short life has brought a barrage of criticism on state Child
Protective Services, whose caseworkers knew three weeks before Anndreah's
Oct. 30 birth that crack cocaine was being smoked in her family's Phoenix
apartment.

Still, caseworkers let the girl stay with her mother and did not remove her
brothers, ages 1 and 2. The 2-year-old also was born addicted to cocaine.

A CPS investigation for possible neglect was ongoing when Anndreah died.
The boys now are in a relative's care.

"The bottom line is: From what we know now, there's certainly enough blame
to go around," said Carol Kamin, director of the Children's Action Alliance
and a panel member.

Typically, babies with NEC spend at least 10 days in the hospital, are fed
intravenously and given antibiotics until the intestine can repair itself.
Anndreah was kept in the hospital for three days, until the cocaine cleared
her system.

Hospital staff told her mother the baby would die if exposed to any crack
cocaine smoke and to bring her back in three days for a check- up. Anndreah
was not brought back to see a doctor.

Anndreah began crying uncontrollably in the two days before her death. She
wouldn't eat and had foul-smelling diapers. She vomited and moaned.

At dawn on Nov. 8, she was taken to St. Joseph's Hospital and Medical
Center in a taxi. Surgeons opened up her tiny belly and could only stitch
her back up because her entire bowel was dead.

The doctors told the panel Friday that there is no evidence in medical
literature that the condition can be caused by secondhand crack cocaine smoke.

A 1998 Yale study found that exposure to cocaine smoke poses health risks
for babies but did not cite any deaths.

It's unlikely secondhand cocaine smoke could kill a child, said Detective
Tom Salisbury of the Riverside County, Calif., Sheriff's Office. He is
director of that county's Drug Endangered Children's Project.

"Someone would have to blow the smoke directly up the baby's nose," he said.

The panel will make a report to John Clayton, head of the state Department
of Economic Security, which oversees CPS, within a few weeks.