Did Alexander Marden have to die?
Nearly three years after they found their 3-month-old son dead in a cradle swing at their home in West Bridgewater, Mass., John and Ruth Marden are still haunted by that question.
The Mardens have learned that several infants died in the same kind of cradle swing before their son, including one more than a year before.
They have learned that Graco, the Pennsylvania-based company that made the cradle, did not pull it off the market immediately after being informed of the initial deaths.
And they have learned that there was no premarket government testing of the cradle, in which at least 10 babies have died.
Worst of all, say John and Ruth Marden, they have learned that the profitability of industry is sometimes considered more important than the safety of children.
Alexander Marden loved his Converta-Cradle. It gently rocked him to sleep. His parents loved it too. John Marden, 49, is a pilot for Boston Med Flight, which transports seriously injured people to hospitals. Ruth, 35, is a nurse.
On the night of Nov. 10, 1991, John put the baby in the cradle and turned on the motorized swing. Ruth was in the bedroom sleeping. John lay down on the sofa, a few feet from the cradle. At some point, he fell asleep. When he woke up less than two hours later, the cradle had stopped. It was resting at an angle, and Alexander had slid down from where he was placed, into the mesh siding.
“I knew he was gone as soon as I looked at him,” Ruth recalls. “I’ve seen enough dead bodies to know. He was gone.”
The pathologist who examined Alexander’s body attributed his death to Sudden Infant Death Syndrome, for which there is no explanation. SIDS was also listed as a cause of death for most of the other babies who died in the Converta-Cradle.
But the Mardens and their lawyer, Daniel Leonard, of Boston, believe a flaw in the cradle’s design caused Alexander’s weight to shift during the head-to-toe rocking motion, leading him to slide into a position that cut off his air supply. Lawyers representing other families throughout the country hold a similar view.
Richard W. Bethea Jr., of Chattanooga, Tenn., the lawyer who represents Graco, contends that all of the contested deaths were due to SIDS. If that is so, the company cannot be held liable for any of them.
“Our position on these cases is that Graco is not responsible, and the design of the cradle has nothing to do with the deaths,” he said. “We sympathize with the Mardens. They seem like very fine people. It’s a sad, sad situation.”
Bethea refused to say how many deaths Graco has been notified about. Nor would he say how many lawsuits have been filed against Graco.
“It’s a modest number,” he said.
Bethea said that in each case the dead children’s parents or guardians left them unattended for some period.
“These things are not beds,” said Bethea.
Informed of that remark, Leonard replied: “Since when is a cradle not a bed? Cradles are for infants to sleep in. It takes minutes for a child to die in these circumstances, not hours.”
Leonard said he would file suit soon. He and lawyers representing other families give varying numbers of how many deaths may be linked to the cradle.
“The truth is,” Leonard said, “we’ll never know how many babies died in that cradle.”
The U.S. Consumer Product Safety Commission refused to say how many deaths have been linked to the cradle. But, from a variety of sources, the Boston Globe has obtained autopsy and epidemiologic reports filed in connection with 10 deaths that occurred in Converta-Cradles, including Alexander Marden’s.
An examination of these reports reveals that, in all of these cases, very similar situations led to differing conclusions. Nearly identical circumstances led a New York City pathologist to say death was caused by positional asphyxia, which might implicate the cradle in contributing to the death, while others chalked it up to SIDS, which would clear Graco of responsibility.
From the outset, the Mardens believed the cradle had something to do with their son’s death. Initially, the state medical examiner who handled the case, Dr. Samuel Barrera, seemed to agree, Ruth Marden says. But then he stopped returning her calls.
She had urged Barrera to visit their home. He never did. When Barrera listed the cause of death as SIDS, without having examined the death scene or interviewing them about Alexander’s medical history, the Mardens were irate.
The Mardens believe Barrera’s diagnosis cannot be medically supported. Some experts agree with them.
The definition of SIDS, offered by the National Institute of Child Health and Development, says it is “the sudden death of an infant under 1 year of age which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene and a review of the clinical history.”
Like nearly all of the pathologists who made determinations in the cradle deaths, Barrera appears to have fulfilled only one of these three criteria: an autopsy.
Some researchers suggest that pathologists sometimes list SIDS as the cause of death so parents won’t feel guilty. Others suggest that a SIDS diagnosis is a matter of expediency-it requires less work and shields pathologists from being called to testify in any legal action that might follow a contentious death.
Two of the most influential SIDS researchers, Dr. James Kemp and Dr. Bradley Thach, of the Washington University School of Medicine in St. Louis, contend that SIDS is too often used as a diagnosis in the absence of a thorough examination of death.
“Infants are at risk for both SIDS and accidental suffocation,” Kemp and Thach wrote in the New England Journal of Medicine in 1991. “On post-mortem examination, however, it is difficult to distinguish one from the other without information from the scene of death.”
The American Academy of Pediatrics is more blunt. In its policy statement on SIDS, the Academy says: “Without a complete autopsy, a careful scene investigation and a review of the medical history, a diagnosis cannot be made.”
Barrera did not return calls seeking his comment.
By the time Graco announced a voluntary recall on Feb. 24, 1992, about 169,000 cradles had been sold over two years. At the time, Graco and the Consumer Product Safety Commission said two infants had died and two others had breathing difficulties. But as news of the recall spread, other families, including the Mardens, came forward to say their children had died in the cradle.
A Boston Globe investigation found that the first recorded death of a child in the cradle was Oct. 24, 1990, when an 8-week-old girl was found dead in Brooklyn Park, Minn. The cause of death was undetermined, but the pathologist suggested that the girl died of either SIDS or suffocation.
“The deceased,” Dr. Garry Peterson concluded, “may have suffocated in a swinging bassinet,” the first known reference to the Converta-Cradle.
The Boston Globe obtained reports linking the Converta-Cradle to the deaths of seven boys and three girls, all between the ages of 7 weeks and 3 months. Besides Alexander Marden and the Minnesota girl, two of the deaths took place in Louisiana, while the others occurred in Washington, Texas, New Jersey, New York, Ohio and California. The families came from various socio-economic, racial and ethnic backgrounds.
In Yakima, Wash., Mark Fortier, a lawyer representing the parents of Austin Main, a 7-week-old boy who died in the cradle, got the cause of death changed from SIDS to asphyxia after he showed that the death investigation was flawed.
“The pathologist in our case didn’t examine the death scene, which I take is a common problem in these cases,” Fortier said. Bethea, Graco’s lawyer, said the company learned of the deaths in September or October 1991. He said Graco launched a recall even though there was no conclusive evidence linking the cradle and the deaths. In fact, Bethea said, by recalling the product before it was required to do so, the company was “inviting litigation that otherwise would not have occurred.”
The Mardens and Leonard, their lawyer, contend that the cradle was not subjected to adequate testing because they believe the problem of sliding children would have been detected.
But Bethea said the same type of cradle was made and sold throughout the 1970s and early 1980s before the product line was suspended briefly.
“During all that time, we didn’t have one complaint,” he said.
Graco still sells a similar cradle that swings from side to side. But he said market research found that consumers wanted a cradle that rocked front to back because that design did not need as wide a leg base and took up less space.
Bethea disputes suggestions that the cradle was not sufficiently tested.
“Graco people test their products on their own children,” he said. “They put them in the homes of their employees who have small children. There were never any problems.”
Behind all the talk of liability, of governmental regulation and the legal niceties of business responsibility, there is a family in West Bridgewater that is not whole. After Alexander died, the Mardens had a little girl, Claire. She has two siblings, A.J., 4, and David, 17.
“You’re never the same,” John Marden says, sitting in the back yard of his rural home. “I look at the two little ones, and I think there’s one missing in between.”
Once, Ruth went to visit Alexander’s grave at Pine Hill Cemetery, not far from their home. She brought A.J. along. As they stood at the grave, A.J. blurted out, “I hate Alec.”
Ruth was stunned. She looked down at him and asked, “Why?”
“Because,” the little boy replied, “he makes you sad.”
It was impossible to explain to a 4-year-old, so Ruth hugged him.
“You shouldn’t hate Alec,” she said. “It’s not his fault.”
