How the Legal and Medical Systems failed Patricia and
By Rhonda Riglesberger
(Published in Justice:Denied, Volume 2, Issue 8)
In July of 1989, life seemed perfect and complete for
the Stallings family who had just moved from St. Louis to a pretty
little white house overlooking Lake Wauwanoka, a large, beautiful,
private lake surrounded by a variety of modestly priced and expensive
Patricia and David Stallings had moved into their
tiny, white, dream house approximately a month before their son Ryan
became ill and was hospitalized. Patricia says, "He had my hair and
David's face. He had huge dimples and big blue eyes." She went on to
say, "That was the happiest time of my life. Everything was perfect,
everything. A new house, a healthy and happy baby, I mean, what could
Everything was about to change for Patricia. On the
evening of July 7, 1989, a Friday, Stallings says that she gave Ryan
his evening bottle before she put him to bed. Ryan threw up immediately
after he drank it.
On Saturday, the baby seemed to be feeling better so
Patricia left Ryan with her husband and went swimming at her sister's
house. She did not become alarmed about Ryan's condition until Sunday
morning when she discovered that he had become lethargic, could not
keep his food down and his breathing grew labored.
Patricia called Children's hospital and made
arrangements to meet a Doctor there. She bundled up Ryan and placed him
in his car seat. Patricia said that she got lost trying to find
Children's hospital and end ended up at Cardinal Glennon Hospital
On July 12, 1989, after a series of tests had been
performed on Ryan, the emergency room physician read the test results.
Ryan's blood tests reportedly showed extremely high levels of ethylene
glycol (found in antifreeze). The pediatrician Dr. Robert Lynch called
in the Missouri Division of Family Services and signed an affidavit
saying that he believed the child might have been poisoned. The
Missouri Division of Family Services immediately took custody of Ryan.
On July 17, 1989, Ryan was discharged from the hospital and placed in a
Foster care for Ryan continued throughout the rest of
the summer. Patricia visited her son on September 1, 1989. During her
short supervised visitation period, Patricia fed her baby a bottle. On
September 4, 1989, Ryan was hospitalized again. The next day Patricia
was handcuffed and arrested at her home. She did not know that Ryan
died until after she reached the police station.
"It happened real fast," Patricia stated, "I kept
thinking this would get straightened out, I thought somebody would
figure this out, they'd say oops, and we'd all go home." She went on to
say, "I don't think I believed it. I just went around that entire day,
saying no, no, no ... I had just seen him; I had just spent the night
with him, I was mad at everybody, the whole thing just seemed so
Patricia Stallings was arrested and charged for the
murder of her son because the authorities said that she had poisoned
Ryan during her last visit. They said that traces of ethylene glycol
were found on Ryan's baby bottle, the same bottle that she had used to
feed him on September 1st. Patricia spent the next seven months in jail.
Although, she did not know it at the time of her
arrest, Patricia Stallings was pregnant with the couple's second child.
This child would be the key to proving Patricia's innocence.
The newly appointed Prosecuting Attorney, George B.
McElroy III, felt he had enough evidence to convict Patricia Stallings.
As he immersed himself in the Stallings' case, he interviewed all the
witnesses himself. He talked to all the experts involved and reviewed
their findings. They found a gallon of antifreeze in the basement of
the couple's home. In the Prosecuting Attorney's mind, all the evidence
pointed to Stallings' guilt. McElroy grew disturbed by news reports
that Patricia's second baby suffered from a rare metabolic disease
called Methylmalonic Acidemia, commonly referred to in the medical
field as (MMA.)
Two major pieces of medical evidence seemed to
positively indicate that Ryan's mother had poisoned him. The first was
the finding of ethylene glycol in the infant's body by two independent
laboratories. McElroy, consulted with a couple of "experts," who
wrongly advised him that even if Ryan suffered from the rare metabolic
disease (MMA) that it still would not account for the high levels of
ethylene glycol found in the baby's blood. The second disturbing piece
of evidence was the finding of crystals in Ryan's brain that the
experts concluded were positive signs of ethylene glycol poisoning.
Patricia's Attorney, Rathbone, who took the case as a
favor to the Stallings family and "Because no one else would take it,"
had a hard time finding any witnesses who would testify that the infant
had likely died of a rare inborn metabolic disorder. "The problem is
that there was no one who would back me up on it," Rathbone said.
Rathbone says that he extensively researched the
subject and consulted with a nationally known expert on metabolic
diseases. That expert, Rathbone said, told him there was no way that
any metabolic byproducts of MMA could be mistaken for ethylene glycol
in lab tests.
Rathbone, who said that he has a degree in
biochemistry, stated that he had also looked at the test results and
had determined "on his own" that there was no reason to question their
findings. When the trial began Rathbone had subpoenaed no expert
witnesses to testify for Patricia. He did not believe that there were
any experts who would support his theory. Rathbone decided to try to
introduce his theory to the jury. Because Rathbone had no solid
evidence to support his defense theory, the Judge did not allow him to
present it to the jury.
Records show that Judge Kramer reprimanded Rathbone
during the Stallings trial by gruffly remarking, "You have to prepare
and subpoena the evidence necessary to prove your theory!" Who could
blame the Judge? After all, if an Attorney shows up unprepared and
tries to introduce an inadequate defense strategy, what choice did the
The jury convicted Patricia Stallings of first-degree
murder and sentenced her to spend the rest of her life in prison.
Patricia was devastated by the verdict.
Who Says All Prosecuting Attorneys have no
Six months after the Stallings trial, Prosecutor
McElroy set a groundbreaking precedent when he wrote a motion to Judge
Kramer asking for a new trial for Patricia; where he acknowledged that
Rathbone's defense of Stallings was woefully inadequate. Judge Kramer
stated, "This is the first time I have ever known this to happen. It's
unheard of for a prosecutor to acknowledge ineffective counsel."
Based on McElroy's motion Judge Kramer decided to
grant Stallings a new trial.
Doubts about whether Stallings had actually poisoned
her son began to show as early as April of 1990, a full nine months
before Patricia's original trial.
As previously stated, after the birth of Patricia's
second son, David, Jr., press reports grew disturbing to McElroy. The
media introduced the fact that the second child suffered from a rare
genetic metabolic disease called Methylmalonic Acidemia, commonly
referred to in the medical field as (MMA.) There was a one in four
chance that Ryan had suffered from the same rare genetic disorder. "I
had heard enough to be concerned," McElroy later stated.
Doctor Christopher Long, the head of the St. Louis
University's toxicology laboratory, one of the testing facilities that
had previously found ethylene glycol in Ryan's blood, miraculously
agreed to turn over a tiny bit of Ryan's blood serum to Dr. James
Shoemaker, who had just set up a genetic disorder testing laboratory at
the same University.
Shoemaker received approximately one tenth of a
teaspoon of Ryan's blood serum. Using a test designed to detect MMA in
urine, Shoemaker discovered on April 21, 1990 that Ryan Stallings
actually suffered from MMA. Shoemaker also discovered a trace of
ethylene glycol in the baby's blood, but he believed that it was not
highly concentrated enough to have killed the little boy. This
groundbreaking discovery went no further because of the following.
Shoemaker reported his findings to his superiors and
held a meeting with some of the university's senior staff. Most agreed
that Ryan likely had MMA, but could not agree on whether or not Ryan
had died of the disease. The senior staff members believed that some of
the ethylene glycol that had been in the child's blood could have
dissipated with time and storage. Most of the senior staff members
still came to the conclusion that Ryan had been poisoned. Since
Shoemaker was not a senior staff member, his findings weren't
considered credible and therefore the evidence he had discovered
couldn't be used to help Patricia prove her innocence.
Shortly before Patricia's trial, the prosecutor's
office called Shoemaker. This was the first time that Shoemaker
reported his findings to McElroy, who then reported the same findings
to Patricia's Attorney. Rathbone says that had he known that Shoemaker
had only found a trace of ethylene glycol in Ryan's blood that he would
have pursued it. Rathbone never contacted Shoemaker because he said,
"that he didn't need another witness to say that Ryan had probably been
The media continued to report on the Stallings' case
and "Unsolved Mysteries" aired her story. This story alone proved
helpful to ending Patricia's long ordeal.
Dr. William S. Sly, professor and chairman of the
Department of Biochemistry and Molecular Biology at St. Louis
University, happened to watch the program and instantly realized that
no other tests had been performed on Ryan's blood. He ordered
additional testing on the blood sample, which Dr. Shoemaker performed.
The results stunned everyone there and Doctor Sly proceeded to write a
letter to another university official. This official in turn relayed
the letter to McElroy.
In his letter Dr. Sly reached three important
1.) They confirmed the absence of ethylene glycol in
blood tests performed before Ryan Stallings' untimely death.
2.) They confirmed abnormal elevations of organic acids in Ryan's blood
serum, which made the diagnosis of MMA virtually certain.
3.) Dr. Sly confirmed that one of the compounds in Ryan's blood, which
are elevated by MMA could be confused with ethylene glycol when the
older gas chromatographic testing techniques were used.
McElroy grew intrigued with Shoemaker's findings, but
he wasn't entirely convinced that Patricia Stallings was innocent. The
question of Patricia's innocence nagged upon the mind of the prosecutor
and he decided to investigate the university's findings.
McElroy consulted with Dr. Piero Rinaldo, a young,
world renowned genetics expert from Yale University and when Dr.
Rinaldo concurred with Dr. Sly's findings that the young prosecuting
attorney realized that Ryan had likely died of MMA and not ethylene
Rinaldo was highly critical of the original tests
performed on Ryan's blood serum. "The quality of the tests was highly
unacceptable. "They were unbelievably out of this world."
Rinaldo further stated: "I was astonished, I couldn't
believe that somebody would let this go through a criminal trial
unchallenged." Rinaldo performed his own tests on the baby bottle that
Patricia had used to feed Ryan on September 1st; and concluded that no
traces of ethylene glycol were found on it. Rinaldo shocked both the
medical and legal worlds when he further stated that the treatment that
Ryan received at Cardinal Glennon Hospital was inappropriate for a
child with MMA. Because the hospital staff believed that Ryan had
ethylene glycol poisoning, the proposed treatment actually helped end
McElroy, more uncertain now about Patricia's
conviction questioned Dr. Rinaldo further. Ryan's autopsy had shown
high concentrations of brain crystals, which were consistent with
ethylene glycol poisoning. Dr. Rinaldo explained that there was a high
likelihood the crystallization had come about as a direct result of the
ethanol drip the hospital used to treat Ryan for ethylene glycol
poisoning. Their faulty treatment caused the death of little Ryan
"Dr. Rinaldo was very persuasive," McElroy later
stated, "I was persuaded that Patricia did not murder her son. My
charge as a prosecutor is to seek justice, and justice for Patricia
Stallings required that I seek a dismissal."
After Patricia Stallings was released from Prison, she
and her husband David had their hands full between coping with the
death of one son and trying to manage the illness of their second son.
MMA is difficult to treat and manage; and the struggle to keep David
Jr. alive would be a difficult task.
The couple filed a wrongful death lawsuit against
Cardinal Glennon Hospital, St Louis University laboratory and
SmithKline Beecham Clinical Laboratories and against several Doctors
who participated in Ryan's care.
Prosecutor McElroy says, "It will be impossible to
make restitution for what happened to Patricia Stallings." He went on
to say, "As sad as it is that she had to suffer what she has suffered,
I think the final outcome shows real strength in our system of Justice."
McElroy also states, "It's difficult at any time to
step up and say that a mistake has been made, but my gosh, there's a
time when it has to be done."
Source: TLC Discovery Channel's Innocence Files.
The authorities based Patricia's case on the theory that she suffered
from Munchausen's Syndrome by Proxy. Every parent who is advocating for
a seriously ill child is in imminent danger of being wrongly accused of
participating in Munchausen's by proxy. Is Munchausen's by Proxy a
threat to children? The answer is yes, this dangerous disorder can and
has caused children to undergo unnecessary medical procedures, which in
turn have led to the deaths of many innocent children by the hands of
their parents or those entrusted to care for them.
There are no simple answers for the caretakers or the
caregivers in this situation. We have all heard horror stories about
the crimes perpetrated against innocent children by their own parents.
Several parents have been rightfully diagnosed with
this disorder; and thankfully, the laws are in place to protect the
innocent children from the perpetrators. In the Stallings case,
however, the authorities used the excuse that it was better to err on
the side of the child. This is a classic example of a time when the
authorities erred at the expense of an innocent mother and her baby,
Ryan Stallings died because those in authority failed him.