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How the Legal and Medical Systems failed Patricia and Ryan Stallings

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 homes.

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 be wrong?"

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 instead.

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 home.

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 absurd."

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 Judge have?

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 heart?

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 poisoned."

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 conclusions:

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 glycol poisoning.

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 Ryan's life.

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 Stallings.

"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.

Author's note: 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.

Justice Denied

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