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The State Convicted Him of Child Abuse. A Medical Expert Said It Was Likely Diaper Rash

A man is serving two life sentences for a crime that, according to his legal team, never occurred.

Stock photo via Getty Images

In 2007, former police officer Keith Winfield went on trial in Middlesex County, Massachusetts, for allegedly inserting a hot curling iron or a similar object into the anus of his 23-month-old niece. He laid that same hot object on her vagina, according to the prosecution.

“This is a case about an act too horrible for most to contemplate done to a little girl left alone with the wrong person,” the prosecutor told the jury. 

Winfield was convicted and sentenced to two life terms.  

“Former cop guilty of ‘horrific’ crime,” read one local headline after his conviction. “‘I hope he rots,’” read a headline by a local blogger.

Winfield has maintained his innocence since he was accused. He and his legal team aren’t pointing to another perpetrator, though. The child, they say, was not burned by Winfield or anyone else—she had a diaper rash. 

In 2018, at an evidentiary hearing before the Middlesex County Superior Court, Winfield’s legal team argued that his trial counsel, Douglas Louison, had been ineffective because he failed to retain a medical expert. At trial, Louison called no witnesses. On Jan. 9, 2019, the judge agreed with the legal team and ordered a new trial. Five days later, Winfield was released on bail. 

“A new trial did not worry me,” he said in a handwritten letter to The Appeal. “I had the truth and would prove my innocence.”

And then, last July, the Massachusetts Appeals Court reversed the Superior Court’s ruling, finding instead that the trial counsel’s strategy was reasonable. Winfield appealed to the Supreme Judicial Court, the state’s highest appellate court. While he waited, he was placed on home confinement. 

“Now began the torture of sitting home 24 hours a day in mental anguish wondering if indeed the unthinkable would happen,” he wrote. “I had nightmares that my doors were getting kicked in and I was being ripped from my home.”

On Oct. 22, the court declined to hear his appeal without explanation. The next day, Winfield was ordered back to prison, where he remains today.

Winfield’s case began on Oct. 13, 2005, when he was looking after his niece and his 8-month-old daughter for about an hour. Winfield’s wife then returned home with their oldest daughter, he told The Appeal.

The grandmother of Winfield’s niece testified that she picked up the child in the afternoon. When they arrived home, she changed the child’s diaper and saw that her vagina appeared puffy. She called the child’s mother and told her she had “a bad diaper rash.”

At trial, the child’s mother testified that her daughter’s genital area was “very red” that night. When she wiped her daughter with a damp cloth, the child’s vaginal and anal areas began to bleed, she said. 

The next day, the woman took her daughter to their pediatrician’s office, Harvard Vanguard. The “diaper area” was pink and part of her labia was swollen, according to the physician’s notes, which were read into the court record. She also observed bruising on her face and thigh. The pediatrician said she suspected sexual abuse and sent them to Boston Children’s Hospital. 

At Children’s Hospital, the mother and child met Alice Newton, who was then the head of the Child Protection Team, an interdisciplinary group of legal and medical professionals who investigate child abuse. She examined the child and concluded that her anus had been penetrated, she would later tell a jury, with a “cylindrical instrument perhaps such as [a] curling iron.” That hot object had also been laid across her vaginal area, according to Newton.

A CAT scan revealed a skull fracture, which Newton opined had occurred within the previous few days, and healing rib and wrist fractures, which could have been weeks old. The child was transferred from Children’s Hospital to a hospital that specializes in burns.

At trial, the state’s case primarily hinged on Newton’s testimony. A curling iron or similar object was never found in Winfield’s home, according to the trial transcript. 

“My view was that the Commonwealth evidence was so lacking and weak pointing to the defendant Winfield that the best strategy in front of a jury was to just proceed that way rather than attempting to attack the Commonwealth’s medical evidence,” Louison, Winfield’s trial attorney, told The Appeal.

When the jury went out to deliberate, he said, he was confident Winfield would be acquitted. 

“I felt then and I feel now that Mr. Winfield was innocent and has been falsely convicted,” he said.

More than a decade later, Louison testified at the 2018 evidentiary hearing. 

Of Winfield’s conviction he told The Appeal, “This was probably the most difficult result that I’ve had in 37 years of trial work.”   

Newton’s theory of the crime—the basis of the prosecution’s case—was impossible, according to Winfield’s appellate legal team. 

During the 2018 evidentiary hearing, Winfield’s attorneys presented testimony by physician and burn expert Stephen Milner. He had previously been director of the Johns Hopkins Burn Center, surgical director at the Johns Hopkins Wound Center, and director of the Michael D. Hendrix Burn Research Center. He testified that he had performed over 5,000 burn-related procedures. In the Superior Court’s ruling, the judge wrote that the “court infers that Milner has seen many more burns and genital burns in children and infants than [Newton].” 

Newton is the medical director of the Child Protection Program at Massachusetts General Hospital, a position she also held when she was at Children’s Hospital. She told The Appeal that she is not able to comment because this is an active legal case. The district attorney’s office referred The Appeal back to court filings.

At Winfield’s evidentiary hearing, Milner told the court that, after reviewing the child’s medical records, he concluded that she had not been burned. In all likelihood, she had a severe diaper rash, he testified. At the time she was admitted to the hospital, she also had candidiasis, a fungal infection that can complicate a diaper rash, according to Milner, who is also a dermatologist. “I think this is an erosive dermatitis,” Milner told the court. “It’s basically a very aggressive diaper rash.”

In an email to The Appeal Milner confirmed that he stands by his testimony.

A few months before the alleged crime, in August 2005, the child was diagnosed with diaper dermatitis, also known as diaper rash. Her thighs and vulva were red, and on her buttocks there was “erosion in some areas,” according to the doctor’s notes. The diagnosis, Milner testified at the hearing, “bears a remarkable resemblance to Dr. Newton’s testimony.”

Shortly after the child arrived home from the hospital, she was diagnosed with another diaper rash, according to a recent appellate filing from Winfield’s legal team.

If the child had been burned with a curling iron, her injuries would have been catastrophic, Milner testified. A curling iron heats to 200 degrees or higher, according to Milner. At temperatures above 162 degrees, “there would be instantaneous destruction of the entire skin.” 

Less than one second of contact with a curling iron would have destroyed the blood vessels in her skin, Milner testified. However, her medical records reflect that days after the alleged crime occurred, her skin blanched—turned white when pressure was applied—which indicates that the blood vessels were still intact, according to Milner. 

The child’s recovery from the insertion of a curling iron into her anus, if possible, would have taken months and necessitated reconstructive surgery, he testified. 

But while hospitalized, the child’s wounds were only treated with cream, according to Milner’s testimony. Milner told the court that, according to her medical records, a physician who examined her said she “healed beautifully.” About a month after arriving at the hospital, the child was released.

What can initially appear as a burn may be due to other factors, Milner explained. For instance, Milner said the repeated application of diaper cream—which had been applied at least four times before the child arrived at the hospital—could have caused a whitish discoloration of the skin that can look like a burn.  

Milner told the court that defense counsel had paid for his travel and lodging, but he was not taking a fee for his testimony. 

“Because I believe in this case,” he told the court. “I believe there are faults in the evidence here.”

Newton’s findings have been challenged in other cases. In 2010, she diagnosed a 6-month-old baby boy with abusive head trauma, also known as shaken baby syndrome. Shaken baby syndrome is a fundamentally flawed and unreliable diagnosis, according to a growing number of critics. 

The Middlesex County District Attorney’s office charged the baby’s father with murder. Further investigation, conducted by the defense team, showed that the baby may have had a rare genetic defect that could have contributed to his death, according to news reports. In 2014, the prosecutor’s office dropped the charge. 

In another Middlesex County case, Newton diagnosed a 1-year-old with abusive head trauma; the baby’s nanny was charged with murder. Two years later, in 2015, the medical examiner changed the cause of death from homicide to “undetermined,” according to news reports. All charges were dropped. 

When asked whether the district attorney’s office still pursues charges based on Newton’s diagnoses, a spokesperson said the office would “never pursue charges based solely on a diagnosis” and that is “just part of what we look at.”

Winfield’s attorney, David Siegel, a professor at New England Law Boston, told The Appeal that he and his co-counselors, who are all working pro bono, will continue to fight what they believe is a wrongful conviction.

“We will seek Mr. Winfield’s freedom, in all forums, for as long as it takes,” Siegel told The Appeal in an email.   

Winfield’s legal team won’t be fighting alone. The Boston College Innocence Program, the Center for Integrity in Forensic Sciences, the Massachusetts Association of Criminal Defense Lawyers, and others submitted a joint letter in support of his motion for a new trial. 

“The jury was presented with an unrebutted medical diagnosis of a crime so gruesome it is difficult to imagine,” they wrote to the court. “Yet imagined it was.”

Of the more than 2,800 known wrongful convictions since 1989, about 1,000 people were convicted of a crime that did not occur, according to the National Registry of Exonerations.

“Once that label of abuse is applied to a case, everything kicks in to get that conviction,” said Jessica Henry, author of “Smoke But No Fire: Convicting the Innocent of Crimes That Never Happened. Henry was a signatory on the joint letter supporting Winfield’s innocence claim. 

Caregivers have previously been wrongfully accused of physically abusing or killing children in their care based on misdiagnosed injuries or overlooked causes, such as an illness.  

“People are looking for proof of a crime and not keeping an open mind about all the explanations that could explain an injury or even a death,” she said. 

When Winfield first went to prison, his wife told his daughters, then 2 and 6 years old, that he was working in the mountains. He and his wife believed, he told The Appeal, that his incarceration was temporary. “We actually thought the judge would fix this and throw this case out,” he wrote. They later divorced amicably, according to Winfield. 

Winfield with his daughters in 2019. Supplied

In 2019, when he was released, his daughters were 13 and 17. While home, he swam in the ocean and took long, aimless walks “just because I could.” He spent time with his family, found work, and started a relationship with an old girlfriend.  

“By the end of 2019 I was really starting to feel like a part of society again,” he wrote. 

And then last fall, as COVID-19 spread through prisons, he was ordered back over Zoom. 

“I spent the rest of the afternoon in a cage with leg irons on,” he wrote.

During his first four days back in prison, Winfield was placed on suicide watch. “I wasn’t suicidal and I made that abundantly clear,” he wrote. While in the cell, he didn’t have a pillow, blanket, toothbrush, soap, or utensils. The light was on 24 hours a day. “After one night in that cell, I wanted to die,” he wrote.

Within his first three months back in prison, he contracted COVID-19, he told The Appeal through his attorney.

“I pray constantly that this will end,” Winfield wrote to The Appeal. “Im [sic] back in prison for a crime that I did not commit and in fact didn’t even happen.”