By Richard A. Knox, Globe Staff, 09/10/97

In April 1994, Suffolk County District Attorney Ralph C. Martin II got a letter from his counterpart in Syracuse, N.Y., alerting him to ''the strong likelihood'' that a 1987 report by Massachusetts General Hospital researchers on sudden infant death syndrome ''recounts (inadvertently) a number of homicides.''

The warning went unheeded until yesterday, when Martin read in his morning newspaper that a former MGH researcher, Dr. Thomas Truman, had independently come to the same conclusion. Truman says the hospital's records harbor evidence that a number of parents may have deliberately smothered their children and blamed the deaths or near-deaths on sudden infant death syndrome, or SIDS.

This time, the Suffolk district attorney says he will look into it.

''We need to see the science,'' James Borghesani, Martin's spokesman, said yesterday. ''We need to see the basis for these opinions. Only then will we and the medical examiner's office, together with the appropriate law enforcement agencies, be in the position to determine whether further investigation is warranted.''

In May of 1996, Borghesani told the Syracuse Post-Standard that the Suffolk County district attorney was too busy ''to sit down and reflect on something that at this point is a cerebral thing.'' The newspaper had contacted Borghesani after learning about the 1994 letter from Onondaga County District Attorney Bill Fitzpatrick to Martin.

Borghesani yesterday verified the accuracy of that quotation, but said Fitzpatrick's letter ''was too vague, there was virtually nothing to go on.''

There is increasing concern about the practice of attributing infant deaths to SIDS when a family has experienced more than one such unexplained death. Critics say the MGH case illustrates how difficult it is to raise officials' suspicion when respected researchers back up the parents and insist that the real cause is an elusive genetic defect, even though 25 years of research has failed to find a hereditary pattern to SIDS.

MGH, where Truman's allegations were presented internally nearly 18 months ago, issued a statement yesterday in which officials said they ''have reported suspected cases of child abuse whenever there has been sufficient evidence.''

The hospital's statement said that issues of possible abuse in suspected SIDS cases or near-death episodes ''are extremely complex and sensitive ... Because of its complexity, this subject is constantly debated within our department and in academic pediatric centers across the country.''

Dr. Daniel C. Shannon, director of Mass. General's SIDS program, was not available for comment. Attempts to reach former MGH researcher Dr. Dorothy Kelly, who coauthored the 1987 paper with Shannon on families with multiple cases of SIDS or near-death, were unsuccessful.

One study by Kelly included two families that had four purported SIDS victims each, and two with three deaths each attributed to SIDS. Truman, who is now practicing in Tallahassee, Fla., concludes that about one-third of 156 cases of sudden infant death or near-death episodes among the MGH caseload may have involved parental abuse.

Truman and Fitzpatrick were not the only ones who have called attention to the possibility that some of the cases of multiple SIDS within families studied at the MGH might actually be murder. In May 1988, the journal Pediatrics, which had published the 1987 SIDS research by the MGH doctors, printed a letter by Dr. Vincent DiMaio, chief medical examiner in San Antonio, alleging that some of the MGH cases were probably homicides.

Fitzpatrick, who stumbled upon the MGH research while investigating a child homicide case in his district, also sent the DiMaio letter to Martin in 1994.

Fitzpatrick said yesterday that he was glad to hear Martin's office was responding to Truman's allegations. ''It's never too late,'' Fitzpatrick said, adding that if he were in Boston, he would be ''prosecuting serial killers who are apparently using the MGH as a place of refuge.''

Fitzpatrick and others who have investigated families with multiple deaths wrongly attributed to SIDS believe such homicides - while undoubtedly a small fraction of the reported 3,300 SIDS cases reported annually - are not as uncommon as most would think.

''It's kind of an exotic thing but I don't think it's rare,'' Fitzpatrick said. ''I'm just one prosecutor in just one area of New York state, and I've helped uncover 17 dead babies who were murdered. Nationally, there's got to be hundreds of these cases.''

A paper to be published in the November issue of the journal Pediatrics will report that 39 women were caught by concealed video cameras trying to smother their babies in a London hospital over a period of several years.

According to a book published this week, ''The Death of Innocents,'' Truman's superiors at MGH reacted with hostility when he raised suspicions, and even contradicted him after he warned caregivers in one child's hometown.

As Truman's experience and Martin's initial response illustrate, those who raise suspicions about parental abuse in purported SIDS cases encounter formidable obstacles.

Although the past few years have seen the conviction of mothers who have killed as many as nine children under the cloak of SIDS, district attorneys and police investigators often shy away from such cases because they are difficult to prove.

Some academic experts have a strong stake in their familial hypothesis of SIDS - in reputation, grant money, referrals, and money to be made by putting children on expensive electronic monitors if a sibling has died of SIDS. ''When an unsupported hypothesis attracts support from parents and government, and becomes `a religion,' it's impossible to stop,'' Dr. Jerold Lucey, editor of Pediatrics, writes in a commentary to be published next month.

Community pediatricians don't often entertain the possibility of foul play.

''It's often difficult to get some of my colleagues to understand that abuse needs to be considered,'' said pediatrician Robert Reece, medical director of the Massachusetts Society for the Prevention of Cruelty to Children. ''There is a sense of protecting the families you're dealing with. But this needs to be viewed with a little more skepticism.

''If there's more than one case in a family, that would be my threshold of suspicion,'' Reece added. ''SIDS should not occur more than one time in a family. It's not a familial disease.''

This story ran on page A01 of the Boston Globe on 09/10/97.
© Copyright 1997 Globe Newspaper Company.