Three-year-old Eliza Jane Scovill died in May from what the Los Angeles County coroner said was AIDS-related pneumonia. Her HIV-positive mother, Christine Maggiore, has gained a national reputation and following as someone who does not believe that the human immunodeficiency virus causes AIDS. The debate over her views has intensified since her daughter's case was profiled by The Times in September.
ABC show "Primetime" on Thursday, Maggiore defended her decision to refrain from testing or treating Eliza Jane for HIV.
"Why would I risk the stigma, the medical label, the toxic drugs?" asked Maggiore, who learned she was HIV-positive in 1992 but did not take HIV medications even when pregnant. "It didn't make any sense to me at all to subject her to that. It's my job as a parent to protect my children and do everything I can to ensure they lead a long, healthy, happy, productive life."
Dr. James K. Ribe, senior deputy medical examiner at the Los Angeles County coroner's office, who also appeared on the telecast, stood by his agency's conclusions.
"The findings are clear-cut, I'm afraid, and the findings are unequivocal," he said.
"The body shows what it shows. The organs show what they show. That hasn't changed before, since or ever."
Ribe added that Eliza's life might have been saved if her illness had been caught days or weeks earlier.
"It's very treatable," he said.
Los Angeles police continue to investigate whether Maggiore and her husband, Robin Scovill, should be charged with criminal neglect, and the California Medical Board is looking into the care provided to Eliza Jane by three doctors in the last weeks of her life. Both agencies said Thursday that it would be premature to comment on their findings.
In recent weeks, Maggiore has been touting a report by toxicologist Mohammed Ali Al-Bayati, who practices in Dixon, Calif., that concludes that Eliza Jane died of an "acute allergic reaction" to amoxicillin. Less than two days before she died, she was given the drug to treat what Maggiore said was an ear infection. Al-Bayati's 44-page report, dated Oct. 25, said the allergic reaction caused low blood pressure, shock and cardiac arrest.
Al-Bayati reviewed Eliza Jane's medical records but did not perform an autopsy or look at the coroner's pathology slides. He told The Times his customary charge for such a review is $22,000, but he probably would give Maggiore a discount and hadn't yet sent her a bill. (Maggiore said she had expected the review would be free.)
Though Maggiore calls Al-Bayati's analysis "independent," he is a member of the advisory board of her nonprofit group, Alive & Well AIDS Alternatives, and shares her views on HIV.
In 1999 Al-Bayati published a book, "Get All The Facts: HIV Does Not Cause AIDS," and he has always identified a cause other than HIV for patients whose illness has been diagnosed as AIDS, Maggiore said on her website.
Al-Bayati refers to himself as a pathologist and toxicologist. He has a doctorate in comparative pathology from UC Davis but he is not a medical doctor and is not certified by the American Board of Pathology. He is certified by the American Board of Toxicology and the American Board of Veterinary Toxicology. The latter two do not require a medical degree.
His company, Toxi-Health International, specializes in reevaluating the cause of death in cases in which parents or others have been convicted of killing children, often by shaking them to death.
Of the 10 cases in which he has been hired to reassess the cause of death after a criminal conviction, Al-Bayati said he has found the cause of death to be natural in all 10. In one recent case in Maryland, in which a baby-sitter was convicted of shaking an infant girl to death, he instead concluded that the child died from an inflammation of the pancreas and internal bleeding brought on by a vitamin K deficiency. The conviction was upheld, he said.
Dr. Harry Vinters, chief of neuropathology at UCLA Medical Center, reviewed Al-Bayati's report and the coroner's findings at the request of The Times.
He said he believes the coroner was correct in ruling the cause of death as AIDS-related pneumonia. Such a diagnosis "is really quite straightforward. It's not a subtle or tricky diagnosis."
Vinters, who has published a book on the neuropathology of AIDS, said Al-Bayati's findings probably were "incomplete" because he did not review the pathology slides in the cases. That is considered a common practice when completing a review of a pathology report, he said.
In an interview with The Times, Maggiore said she was pleased with Al-Bayati's findings because they made "more sense to me and my family and the people that saw Eliza Jane every day than the coroner's determination."
Asked if she worried that Al-Bayati wasn't independent because of his affiliation with her group and his denialist views on HIV and AIDS, Maggiore said, "Dr. Al-Bayati is not afraid to go where the facts lead and to speak his mind, and that is the kind of person I needed here."
Maggiore and Scovill also have an 8-year-old son, Charlie. Only after Eliza Jane's death, as child protection authorities and police investigated the case, did the couple have him tested for HIV. He tested negative and was allowed to stay with his parents.
According to Maggiore's lawyer, Mark Overland, he has been contacted by the police several times in the last two months, most recently in late November.
Maggiore said she continues to counsel HIV-positive parents around the country about how to keep from using anti-retroviral drugs during childbirth and from giving medications to children who have tested positive for the virus.
Eliza Jane would have turned 4 last week.