An Alaska military couple says an erroneous child abuse diagnosis led to their children being taken away. Now they want to tell their story.

Experts say Dr. Barbara Knox ignored birth injuries in accusing an Eielson Air Force Base couple of battering their 3-week-old baby. “We were robbed,” said 24-year-old Emily Acker. “Of a lot.” In over a dozen cases, Knox’s assessments of child abuse have been rejected by medical specialists, child welfare authorities, law enforcement or the courts.

This story is a collaboration between the Anchorage Daily News and Wisconsin Watch. The Fund for Investigative Journalism provided financial support.

EIELSON AIR FORCE BASE — Izabel Acker is 1 year old now, a smiling, crawling baby with a gummy smile, waving her hands to the songs in the Disney movie on TV.

On a recent January afternoon, her 24-year-old mom, Emily Acker, strolled into the kitchen of their military base duplex to prepare a bottle, settling back into the couch to feed her. Izabel’s brother Ezekiel raced trucks across the carpet.

Outside, it’s dark and frigid by 4 p.m. on isolated Eielson Air Force Base in Alaska’s Interior. Inside, the household is warm with the activity of a young family’s life: A room full of toys, a counter covered in baby bottle supplies, requests for graham crackers being made by the minute.

It’s all so different from the last bleak year.

For most of the first year of their daughter’s life, Acker and her husband, Justin, stood accused of causing injuries that led to a devastating stroke when Izabel was a newborn. The couple has always denied the accusation.

They say Izabel’s injuries were caused by a traumatic birth that ended in a rough emergency cesarean section — an assessment shared by two experts who reviewed Izabel’s medical records. And a forensic psychologist who examined Emily Acker found she posed no danger to her children.

In January of 2021, Alaska child welfare authorities took custody of both the children after Dr. Barbara Knox, a pediatric child abuse doctor affiliated with Providence Alaska Medical Center, diagnosed Izabel with abusive head trauma. Knox formerly worked at American Family Children’s Hospital in Madison, Wisconsin.

For months, Justin and Emily Acker — a U.S. Air Force staff sergeant and an Alaska Air National Guard staff sergeant — visited their kids at the foster home across the street as they battled in court to clear their names and keep their children.

In late October, the Ackers fully regained custody of Izabel and 2-year-old Ezekiel. But the process of getting the children back took crucial months that cannot be replaced.

“I feel like we were robbed,” said Emily Acker. “Of a lot.”

Izabel’s case is the latest in over a dozen cases uncovered by Wisconsin Watch and the Anchorage Daily News in which Knox’s assessments of child abuse were later rejected by medical specialists, child welfare authorities, law enforcement or the courts. Reporters verified the Ackers’ account by reviewing Izabel’s and Emily’s medical records, Knox’s reports and child welfare documents and by interviewing the medical experts and examining their reports.

A spokesperson for Providence Alaska Medical Center, Mikal Canfield, said in an email that privacy laws prevent the hospital from commenting on any specific case, but “cases referred to Alaska CARES have already been reported to law enforcement and/or the Office of Children’s Services and those agencies participate in our evaluation process.”

”When injuries are unexplained or concerning regarding child maltreatment, medical providers are mandated by state law to notify the Office of Children’s Services,” Canfield wrote.

Brain injuries spark interrogation

Again and again for hours on a January evening in 2021, Emily Acker recounted the story of her daughter’s traumatic birth just three weeks earlier. Sitting in an Anchorage hospital conference room, the then-23-year-old told Knox that she had pushed for three hours during labor, but the baby’s head had gotten stuck in her pelvis, prompting doctors to perform an emergency C-section so forceful her uterus ripped.

The doctors who delivered Izabel documented her birth injuries — some of which were clearly visible — in medical records. Purple bruises covered the right and front sides of her head. The blood vessels in her right eye had burst.

Knox, a prominent national child abuse expert, had invited Acker to the conference room of the Anchorage hospital, saying it was a meeting of her “medical team.” Instead, she arrived for what would become a three-hour interrogation as a child welfare worker and two Air Force investigators confronted the new mother. They flashed their badges and told Acker she was suspected of violently injuring her newborn daughter.

Acker declined their invitation to have a lawyer present. “I didn’t think I needed one,” she recalled.

The nursing mother described for the group Izabel’s worrisome symptoms — lethargy, lack of appetite, blood in her diaper and a twitch in her left eye — that had intensified over the previous two days, prompting her and Justin to take the 3-week-old to the Fairbanks Army hospital’s emergency department. Doctors there found a litany of serious concerns, among them a skull fracture, brain bleeding, possible seizures and an infection.

The doctors could not determine whether the injuries were new or from Izabel’s difficult birth, but as mandated reporters, they were required to report the baby’s injuries to authorities, according to medical records. They ordered an air ambulance to take Izabel to Anchorage — more than 350 miles away — for a thorough examination at Alaska CARES, the state’s forensic child abuse clinic run by Knox. Acker rode alongside her daughter in the plane.

The Ackers had been through a child welfare investigation before. A few weeks after their son Ezekiel was born in Arizona, it was discovered that his clavicle was broken. Child welfare workers investigated, but doctors dated the broken bone to his delivery — also traumatic because of Acker’s small pelvic bones. The parents were cleared.

When Acker finished recounting Izabel’s medical history at the Anchorage hospital, Knox scrolled through her cellphone and pulled up an X-ray of the baby’s head. Knox thrust the phone at Acker.

“She said, ‘This was not done during birth. This bleeding is new. And that’s done by a metal bar and blunt force,’ " Acker recalled. “I told her, ‘That’s not what happened.’”

In her report, Knox wrote that Izabel was intentionally injured and diagnosed her with “child physical abuse/abusive head trauma.” “There is no medical condition that would explain the totality of the findings other than trauma,” Knox wrote in her report.

Around 2:30 the next morning, the social worker came to Izabel’s hospital room and said her agency, the Alaska Office of Children’s Services (OCS), was taking emergency custody of Izabel.

Then she told Acker to leave the hospital — visiting hours were over.

Acker found herself standing outside the hospital in a city where she knew no one, freshly accused of terribly injuring her newborn, her breasts full of milk and her body still wracked with pain from her C-section.

Justin Acker had stayed behind in Fairbanks, six hours away, with the couple’s 18-month-old son. Once authorities opened a child abuse investigation, he stayed there on orders from his superiors, according to a base spokeswoman. Emily Acker recalled pleading with the OCS worker that night: “I don’t know anybody. What am I supposed to do? Where am I supposed to go?”

She was told to find a hotel and take an Uber. Acker cried and did as she was told.

Separation leads to surreal family life

Faced with losing custody of Izabel and their toddler son, the Ackers asked Emily’s father to fly from Las Vegas to Eielson Air Force Base to satisfy an OCS requirement to have a second adult supervise the parents around their children. His ticket cost $1,600.

Neighbors across the cul-de-sac volunteered to become foster parents. The cribs and diaper changing tables Acker had meticulously picked out for the children’s nurseries were lugged across the street.

The parents could only see their kids from 2 to 9 p.m., and only under supervision. Emily Acker’s younger sister moved to Alaska so she could provide the 24-hour watch required. Emily’s milk dried up, and nursing stopped.

The Ackers were thankful their children weren’t placed with strangers — but the new arrangement was surreal. The couple crossed the street each night to tuck their children into bed and then left. Ezekiel began to have ferocious nightly tantrums.

“He knew that his bedtime meant that he was going to sleep, and we wouldn’t be there in the morning. So he would never want us to put him to sleep,” Acker said.

The day he turned 2, Acker had to work late, which meant they rushed the birthday celebration to say goodbye and walk home before the 9 p.m. deadline.

The deeper, more subtle losses were slowly unfolding: While Acker was allowed to take Izabel to her many medical and physical therapy appointments — with her sister as escort — mother and baby were never allowed to be alone together.

Izabel began to reach for her aunt more than her mother.

“She kept wanting my sister for everything,” Acker said. “Because my sister had been there. And I wasn’t.”

Experts reject child abuse charge

Maryland-based pediatric neurologist Dr. Joseph Scheller, who reviewed Izabel’s medical records, attributed her condition to her traumatic birth.

”Based on the lack of evidence of trauma on Jan. 1 or 2, it is most likely that Izabel’s seizures and strokes beginning around age 3 weeks of life developed as a result of her birth trauma,” wrote Scheller, who estimated he has reviewed over 500 abusive head trauma cases and testified in 250 of them.

Clinical forensic specialist Dr. Steven Gabaeff wrote that Izabel’s head X-rays were “100% inconsistent with abuse and 100% consistent with nonabuse problems from birth, infections, increased ICP (intracranial pressure) and hemorrhage, consistent with . . . a massive and severe stroke.”

Where Knox called a mark on Izabel’s cheek a bruise and a “sentinel” indicator of child abuse, Gabaeff said it was likely a rash caused by the baby lying with her cheek in spit-up. Two days later, the mark cleared, which Gabaeff noted is “inconsistent with physical trauma.”

But Knox’s medical opinion carried immediate weight with Alaska authorities — just as it had in other cases examined by Wisconsin Watch. The Ackers became entangled in two child abuse investigations, one by the Air Force and one with the state of Alaska.

The family requested that a second doctor examine Izabel.

“I think another doctor would have gotten a second opinion,” she said. “That’s something that we asked her to keep doing and she never did.”

Gabaeff said in his report that Knox did seek the opinions of multiple radiologists — but then pressured them to support her “ill-conceived” diagnosis.

“(Knox) was relentless in setting up a prosecution and the disruption of this apparently decent family, to validate her non-evidenced (sic) based, highly speculative belief that this case involved abuse,” he wrote.

Knox placed on leave — twice

The Ackers and their experts were not the only ones questioning Knox’s diagnoses.

A joint investigation by Wisconsin Watch and the Anchorage Daily News in November revealed Knox’s current and former co-workers at Alaska CARES complained for months to supervisors without response about Knox’s medical judgment and bullying behavior. The entire medical staff has left or has been reassigned since Knox came to head the facility in 2019.

Knox’s employer, Providence Alaska Medical Center, placed her on leave this fall pending a workplace environment investigation. Mikal Canfield, a spokesperson for the hospital, said there has been no update to Knox’s employment status.

Knox moved to Alaska after her former employer, the University of Wisconsin-Madison, had also placed her on leave while they investigated allegations she bullied her colleagues there. A settlement agreement signed by Knox and the University of Wisconsin shielded the reasons behind Knox’s leave from future employers and credentialing boards.

Knox did not respond to interview requests.

Psychologist: Separation hurting the kids

In March, a forensic psychologist who assessed Emily Acker’s ability to parent found she posed no risk to her children. However, he did express concern that “more serious and long term psychological issues will likely begin to develop for the children” if they were not reunited with their mother soon.

The judge ruled in April that the children could move back home with their parents. Although the family was physically back together, it would take another six months of child welfare visits, court hearings and negotiations before the state released full legal custody of Izabel and Ezekiel back to their parents. As they fought to regain custody of their children, the Ackers took Izabel to specialists — an ophthalmologist, a neurologist and a neurosurgeon — and to various types of therapy including physical, occupational and speech.

The family calendar is filled with Izabel’s therapy appointments, and the bulletin board above her changing table is covered with flyers demonstrating helpful exercises for her. The baby has now achieved all of her developmental milestones, although her left side remains weak, Acker said.

The Office of Special Investigations, the Air Force’s law enforcement arm, ended its investigation on Aug. 27, 2021, according to OSI spokeswoman Linda Card. But it has yet to render a final judgment, Card said in an email.

Justin Acker declined to be interviewed for this story because the military’s case remains open.

Settlement ends child welfare case

As the court date in the state child welfare case approached, the Ackers’ lawyers advised them to settle. They did. “Basically, our attorney said that if we did the settlement, there was absolutely zero risk of … us being found guilty and our kids ever being removed from our home,” Acker said.

The state gave legal custody of the children back to the Ackers on Oct. 26 under the condition they agreed to take parenting classes and individual counseling. The OCS declined to answer questions about the case, citing privacy laws.

But life in Alaska has not returned to normal. The settlement with the OCS means Izabel’s medical episode continues to be labeled as “substantiated abuse.”

The Ackers no longer see Alaska as a place they want to live — or raise their children. Acker said she feels viewed with suspicion, by her co-workers, pediatricians — by everyone.

“We live on base. OSI was questioning our neighbors,” she said. “So now we go home and our neighbors literally watch us out their windows to see, ‘Is anything happening?’ "

The friendships that sustained the early months of their time in Alaska are “strained,” Acker said. It’s hard to imagine three more years here, but that’s how long they likely will be stationed at Eielson. Eventually, Acker hopes to move back to her hometown of Las Vegas.

Acker has some thoughts on why she and her husband were viewed with such suspicion.

“We were young. We were isolated. We didn’t have anybody here. And we had had something with OCS in the past … it was easy for them,” she said.

Izabel crawled to her mother and lifted herself up on the side of the couch, sliding into her lap. Despite the damage done by her stroke, she’s beginning to cruise, taking tentative steps toward walking. Acker knows that for parents, the days are long but the years are vanishingly short.

There’s no way to get back the time or memories of the last year, she said.

Talking about what happened is “incredibly hard,” Acker said. “But mostly I don’t want it to happen to somebody else.”

Michelle Theriault Boots

Michelle Theriault Boots is a reporter who covers news and features about life in Alaska, and has been focusing on corrections and psychiatric care issues in the state. Contact her at mtheriault@adn.com.