(Editor’s note: The Clay case, and The Vanguard’s coverage of it, is part of an ongoing investigation.)
FAIRFIELD, CA – A preliminary hearing proceeded this week in Solano County Superior Court for Tre Kenneth Clay, a father facing alleged wrongful accusations of the murder of his two-month-old son, Elijah Clay.
New testimony from medical experts asserted Elijah’s death was caused by bone fragility from birth trauma and in-utero malnutrition because of his mother’s pregnancy complications.
This new testimony from medical experts is challenging the prosecution’s original claims of repeated abuse and Abusive Head Trauma (AHT) as the main causes of baby Elijah’s death
Case History
As outlined in previous Vanguard coverage, Tre Clay has been facing a charge of assault on an infant causing great bodily injury and death, and has been behind bars since 2021, despite his defense attorney, Jeannette Garcia, continuing to maintain Clay’s “factual innocence.”
Genetic testing performed in late 2024 confirmed the presence of Osteogenesis Imperfecta (OI), also known as brittle bone disease, in Elijah, making him especially susceptible to injury from normal handling.
Defense attorney Garcia used this evidence to undermine Deputy District Attorney Barry Taira’s argument that sustained abuse inflicted by Clay caused Elijah’s death.
On March 3, according to court documents, jury selection for Clay’s case was supposed to begin.
However, on March 3, DDA Elaine Kuo, the prosecutor who took over the case after DDA Taira’s retirement, requested more time before jury selection began. Judge John Ellis denied her request.
Following the denial, DDA Kuo, not ready to proceed with jury selection, then moved to dismiss the felony charge against Clay and announced that she would refile the case.
Under a new case number, Tre Clay is now facing the same charge of assault on an infant causing great bodily injury and death and still remains incarcerated.
Medical Expert Disputes Abuse Theory
Testimony from Dr. John Galaznik was heard in court Tuesday during the fourth day of Clay’s second preliminary hearing. Dr. Galaznik specializes in pediatrics and has a special interest in studying pediatric death cases.
“I followed the literature closely. I have actually participated in hands-on biomechanical studies…and I have published in this area,” Dr. Galaznik noted to the court when questioned about his expertise.
Dr. Galaznik also added that he has reviewed 400-500 of child abuse/death cases and has testified “over 150 times” in more than 33 states and several countries.
Although familiar with AHT and the mechanisms in which AHT can be inflicted, Dr. Galaznik said, “My role in this case is actually to look and see if there are alternative, plausible explanations, which adequately account for the findings, the objective findings, the clinical presentation, and the clinical course and outcome.
“It’s not my job to prove abuse or not abuse. It’s my job to see if the presentation in the findings are plausibly explained by non-abusive phenomena.”
After establishing his credibility and experience to the court, Judge Ellis accepted Dr. Galaznik as an “expert in pediatrics and injuries to children,” over objections from DDA Kuo.
Upon being questioned by Garcia about Elijah’s birth and medical records, Dr. Galaznik confirmed he did receive and review records, photos, and reports from both hospitals Elijah had been admitted to on Jan. 18, 2021, as well as pre-natal records such as ultrasounds.
Dr. Galaznik identified “Intrauterine Growth Restriction (IUGR)” as being a main “issue” that affected Elijah while he was in-utero, adding the IUGR was caused by absent diastolic flow velocity when the “placenta is defective or damaged or not working right for some reason.”
The doctor added this condition would ultimately result in the fetus not getting blood to and from the placenta, noting without the blood flow, the uterus would not receive the proper nutrition and would “result in the baby (in this case Elijah) not growing well.”
Because of these conditions and that “clearly things were not going well during the pregnancy,” according to Dr. Galaznik, a Cesarean Section (C-Section) was performed on Elijah’s mother and Elijah was born prematurely at 34 weeks old, weighing only 1,430 grams (approximately 3.1 lbs.).
Dr. Galaznik stated that any baby born under 1,500 grams, especially via C-Sections, which are notoriously not gentle and are “traumatic” births, and having suffered from not getting enough nutrients in-utero, is predisposed to being at higher risk of getting injured and fractured with “routine handling” because of bone fragility.
When questioned by Garcia about the significance of Elijah being born prematurely, Dr. Galaznik said, “The literature suggests that probably 80 percent of the bone minerals get to the baby in the last three months of pregnancy. So you miss out on a month and half of that, then nothing is as good as getting calcium and phosphorus into the developing bones of the fetus as a properly functioning placenta.”
Addressing Elijah’s multiple rib fractures discovered during the autopsy, Dr. Galaznik noted Elijah’s “bones were crumbling under minimal stress which is what we see in cases of infants who have bone fragility from prematurity or IUGR where the fetus is malnourished.”
Dr. Galaznik said he identified, from the reports, “There were no documented acute rib fractures” and there was “significant callus formation,” showing the old age of the fractures.
Clarifying that “acute” meant fractures occurring within the past week or two, Dr. Galaznik asked the court, “If one is to assert that this child was abusively handled in the time frame of Jan. 18, the question would be why weren’t there acute fractures?”
What Happened at the Hospital?
As reported in previous hearings, on Jan. 18, 2021, two-month-old baby Elijah Clay arrived at Kaiser Permanente Antioch Medical Center after his mother noticed Elijah lying on his back in their residence, “pale and cold to the touch,” with shallow breathing.
After arriving at Kaiser, Elijah presented as “surprisingly normal, neurologically normal, pink, alert…stable, and sucking on his pacifier” reported by Dr. Galaznik.
Elijah was then transferred to UCSF Benioff Children’s Hospital – Oakland.
According to records, medical staff at Oakland Children’s Hospital decided to intubate Elijah, with the first intubation effort occurring at around 8 p.m.
However, Dr. Galaznik explained that upon his review of the records, this first intubation effort failed because within eight to 10 minutes, Elijah lost a pulse, was bradycardic, and went into “arrest within minutes after their intubation efforts.”
Medical staff then intubated Elijah for a second time and within 25 minutes of being intubated, Elijah “went from being perfectly normal to being pronounced dead,” according to Dr. Galaznik.
When questioned by Judge Ellis as to why intubation occurred if Elijah presented at both hospitals as being “normal,” Dr. Galaznik stated, “I am not sure why…with normal vital signs and neurologically normal, I don’t understand the reasoning behind pursuing intubation,” adding there was nothing in the medical notations reporting that “intubation was medically necessary.”
Concluding his testimony about what occurred at Oakland Children’s Hospital, Dr. Galaznik stated, “It’s very suspicious that something went very foul with the intubation efforts. Medical procedures all have complications that are not always predictable, but in this case, it’s pretty stark.”
Expert Geneticist Challenges Autopsy Findings
Defense witness Dr. Gerard Pals, an expert geneticist and OI specialist from The Netherlands, testified Wednesday, referencing several of the CT Scan images of Elijah’s skull and providing more support to the defense case Elijah’s death was not caused by repeated abuse, but was caused from birth trauma.
Addressing forensic pathologist Dr. Katherine Raven’s identification of skull fractures during Elijah’s autopsy, Dr. Pals noted, “the edges of the lesions are rounded instead of sharp,” which depict accessory sutures, not fractures as Dr. Raven identified.
“Why would a pathologist confuse the fractures with the sutures?” Judge Ellis interjected during Dr. Pals’s testimony.
“Well, the pathologist didn’t know what she was talking about apparently,” Dr. Pals said, explaining fractures typically cross the suture lines on a skull and have sharp edges, unlike what is depicted on Elijah’s CT scans, where Pals said the lesions do not cross suture lines and have rounded edges.
When questioned further about the significance of Elijah’s medical records, Dr. Pals explained Elijah’s rib fractures are “old fractures because they have a blob of callus formation on them,” indicating that “the fractures were older….likely from the age of birth” and from “birth trauma.”
Clay will remain in custody without bail. The fifth day of the preliminary hearing will occur on April 3.
