Unaware of the mental deficits of the defendants who appear before them, judges routinely shuttle lead-poisoning victims into the criminal justice system without educational or medical treatments that might help them overcome their affliction.
With more than 1,000 cases of reported lead paint poisoning every year, Baltimore ranks as one of the most toxic cities in America, according to The U.S. Department of Housing and Urban Development.
Research has shown that lead poisoning increases the tendency toward both violence and drug abuse, and a recent University of Pittsburgh study suggests that poisoned children are almost twice as likely to commit crimes.
But the state's criminal justice system collects no data on the lead-poisoning history of criminal defendants. Even juveniles are sentenced without judges ever becoming aware that many have suffered irreversible brain damage in early childhood.
"Lead poisoning is not subtle," said Dr. Gerry Gioia, an expert on brain injuries at Baltimore's Mount Washington Pediatric Hospital.
"In a city like Baltimore, where we have so many kids coming into contact with such a well known and well-documented environmental toxin, it's a major risk factor for brain dysfunction. This is not an academic question, by any means."
Baltimore State's Attorney Patricia C. Jessamy said she has been concerned about the problem for at least two years - ever since she received troubling reports from tutors in a reading program run by her office for first-time, nonviolent juvenile offenders.
Tests revealed that nearly one out of every five kids scored in the range of mild mental retardation or worse.
"That's when my eyes got opened," she said. "These were kids who were acting out in school, were truant, were aggressive, who couldn't read at all.
"We need a system that identifies these children at the moment they are poisoned, and then tracks them all along so services can be delivered to them before they are thrown at the door of the courthouse. By the time they show up here, nobody knows who's been poisoned and who has not."
The state's failure to track poisoning victims came to light in an article in The Sun on Sept. 10 about a young woman who developed a long record of arrests for violent crime after suffering severe lead poisoning as a toddler.
Barbie Kress, 31, went on to spend her elementary school years in special education classes before dropping out after the eighth grade. She later made 11 trips through Baltimore's court system - spending weeks in the city Detention Center over the past decade - without anyone noting that her brain had been damaged by lead paint.
"This has blocked generations and generations of little kids from even beginning to function in school, and when they wind up on the street unable to hold a job, we dump them in prison," said Ruth Ann Norton, director of the nonprofit Coalition to End Childhood Lead Poisoning.
"It is astounding that we have not looked at this before now."
Nicholas Conti, deputy director of medical services for the Circuit Court of Baltimore, which performs health background checks on defendants, said his staff of about 15 doctors and caseworkers is so overloaded that medical histories in most cases are cursory at best.
In all but a small fraction of the 3,700 adult and juvenile cases reviewed annually, evaluators depend almost entirely on reports by a defendant's family in compiling a medical history for judges to consider before sentencing.
"We've had kids involved in major hit-and-run accidents - comatose in the hospital with brain trauma for days or even weeks - and it never occurred to the mother to report it as part of the child's medical history," Conti said. "The kid appears in court, gets processed, convicted and sentenced without anyone in the system being made aware of the event.
"Lead paint? That's not even on the radar screen."