In the meantime Cambridgeshire applied to the family court for a care order, allowing them to remove William from his parents. The maternal grandmother ('the grandmother') is also a party, as she was present in the family home at the material time, and has been represented by Miss Trustman. The question arose as to whether genetic abnormality of bones, metabolic bone disease or demineralisation of the bone caused by Vitamin D deficiency gave rise to an increased propensity to fracture. (2) I note his evidence that there is no uniformity of Vitamin D testing in the United Kingdom and that Vitamin D is difficult to measure. Metaphyseal fractures result from pulling and twisting being applied to the limb. But the drama turned into a nightmare when they were accused of having deliberately harmed their little boy. The outcome of the case, in a landmark High Court judgement, has helped to lift the secrecy surrounding England's family courts, where campaigners claim that a lack of openness creates an environment in which miscarriages of justice can go unnoticed. Yet even after the criminal case collapsed for lack of evidence and a family court finally decided that the parents posed no threat to their son, the couple were astonished to find that the names of the doctors who had given evidence against them were kept secret. I note his view that osteogenesis imperfecta was 'exceptionally unlikely.' Consultant Paediatric Radiologist and Service Group Lead for Radiology, Alder Hey Childrens Hospital, Liverpool, UK. I have not found any instances that cannot be attributed to genuine mis-recollection especially given the distance in time over which they were attempting to deal with detailed events. Upper limb rheumatology/radiology MDT: . 4. Dr Neil Stoodley, Consultant Neuroradiologist, Bristol Royal Hospital for Children Dr Musa Kaleem, Consultant Paediatric Radiologist, Alder Hey Children's Hospital, Liverpool Dr Karl Johnson, Consultant Paediatric Radiologist, Birmingham Children's Hospital Dr Sally Old, Medical Defence Union Left upper arm fracture, a spiral fracture of the distal shaft of the left humerus (16th-19th October 2011). I have examined the evidence as to the appearance of the symptoms of both the leg injury and the arm injury and noted the consistency of evidence that S was holding her leg differently before the hospital visit on 13th October 2011, and a consistency as to there being something wrong with S's arm which prompted the parents to seek medical attention. N and D appeared able to actively provide a high level of basic care for their children.'. The Wards subsequently won a legal fight in the High Court for the judgement to be made public. Both gave compelling evidence that, in particular, the rib fractures suffered to the baby could only be caused by " excessive/abusive squeezing" or "gripping of the chest". She was accompanied by both parents. DR KARL JOHN JOHNSON is British and resident in England. The Judge formed the view that the maternal grandmother was seeking to assist the Court in her evidence. The Father said in evidence that when the hospital phoned on Monday morning, his wife told them that S was "fine".21. Mr Johnson and Dr Vickers declined to comment. Her expertise within paediatric radiology covers the full range of imaging modalities including plain X-ray, ultrasound, fluoroscopy, CT, MRI, and nuclear medicine. The consultant paediatric radiologist was able to date the fractures as follows: The rib fractures occurred between 15th and 28th September 2011. She refers to the fact that in relation to allegation 3, 4, 5 and 6 the mother had noticed the child's discomfort and taken S to the Medical Centre and then on to the Accident and Emergency Unit at the local hospital where S was examined by a paediatrician and X-rayed, following which she was told that everything was normal and she was discharged. DAY 2: EMERGENCY PAEDIATRIC IMAGING - THURSDAY 10 FEBRUARY 2022 NS>zu=/_jwJa:S Added to this was the unfortunate position of counsel for the grandmother, who was not present and who had sent a message to the court that her client's public funding certificate had been embargoed for the reasons and with the consequences set out in para. Their evidence would have to be regarded as a tissue of lies and their manner of dealing with S would need to have been abusive, violent to the point of sadism, and the subject of a conspiracy of silence given the unlikelihood of such conduct being committed in secret or the strength of S's reaction passing unnoticed. (7) It is safe to extrapolate from the mother's levels taken in May 2012 that Vitamin D levels would have been lower in pregnancy. The maternal grandmother denied harming S and did not accept that her daughter or son-in-law would not do the same. Dr. Karl Johnson is a Consultant Paediatric Radiologist at Birmingham Children's Hospital, and has been there since 1998. There is no evidence of drugs or alcohol abuse, of anger or violent outbursts, of short temper, volatility, irritability or dysfunction. The history squares rather more comfortably with the account given by the father in his statement than in his oral evidence. Judge Isobel Plumstead finally concluded that Mr and Mrs Ward presented no threat to William, declaring in her judgement: "There is no cogent evidence that these parents injured their son.". That theory has to overcome the difficulty that observations of S were made when she was seen at the clinic for weighing on the 19 October and for immunisations on 20 October, and the earliest reported symptom in the arm not moving her arm was on Thursday 20 October or Friday 21 October, which arguably places the timing of that fracture later than 19 October, as the Health Visitor and clinic staff could have been expected to notice or pick up symptoms and appearances that were (reportedly) evident to the parents on the Friday, and very apparent to the hospital doctors on Saturday 22 October 2011.29. endstream
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While T was originally the subject of the local authority's applications at the outset when proceedings were issued on 27th October 2011, I made an order on 13th December 2011 returning him to the care of his parents and no continuing orders were made relating to him. The mother's tend to be shorter responses but amplify the general stance of the parents as well as the grandmother that while accepting that the fractures occurred and that they occurred while S was in their care they reject the allegations that they caused the injuries in a non-accidental way. The note records both mother and grandmother as being present. In surveying the 'wide canvas' further, I take into account the evidence of Professor Nussey because the manifest injuries do call for explanation. 012 133. After the immunisation, the parents were advised to give her Calpol. Mr Sami Al-Ani If no better, to review or sooner at any time if concerns'. Tell us your views in a simple 5 minute survey to help us make the service even better. endstream
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She was discharged from hospital on 25 July 2011. The Court found that the medical evidence raised a substantial likelihood that the injuries were caused non accidentally and by force used by at least one of the adult members of the household. hb```e``rg OP#0p4 B1 SGVp_Cb&ow!4MlPU
Injuries to S could not have been caused by a person rolling onto her. Akin, MD, Diagnostic Radio Father said that he was told it was likely that she would get a high temperature and her thighs might swell. (6) It is not possible to say what difference formula feeding might have provided because there is no baseline to measure from. Right lower leg fracture, a metaphyseal fracture of the proximal right tibia (shin bone) (12th September-10th October 2011). Finding of Fact Hearing in Respect of a Number of Fractures Sustained by S aged 3 months, On 13 October 2011 S was taken to hospital by her parents with a swelling to her left knee. At this point I summarise his evidence by identifying the following features: (1) Professor Nussey has a clear and far-reaching understanding of endocrinology and the systems involved with Vitamin D and bone mineralisation. The local authority alleges that the injuries were suffered by S and caused by an adult carer and they are non-accidental. Nor is it possible to conclude at what point 'normal day to day handling' a vague phrase at best, and which must include the use of reasonable force and pressure at times crosses over to the point where S's vulnerable bone structure was compromised and exceeded. Torus fracture of the distal left femur caused by (a) her left leg being gripped and forcibly bent; (b) she would have shown distress for 15 minutes and would have shown discomfort when the leg was moved; discomfort would have lasted for several days. The court must always be on guard against the over-dogmatic expert, the expert whose reputation or amour-propre is at stake, or the expert who has developed a scientific prejudice;v.The judge in care proceedings must never forget that today's medical certainty may be discarded by the next generation of experts, or that scientific research will throw light into corners that are at present dark.". Lovely baby." At 17.10, the presenting complaint was noted as "swelling and pain in the left upper arm, since yesterday" [Friday] those symptoms noted by the parents "yesterday" with swelling of the left arm and "crying ++" when she was moved. The parents' observations are also a matter of record, as are the consultants' examination. The maternal grandmother had not witnessed T intentionally being rough or boisterous towards S and had not witnessed him attempting to hold S or pick her up. s Pediatric Diagnostic Imaging textbook is renowned as one of the oldest and most prominent general textbooks in the field of paediatric text consists of two reasonably sized volumes covering all key areas using an intuitive systems-based approach. It was inevitable, that the local authority had to bring this case to court. %r W!p-zC1')v?nP=^:;J2wFT$8N&j '(&NJdsB. Several of these fractures are highly specific for non-accidental causation by an adult. 09. Fax 847-678-6286 Tooting whose report is at E76-E 279 and Dr. Karl Johnson, consultant paediatric radiologist at the Birmingham Children's Hospital . No local tenderness in leg or hip", S was x-rayed, but nothing abnormal was observed. He found it was not possible to conclude at what point normal day to day handling crossed over to the point when S's vulnerable bone structure was compromised and exceeded. Her parents returned with S on 22.10.11 with a swollen arm. Only now, three years later, have the Wards managed to draw a line under the affair by forcing the name of the key expert witness to be made public. As a result of her expertise she receives both regional and national referrals for review of musculoskeletal imaging from radiological and clinical colleagues with an emphasis on imaging in cases of suspected inflicted injury. Now the Local authority has promptly and appropriately put into effect a revised Care Plan to give effect to the orders made that day. Further X-rays revealed what appeared to be three more fractures and an injury to his arm. The Judge found that neither parent was seeking to cover up matters or to deal other than truthfully to the best of their ability. I accept the submission that there is a lack of current research on the susceptibility to fracture in babies who are Vitamin D deficient. The Wards took their son to Addenbrooke's hospital in Cambridge, where an x-ray revealed he was suffering from a spiral fracture of the lower right leg, an extremely rare condition in children who have not yet begun to walk. Doctors, medical appointments, hospitals, medical staff. A diagnosis of OI (osteogenesis imperfecta) is exceptionally unlikely. Mr Johnson, who is chairman of the British Society of Paediatric Radiology and works as a consultant at Birmingham Children's Hospital, told police that in his view William had suffered repeated fractures and had a history of being abused. After 22 September 2011, S was next seen at the GP surgery on the 13 October 2011. I have noted the reference to Lancashire County Council v B [2000] AC 147. 0121 472 1377. At para. S was discharged and the parents reported that her knee improved. She took the view that the two left leg fractures (3 and 4) could have happened at the same time. Furthermore, Professor Tim David, an expert paediatrician, told the court that in this and many other cases, police and social workers were wrong to assume that an unexplained injury could normally be attributed to child abuse. The child appears by her children's guardian and has been represented by Miss Dixon. She is the radiology lead for child protection, rheumatology, orthopaedic and skeletal dysplasia multidisciplinary meetings at Alder Hey Childrens NHS Foundation Trust. 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