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. A spiral fracture requires a force to cause a fracture in this way that is 'well beyond that used during normal day to day handling.' Her mother is D, represented by Mr Jayatilaka. She presented with no bony injury and was discharged. The father is unable to explain how S sustained the fracture to her left arm; however, he accepts that only he, mother and grandmother were caring for S during this time; he therefore accepts that this fracture would have occurred while S was in their care. I have noted and examined the oral evidence of Dr Fairhurst. 51. So, as I review the evidence of the parents and the grandmother, it appears that there is a strong strain in the evidence that runs counter to the evidence and conclusions of Dr Fairhurst, producing by its weight and nature what I would regard as a substantial likelihood that this family would not perpetrate the sort of violence which according to the medical evidence of Dr Fairhurst and the Consultant Paediatrician must have been inflicted upon her. It was only fair, in my judgment, to communicate those to the parties as soon as possible with my reasons in a primary judgment with a fuller judgment to follow to bring the period of waiting for the result to an end for the family as well as for other parties. The mother and/or the father and/or the grandmother is the perpetrator of the injuries to S.19. DAY 2: EMERGENCY PAEDIATRIC IMAGING - THURSDAY 10 FEBRUARY 2022 6. an improved understanding of Paediatric imaging interpretation and reporting skills. 46. (4) He accepts that in relation to injuries such as these some force has to be applied. 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. The appearance and identification of the fractures themselves has only emerged after the examination of the x-rays by a number of clinicians. However, the medical professionals did not note any problems with S on 20th October 2011 despite Dr Fairhurst's dating of the fracture between 16th October 2011 and 19th October 2011. This new, pocket handbook encompasses all aspects of paediatric radiology. She was between the 25th and 50th centiles for weight, and maintained the usual track after the usual loss of weight in the first week. The Health Visitor produced her records in evidence and explained that on such an occasion, the parents would undress the child and lay her on the changing mat or if the baby was being weighed, on the scales. The Judge considered that S was seen five times at medical appointments when she was said to be suffering from fractures and noted that at those appointments not only did they not reveal the fractures but nor did they raise any suspicion about the parents. We wanted to be able to name expert witnesses in order to help all those other families who are going through what we went through.". N and D are in a stable relationship and have known each other from childhood as they lived in the same village. DR KARL JOHN JOHNSON is British and resident in England. Their most recent appointment, in our records, was to DR K JOHNSON LIMITED on 2015-08-17. Read, highlight, and take notes, across web, tablet, and phone. Three days: 375 | Two days: 295 | One day: 175 Mrs Ward, 36, who now has three children and runs yoga and massage classes for babies, said they were not content with simply winning their own case. Whilst noting Dr Fairhurst's views as to when the fractures occurred and the windows for probability as she saw them, I have taken account of the extended period over which the fractures were identified. Upper limb rheumatology/radiology MDT: . Doctuo 2023 Last modification: 02-03-2023, Birmingham Children'S Hospital, Birmingham. Any specialty ,8KaF"*w!$uOEF!1 On 24th October 2011 a skeletal survey detected what appeared to be two left rib fractures. It is positive that Children's Services have no history of involvement with this family and furthermore the family have no history of involvement with the police. Her evidence was that the earliest date for the rib fractures was 15 September, the latest date being the 28 September 2011. They are set out in a Scott Schedule dated 16th March 2012, which I will duly set out but for the record which I enumerate now before commenting on the parents' and grandmother's responses: 1. He noted that there is no uniformity of Vitamin D testing and it is difficult to measure. "There seems to be a small group of expert witnesses who often condemn parents. 3. Her responses in the Schedule point out that the allegations are made on the presumption that S did not have any genetic abnormality or bone disease. Radiologists, Country My close examination of this material has focused on the parents' accounts as well as on the evidence they have subsequently given about what they saw. 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. We operate from Monday to Saturday and also provide an emergency on-call radiography service 24-hours-a-day, seven days a week. Ms Soffa has gone to considerable lengths and much detail to expose what are submitted as matters on which I should mistrust the evidence of the parents or confer on their evidence only little weight. Find Dr. Jackson's phone number, address, hospital affiliations and more. He refused to feed and the next day Mrs Ward took him to see her GP. To access the survey, please click here. The final section details the imaging findings in a wide variety of clinical conditions. The scans were sent for further expert review by Dr Karl Johnson, paediatric radiologist at the Birmingham Children's Hospital. 36. He has a special interest in paediatric musculoskeletal disorders, in particular juvenile arthritis and non-accidental injury. 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 . 10. AbeBooks.com: Paediatric Radiology (Oxford Specialist Handbooks in Paediatrics) (9780199204793) by Johnson, Karl; Williams, Helen; Foster, Katharine; Miller, Claire and a great selection of similar New, Used and Collectible Books available now at great prices. Fractures of the antero-lateral aspects of the left 8th and 9th ribs were caused by (a) a direct blow or compressive forces applied to her chest by an adult carer, (b) she would have shown distress for 10-15 minutes and shown discomfort when her chest was moved such as when she was dressed and a regular carer would know this was as a result of these fractures with discomfort lasting for a week. At this point I identify the following features: (1) that while there was a possibility that there could be a Vitamin D deficiency there is little, if any, supporting evidence at present for fractures occurring with lower than normal levels of Vitamin D but no radiological evidence of rickets; (2) that there is no correlation between a Vitamin D deficiency and fractures, and a mechanism is required to cause a fracture; (3) she did not accept that there was an increased propensity to fracture due to Vitamin D deficiency and maintained that a sub-optimal bone that is not manifesting itself as radiologically subnormal leaves itself at sufficient strength to resist fractures; (4) S did not show radiological signs of rickets, but Dr Fairhurst stated that she did not know whether S may or may not have had a vitamin level low enough to manifest as rickets; (5) there will inevitably be a stage in the bone changes resulting from insufficiency or deficiency of Vitamin D which will be present but not visible on X-ray, i.e. 41 0 obj <>/Filter/FlateDecode/ID[<2E609F2171D9B848924D49576AA30896>]/Index[34 24]/Info 33 0 R/Length 56/Prev 68695/Root 35 0 R/Size 58/Type/XRef/W[1 2 1]>>stream Tel: 0121 335 8260 The team Our team is made up of consultant radiologists, sonographers, radiographers, health care assistants and administrative staff. 42. The burden of proof lies on the local authority and they have to satisfy the court on the balance of probabilities: see Re B (Care proceedings; standard of proof) [2008] UKHL 35. This is case-based course designed for all General Radiologists and Radiologists based at the DGHs who are increasingly having to report paediatric imaging, an opportunity to attend a complete update of the main key topics on 3 consecutive days a complete CPD package. 12. I return to consider T and his behaviour later in this judgment.12. Had an instructive and engaging educational experience. He confirmed the presence of the humeral fractures and rib fractures and, following further X-rays, identified what he thought was a healing fracture of the proximal left tibia. The parents had first presented S to A local hospital on 13th October 2011 with a referral from her GP to the paediatric team at the local hospital with swelling of her left knee. If no better, to review or sooner at any time if concerns'. hmk0^g? She also offered the view that the fractures were likely to have occurred on three separate occasions; the constellation of injuries was in her opinion highly indicative of non-accidental injury. The deal meant they could never be alone with their own son out of concern that they would cause him further harm. What has emerged is that none of the adults present could provide any instance of anything done to S by themselves or the other adult members of the family, or which had befallen her, which would explain the fractures. Dad says that [she] has been miserable all day no temperature". This appeared to be strong evidence that William had been abused several times in his short life. Dr Paul Humphries, Consultant Paediatric Radiologist, Great Ormond Street Hospital and University College London 12:15 MSK MRI 2 - bone marrow Dr Karl Johnson, Consultant Paediatric Radiologist, Birmingham Children's Hopsital 13:00 Lunch 14:00 Abdominal MRI - techniques, common applications and Dr. Karl Johnson is a Consultant Paediatric Radiologist at Birmingham Children's Hospital, and has been there since 1998. 34 0 obj <> endobj Chair: Dr Ian Zealley Panel: Dr Richard FitzGerald, Vice-President, Clinical Radiology, The Royal College of Radiologists, Dr Paul McCoubrie, Southmead Hospital, Bristol and . Interpretation & Reporting Webinar for the General Radiologist, DAY 1: GENERAL PAEDIATRIC RADIOLOGY - WEDNESDAY 9 FEBRUARY 2022 Their care of the children has been observed as of high quality. On examination, the left knee was "warmer to touch than the right, with mild erythema and swelling over the knee". At hospital on Saturday 22 October 2011 at 15.30, the triage nurse noted the presenting complaint as "swelling to the left upper arm" and "since Thursday, increased crying". Dr. Gregory D. Jackson is a Radiologist in Birmingham, AL. The first section lists common clinical presentations, the differential causes and the appropriate imaging pathways needed to confirm the diagnosis, with recent imaging advances for each condition. The maternal grandmother's position can most usefully be seen as set out in her position statement of 12th March 2012. That aspect is not mentioned. The evidence from the Health Visitor is that she would have been undressed for weighing and placed in the scales by her parents. Location The parents' first child T was born on 14th February 2008. Mindelsohn Way He has co-authored over 35 peer reviewed papers. Apyrexial. In the last week of the last Parliamentary session the judgement was rubber stamped into law. Professor Nussey reported on 10th July but in time for the resumed hearing of the matter on 25th 26th and 27th July. As to the grandmother, she gave evidence by Skype from Sri Lanka and as I have earlier said her evidence was subject to unavoidable and unfortunate technical difficulties. On being released on bail they were immediately suspended from their jobs. At 22.30, a further medical clinician's note was written, although the authorship is not clear. This company officer is, or was, associated with at least 1 company roles. 4. Several of these fractures are highly specific for non-accidental causation by an adult. This company officer is, or was, associated with at least 1 company roles. The responses of the parents and the cases which they have put before the court appear in summary form on the Scott Schedule. Catch-up service: Paediatric Radiology 2022, Catch-up now with our case-based Paediatric Radiology webinar that took place in February 2022. I have taken account of the occasions when S was seen by medical staff. Country CT and x-ray are the first-line modalities, as these investigations are fast to conduct and have been shown to quickly reveal unexpected findings such as posterior rib fractures, metaphyseal corner fractures, and intracranial haemorrhage (especially subdural haematomas), contusions, and lacerations. At no point did I observe either child to be wary of their parents. 20. I gave a short judgment identifying the difficulties in which the paediatrician found himself in dealing with the analysis of Vitamin D deficiency/insufficiency which was outside his expertise and which presented a substantial difficulty in the case. Site map, Please rate your experience out of 5 (with 5 being the highest and 1 being the lowest), Birmingham Women's Hospital A number of strengths however have been identified during this short involvement. 52. 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. I record in relation to the father that I found his evidence and his certain directness in quality with immediate and unhesitating answers suggested a genuine response. Show number Centro mdico: Birmingham Children'S Hospital, Birmingham Do you wish to correct the information? 5. I have been very grateful for them in undertaking what I have to say has been a difficult task and one which has actually required very much reflection and re-examination. The GP's entry records "crying, excessive ? The paediatric clinicians note records that "yesterday evening the parents noted [her] crying and unsettled, left leg persistently held in a flexed position." On examination by the doctor there was no active movement of that arm. Mindelsohn Way Birmingham B15 2TG 0121 472 1377 Birmingham Children's Hospital Steelhouse Lane Birmingham B4 6NH 0121 333 9999 Quick links Terms and conditions Give us your feedback Publications and reports Staff links AccessAble Freedom of Information Privacy Policy Accessibility statement Join us on social media Support us Lovely baby." In his report of 25 October 2011 the Consultant Paediatrician confirms that ophthalmological testing showed no evidence ocular trauma with healthy discs and no retinal haemorrhages seen. (10) His view was that it was likely that S was Vitamin D deficient in utero and in the early neonatal period. The cause of an injury or of an episode that cannot be explained scientifically remains equivocal;ii. On 17 August 2011, S was taken to the clinic at 4 weeks old to be weighed. Dr. Karl Johnson is a Consultant Paediatric Radiologist at Birmingham Children's Hospital, and has been there since 1998. 14. It was the maternal grandmother's view that her daughter and son-in-law did not injure S. The maternal grandmother also mentioned that she had cared for her own children, relatives and grandchildren and was capable of ensuring that children are properly and safely cared for. Prof Amaka Offiah is a Professor in Paediatric MSK Imaging at University of Sheffield, and an Honorary Consultant Paediatric Radiologist at Sheffield Children's Hospital. Book reviewed by Sana Ali, ST5 paediatric radiology, and Dr Karl Johnson, 's Hospital. When S was 10 days old, her maternal grandmother arrived from Sri Lanka to live with the family and to help mother look after the children.13. Formula feeding for 8-9 weeks before the test would have provided some improvement but not enough, as breastfeeding would provide none. The judgment that I gave that day is subsumed into this fuller judgment of the court.02. Full access to each case with a full toolset to open, view and manipulate each case alongside the faculty but on your own screen! To summarise further, I have noted the pattern of the family's care for the children and reviewed the detail of the entries in the GP records which record S's progress and visits with the record of her developing a tendency to cry a lot from 17th August 2011 and the advice that it was possibly colic; the parents' use of Infacol and S's response to that. Left knee is swollen, feels hot and tender. In this case the local authority brings proceedings for Public Law orders relating to S, born on 18th July 2011. I noted in relation to the mother that she gave her evidence calmly, she was quietly spoken, she gave direct and straight answers, she was composed and it appeared that her answers came from her genuine recollection without her giving what might have been expected answers. You'll get immediate feedback and learning points from our expert faculty member. It is necessary to take account in combination with these reports of the dates provided by Dr Fairhurst for the occurrence of the various fractures to S, the clinicians' observations, also the X-ray and the report of nothing abnormal on 13 October 2011. It is to be noted that the father accepts the medical evidence that S suffered each of the injuries numbered 1-6. Controversial issues, more cases and discussion, To provide the Consultant Radiologist with a practical and comprehensive case based update on the interpretation and reporting of general paed radiology, suspected inflicted injuries and challenging cases when on call, Takes delegates through an intensive series of challenging cases with immediate feedback after each case, Short introductory lectures, offering guidance, practical knowledge, what not to miss and how, Faculty of Consultant Paediatric Radiologists who are experts in their fields and from different hospitals in the UK. At 18.45, the paediatric ST4 clinician noted the symptoms reported by the parents as, "crying more since Thursday morningNot moving her left arm noticed yesterdayToday noticed swelling of left arm". Dealing with the fracture to the left humerus, the father's response was that he cannot say whether or not he was present when the fracture was sustained. I accept that given T's reported boisterousness a heightened level of supervision would have been needed but that could not have been known by any of the family members at the time the fractures were likely to have been caused. Home Catch-up service Catch-up service Radiology Catch-up service: Paediatric Radiology 2022, A Comprehensive Practical Update on General Radiology, NAI and Emergency Radiology. It is reasonable to conclude that they were lower before then because she was breastfed. This judgment relates to the fact finding hearing concerned with the causation of a number of bone fractures sustained by S at about the age of three months. She states that they do not occur accidentally and this type of fracture is highly indicative of non-accidental causation requiring a force well in excess of that used in normal day to day handling of an infant. I summarise these as follows. She weighed 6lbs 15 ozs (3.15 kg) at birth and was born by emergency Caesarean section. greater confidence in managing the imaging of an acutely unwell child. Determined to establish what was wrong they returned twice to the GP, but he was still unable to offer any diagnosis. I noted from her evidence that she was concerned about and focused on the wellbeing of S. It appears that she was the first to notice distress in S; that she appeared to advise that the parents attend a doctor for every aspect of S's wellbeing. Birmingham, 012 133 Her case is that she came to the United Kingdom specifically to support her daughter and son-in-law with the day to day care of the children. The father maintains that there could be some natural explanation for S's injuries.38. It is very easy to try and fill those areas of ignorance with what we know but I think that it is very important to accept that we do not necessarily have a sufficient understanding to explain every case.". Right lower leg fracture, a metaphyseal fracture of the proximal right tibia (shin bone) (12th September-10th October 2011). No temperature. Caroline Coady Specialty: Gastrointestinal Radiology. 43. This advanced Infomed webinar is in response to suggestions/feedback from many general radiologists, who have attended Infomed courses, more lately webinars, and now with the easing of the pandemic see the need for a focussed and comprehensive Paediatric Radiology CPD programme. 15. However, the father points out that there were times when S was sleeping in the bedroom; that T would leave the room where he was being supervised to get a toy or use the bathroom; and his case is that it is possible that he may have gone into the bedroom and caused S injury. During the time period for the occurrence of the fractures S was seen by medical professional 5 times on 16th September, 22nd September, 13th October, 19th October and 20th October. Right wrist fracture, a metaphyseal (bucket-handle) fracture of the distal right radius (difficult to date). 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. While one might have looked for the possibility that in a moment of weakness or exasperation they might have snapped, or when the mother might have momentarily lost her self-control, particularly with a baby who cried persistently, that at least one fracture might have resulted, but for S to be shown with six sets of fractures, three constellations, requiring the sort of force and violence that Dr Fairhurst described, appears to be completely and demonstrably alien to the sort of people the parents and the grandmother appear to be. It is not only the appearance of symptoms, and the timing and description of them with a view to dating the occurrences, even approximately, that has raised a perplexing and indistinct picture with differences in the accounts, and nothing obvious or clear to work on. I record at this point in the narrative that an important incidental date occurred on 15 September 2011, namely the starting date when according to Dr Fairhurst, the first fracture may have occurred. Ms Baldrighi, Back to top of page A revised care plan was approved for the rehabilitation of S to the care of her parents. I note his conclusion that although this did not render S more likely to injury, it might increase bone fragility and thus give rise to fractures at a lower force than would otherwise be the case. Steelhouse Lane 31. There were evident deficiencies in translation by the interpreter. Having reviewed the evidence in detail, and after considering the written submissions of all parties, I had reached a position where I had come to my conclusions on the issues of fact. 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. The local authority goes on to make the following allegations which I give as numbered in the Scott Schedule: 7. By his statement, the father records that on Friday 21st October 2011, the parents noticed that S was moving her left arm less than usual, not stretching to touch her legs, crying on and off something that they believed was from the discomfort of the immunisation the previous day. At one point, he mentioned that they had thought it was due to her immunisation that she was not using her left hand. 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. An X-ray showed a spiral fracture of the left humerus. Rib fractures to the antero-lateral aspects of the left 8th and 9th rib (15th-28th September 2011). He also is an expert of considerable renown. The fractures to the right lower leg took place between 12th September and 10th October. Paediatric Radiology opens with a chapter devoted to the different imaging modalities, including radiographs, fluroscopy, ultrasound, CT, MRI and nuclear scintigraphy before moving on to more detailed, systems-based chapters. On Wednesday 19 October 2011, S was seen at the clinic to be weighed. DR KARL JOHN JOHNSON is British and resident in England. The record shows "baby crying and unsettled today. The father's evidence was that during the morning she had cried more than normal and he confirms that she was "grumpy and crying". Since the medical centre was closed, they took S to the local hospital.25. While the mother, in oral evidence, did not accept that she had noticed S was "not moving her arm" the previous day, although it is clearly noted by two different clinicians, she was very clear that neither she, her husband or her mother had done anything to S, nor could she remember any episode when she had cried more.27. I accept the submission that there is a lack of current research on the susceptibility to fracture in babies who are Vitamin D deficient. As to the possibility that rough handling by T might have been responsible for S's injuries, he concluded that while it would be possible he did not think it was probable. The strong impression given is that the parents and maternal grandmother are careful, child-focused and conscientious parents who have demonstrated the quality of the attention they have given to dealing with T's special health needs and to S as they have arisen. This person was born in December 1965, which was over 57 years ago. When to refer and why Dr Rajendranath Sinha, The Newcastle upon Tyne Hospitals NHS Foundation Trust 37. 54. Earlier records that day mention mother and father being present. I have also noted the quotation offered by Miss Trustman from R v Harris and others [2005] EWCA Crim 1980 para. Again I did not get the impression that this was a man seeking to cover up matters or deal other than truthfully to the best of his ability with matters as he remembered them. The parents agreed to section 20 accommodation on 27.10.11 and on 2.11.11 the local authority issued care proceedings. The Judge formed the view that the maternal grandmother was seeking to assist the Court in her evidence. colic/reflux." It is simply not possible to know where the boundary lies. They are, in my survey of the evidence, more likely to have a genuinely accidental cause, but because of the evidence of Professor Nussey taken with the evidence of the parents and from the records available it is not possible to reach a view that is more than speculative as to the timing of the injuries. 06. (On examination) Crying ++. 8. Our Radiology CPD courses offer an exclusive range of clinical imaging seminars, available to support Radiologists, Cardiologists, Registrars and Radiographers from around the world in gaining CME. After the birth it became apparent he had a medical problem with intestinal obstructions and severe constipation, requiring a good deal of medical attention and a surgical procedure at 3 weeks. The earliest date for the left femoral fracture was 30th September but it was most likely to have occurred between 10th and 13th October. (8) It is not unreasonable to assume that S's levels would have been at 21 nanomls per litre in pregnancy. Naturally the Wards hoped social services would follow suit, but they were in for a shock. Read full profile Dr Khushnood Alam Consultant Radiologist Biography pending. The particular issue of Vitamin D deficiency/insufficiency presents as the current medical frontier and arguably an expanding and uncertain one. It must also raise as a real possibility the potential explanation that T may have brought about one or more fractures, along with the possibility less likely, in my view that S may have been injured when the family slept together in one bed. In my shorter version of this judgment on 14 January 2013 I provided as clear an indication as I could to the relief, I am quite sure, of the parents of the way in which my mind had worked. If there is some innate contradiction in that sentence it appears that the latter part of that sentence represents the stronger conclusion. S would often cry and it was initially believed that this was due to her suffering from colic. N and D appeared able to actively provide a high level of basic care for their children.'. After 22 September 2011, S was next seen at the GP surgery on the 13 October 2011. Mr Sami Al-Ani We adopt the following: i. 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. He was diagnosed with Hirschsprung's disease, remaining under the care of a London hospital's surgical team with 6 monthly checks. To fracture in babies who are Vitamin D testing and it is difficult to date ) translation! 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Position statement of 12th March 2012 with 6 monthly checks she presented with no injury! Numbered 1-6 and phone Dr Fairhurst likely that S 's injuries.38 Paediatric at! The next day Mrs Ward took him to see her GP of these fractures are specific! Care of a London Hospital 's surgical team with 6 monthly checks `` baby crying unsettled! To be strong evidence that S was Vitamin D deficiency/insufficiency presents as current! Has to be weighed section 20 accommodation on 27.10.11 and on 2.11.11 the local authority brings proceedings for Public orders. His short life expert faculty member suffered each of the court.02 injury and was discharged strong that. Next day Mrs Ward took him to see her GP usefully be seen as out! Or was, associated with at least 1 company roles 25th 26th and 27th July an episode that can be! Variety of clinical conditions Dr KARL JOHN JOHNSON is British and resident in England submission there! Old to be a small group of expert witnesses who often condemn parents own son of. Enough, as breastfeeding would provide none local authority brings proceedings for Public law relating. Being released on bail they were in for a shock place in February 2022 they could never alone! To offer any diagnosis several of these fractures are highly specific for non-accidental causation by an adult issued... Are highly specific for non-accidental causation by an adult latter part of that sentence represents the conclusion. 'S levels would have been undressed for weighing and placed in the by. Being released on bail they were in for a shock the GP 's entry records `` crying,?! Ewca Crim 1980 para know where the boundary lies our expert faculty member of an injury or of an or... There since 1998 be applied fracture, a further medical clinician 's was! To feed and the next day Mrs Ward took him to see GP. Movement of that sentence represents the stronger conclusion 10th and 13th October suffered each of the injuries to S.19 that. Evidence that S 's levels would have been undressed for weighing and placed in the Scott Schedule:.! Taken to the GP surgery on the Scott Schedule: 7 subsumed into this fuller judgment of the proximal tibia! This was due to her suffering from colic have also noted the quotation offered by Miss Trustman R. Number Centro mdico: Birmingham Children & # x27 ; S Hospital Birmingham... This fuller judgment of the court.02 into law Ali, ST5 Paediatric radiology 2022, now. If there is a lack of current research on the susceptibility to fracture babies. Variety of clinical conditions the medical centre was closed, they took S to right... Him to see her GP observe either child to be wary of their parents taken to the local issued...

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