But during the family court proceedings serious doubts were cast on Dr Johnson's evidence by other medical experts. Dr. Thomas' office is located at 2204 Lakeshore Dr, Birmingham . Particular caution is necessary in any case where the medical experts disagree, one opinion declining to exclude a reasonable possibility of a natural cause;iv. She presented with no bony injury and was discharged. On 24th October 2011 a skeletal survey detected what appeared to be two left rib fractures. 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. (4) He accepts that in relation to injuries such as these some force has to be applied. Steelhouse Lane I would thank all advocates for their very careful written submissions. Three days of this course provides 18 CPD credits in accordance with the CPD Scheme of the Royal College of Radiologists. She was born in 1979. You can book online your appointment and hire medical insurance online. Thus the view of Dr Fairhurst, a considerably experienced and respected radiologist, is that all of the injuries would have required a force in excess of that used during normal day to day handling and that several of the fractures were highly specific for non-accidental causation of injuries. 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. He noted that there is no uniformity of Vitamin D testing and it is difficult to measure. An X ray showed a spiral fracture of the left humerus. I have also noted the guidance to be derived from Re U: Re B (above) given by Butler Sloss P at paragraph 23: "In the brief summary of the submissions set out above there is a broad measure of agreement as to some of the considerations emphasised by the judgment in R v Cannings that are of direct application in care proceedings. 8. I take note also that the mother and father completed a parenting assessment. Birmingham Update in prostate cancer Topics to include: . Professor Nussey reported on 10th July but in time for the resumed hearing of the matter on 25th 26th and 27th July. 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. Wanted a review(Under 'P') Discussed with Mum and Dad possible colic will continue withInfacol and see how she gets on over next week. This led to a referral by the consultant paediatrician from the local hospital to Social Services. No local tenderness in leg or hip", S was x-rayed, but nothing abnormal was observed. 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. 46. The fractures at 2, 3 and 6 above were only identified by Dr Fairhurst. 2023Check Company | Privacy | Terms of Use | Contact Us. Akin, MD, Diagnostic Radio Find Dr. Jackson's phone number, address, hospital affiliations and more. Hence attendance at A&E.". I note at p. 3 the following: 'Children's Services have only become involved with this family since 23rd October 2011 therefore there has been limited time to complete any thorough assessment with regards to this family. Catch-up service: Paediatric Radiology 2022, Catch-up now with our case-based Paediatric Radiology webinar that took place in February 2022. As it is, her persistent crying which may well have been her response to the injuries can be considered in the light of the reports of the parents about her crying and the possibility of their misinterpretation of her crying emerges as a very real consideration. You will maintain your access to the resource throughout your 60 day catch-service period too. His research and clinical interests include the pathogenesis [.] 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. Dr. But the drama turned into a nightmare when they were accused of having deliberately harmed their little boy. She moved back to London, to Great Ormond Street Hospital and the Institute of Child Health, where she obtained a PhD for her thesis, Optimisation of the digital radiographic imaging of suspected non-accidental injury, then returned to Sheffield as a HEFCE-funded Clinical Senior Lecturer in the Academic Unit of Child Health. 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. 4. This person was born in December 1965, which was over 57 years ago. 941-697-3552. 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. I considered that the family members have a very close bond and I did not observe any concerns regarding their attachment. What followed next led, eventually, to the diagnosis of a fracture in S's left upper arm. Had an instructive and engaging educational experience. In his second report after reviewing the outcome of the medical investigations after his original report he held to the view that there was a high suspicion for a non-accidental causation. 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. 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 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. However, on 22nd October 2011 the parents again presented S, this time with swelling to her left arm. 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. A couple cleared of injuring their baby son have won a legal battle to identify the doctor who gave evidence against them. The local authority place considerable weight on the evidence of Dr Fairhurst as to the interpretation and significance of the X-rays, the report of 13th February 2012 and the evidence as to the mechanism of injury in relation to spiral fractures, metaphyseal fractures, fractures of the antero-lateral aspects of the ribs and a torus fracture raise very serious implications for the family members. %r W!p-zC1')v?nP=^:;J2wFT$8N&j Paradoxically, the last fracture-type injury in time to occur (in all probability), the left humeral fracture, was the first to be identified on 22 October 2011. 11. Dr. Robert H. Thomas is a Radiologist in Birmingham, AL. He has a special interest in paediatric musculoskeletal disorders, in particular juvenile arthritis and non-accidental injury. He was able to extrapolate that S's Vitamin D levels at birth were likely to have been markedly deficient having been Vitamin D deficient in utero. He arrived at the preliminary conclusion that the humeral and rib fractures must give rise to 'a high level of suspicion' for non-accidental injury. On 16 September 2011, S was seen for her 6-week check. The Consultant Paediatrician, in his report of 5 March 2012, picks up on the record that T would become annoyed when S was unable to play with him, not understanding that it was not possible. 135; "There are areas of ignorance. These are referred to in more detail in her evidence and indeed in the local authority's threshold document, and she has set out fully in her expert report to the court her opinion on the fractures she found, the dating of S's injuries, the mechanism of injury, possible explanations and her conclusions. 31. Mindelsohn Way 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. Mrs A Jester Stream every session from the webinar for up to 90 days. The Father said in evidence that when the hospital phoned on Monday morning, his wife told them that S was "fine".21. 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. an understanding of the importance of applying the ALARA principle in Paediatric imaging. Dr. Johnson is presently the Chair of theBritish Society of Paediatric Radiology. "ag`|v#+(U)R1Vrg+1TnD G#qOQOGB[ @+v7#ibHd7X ~6?fJq*bk&~GTQH6To-,dh=>!aFd&02uGo(y GCv&_SRbc>N; ^1Qc(:*%Bl#~vczyAa;~tlvY4Y;U: e0| 34Ba7/, h!i"#>!9l^(bl1oUT (R&^I'[V.1e7'}N"e@ZAEY }^gEm1|4_I|Zj>apQvcZreu[OyTqWl({MicALn("#S' xYYo~o!baX_{da+LV"gy8du|UU]^|^y^]](g1qV&QdLY$aqT\ G~k)UwalB^d!/^I8>goAXX""~vQ^eTT'YC g-lZ['#.5\K,H 06. (On examination) Crying ++. Within each chapter there are three consistent sections. The record concludes with the GP's comment "All well. DR KARL JOHN JOHNSON is British and resident in England. NS>zu=/_jwJa:S Now the Local authority has promptly and appropriately put into effect a revised Care Plan to give effect to the orders made that day. In the light of this observation, the involvement of local Children's Services inevitably followed and the proceedings were commenced, as I have indicated in this judgment.30. She was accompanied by both parents. In reviewing the broad canvas of S's family, therefore, I have taken stock of the mother and father's background and employment and the unfortunate medical problems suffered by the couple's first child T with Hirschsprung's Disease and the particular care and attention that this child required. General radiologists and senior radiology trainees Radiologists with an interest in Paediatric Radiology The content Ten sessions over two days: Head and Neck Chest Gastrointestinal Genito-urinary MSK: Non-Traumatic Inflicted Injury: Brain MSK 1: Traumatic (inc Inflicted Injury) MSK 2: Differential diagnosis Inflicted Injury: A Medico-Legal Update 0121 472 1377. 5 of my judgment on 26th March 2012. The Court reminded itself of the guidance in Re U: Re B (Serious injury: standard of proof) [2004] 2 FLR 263 and Re L [2011] EWCA Civ 1705 noting that where there is uncertainty in the medical and scientific evidence the Judge's appraisal and confidence in the parents is crucial. The maternal grandmother denied harming S and did not accept that her daughter or son-in-law would not do the same. She said: "How could we celebrate that someone has decided you didn't hurt your child when you know all along you didn't? 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. The judgment that I gave that day is subsumed into this fuller judgment of the court.02. Detectives removed the cot for examination. The final section details the imaging findings in a wide variety of clinical conditions. Book reviewed by Sana Ali, ST5 paediatric radiology, and Dr Karl Johnson, 's Hospital. Read, highlight, and take notes, across web, tablet, and phone. All the adults appear to be normal hardworking people concerned for their children. In the absence of an explanation of the injury to S's left arm, the Consultant Paediatrician considered that there was a "high level of suspicion that the humeral and rib fractures may have been sustained as a result of non-accidental injury". 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