Toddler Returns

Toddler Returns to Parents Care – NAI & EDS

Re B (A Child) [2014] EWHC B1 (Fam)

One of the best parts of my job is when a parent is exonerated and a child goes home to his parents.

The case in question (which is reported here on Bailli involved subdural haemorrhages (both old and new) and bilateral retinal haemorrhages. The child was 9 months old on admission to hospital when the injuries were discovered.

The medical evidence from the neurosurgeon was that the chronic subdural haemorrhage was already present and the significant head circumference increase after birth meant it was most likely a birth injury.  This is a significant development and is, to my knowledge, the oldest chronic subdural ever reported.

Another important feature of this case was Ehlers Danlos Syndrome (EDS); the father had been diagnosed with type 3 (joint hypermobility).  There is a 50% chance that a child will inherit EDS.  The child was deemed to have features of joint hypermobility which is significant as children under 3 years old are hard to diagnose as they do not usually display joint laxity (therefore increasing the likelihood of EDS if they display signs of joint laxity).

The evidence was clear that any kind of EDS predisposes to easy bruising and the easier rupture of small blood vessels and capillaries (vascular EDS/type 4 also effects the larger arteries and vessels).

By the time we reached the fact find and heard evidence, the expert paediatrician was ‘uncomfortable’ with the notion that this was NAI and the neurosurgeon felt the findings were consistent with a birth subdural haemorrhage and rebleed due to a short fall with the EDS adding to the vulnerability of this child.

The judge found that the parents were consistent in their account from the first point of contact (dialling 999).  Their account was tested vigorously in cross examination but the judge felt that there was nothing in their evidence to suggest that they were not telling the truth.  The local authority therefore failed to discharge the burden of proof.  The interim care order was discharged and the parents were able to collect their little boy from the foster carers.

You can read what The Telegraph said about the case here