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What is Non-Accidental Injury?

Non-accidental injury (NAI) is a term which is used to refer to many different types of physical injury or abuse, for example:

  • Non-accidental head injury (NAHI previously known as shaken baby syndrome)
  • The triad (the term used to describe a collection of symptoms suggestive of NAHI)
  • Brain injury (e.g. contusion, subdural or subarachnoid haemorrhage, hypoxic-ischaemic injury)
  • Eye injury (e.g. retinal haemorrhage, sub conjunctival haemorrhage)
  • Bony injury (e.g. fractures, metaphyseal lesions/fractures, periosteal reaction)
  • Skin injury (e.g. bruising, petechiae, blisters, torn frenulum)
  • Fabricated or induced illness (Munchausen’s syndrome, poisoning)
  • Infant death

Where a non-accidental injury is suspected, there are many issues that will need to be considered including the timing/age of the alleged injury, the degree of force needed to cause it, how such an injury can be caused (the mechanism), the presentation of the child and, most importantly, the differentiation between natural causes (medical conditions), accidental causes and non-accidental causes.

When an injury has been identified, either with no explanation or with an explanation that the doctors do not accept, it is likely that social services will become involved and the Local Authority will start care proceedings.  It is vital that parents seek legal advice from an experienced care solicitor as soon as possible where non-accidental injury is suspected.

Below are a few of the cases in which I have successfully represented a parent in the last 12 months.  I have been working in this field for many years and more details about my previous cases can be seen here

Re P (2015)

The mother was accused of causing a skull fracture to her young daughter.  By exploring the mother’s own medical history we were able to obtain a diagnosis of EDS.  We also explore other issues including an accident and use of steroid cream.  Threshold was not met and the mother was cleared of causing the fracture.  Her daughter was returned to her care immediately.

Re S (2015)

The parents were accused of shaking their daughter but through expert evidence we were able to demonstrate that the bleeding on the brain had been caused by a genetic problem coupled with a witnessed fall.  The parents were cleared and reunited with their children.

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

This case, in which I represented the mother, involved allegations of shaken baby syndrome against both parents.  The child fell of a bed whilst in father’s care and started to have seizures.  An ambulance was called and the child was resuscitated at hospital.  Investigations revealed subdural and retinal haemorrhages.  This case deals with some significant advances in medicine involving chronic (old) subdural haemorrhages as well as a connective tissue disorder called Ehlers Danlos Syndrome (EDS) which increases a child’s vulnerability to bleed or bruise.  Both parents were exonerated and their son was swiftly returned to their care. Read the full judgement here.

Re R (2014)

I represented a mother in care proceedings concerning a child with two metaphyseal fractures.  Findings were made that these injuries were non-accidental, despite the many positive remarks made about the care afforded to this child by her parents.  The child was rehabilitated to my client’s care with a safeguarding plan to manage the risk. However, just prior to the conclusion of the case, I became aware (through two other cases I was involved in) of some research and a change in the view of some experts as to how a metaphyseal fracture was caused.  We applied to reopen the fact finding hearing and were successful in this application.  More expert evidence is being gathered and there will be a further fact finding hearing later this year.

Re O (2013)

This High Court trial involved allegations of shaking against the parents and my client, the grandmother.  The child had collapsed at home and was having seizures.  Investigations revealed bleeding on the brain and in the eyes.  We were able to demonstrate, after a 10 day fact finding hearing, that my client was not responsible for the injuries.

Lancashire County Council v R & W [2013] EWHC   3064 (Fam)

I represented the mother in these proceedings heard by the High Court concerning a child who had suffered a serious head injury.  The child collapsed at home and investigations in hospital revealed subdural and retinal haemorrhaging.  The local authority claimed that the injuries were non-accidental and just before the fact find accepted that the mother was not the perpetrator but that the father had deliberately injured the child.  Both parents were exonerated and their daughter was returned to their care swiftly. Read the full judgement here.

Re A (A Child) [2013] EWHC 3502 (Fam)

This was a retrial involving allegations of shaken baby syndrome in which I represented the father who had learning difficulties.  The first fact finding hearing was deemed by the Court of Appeal to have breached my client’s human rights (art 6 right to a fair trial).  We successfully argued that the original findings should be set aside and that a retrial should take place in (see Re M (a child) (oral evidence: vulnerable witness) [2012] All ER (D) 272 (Nov) for the Court of Appeal judgment).  In this retrial judgment, Mr   Justice Baker gives guidance on how to progress a case when a parent has a   learning disability. Read the full judgement here.

Re L and M (Children) [2013] EWHC 1569 (Fam)

This case, in which I represent the father, is the retrial of a finding of fact hearing following our successful appeal of the original fact finding hearing (see Re M [2012] EWCA Civ 1710 for the Court of Appeal judgment).  This case involved the most ‘spectacular’ skull fractures ever seen by the 4 eminent experts or indeed the court.  Additional medical expert evidence assisted the court at the retrial in which skull fractures and skull fissures were explored in great detail. Read the full judgement here.

Re J (children) (care proceedings: past ‘possible perpetrators’ in new family unit) [2013] All ER (D) 232 (Feb)

I represented a mother within lengthy care proceedings which involved a Court of Appeal matter which progressed up to the Supreme Court which had to deal with this important issue of law.  The Supreme Court held that a finding of a real possibility that a person had harmed a child in the past was not, by itself, sufficient to establish the likelihood that that person would cause   harm to another child in the future. Accordingly, by itself, an earlier finding of harm (being in the pool of perpetrators) could not be relied upon to establish a likelihood of harm in the future for the purposes of s 31 of the Children Act 1989. Further information.