Thursday, July 17, 2014

Mistaken for child abuse

Recently I consulted on two cases of mistaken child abuse.  I was contacted by two defense attorney's in Texas who had clients facing charges on child abuse and other related charges.  I always approach these cases with an open mind, but look at the facts of the case and what the issues with the child tell us.  Both of these cases the children lived, thus this was a consult taking forensics and applying it to the living.  What I found was shocking and upsetting.

In the first case, the defendant was accused of "shaking" his baby to the point of producing bleeding on the brain.  When I reviewed the case I indicated to the attorney the child had bleeding on the brain consistent with a natural process, the bleeding was not midline or in areas that are typical in abuse cases.  Rather, the bleeding was along the base of the brain.  As I searched further, the baby was diagnosed with benign external hydrocephalus.  This is a condition in which there is benign enlargement of the subarachnoid spaces in infancy.  Typically it is self limiting and no treatment is needed, but in some infants the skull will not expand as the brain does, thus producing seizures.  This infant had a seizure and was without oxygen for a period of time, which can irritate the brain and cause leakage of blood out of the vessels and produce bleeding on the brain.  The child showed no other injuries to the neck, ribs, back, or extremities.  You mean to tell me this infant was shaken hard enough to produce bleeding on the brain, but no neck injuries?  Impossible and from experience on other true child abuse cases there is other associated trauma.  The first hospital diagnosed this condition, but the Dallas Children's Hospital jumped to conclusions and got tunnel vision.........after I testified in court for two days, the defendant was found "not guilty".

My second case involved two twins who had osteogenesis imperfecta, a condition that causes the bones to fracture easily.  The children were tested and showed they were positive for a rare form of this disease.  Yet the State of Texas brought charges.  Myself and a geneticist testified and the defendant was found "not guilty"

The point of this blog is the bring attention to the need of a complete investigation.  If the children are still living, everything needs to be looked at.  The second case above was in a small town and the children where never referred to a major University Medical Center.  If they had been I believe charges would never have been brought on.  The first case shows homework wasn't done.  Even in the medical center more tests need to be done, that are not.  Recently the Journal of Child Maltreatment stated that child abuse experts agree that special "child abuse" blood test panels need to be developed.  This also applies to children who have unfortunately died.  We need to be exact with our facts during these investigations.  We do not want to miss a child abuse case, but we also do not want to misdiagnosis these cases because we not only tie up tax payer money, but put the lives of the accused on the line which can destroy families.