an improved understanding of Paediatric imaging interpretation and reporting skills. Dr Caren Landes obtained her medical degree from the University of Birmingham in 1997 and was appointed a Consultant Radiologist at Alder Hey Childrens NHS Foundation Trust in 2006 and has been Clinical Lead for Radiology since 2012. On 14 January 2013 I made orders and gave a foreshortened (primary) version of the judgment in this case which had run over a substantial period in 2012 and before, because having reserved judgment in what was on any view a difficult case, delays in preparing the judgment for administrative reasons and with difficulties over my own health meant the process became much longer than I would have wished. Dr. Karl Johnson is a Consultant Paediatric Radiologist at Birmingham Children's Hospital, and has been there since 1998. The Wards were arrested and questioned by police on suspicion of grievous bodily harm and child cruelty towards William. 36. 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. (8) It is not unreasonable to assume that S's levels would have been at 21 nanomls per litre in pregnancy. It also records the following: "Mother is not able to recall how the fracture might have occurred: S, she advises, was using her arm less and appeared irritable from Thursday a.m. on 19/10/11 [sic 19/10 was a Wednesday] then went with Mum to have immunisations Thursday 1pm, where she was placed on a couch and not, to mother's recollection, held tightly, then seemed intermittently in discomfort with on-going reluctance to use her left arm as much as right, then today arm appeared swollen. Detectives removed the cot for examination. Mrs K Oestreich Catch-up service: Paediatric Radiology 2022, Catch-up now with our case-based Paediatric Radiology webinar that took place in February 2022. The main functions of MRI are as follows: a. early diagnosis of CADM and fasciitis; b. differential diagnosis with other types of myopathies, such as congenital myopathy; c. locating the site for. The local authority alleges that the injuries were suffered by S and caused by an adult carer and they are non-accidental. In relation to the spiral fracture of the distal shaft of the left humerus, the local authority allege that S's arm has been gripped and twisted by an adult carer; she would have shown immediate distress lasting 10-15 minutes; any regular carer would have noticed a change in her behaviour as a result of the fracture with discomfort which would last for up to a week. In my judgment their accounts do have a certain coherence and quality that would suggest that they have sought to do their best in bewildering circumstances. 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. Tel: 0121 335 8260 The team Our team is made up of consultant radiologists, sonographers, radiographers, health care assistants and administrative staff. Dr Fairhurst thinks that they may have been sustained as I set out in their approximately chronological order: 1. The Wards were only allowed to take William home with them when they agreed to be supervised 24 hours a day by Mr Ward's parents, who had to relocate from Devon to move into the couple's home. 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. Find Dr. Thomas's phone number, address, hospital affiliations and more. He also is an expert of considerable renown. Lovely baby." Gordon Jeyes, director of children's services at Cambridgeshire county council until this year, defended his department's decision to press ahead with its application to remove William from his parents' care. The parents needed to be careful over his food, medicine and health. 31. Naturally the Wards hoped social services would follow suit, but they were in for a shock. You will maintain your access to the resource throughout your 60 day catch-service period too. ,8KaF"*w!$uOEF!1 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. Ms Baldrighi, Back to top of page After 22 September 2011, S was next seen at the GP surgery on the 13 October 2011. There was then a further sharp issue over which expert should be instructed in this field which was not brought before the court until 24th May 2012. Location 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. The question arose as to whether genetic abnormality of bones, metabolic bone disease or demineralisation of the bone caused by Vitamin D deficiency gave rise to an increased propensity to fracture. 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. As I identify the main points in the chronology, I note first that Dr Fairhurst regards the 16 October 3 days after S was first seen and x-rayed at hospital as the "earliest date" on which the fracture to the left humerus occurred, and thinks it probably would have occurred before the 19 October. %r W!p-zC1')v?nP=^:;J2wFT$8N&j The local authority took action on 26th October 2011 after the Consultant Paediatrician concluded that there must be a high level of suspicion in the absence of explanation of the injury to the left arm that the humeral and left rib fractures may have been sustained as a result of a non-accidental injury. So the records engage even closer scrutiny. an understanding of the importance of applying the ALARA principle in Paediatric imaging. Fee includes 90 days of access with unlimited playback during this time. To access the survey, please click here. I accept that the parents have displayed the same level of alertness for S as to her medical needs when they became aware that there was something wrong, as they saw it. I have noted the reported reactions of T to the birth of S. I have considered S's early developmental history after her birth; also the arrival when S was about 10 days old of the maternal grandmother from Sri Lanka to help the mother look after the children. 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. 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. This hearing has run over a prolonged period of months in the course of 2012; in particular because it encountered difficulties in the procurement of the services of one of the experts necessary to address the issues in the case, and also because of practical difficulties in the hearing itself in adducing the important evidence of the children's grandmother from Sri Lanka. Nothing untoward is reported by the clinician who weighed her and the Health Visitor could not recall S as being unhappy.23. Arrested, charged by police and threatened with having their child taken away by Cambridgeshire county council's social workers, it took two years for the Wards to clear their name. 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. 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 final section details the imaging findings in a wide variety of clinical conditions. 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. Site map, Please rate your experience out of 5 (with 5 being the highest and 1 being the lowest), Birmingham Women's Hospital I will quote only two passages, in order to convey the tone and broadly positive view that emerges from this report, at p. 3 and from the Conclusions at p. 16. Father said that he was told it was likely that she would get a high temperature and her thighs might swell. The father accepts that only he, the mother and the grandmother were caring for S during this time. 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. Dr. Foster spent two and a half years working in paediatricsbefore moving into radiology. It is reasonable to conclude that they were lower before then because she was breastfed. I have noted and examined the oral evidence of Dr Fairhurst. Dr. Johnson is presently the Chair of the British Society of Paediatric Radiology. 2018 Karen Johnson Andrea Schnell, a Internist practicing in Madison, WI March 27, . Opportunity to submit questions by email to the faculty. 05. 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. The earliest date for the left femoral fracture was 30th September but it was most likely to have occurred between 10th and 13th October. (4) He accepts that in relation to injuries such as these some force has to be applied. HkBsD R#\#[(!$D(AyLgtJ%{mc8zA&+;*JV [a%4[)Er_'! By the time the two-week family court hearing began, Mrs Ward was pregnant with her second child and feared that if William was taken, her new baby would be too. Thank you! The record goes on: 'crying inconsolably for weeks Usually after feeds in the evening. He stated that on the Saturday morning, at bath time, the grandmother noticed her left arm was swollen and tender and she cried when being dressed or undressed. greater confidence in managing the imaging of an acutely unwell child. 3.o-VR;+lZsA30PK#>] FP+irJBp%MU :g
I{,8fVn|aQY/,E/sa8Cd8sfhD5wGtkE4*8*q0zW,7(Ic The other parties to the case are S's parents, who are married. The child appears by her children's guardian and has been represented by Miss Dixon. The deal meant they could never be alone with their own son out of concern that they would cause him further harm. Only now, three years later, have the Wards managed to draw a line under the affair by forcing the name of the key expert witness to be made public. Her weight gain was recorded as normal. I go into detail on the background facts to this case which important in my consideration because they form part of the 'wide canvas' mentioned by the President Lady Butler-Sloss in the case of Re U (Serious injury: standard of proof) [2004] 2 FLR 63. Determined to establish what was wrong they returned twice to the GP, but he was still unable to offer any diagnosis. The fractures to the right lower leg took place between 12th September and 10th October. 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