Commentary

In this case of suspected non-accidental injuries to an infant, only one of the experts was required to give evidence. This was Professor Fleming and as the judge found that he gave his evidence in his characteristically understated and calm fashion and was precise, knowledgeable and reasonable in his evidence, it is set out here in full as a model.

The case also illustrates how the expertise of clinical geneticists, endocrinologists, haematologists, neonatologists, paediatricians and radiologists can all be necessary where non-accidental injury of a child is the issue.

Case

A was born in Summer 2022.

On 25 November 2022 A was taken to hospital where a paediatric registrar observed seven red marks on A’s left leg and right ankle and foot for which there was no explanation. Each was considered to be consistent with bruising. Father suggested that each of them could be due to tight clothing. As a consequence, A was admitted to hospital for observation and investigation. Those investigations did not include a skeletal survey.

On 12 January 2023 he was admitted to hospital with suspected non-accidental injury. He had presented to the Paediatric Emergency department where the following was noted:- (i) Non-blanching linear lines red in colour around 1 cm in length over the right iliac fossa; (ii) A large area of bruising measuring 7 cm x 4.5 cm x 2.5 cm which was bluish in colour; (iii) Linear scratches on the left ankle 0.5 cm -1 cm; (iv) A brown circular mark on the right posterior calf which was 0.5 cm.

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