He found it was not possible to conclude at what point normal day to day handling crossed over to the point when S's vulnerable bone structure was compromised and exceeded. The father accepts that only he, the mother and the grandmother were caring for S during this time. 20. At 18.45, the paediatric ST4 clinician noted the symptoms reported by the parents as, "crying more since Thursday morningNot moving her left arm noticed yesterdayToday noticed swelling of left arm". She also asserted that in her view there was no correlation between Vitamin D deficiency and fractures nor was there an increased propensity to fracture due to a Vitamin D deficiency. When Victoria and Jake Ward saw their baby son crying and refusing to feed, they took him to their doctor. The scans were sent for further expert review by Dr Karl Johnson, paediatric radiologist at the Birmingham Children's Hospital. T was described as "very attached to his mother" becoming jealous when mother was with S. He was described on examination as very active in clinic, playing with his sister and wanting to hold her. He also is an expert of considerable renown. She presented with no bony injury and was discharged. He was earnest, straightforward and did not quibble with the questions although he did not always understand the question. Dr. These are referred to in more detail in her evidence and indeed in the local authority's threshold document, and she has set out fully in her expert report to the court her opinion on the fractures she found, the dating of S's injuries, the mechanism of injury, possible explanations and her conclusions. When S was born on 18 July 2011, T was 3 years and 5 months old. On 3 August 2011, S and the mother were seen at home by the Community Nurse, and the record shows that the mother had no concerns. I have also noted the quotation offered by Miss Trustman from R v Harris and others [2005] EWCA Crim 1980 para. In the last week of the last Parliamentary session the judgement was rubber stamped into law. The strong impression given is that the parents and maternal grandmother are careful, child-focused and conscientious parents who have demonstrated the quality of the attention they have given to dealing with T's special health needs and to S as they have arisen. Three days of this course provides 18 CPD credits in accordance with the CPD Scheme of the Royal College of Radiologists. At one point, he mentioned that they had thought it was due to her immunisation that she was not using her left hand. It is remarkable that these and in particular the hospital appointment of 13th October did not reveal or suggest the presence of fractures, nor did they raise any element of suspicion about the parents. Upper limb rheumatology/radiology MDT: . Her responses in the Schedule point out that the allegations are made on the presumption that S did not have any genetic abnormality or bone disease. On 24th October 2011 a skeletal survey detected what appeared to be two left rib fractures. A diagnosis of OI (osteogenesis imperfecta) is exceptionally unlikely. This, unfortunately, was soon to change. hmk0^g? endstream endobj startxref 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. On the balance of probability T could not have caused the injuries to S either by (a) jumping on the family bed whilst S was lying on it or (b) pulling her bouncy chair when she was in it. The Wards were arrested and questioned by police on suspicion of grievous bodily harm and child cruelty towards William. I come to the conclusion that Dr Fairhurst's evidence as to the identification of the injuries is, taken as a whole, and in the light of all the evidence and my acceptance of Dr Fairhurst's evidence in her own field of specialism, reliable and acceptable. I have also noted in relation to the injuries that it is 'always open to a judge to rule that the cause of the injury remains unknown' and the case of Re R (Care proceedings: causation) [2011] EWHC 1715, a decision of Mr Justice Hedley. The parents did not return her, the Father stating that by Sunday [14th October] she was "back to normal". Both gave compelling evidence that, in particular, the rib fractures suffered to the baby could only be caused by " excessive/abusive squeezing" or "gripping of the chest". "There seems to be a small group of expert witnesses who often condemn parents. Full access to each case with a full toolset to open, view and manipulate each case alongside the faculty but on your own screen! All prices include VAT, Viewers will be asked to evaluate each session and will be provided with a CPD certificate upon completion 09. Controversial issues, more cases and discussion, To provide the Consultant Radiologist with a practical and comprehensive case based update on the interpretation and reporting of general paed radiology, suspected inflicted injuries and challenging cases when on call, Takes delegates through an intensive series of challenging cases with immediate feedback after each case, Short introductory lectures, offering guidance, practical knowledge, what not to miss and how, Faculty of Consultant Paediatric Radiologists who are experts in their fields and from different hospitals in the UK. The constellation of findings is highly indicative of non-accidental injury by an adult. I do not propose to go through all the responses to the various fractures but what I have mentioned sets out much of the content and gist of the father's response and denials of the local authority's allegations.39. Victoria and Jake Ward and William, right. s Pediatric Diagnostic Imaging textbook is renowned as one of the oldest and most prominent general textbooks in the field of paediatric text consists of two reasonably sized volumes covering all key areas using an intuitive systems-based approach. Left lower leg fracture, a metaphyseal fracture of the left tibia (shin bone) (3rd-10th October 2011). I note his view that osteogenesis imperfecta was 'exceptionally unlikely.' In all sections, the value of all imaging modalities are stressed. Her expertise within paediatric radiology covers the full range of imaging modalities including plain X-ray, ultrasound, fluoroscopy, CT, MRI, and nuclear medicine. Paediatric Radiology opens with a chapter devoted to the different imaging modalities, including radiographs, fluroscopy, ultrasound, CT, MRI and nuclear scintigraphy before moving on to more detailed, systems-based chapters. There was no active movement of the left upper arm, and she cried a lot on passive movement of the left upper arm which was swollen and showed some inflammation of the left elbow.26. When the cause of his pain could not be found, they took him back twice more. Fax 847-678-6286 Tooting whose report is at E76-E 279 and Dr. Karl Johnson, consultant paediatric radiologist at the Birmingham Children's Hospital . 2. I noted in relation to the mother that she gave her evidence calmly, she was quietly spoken, she gave direct and straight answers, she was composed and it appeared that her answers came from her genuine recollection without her giving what might have been expected answers. 135; "There are areas of ignorance. The x-ray of the left femur had been reported as showing no bony injury on 13 October 2011 and no obvious metaphyseal infraction. The father's responses set out a general defence to each allegation setting a number of relevant points that formed part of his evidence. However, in September 2006 the Crown Prosecution Service decided not to proceed with the case after detectives said they were unable to prove who had harmed the baby. 1808 7th Ave S, Birmingham, AL, 35233 3 other locations (205) 934-3333 OVERVIEW Dr. Johnson graduated from the University of Pittsburgh School of Medicine,University of Pittsburgh School of. (3) It is not known why some patients with rickets become hypocalcaemic, one of the clinical pictures of rickets or Vitamin D deficiency, and why in some patients with rickets patients have fractures, some have two or three, others have none. It is necessary to take account in combination with these reports of the dates provided by Dr Fairhurst for the occurrence of the various fractures to S, the clinicians' observations, also the X-ray and the report of nothing abnormal on 13 October 2011. His father described him as "very possessive" of his baby sister, trying to open her clenched fists to place toys in them, to straighten his 'folded' arms and play with her. She states that they do not occur accidentally and this type of fracture is highly indicative of non-accidental causation requiring a force well in excess of that used in normal day to day handling of an infant. The maternal grandmother's position can most usefully be seen as set out in her position statement of 12th March 2012. Fractures of the antero-lateral aspects of the left 8th and 9th ribs were caused by (a) a direct blow or compressive forces applied to her chest by an adult carer, (b) she would have shown distress for 10-15 minutes and shown discomfort when her chest was moved such as when she was dressed and a regular carer would know this was as a result of these fractures with discomfort lasting for a week. Birmingham, 012 133 His claim that William had suffered four fractures on at least two occasions was contradicted by their assertion that he had only two fractures, both of which had probably been caused at the same time. There are a number of other features of the evidence about the parents which I must take into account as part of the 'wide canvas' of evidence that I have surveyed. At that point a number of problems faced the court. Mr Johnson, who is chairman of the British Society of Paediatric Radiology and works as a consultant at Birmingham Children's Hospital, told police that in his view William had suffered. The GP note for 20 October 2011 records "First meningitis vaccination. The parents' first child T was born on 14th February 2008. Book yoUR 2023 CME TODAY. We adopt the following: i. The mother also worked there.10. 7. I gave a short judgment identifying the difficulties in which the paediatrician found himself in dealing with the analysis of Vitamin D deficiency/insufficiency which was outside his expertise and which presented a substantial difficulty in the case. This would have involved manipulation of the legs and arms, and the conducting of other tests. Dr. Johnson is presently the Chair of the British Society of Paediatric Radiology. Earlier records that day mention mother and father being present. (1) D(2) N(3) S(4)S (by her Children's Guardian) Respondents____________________MISS HELEN SOFFA (instructed by the local authority) appeared on behalf of the Applicants.MR UPALI JAYATILAKA (solicitor) appeared on behalf of the Respondent Mother.MISS ALICE DESCHAMPNEUFS (instructed by solicitors) appeared on behalf of the Respondent Father.MISS JUDITH TRUSTMAN (instructed by solicitors) appeared on behalf of the Respondent Maternal Grandmother.MISS SORREL DIXON appeared on behalf of the Children's Guardian.____________________Digital Tape Transcription by:John Larking Verbatim Reporters(Verbatim Reporters and Tape Transcribers)Suite 91, Temple Chambers, 3-7 Temple AvenueLondon EC4Y 0HP.Tel: 020 7404 7464 Fax: 020 7404 7443 DX: 13 Chancery Lane LDE____________________Words: 11,229Folios: 156(FULL) JUDGMENT20th March 2013.01. This is case-based course designed for all General Radiologists and Radiologists based at the DGHs who are increasingly having to report paediatric imaging, an opportunity to attend a complete update of the main key topics on 3 consecutive days a complete CPD package. The local authority relied upon the evidence of the consultant paediatric radiologist who acknowledged what whilst there could be a Vitamin D deficiency there was little, if any, supporting evidence of fractures being caused by lower than normal Vitamin D levels where there is no evidence of rickets. Site map, Please rate your experience out of 5 (with 5 being the highest and 1 being the lowest), Birmingham Women's Hospital I have also noted the guidance to be derived from Re U: Re B (above) given by Butler Sloss P at paragraph 23: "In the brief summary of the submissions set out above there is a broad measure of agreement as to some of the considerations emphasised by the judgment in R v Cannings that are of direct application in care proceedings. Thank you! "Unfortunately the job of social workers is to think the unthinkable because sometimes terrible things happen. He confirmed the presence of the humeral fractures and rib fractures and, following further X-rays, identified what he thought was a healing fracture of the proximal left tibia. The record concludes with the GP's comment "All well. Detectives removed the cot for examination. Call. Displaying companies where the director has shareholdings or significant control. There is no radiological evidence that S suffers from rickets or any other vitamin deficiency. Within each chapter there are three consistent sections. All the family carers accept therefore that they are in the potential pool of perpetrators as they were all involved in her care, but they deny inflicting injuries upon her. In the course of surveying the 'wide canvas' of evidence I have reviewed the evidence of the mother, the father and the grandmother. endstream endobj 35 0 obj <>/Metadata 4 0 R/Outlines 8 0 R/Pages 32 0 R/StructTreeRoot 11 0 R/Type/Catalog>> endobj 36 0 obj <>/MediaBox[0 0 595.32 841.92]/Parent 32 0 R/Resources<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 37 0 obj <>stream Her weight gain was recorded as normal. She also offered the view that the fractures were likely to have occurred on three separate occasions; the constellation of injuries was in her opinion highly indicative of non-accidental injury. X-rays Karl Johnson is a Consultant Paediatric Radiologist at Birmingham Children's Hospital, and has been there since 1998. S has suffered multiple fractures which have occurred on at least three separate occasions. View more radiologists birmingham Consultations Consultations Steelhouse Lane, Birmingham, England. This advanced Infomed webinar is in response to suggestions/feedback from many general radiologists, who have attended Infomed courses, more lately webinars, and now with the easing of the pandemic see the need for a focussed and comprehensive Paediatric Radiology CPD programme. 13. Dr. Johnson is presently the Chair of theBritish Society of Paediatric Radiology. When to refer and why Dr Rajendranath Sinha, The Newcastle upon Tyne Hospitals NHS Foundation Trust The court had no expert views on these aspects or on a number of potential issues relating to bone metabolism. She was born in 1979. I have in particular noted the GP entry reports and the visits made by the parents for checks or routine appointments. 3. With no help from outside agencies their couple mounted their own investigation into the cause of their son's injuries. The earliest date for the left femoral fracture was 30th September but it was most likely to have occurred between 10th and 13th October. Full access to the cases to follow alongside with the sessions. As it is, her persistent crying which may well have been her response to the injuries can be considered in the light of the reports of the parents about her crying and the possibility of their misinterpretation of her crying emerges as a very real consideration. 22. So the records engage even closer scrutiny. Having reviewed the evidence in detail, and after considering the written submissions of all parties, I had reached a position where I had come to my conclusions on the issues of fact. The record goes on: 'crying inconsolably for weeks Usually after feeds in the evening. The parents needed to be careful over his food, medicine and health. It was noted that the parents were unsure how the fracture may have happened and there had been no recent accidents of falls. The maternal grandmother had not witnessed T intentionally being rough or boisterous towards S and had not witnessed him attempting to hold S or pick her up. It is very easy to try and fill those areas of ignorance with what we know but I think that it is very important to accept that we do not necessarily have a sufficient understanding to explain every case.". 9. The advice to 'persist with Infacol' also bears out the father's account. Post-immunisation advice was given". colic/reflux." 11:00-11:30 Imaging of arthritis Dr Emma Rowbotham, Leeds Teaching Hospitals NHS Trust 12:00-12:30 Common paediatric MSK conditions Dr Karl Johnson, Birmingham Children's Hospital NHS Foundation Trust 12:30-13:00 Soft tissue and bone lesions. On Wednesday 19 October 2011, S was seen at the clinic to be weighed. @ $ lp-5v|v3+F;%`(E4Di 33. But in the light of all that is known about the parents and from my impression of them in evidence balanced against all that is submitted and produced by the local authority it is not likely, in my judgment, that her injuries were caused by non-accidental force. In his second report after reviewing the outcome of the medical investigations after his original report he held to the view that there was a high suspicion for a non-accidental causation. The Father said in evidence that when the hospital phoned on Monday morning, his wife told them that S was "fine".21. (S> $}=I% l S2QBC(*YMhTX^Gf=,HO)t}cg3F 0s/yGUu. I have heard the evidence of the experts as follows: (1)Dr Fairhurst, consultant paediatric radiologist, and read her reports, notably that of 13th February 2012; (2) A Consultant Paediatrician and his report of 5th March 2012; (3) I have heard the evidence of Professor Steven Nussey, Professor of Endocrinology, and read his reports of 10th and 22nd July 2012; (4) I have heard the evidence of the mother; the father; and the grandmother, and read their statements filed in this case; (5) I have heard the evidence of the health visitor. She refers to the fact that in relation to allegation 3, 4, 5 and 6 the mother had noticed the child's discomfort and taken S to the Medical Centre and then on to the Accident and Emergency Unit at the local hospital where S was examined by a paediatrician and X-rayed, following which she was told that everything was normal and she was discharged. In my shorter version of this judgment on 14 January 2013 I provided as clear an indication as I could to the relief, I am quite sure, of the parents of the way in which my mind had worked. 11. 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. Dr. Karl Johnson is a Consultant Paediatric Radiologist at Birmingham Children's Hospital, and has been there since 1998. (10) His view was that it was likely that S was Vitamin D deficient in utero and in the early neonatal period. Right lower leg fracture, a metaphyseal fracture of the proximal right tibia (shin bone) (12th September-10th October 2011). Interpretation & Reporting Webinar for the General Radiologist, DAY 1: GENERAL PAEDIATRIC RADIOLOGY - WEDNESDAY 9 FEBRUARY 2022 Rib fractures to the antero-lateral aspects of the left 8th and 9th rib (15th-28th September 2011). As to the possible involvement of T, he asserts that he had not witnessed T twisting S's arm (or leg or wrists). A week later William was placed on the council's child protection register. 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. 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. Dr. Karl Johnson is a Consultant Paediatric Radiologist at Birmingham Children's Hospital, and has been there since 1998. To access the survey, please click here. S had only been in the house with the parents, grandmother and T. Investigations were put in hand. Tel: 0121 335 8260 The team Our team is made up of consultant radiologists, sonographers, radiographers, health care assistants and administrative staff. Dr. Karl Johnson Consultant Paediatric Radiologist Birmingham Children's Hospital 15:05 - 15:20: Break 15:25 - 16:25: SEN disability impact of covid on safeguarding Caroline Coady Assistant Director for Social Care National Children's Bureau 16:25 - 17:25: Sexual Abuse Update Deborah Hodes 17:25 - 17:30: Close 17:30: Room open for networking 45. In the absence of an explanation of the injury to S's left arm, the Consultant Paediatrician considered that there was a "high level of suspicion that the humeral and rib fractures may have been sustained as a result of non-accidental injury". Furthermore, Professor Tim David, an expert paediatrician, told the court that in this and many other cases, police and social workers were wrong to assume that an unexplained injury could normally be attributed to child abuse. Virgil van Dijk: I should have taken a break before World Cup, Britain's second lockdown was based on 'very wrong' Covid data, Boris Johnson feared, How Boris Johnsons desire to lift lockdown was thwarted by public opinion, Misplaced breathing tube contributed to death of first child Covid victim, inquest rules, William Sitwell reviews St Barts, London: This food will win over any tasting-menu sceptic, How to bring a cosy, Scandi-inspired aesthetic to your wardrobe. greater confidence in managing the imaging of an acutely unwell child. 06. Karl John Johnson Radiologist Steelhouse Lane, B4 6Nh, Birmingham, England. 0121 472 1377. Injuries to S could not have been caused by a person rolling onto her. 36. But the drama turned into a nightmare when they were accused of having deliberately harmed their little boy. With Doctuo you can find the doctors you need. It is further positive that the professionals involved with the family have reported no concerns regarding the children's wellbeing whilst in the care of their parents prior to S being admitted to a local hospital with a fracture to her left femur.'. 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. On 19 August 2011, two days later, there is a record in the GP notes confirming a visit by the mother and father with S. She was seen by the GP. S was discharged and the parents reported that her knee improved. In his report of 25 October 2011 the Consultant Paediatrician confirms that ophthalmological testing showed no evidence ocular trauma with healthy discs and no retinal haemorrhages seen. I have given a relatively brief overview of the medical evidence adduced by the local authority, but, having reviewed the medical evidence so relied on, I have no difficulty in acknowledging that the inferences to be drawn from the medical expert evidence raise a substantial likelihood that the injuries were caused non-accidentally and by force used by at least one of the adult family members that was in excess of normal day to day handling, although expressing reservation as to what precisely that might mean, and that the evidence of Dr Fairhurst in particular deserves significant weight. 2018 Karen Johnson Andrea Schnell, a Internist practicing in Madison, WI March 27, . Her evidence was therefore protracted and interrupted and I note Miss Trustman's observation that her evidence lasted in Sri Lankan time from 4:05 pm to 8:20 pm, and I have no reason to doubt the accuracy of that record. On 22 October a skeletal survey was performed and reported on by Dr Steven Johnson, Consultant Radiologist. DAY 2: EMERGENCY PAEDIATRIC IMAGING - THURSDAY 10 FEBRUARY 2022 Birmingham B4 6NH, Questionnaire for parents with children aged 5-9, Monday, Wednesday and Thursday/Friday afternoon, Four to six times per year at Queen Elizabeth Hospital on a Tuesday morning. . One or both of the parents, and/or the grandmother knows what has happened to S on all the occasions she has suffered injury. There is no evidence of drugs or alcohol abuse, of anger or violent outbursts, of short temper, volatility, irritability or dysfunction. The parents/grandparent who did not inflict the injuries on each occasion to S failed to protect her. (5) S's Vitamin D levels, which were on the borderline on 2nd November 2011, were never higher than insufficient. Mrs Ward, 36, who now has three children and runs yoga and massage classes for babies, said they were not content with simply winning their own case. An X ray showed a spiral fracture of the left humerus. 50. Doctuo 2023 Last modification: 02-03-2023, Birmingham Children'S Hospital, Birmingham. 0 The final section details the imaging findings in a wide variety of clinical conditions. %PDF-1.6 % Dr. Karl Johnson is a Consultant Paediatric Radiologist at Birmingham Children's Hospital, and has been there since 1998. The burden of proof lies on the local authority and they have to satisfy the court on the balance of probabilities: see Re B (Care proceedings; standard of proof) [2008] UKHL 35. N and D appeared able to actively provide a high level of basic care for their children.'. Her evidence was that the earliest date for the rib fractures was 15 September, the latest date being the 28 September 2011. 5. DR KARL JOHN JOHNSON is a Consultant Radiologist from Birmingham. I have noted and examined the oral evidence of Dr Fairhurst. The family's nightmare began one night in July 2005 when, at three months old, William woke up in pain. The father said in evidence that her crying was first mentioned then, although there is no entry about it in the record, but the following record in the GP Notes does suggest that the Health Visitor had "advised giving her Infacol" at this point, so it probably was raised then. The GP was unable to identify the cause of William's pain, but on returning home the Wards noticed his leg was swollen. The Judge found that neither parent was seeking to cover up matters or to deal other than truthfully to the best of their ability. She said: "How could we celebrate that someone has decided you didn't hurt your child when you know all along you didn't? Again I did not get the impression that this was a man seeking to cover up matters or deal other than truthfully to the best of his ability with matters as he remembered them. The Judge was satisfied that neither the mother, father, nor grandmother could be held responsible for causing the injuries. Radiologists, Country They both appear to value education and a need to promote this ethos with their children. He had known his wife (the mother) since 1990. endstream endobj 38 0 obj <>stream The judgment that I gave that day is subsumed into this fuller judgment of the court.02. Mr Sami Al-Ani He has co-authored over 35 peer reviewed papers. On the balance of probability T could not have caused the injuries to S. 16. Reviews aren't verified, but Google checks for and removes fake content when it's identified, Oxford Specialist Handbooks in Paediatrics, Medical / Allied Health Services / Imaging Technologies. Birmingham Update in prostate cancer Topics to include: . However, she was very unsettled again by 22nd October 2011 and so the parents and grandmother took her to the A&E Department at the local hospital. 41. The maternal grandmother ('the grandmother') is also a party, as she was present in the family home at the material time, and has been represented by Miss Trustman. Any specialty Nothing untoward is reported by the clinician who weighed her and the Health Visitor could not recall S as being unhappy.23. While T was originally the subject of the local authority's applications at the outset when proceedings were issued on 27th October 2011, I made an order on 13th December 2011 returning him to the care of his parents and no continuing orders were made relating to him. He has a special interest in paediatric musculoskeletal disorders, in particular juvenile arthritis and non-accidental injury. He arrived at the preliminary conclusion that the humeral and rib fractures must give rise to 'a high level of suspicion' for non-accidental injury. None of the fractures could have occurred at birth. The second section discusses the differential diagnosis of radiological features. Dr. Katharine Foster is a paediatric radiologist and has been working at the Birmingham Children's Hospital for two years, following a fellowship year at The Hospital for Sick Children in Toronto. Dr Johnson, however, reported "a number of equivocal appearances on radiographs with respect to the left distal femur and proximal left tibia" and suggested further films. Their evidence would have to be regarded as a tissue of lies and their manner of dealing with S would need to have been abusive, violent to the point of sadism, and the subject of a conspiracy of silence given the unlikelihood of such conduct being committed in secret or the strength of S's reaction passing unnoticed. > $ } =I % l S2QBC ( * YMhTX^Gf=, HO ) T } cg3F.... Imaging findings in a wide variety of clinical conditions when, at three months.. Differential diagnosis of OI ( osteogenesis imperfecta was 'exceptionally unlikely. 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Internist practicing in Madison, WI March 27, grandmother could be held responsible for causing the.! Was 30th September but it was noted that the earliest date for the tibia... On each occasion to S on all the occasions she has suffered multiple fractures which occurred... Injury on 13 October 2011 records `` First meningitis vaccination, Viewers will be provided with a CPD certificate completion... Interest in Paediatric musculoskeletal disorders, in particular juvenile arthritis and non-accidental injury by an adult Madison WI! Parents were unsure how the fracture may have happened and there had been no recent accidents of.. Modification: 02-03-2023, Birmingham, England x27 ; S Hospital, Birmingham was 15 September, the date. Judge found that neither the mother and the health Visitor could not been! Was 'exceptionally unlikely. ' refusing to feed, they took him back more! Normal '' fractures was 15 September, the mother and father being present has to. 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