England and Wales Family Court Decisions (other Judges)

This judgment was delivered in private.  The judge has given leave for this version of the judgment to be published on condition that irrespective of what is contained in the judgment in any published version of the Judgment the anonymity of the child and members of his family must be strictly preserved.  All persons, including representatives of the media, must ensure that this condition is strictly complied with.  Failure to do so will be a contempt of Court.

 

IN THE FAMILY COURT

SITTING AT SHEFFIELD                                                                                  Case No. TJ14C00054

IN THE MATTER OF THE CHILDREN ACT 1989

 

 

                                                           IN THE MATTER OF LW

                                                   (A boy born on [a date in] 2013)

 

 

                                                                          _______

 

                                                                      Case heard on

                                          24th July, 28th to 30th July and 4th August 2014

 

                                                                        _________

 

                                                                          Between

 

                                ROTHERHAM METROPOLITAN BOROUGH COUNCIL

                                                                                                                                                (Applicant)

 

                                                                               -v-

 

 

                                                                              MW

                                                                                                                                     (First Respondent)

                                                                               AC

                                                                                                                                (Second Respondent)

                                                                               YS

                                                                                                                                   (Third Respondent)

                                               and the Child (by his Children's Guardian)

                                                                                                                                 (Fourth Respondent)

                                                                        _________

 

                                     This Judgment was handed down on 4th August 2014. 

 

                                                                      JUDGMENT

 

                                                                       __________

 

 

                                     Transcribed from an SD Card by J L Harpham Limited

                                                Official Court Reporters and Transcribers

                                                                    55 Queen Street

                                                                   Sheffield S1 2DX

 

 

 

                                                                  APPEARANCES:

 

                        For the Applicant:                                                       MISS N. ERLEN

                                                                                                            (Instructed by Rotherham Legal

                                                                                                            Services)

 

                        For the First Respondent:                                           Represented by HARTHILLS

                        For the Second Respondent:                                      MISS P. STANISTREET

                                                                                                            (Instructed by Oxley and

                                                                                                            Coward)

                        For the Third Respondent:                                          Represented by HOWELLS

                        For the Fourth Respondent:                                        MR. G. SHELTON

                                                                                                            (Instructed by Bury and Walker)

 

 

                                                                     ____________

 

 

                                                                      JUDGMENT

JUDGE CARR QC:  

INTRODUCTION

1.         This case concerns a little boy LW born on [a date in] 2013.  His parents are the first respondent, mother, MW, hereinafter referred to as M, and the second respondent, AC, the father, hereinafter referred to as F.  The third respondent YS has been caring for LW since February 2014 and she is a family relation. 

2.         The application brought by the local authority is pursuant to Section 31 of the Children Act 1989 essentially in respect of injuries that LW sustained in December 2013 and January 2014.  In addition the South Yorkshire Police and Crown Prosecution Service have requested sight of documents filed in this case and are particularly interested in the finding of fact process that has taken place during the currency of this hearing.  In fact the case was listed for final hearing as the essential dispute between all the parties was what had caused LW's injuries, but in any event it has been agreed that LW should move to live with M in mid-August and be supported by a Family Assistance Order.  The local authority have not sought any findings against M but have sought findings against F and the bulk of these proceedings have been concerned with that issue. 

BACKGROUND

3.         Proceedings were commenced after LW received a second set of injuries whilst in hospital recovering from earlier injuries and whilst he was in the sole care of F.  On discharge from hospital LW was placed with an extended family member, YS, and she has cared for LW throughout these proceedings and has supervised M's contact with LW other than any contact facilitated for the purpose of assessment.  F's contact with LW has been supervised by Social Care.

4.         On 18th December 2013, aged just 20 days, LW was admitted to hospital as he was reported by his parents as being unwell.  He was transferred the next day from Rotherham District Hospital to Sheffield Children's Hospital for further tests. 

5.         On 21st December 2013 it was established that whilst LW had initially been treated for an infection, scans revealed bleeding in the brain that might have been caused by non-accidental injury.  Further tests were undertaken with the treating medical opinion being that the findings were unusual for infection and this resulted in a Section 47 Children Act investigation and the core assessments being commenced. 

6.         On 13th January 2014, LW was transferred back to Rotherham District Hospital and was in fact ready for discharge and at a family meeting at the hospital, other family members being deemed unsuitable, it was identified that grandfather's former partner YS was a suitable person to care for LW pending further investigations and a discharge meeting was to be held on 21st January 2014. 

7.         In fact events overtook themselves because at 2.20 a.m. on 21st January 2014, LW whilst still in Rotherham District Hospital and in the sole care of F, sustained injuries.  F said that he had accidentally dropped LW.  A Section 47 investigation was initiated and thereafter the parents agreed to all contact with LW being supervised and LW was then later discharged into the care of YS.

THE PROCEEDINGS

8.         Proceedings were issued on 4th February  2014.  A Residence Order was made in favour of YS on 12th February 2014, subject to an interim supervision order and arrangements were made that LW would be available for contact with F once per week.  Due to a delay in obtaining documentation from South Yorkshire Police disclosure was slower than it otherwise should have been.  M and F were both interviewed.  M on one occasion and F on three occasions.  The numerous treating doctors at both Rotherham District Hospital and Sheffield Children's Hospital were deeply suspicious of both sets of injuries and had done considerable work to exclude all natural causes involving many extensive tests of LW.  On 25th March 2014 an application was made on behalf of the child for permission to instruct independent medical experts to provide an opinion on the likely causation of both sets of injuries sustained by LW and therefore sought leave to instruct a paediatric neuro-radiologist, a paediatrician and a paediatric ophthalmologist.  I granted permission to instruct Doctor Stoodley, a paediatric neuro-radiologist,  Doctor Wild a paediatrician and Mr. Morrison a paediatric opthalmolgic surgeon.  Later on F applied for permission to instruct further medical experts to try and rule out infection in the form of a paediatric immunologist and a paediatric haematologist but in fact this application was not pursued.

9.         The medical experts reported on time and held an experts meeting on 3rd July 2014 with the result that the final hearing was ready to commence on 24th July 2014. The Court was invited by the local authority to make findings against F, with no findings being sought against M.  Those findings were necessary for the threshold and if the threshold was crossed in the way that the local authority sought then it was agreed final orders should be made giving residence by way of a child arrangement order to M, leaving the question of contact open in relation to F depending on what findings had been made. 

THE FINDINGS SOUGHT BY THE LOCAL AUTHORITY

10.       The following findings are sought by Rotherham against  F in respect of the 2 separate occasions LW sustained injuries, which the applicants submit were inflicted on LW by F.

A

(1)        On 18th December 2013 the child LW had sustained the following injuries

(a)        Bilateral subdural haemorrhages, thrombosis in the superial sagittal sinus, fresh sub-achranoid blood and bleeding into/injury of the brain parenchyma;

(b)        Extensive bilateral retinal haemorrhages;

(c)        Reduced conscious level and focal neurological signs.

(2)        The injuries were due to non-accidental trauma caused by impact and forceful shaking.

(3)        The injuries were inflicted by the second respondent AC on 18th December 2013.

(4)        An adult witnessing the incident would have recognised that LW was in pain and distress.

(5)        An adult witnessing the incident would recognise that LW had suffered very substantial trauma and there was a high risk that serious injury had occurred and he required immediate medical assistance.

(6)        A person observing LW after the injuries had been sustained would recognise that he was unwell and medical assistance was required. 

B

(1)        On 21st January 2014 the child LW had sustained the following injuries:

(a)        Pinpoint bruising in two separate areas above each of the eyes which were approximately 2.8 to 3 centimetres x 2.5 centimetres in size. 

(b)        A semi-circular 0.5 x1 centimetre bruise over the right temple. 

(c)        Pinpoint bruising on the medial aspect of the left upper eyelid over an area of approximately 1 centimetre. 

(d)       Pinpoint bruising over most of the right parietal scalp within an area of approximately 13 x 6 x 4 centimetres within which there were straight striation marks and were noticeable towards the forehead over a 4 x 1centimetre area in front of the right ear extending on to the upper cheekbone lateral to the right eye. 

(e)        Four linear bruises on the left upper anterior thigh which were 1x 0.1 centimetres 2 x  0.1 centimetres, 2.4 x 0.4 centimetres and 2 x 0.1 centimetres.

(f)        Three small blue dot haemorrhages in a line on the left inner mid calf which were approximately 0.1 centimetres in size. 

(g)        A small dot haemorrhage which was 0.1 centimetre in the back of the left calf.

(h)        A 0.3 x 0.6 centimetre bruise below the outer corner of the right lower lip.

(2)        The injuries were all due to non-accidental trauma namely forceful blows or very forceful squeezing of the skin.

(3)        The injuries were inflicted by the second respondent on 21st January 2014

(4)        A person observing the incident would recognise that the force being applied to the child was inappropriate and very likely to cause harm. 

LAW

11.       It is now well known and accepted that the local authority must prove this case on the balance of probabilities Ms Stanistreet relies upon the  recent case of Re. JS [2012] EWHC 1370 which was a fact finding hearing within care proceedings when Baker J, (who heard evidence over 15 days from six leading experts in their field) gave what he called the "Ten Commandments" at paragraphs 36 to 45.  They are as follows:

(1)        The burden of proof lies with the local authority.

(2)        The standard of proof is the balance of probabilities.

(3)        Findings of fact must be based on evidence, not speculation or suspicion. 

(4)        When considering cases of suspected child abuse, the court must consider each piece of evidence in the context of all other evidence.  A judge must view the totality of the evidence in order to come to the conclusion whether the case has been made out to the appropriate standard of proof. 

(5)        In serious non-accidental cases, including head injury cases, the opinion of medical experts must be considered in the context of all other evidence.  The Court must weigh up expert evidence against other evidence.  There may be cases where a Court determines that the weight of the evidence is at variance from that reached by medical experts. 

(6)        In assessing the expert evidence the Court is assessing the evidence of a group of specialists, each bringing a different expertise to bear on the issue.  Each expert must keep within the bounds of his or her expertise.  The expert must defer, where appropriate, to the expertise of others.

(7)        The evidence of the parents or other carers is of the utmost importance.  Credibility and reliability are key issues. 

(8)        Witnesses often tell lies.  The Court must bear in mind that a witness may lie for many reasons, such as shame, misplaced loyalty, panic fear and distress.  A fact a witness has lied about some matters does not mean he or she has lied about everything.

(9)        A court must take into account the possibility that the cause of an injury or condition is simply unknown.  This does not affect the burden or the standard of proof.  It is simply a factor to be taken into account in deciding whether the causation advanced by the party holding the burden of proof is established on the balance of probabilities.

(10)      When seeking to identify the perpetrators of non-accidental injuries the test regarding whether a particular person is in the pool of possible perpetrators is  whether there is a likelihood or a real possibility that he or she was the perpetrator.  To make a finding that a particular person was a perpetrator, the Court must be satisfied on a balance of probabilities.  It is desirable where possible for the perpetrator to be identified.  But a Judge should not strain to do so.

12.       Miss Stanistreet also refers in detail in her closing submissions to the consideration of the Court of Appeal (Criminal Division) in the case of R. -v- Lorraine Harris, Raymond Charles Rock, Alan Barry Cherry and Michael Faulder [2005] EWCA Crim 1980 when the criminal convictions and the outcome of that case led to a review by the then Attorney General, Lord Goldsmith, which is detailed in his report (HMSO 2006) The Review of Infant Death Cases: Addendum to Report, Shaken Baby Syndrome.  As she forcefully points out, in March 2011 this led to the Crown Prosecution Service (CPS) issuing new guidance with regard to bringing what CPS now refers to as non-accidental head injury cases and the various guidelines promulgated therein.  I am also well aware of the decision of Re. (HR) [2010] EWCH 1715 (Fam) as to whether the cause of the injury is simply “not presently known or understood” as was set out by Hedley J.  I am satisfied that the case involving LW does not fall into that category and what is required is a rigorous examination of the factors as set out by Baker J in the case of Re. JS. 

EVIDENCE OF THE TREATING DOCTORS

13.       When LW presented to hospital on the 18th December 2013, he was seen by Doctor McGowan, a consultant paediatrician at Rotherham General Hospital, and unsurprisingly he was treated originally for infection.  LW had earlier been referred by Doctor Choksy from the Walk In Centre who suggested to his parents that he should attend hospital, which LW did at 18.30 on 18th December 2013.  On examination LW looked unwell, had a temperature of 35.9 degrees centigrade and was pale and grey with oxygen saturations of 86 per cent in air and capillary refill, and a refill time of three seconds with a heart rate of 180.  The view was that he may well have septicaemia and was given intravenous antibiotics and fluid and a lumbar puncture was performed on the 20th December which was heavily blood stained and so he was treated with antivirals.  This resulted in further investigation by Doctor McGowan who was by then very concerned.  Further investigations were carried out in the form of an ultrasound report and a CT scan.  The CT scan showed subdural haemorrhages bilaterally and as such a decision was made to transfer LW to Sheffield Children's Hospital to obtain an MRI scan of his brain and further evaluation by the neuro-surgeons and neurologists there.  Doctor McGowan was concerned regarding the issue of non-accidental injury. 

14.       At the Sheffield Children's Hospital LW was seen by Doctor Neil Wright, a consultant paediatrician in endocrinology and diabetes and he took a history from F.  The MRI scan showed bilateral subdural haemorrhages, occlusion of the sagittal sinus and fresh subacranoid bleeding principally at the vertex and some odd bleeding in the brain parenchyma, primarily in the temple regions.  This caused further investigation and  Doctor Harrower was also called in to examine LW.  He concluded that the differential diagnosis included abusive head trauma and infection and that in his opinion abusive head trauma was the most likely diagnosis. 

15.       LW was seen at the Sheffield Children's Hospital by Doctor Marr, an eye specialist, who was concerned and considered differential diagnoses of haemorrhages of this type and concluded that the ineffective cause or non-accidental injury was the most likely cause for the eye findings.  LW was seen by Doctor Desurkar a consultant paediatric neurologist at the Sheffield Children's Hospital on the 26th March 2014 and he concluded that LW's presentation was A-typical to categorise clearly as related purely to infection or injury on the basis of consideration of a variety of diagnoses and as a result of investigations undertaken so far.  In addition, LW was seen by a Doctor Waruiru a paediatric consultant in immunology and also by Doctor Payne a consultant paediatric haematologist.  In effect these treating doctors considered that in respect of the injuries sustained on the 18th December 2013 they were likely to be non-accidental and there was no organic reason for the injuries that LW presented to the hospital with. 

16.       In respect of the injuries LW sustained on the 21st January 2014 LW was seen by an experienced consultant paediatrician, Doctor Harrison, in Rotherham District Hospital, and in her statement to the police she made it clear that no restrictions were placed on the parents visits and the parents had undertaken all of LW's care.  LW himself had been seen on a daily basis and remained stable.  On the morning of 21st January 2014 Doctor Harrison was made aware by Doctor McGowan that LW had suffered injuries to his face and bruising to his thigh overnight whilst in his father's care on the ward.  It was documented that the nurse on duty recorded that she was called in by F on 21st January as F was changing LW's napkin.  F demonstrated to the nurse how he had tripped on the wheel of a cot and dropped LW on the bed face down.  LW was noted to have bruises and F stated that L cried constantly but then settled to feeding.  F stated "I cannot believe this has happened".  Doctor Harrison, on looking at LW was immediately concerned and identified the injuries as appear on the finding of fact document set out at paragraph 10 of this judgment.  Doctor Harrison was concerned by the pattern and extent of the bruising and was satisfied it could not be fully accounted for by F's account of events.  These injuries led to the proceedings eventually being commenced by Rotherham. 

OTHER EVIDENCE IN THE CASE

17.       The evidence principally revolved around the experts instructed, but of course they have had access to all the extensive notes from both Rotherham District Hospital and the Sheffield Children's Hospital.   The actual paperwork in the case extends to three full Lever Arch files.  There has been police involvement and statements have been taken from various interested parties in particular close family members.  F was interviewed in January and March 2014 and M in January 2014.  M and F have filed statements.  F denies categorically that he has harmed LW in any way at all.  The local authority have not sought findings against M and are satisfied that she is a concerned and loving parent and is now capable of caring for LW. 

18.       F has required that the three jointly instructed medical experts, Doctor Stoodley, Doctor Wild and Mr. Morrison should attend and give oral evidence and this they did by video link.  There has been an experts meeting on 3rd July 2014 and there is no substantial dispute between any of the individual experts. 

ANALYSIS OF ORAL EVIDENCE

Doctor Stoodley Paediatric Neuro-radiologist

19.       Doctor Stoodley gave evidence on 24th July.  He had provided a report dated 17th June 2014 and attended the experts meeting on 3rd July.  He was clear in his evidence and did not deviate from his written report.  On a review of the fresh paperwork that he had received, in particular F's interview with the police in January 2014, he told the Court that nothing within the recent documentation including the interview affected the opinion that he had previously expressed.  He explained that the mechanism for the injuries found on LW on 18th December 2013 was as a result of impact against a soft surface such as an mattress, sofa or cushion, although he was unable to quantify the degree of force,  he considered it was likely to be substantial.  He believed that there would have been an observable change in the child's behaviour after the causative event but also that it was likely the change of behaviour would have been recognised by mentally competent adult.  He believed that contusional damage was more likely to result from the trauma rather than a shaking injury.

20.       Dr Stoodley was clear that there was no medical controversy as to the cause of contusional brain injury and birth related subdural trauma was not an explanation for any of the observed injuries on 18th December 2013.  Neither venus sinus thrombosis nor infections were the cause of the subdural bleeding or the contusional changes and the injuries could not be as a result of normal handling.  There was no spontaneous event that he could identify that could cause the injuries that were observed. 

21.       The incident on the 21st January 2014 was from a radiological point of view “completely benign” and did not lead to a recurrence of any of the symptoms seen after the trauma that occurred on 18th December 2013.  Dr Stoodley’s evidence was completely clear, this was not anything other than inflicted trauma.  There was nothing in his evidence that caused him to hesitate when considered by itself, as anything other than inflicted trauma. I am therefore, having considered, with care, the dicta of Hedley J in R. (A child) clear that radiologically this was not something “not presently known or understood”.  I accept Doctor Stoodley's evidence; he was very definite regarding it. 

Mr. Danny Morrison - Consultant Paediatric Ophthalmic Surgeon

22.       He did not deviate from his written report dated 20th June 2014 and he had of course attended the experts meeting on 3rd July.  He detailed in evidence that LW was found to have multiple widespread bilateral multi-layered retinal haemorrhages and he agreed with Doctor Marr's findings from the Sheffield Children's Hospital that haemorrhages have either an infective cause or were non-accidental injury at the time. He described LW's ocular findings as "moderately severe".  The retinal haemorrhages themselves and their appearance did not indicate a cause but that had to be deduced from the whole clinical picture.  Mr. Morrison confidently ruled out infection and/or birth trauma as realistic or reasonable causes for the injuries he identified in LW's eyes.  He was satisfied that all the haemorrhages were likely to have occurred at the same time and they were consistent with both shaking and impact injury or both.  He believed that the retinal injuries were entirely consistent with an event having occurred on the morning of 18th December 2013 and the observed injuries were consistent with this, and in any event were likely to have occurred within seven days of the 23rd December 2013 and anything up to nine days would be “stretching it”.  His considered opinion was that non-accidental injury was the most likely cause and he had no criticism whatsoever of the raft of examinations and investigations that were conducted by the clinicians at the Sheffield Children's Hospital.  A query about Terson's Syndrome had been raised but he considered that that was not relevant and indeed it is not an issue in the case.

Evidence of Doctor Wild - Consultant Paediatrician

23.       Doctor Wild reviewed all the papers and he set out in his report at paragraphs 148 and 149 the injuries that LW was found to have on the 18th December 2013 and on the 21st January 2014. At paragraph 148 he stated that LW had (1) bilateral subdural haemorrhages, thrombosis in the superioral sagittal sinus, fresh subachronoid blood and bleeding into/injury of the brain parenchyma.  (2) extensive bilateral retinal haemorrhages.  (3) signs of encephalopathy (reduced conscious level and focal neurological signs), at paragraph 149 he set out the injuries that were found by Doctor Harrison when LW was examined in hospital on 21st January 2014 as follows (1) pinpoint bruising to two separate areas above each of the eyes, within each of the bruised area there was a small area where fewer pinpoint bruises were present. (2) a semi-circular bruise over the right temple.  (3) pinpoint bruising on the medical aspect of the left upper eyelid over an area of approximately one centimetre.  (4) pinpoint bruising over most of the right parietal scalp within an area of approximately thirteen times six times four centimetres.  Within the area there was possible faint striation that were more noticeable towards the forehead in front of the right ear extending on to the upper cheekbone, blackening to the right eye.  (5) four linear bruises on the left upper anterior thigh.  (6) three small dot haemorrhages in the line of the left inner mid calf.  (7) a small dot haemorrhage on the back of the left calf.  (8) a bruise below the outer corner of the right lower lip which was present on the photographs taken at 11.40 on 21st January 2014.  I have observed those photographs and they are all apparent as identifed by Doctor Wild in his report and as are set out in the findings sought by the local authority.  Doctor Wild attended the experts meeting on the 3rd July.

24.       Doctor Wild was clear that the bilateral subdural and retinal haemorrhages and encephalopathy seen following the admission on the 18th of December 2013 were due to non-accidental trauma caused by forceful shaking and/or impact (para 157).  In evidence Doctor Wild stated that the absence of any external injuries or fractures may be surprising but was frequent in such cases and as such did not particularly assist F in his denials of causing injury to LW.  It was Doctor Wild's opinion that LW suffered his injuries on the morning of the 18th December 2013 and would have suffered marked pain and discomfort causing him to scream and cry.  There would have been a rapid change in his conscious level following the trauma, this would have been within seconds to minutes.  The trauma would have been a memorable event and one for which an adult would be expected to seek immediate medical assistance. 

25.       Doctor Wild stated that a person who did not witness what was occurring would have recognised that LW was unwell and that medical assistance was required but not, that he was unwell because he had sustained serious injuries (para 176).  This fits in with the reaction of mother on seeking the advice of the maternal grandmother and thereafter taking LW to the Walk In Centre.  Doctor Wild stated that it would be obvious to anyone causing or witnessing the injuries that LW had sustained substantial trauma and there was a very high risk that serious injury had occurred. 

26.       In respect of the injury sustained by LW on the 21st January 2014, Doctor Wild roundly discounted F's explanation, he had seen the  photographs of F’s  reconstruction and also F’s DVD recording of the reconstruction as simply “not possible”. 

THE EXPERT EVIDENCE

27.       Each of the experts instructed applying their expertise in their own field conclude therefore that LW's injuries leading to his admission to hospital on 18th December 2013 were caused non-accidentally and were therefore inflicted injuries.  The injuries seen on the 21st January 2014, although radiologically benign, do not fit in any way with the explanations given by F in evidence orally, or in his statements to the police or in  the reconstructions he did by photographs and  DVD and  with the trauma that LW sustained and it is the view therefore of Doctor Wild that those injuries were also inflicted. 

EVIDENCE OF FATHER

28.       The evidence of father is of course of the utmost importance and he had provided evidence both in the form of his police interviews and in his statements.  He also gave oral evidence on 29th July 2014.  I find that his evidence is neither credible nor reliable.  In his police interview of 10 January 2014 he describes struggling with LW at feeding times and spoke at length regarding his concerns on LW's presentation at around 2 p.m. on 18th December 2013 and the steps that he took to wake him up (G21).  He described picking him up, trying to open his mouth, changing his napkin, trying to open his eyes, checking his heartbeat and breathing,  picking him up out of his bouncer on four separate occasions to try and wake him, this carried on for  about an hour.  In his second police interview (at G174 on 2 March 2014) he said he was really concerned for LW but he had no phone and did not know where the hospital was, instead he just waited for M to return. 

29.       This is completely at variance with the evidence of M and also of the paternal grandfather who returned to the flat at about 3 p.m. on 18th December 2013.  M had left the home at about 11 a.m. and F had told her that LW had taken his feed at 11.30 a.m., about two ounces only and fallen back to sleep. She stated "that is all he told me" (G90).  The paternal grandfather's police statement makes no mention of any concerns that F raised about LW that day (G9). 

30.       When giving evidence on 29th July 2014 F accepted that he did not say anything straightaway replying, "I don't know why.  I did not think anything of it at the time".  This can only to be to cover up whatever had happened earlier to LW at F's hands.  There can be no other explanation as only F was present and therefore only F knows what happened.  He left it to mother and the paternal grandfather to raise their own concerns and to seek help for LW unaided by him.  In as much as Miss Stanistreet seeks to persuade the Court that the condition for which LW was admitted to hospital on 18th December 2013 is simply unknown, it is a suggestion I reject completely.  There is no evidence whatsoever that LW's condition could have happened spontaneously and the way in which F behaved to M and the paternal grandfather when they returned to the home at about 3 p.m. is at total variance with his attempts to make LW more alert at the time of trying to feed him and change him.  The only explanation is that these were inflicted injuries as all the medical evidence now supports. 

31.       F's history of how LW sustained the bruising on the 21st January when dropped by him on to the bed and then caught by the upper leg is rejected by two experienced paediatricians, the treating paediatrician Doctor Christine Harrison and the independently instructed expert Doctor Wild.  Such a simple fall would be unlikely to cause any injury or if it did only leave a small bruise at a single site.  There was extensive bruising around LW's head and that is likely to have required more than one blow and some significant forces.  The fall as described and reconstructed in the photographs that I have observed could not possibly have accounted for the side of the head where bruising was found and further the level of force to produce the bruising to LW's upper and lower leg would have been far greater than that described, nor would the act of grabbing LW by the upper leg or buttock explain the pinpoint bruising to his lower leg.  As such I reject entirely F's explanation for what occurred on the 21st January 2014 and it strengthens the fact that I am satisfied well beyond the balance of probability that the injuries inflicted on the 18th December 2013 could only have been caused by F just as it is accepted that the injuries seen on 21st January 2014 occurred whilst LW was in F's sole care and could only have been caused by him. 

CONCLUSION

32.       I am satisfied well beyond the balance that the injuries that were seen by the treating doctors on 18th December 2013 and again on 21st January 2014 were inflicted by F and that as such the threshold is crossed. It is also a fact that the prognosis for the injuries sustained by LW is as yet unknown, but he has made good progress, no doubt in part due to the care given by YS to LW.

33.       I adopt the threshold as drafted Miss Erlen and make the all findings sought, which will be incorporated in a separate document as a court order.

34.       As I indicated to Miss Stanistreet those findings having been made, it makes any contact supervised or otherwise in the immediate future a very real risk and danger for LW.  I have to bear in mind that on 21st January 2014 this baby was in a place of safety yet came to be injured by severe bruising over his head and body, the explanation given by father as simply not being a possibility.  As such for the time being there can be no safe contact between LW and F. 

 

HH JUDGE CARR QC

4 AUGUST 2014

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