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Rapid Responses: Rapid Responses published:
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Staphylococcus aureus from eight sites of the baby's body, including the cerebral spinal fluid.
- Donna Young (10 February 2003)
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The Case of Sally Clark
- John Batt, Michael Mackey, Burton Copeland, Manchester (18 February 2003)
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BEYOND BELIEF?
- Sue B Hood (19 February 2003)
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Re: BEYOND BELIEF?
- Michael D Innis (21 February 2003)
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Who will speak for the next battered child?
- Martin S Schweiger (24 February 2003)
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Re: Who will speak for the next battered child?
- C Johnson (22 March 2003)
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Re: Who will speak for the next battered child?
- C Johnson (12 April 2003)
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Donna Young, www.lotusbirth.com Researcher, Canada V1G 4H4
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RE: Sally Clark's conviction dropped. It would be interesting to know if early cord clamping was a factor in her children's death, the clamps causing the virus to enter her baby's blood stream. Also, were any of the babies who died shortly after birth, given any vaccinations, like Vitamin K or Heb B shots, or had needles pierce the child's pulsating umbilical cord vein to take samples of the blood. Any prick of the infant's skin is risking all infants to infections and these viruses inside the baby's blood stream can be factors in infant deaths, and the parent(s) blamed. Thank you for any more information of the care of the mother who may have been injected with drugs during labor, and all drugs cross the placenta, so both mother and baby are at risk. Please visit my website at, www.lotusbirth.com There I share Dr. Sarah Buckley's experience of no clamping of the infant's lifeline, ever. That was the way the wiser generations prior to 1923 handled home births, no clamping of the cord, no injections to mother or child, truly natural births, that the blue-ribbon-babies of that kind of natural care, in homebirths, are still living today. A fact, my parents, homebirths, are 89 and still living on their own with only moderate extra care services. Thank you for a reply, if you too are concerned with modern immediate and early cord clamping weakening babies to be vitamin and immune deficient, and want a return to natural births. Sincerely,
Competing interests: Natural Birth vs Active Management, the use of drugs and early umbilical cord clamping |
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John Batt, solicitor Batt Holden, 12 Compton Road, Wimbledon, SW19 7QD, Michael Mackey, Burton Copeland, Manchester
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Sally Clark. We write in connection with an article, published in your edition of 8th February, in which you published an extract from a press release jointly issued by CPS and Cheshire Police. The article sought to inform the medical profession of the relevant issues of perhaps the most significant miscarriage of justice ever occasioned, by the failure of doctors to disclose and/or correctly interpret medical findings. Your article relies heavily on the CPS press statement, which itself is seriously misleading. The statement has it that the defence called expert evidence to show that it is “theoretically possible” that the second child died from a common bacterium. Members of the medical profession should be aware of the exact nature of the so- called “theoretical possibility” in this case: a) Staph aureus, with associated polymorphs, was isolated in pure
culture in the child’s cerebro spinal fluid.
As solicitors for Sally Clark, we are aware of the intense concern and medical debate, which this case has provoked. To inform the continuing debate, and prevent your readers being misled again about the true facts of the death of Harry Clark, the following facts need to be restated: 1. The cause of death due to “overwhelming staphylococcal infection”
was certified by Dr Roger Byard, Dr Glyn Walters, Dr Ian Rushton and Dr
Sam Gulino. Professor James Morris added: “no other cause of death can be
sustained”.
It seems that, in some quarters, the most fundamental lesson posed by the case has not been learned. In cases which turn on medical science, it is vital that medical men act as scientists, that the whole truth is disclosed and debated. In his final report, Dr Rushton put it succinctly: “there is no point in performing microbiological tests, if the findings are to be ignored or dismissed …….because they do not appear to fit in with a proposed hypothesis”. This case has demonstrated many areas of concern relating to the formulation, presentation and evaluation of expert evidence. As lawyers, we accept that reasoned opinion depends on provision of the full facts. We trust that the above short summary provides sufficient facts, on which your readers might evaluate the theoretical possibility that Byard, Morris et al were wrong. John Batt
Michael Mackey
Competing interests: We are solicitors for Sally Clark |
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Sue B Hood, medical staffing administrator CM8 1RB
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The conviction was quashed because of procedural errors in that the bacteriology report was not shared. This does not remove the question of guilt, nor does it provide an unequivocal answer to the cause of death of two infants. It is only within the last three decades that the concept of NAI has been taken on board by the medical profession, still less by the public, some of whom formed the Jury. Will we in 20 years time feel comfortable with the release of Sally Clark, or will we be extending child protection procedures to all children in families where a sudden child death has occurred? Do subsequent children of the Clark's - if any - need to be protected beyond the vulnerable stages of infancy? Can we live with ourselves if not? Competing interests: None declared |
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Michael D Innis, Director Medisets International Home 4575
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Editor, Sue Hood asks “Will we in 20 years time feel comfortable with the release of Sally Clark…” Yes, Yes A thousand times Yes. By then; Radiologists will have learned that a ‘callus’ on the rib of a child is not necessarily the result of a malicious blow to the infant’s chest. And if there is more than one such callus they will no longer tell the Court it required a force equivalent to an adult standing on the infant to inflict it. They will offer a more innocent explanation such as perhaps inadvertently acquired Vitamin C deficiency. Barlow’s Disease. Paediatricians will have discarded their “Fabricated or Induced Illness Report” and do not consider ‘frank bleeding from the nose or mouth is significant of physical intervention’. They will have learned to consult their colleagues in other disciplines before consulting the police. Ophthalmologists will no longer confidently declare retinal haemorrhages and retinoschisis pathognomonic of Shaken Baby Syndrome. They will truthfully admit there are other causes such as the Coagulopathies which may cause it. Pathologists will have second thoughts about the significance of Diffuse Axonal Injury being diagnostic of Non-accidental Injury and may, nay will, concede that anoxic ischaemia of whatever origin may cause it. Neurosurgeons, taught by friendly Haematologists, will realize that subdural haemorrhages may result from Haemorrhagic Disease of the Newborn, or should one call it Vitamin K Deficiency Bleeding Disorder, because it is not only the Newborn who may suffer that calamity. But best of all, Sue, by then Judges and Juries will be aware that incriminating Medical evidence is not infallible. Michael Innis Competing interests: Advising, pro bono, another victim of invalid medical evidence. |
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Martin S Schweiger, CCDC / MOEH Leeds NHS Health Protection Unit, LS6 2HF
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Dear Editor I have been reflecting on the news article written by Clare Dyer (8th February 2003, P304) about the appeal court quashing Sally Clark’s conviction and I am deeply troubled about it. As a doctor registered with the General Medical Council I am rightly advised to make the care of my patients my first concern. This injunction appears as first among the list of duties of a doctor. As a public health doctor my patients are the community among whom children merit a high degree of attention. Babies and children too young to talk or defend themselves merit an even higher degree of professional attention. I have chosen to make the control of communicable disease the focus of my practice. It is with some surprise to me that the trail judge appears to have accepted sudden death with reported findings of retinal haemorrhages, fractured rib and bruised legs as being possibly due to staphlococcus aureus. Staphylococcus aureus is a potentially nasty pathogen and has killed thousands, but I have not seen this set of findings associated with it previously. Pathologists and paediatricians involved in the case have been referred to the GMC and their professional reputations besmirched by the media. The willingness of other doctors to get involved in such cases must be deteriorating fast. What ever about the rights and wrongs of the Sally Clark case, for the sake of the next generation of children put at risk by those who should be caring for them I urge the British Medical Association to move promptly to speak up as an advocate for the doctors involved now. I also call on the General Medical Council to move speedily to deal in a fair and open way with the complaints made about the doctors involved. If doctors with the skills and experience to work on child abuse cases are discouraged we are all guilty of ignoring the plea from the next battered child who cries “who will speak for me?” Yours sincerely Martin Schweiger
Competing interests: Public health medicine consultant |
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C Johnson, Parent LA9
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Who will speak for the next child who is deprived of his innocent mother's loving care? Who will speak for the next child wrongly taken by social services? Who will speak for the child who dies because his elder sibling's death was not identified as having a genetic cause? Competing interests: None declared |
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C Johnson, Parent LA9
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The appeal judgment has just been released in full. It includes an overview of the pathology evidence, written by Professor Byard, a Specialist Forensic Pathologist at the Forensic Science Centre in Adelaide, Australia, from which I quote in part: "Unfortunately there appears to have been significant and ongoing problems in the investigation of these deaths. Standard protocols were not followed and essential steps such as routine dissection and histology were omitted which prevented verification of alleged autopsy findings. As well, a number of potentially important diagnoses and conclusions were altered over time. For example, Christopher's initial cause of death of lower respiratory tract infection was withdrawn, observations of no significant haemorrhage within his lungs were changed to marked haemorrhage, .. The finding of retinal haemorrhages in Harry which was vital to sustain the diagnosis of shaken-impact syndrome was altered to no haemorrhage, brain lacerations were found to represent postmortem artefact, swelling of the spinal cord was not present and bruising of paraspinal tissues was also not able to be substantiated..." Perhaps Martin S Schweiger would like to consider this in light of his "surprise". However Dr Schweiger is rightly troubled by the dilemma in which doctors wishing to advocate for children claim to find themselves. I may have a solution: Let every doctor who genuinely suspects abuse make his accusation, secure in the knowledge that unless proved to have been wrong he shall face no censure. BUT: if he is proved wrong, in that a natural cause for the symptoms is later identified, then a criminal prosecution for perverting the course of justice should be mandatory. After all, doctors should have nothing to fear from a criminal justice system to which they seem content to report parents for a similar adversarial trial. If the doctor can demonstrate in court that he took all necessary measures before diagnosing abuse - calling in relevant specialists, co- operating fully with requests for second opinions, releasing medical notes promptly, undertaking all medical tests available (including any requested by the parents themselves), etc. - then no doubt he will be aquitted of the charge on the grounds that he genuinely advocated for the child; and, indeed, he need not face any investigation by his professional body. But if he can not do so, then he may be convicted, and rightly so. A doctor who diagnoses abuse without investigating other possibilites thoroughly first is negligent towards the child and should be criminally liable for those he falsely accuses of a heinous crime. If this is put into practise we shall soon see an improvement in the situation. We will identify (perhaps discourage) any doctor who diagnoses abuse on insufficient grounds or for dubious reasons, while reassuring those who genuinely advocate for the child that their efforts and limitations are appreciated and understood. Genuine mistakes will not attract vilification, diagnosing abuse without good cause will cease to be the backside-covering exercise it has become, public confidence will be restored, and doctors will no longer face a dilemma. But I won't hold my breath. Competing interests: None declared |
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