Judge's concerns over baby guidance
Guidance issued by senior doctors and aimed at protecting babies who might have been attacked may have to be amended following the death of a 16-week-old girl who was assaulted by her father, a High Court judge has said.
Mr Justice Peter Jackson has suggested that a doctor with 30 years' experience appeared to have misinterpreted the guidance - issued jointly in 2008 by the Royal College of Paediatrics and Child Health and the Royal College of Radiologists - after the little girl had suffered a skull fracture when aged five weeks.
The judge said that as a result of the doctor's interpretation of the guidance neither social workers nor police had been alerted to the youngster's injury.
He has raised concerns in a ruling after analysing events surrounding the girl's death.
Mr Justice Jackson concluded that the little girl had been assaulted by her father.
And he said their names could be made public.
He named the father as Martin Thomas and his daughter as Evie.
The judge said Evie had died in February 2013 aged 16 weeks.
Tests had revealed that she had suffered skull fractures on three different occasions, three brain injuries, more than a dozen rib fractures and bruising.
Thomas had been accused of causing grievous bodily harm but acquitted by a jury at Liverpool Crown Court in October 2014.
But Mr Justice Jackson has pointed the finger of blame at him on the balance of probabilities in separate family court proceedings.
The judge has made findings of fact after being asked to consider a family court issue relating to Thomas and Evie's mother Hayley Fisher.
Mr Justice Jackson said Evie was born on October 30 2012 and died on February 21 2013.
He said on December 6 2012 she was taken to hospital by her parents and found to have a "widely fractured skull".
She had been discharged and taken home the following day.
Thomas had told doctors that Evie had been hurt accidentally when another child in the house had fallen and hit her on the head with a toy telephone.
Doctors had checked and discovered that the family was not at that stage known to social workers.
They had "considered the father's account unusual" but had "decided to accept it", said the judge.
And no referral had been made to a local authority social services department or police.
Mr Justice Jackson said in 2008 the Royal College of Paediatrics and Child Health and the Royal College of Radiologists had issued guidance which said that a "pre-mobile child" was less prone to accidental injury and that the "younger the child the more likely is the fracture to have been inflicted".
The guidance had added: "It is the responsibility of all clinicians to ensure that if abuse is suspected an appropriate referral is made to social services as soon as possible."
He said the nominated "child protection doctor" at the hospital had been in clinical practice for 30 years.
"(The doctor) will have been aware of this guidance," said Mr Justice Jackson.
"However, while he ultimately and with some reluctance accepted that the decision not to initiate further investigations had been wrong, he argued that the guidance did not apply.
"He reasoned that abuse was not 'suspected' because he and (another doctor) had in the end concluded that the injury was at least as likely to be accidental as non-accidental."
Mr Justice Jackson added: "I cannot agree with this approach. It neuters the guidance, which applies to investigations not to conclusions. The history shows that the doctors rightly considered that this might be a non-accidental injury: in other words, they suspected it. The fact that they eventually came to a different conclusion is neither here nor there.
"If even a doctor of (the child protection doctor's) experience chooses to interpret the guidance in this way, there may be a case for amending any future edition to refer to physical abuse as being 'a real possibility' as opposed to being 'suspected'."
Mr Justice Jackson concluded that Thomas had assaulted Evie on December 6 2012 by "striking her" or "striking her against something".
Thomas had "got away with this", said the judge. He had known what he had done, had not sought medical help but instead had "concealed" what had happened.
The judge said it was "more probable than not" that Thomas had assaulted Evie shortly before her death.
He thought Thomas was also responsible for other skull fractures and had repeatedly squeezed Evie and broken her ribs.
Mr Justice Jackson concluded that "the sole responsibility" for Evie's injuries "rests with the father".