“There was nothing to suggest … scurvy…”
“All child B’s signs and symptoms, including the bony lesions, can be explained by iron deficiency anaemia and scurvy. I do not believe that he was abused or neglected.”
“My original report was based on the premise that child B did not suffer from any nutritional deficiencies and therefore was skeletally ‘normal’. This was based on the opinions of the paediatricians and clinicians involved in his care. The new evidence provided by Professor P has made a convincing case for the presence of scurvy in child B’s case that I am unable to critically assess.”
“I have therefore revised my interpretation of the radiological findings in view of this new evidence. It is clear that the radiological features of scurvy are almost indistinguishable from child abuse in isolation. If the clinical diagnosis of scurvy is accepted, then the radiographic findings in child B could be explained by this alone. My conclusions with regard to the mechanism of injury and force required to cause his injuries would therefore be no longer valid.”
“It is therefore not possible to make a balance of probability judgment on the radiographic findings between the two possibilities of scurvy or inflicted trauma without a clear clinical consensus as to whether child B suffered from scurvy or not.”
“Hence if the applicant in one set of proceedings wishes to rely on findings made in previous proceedings in order to prove a case, the court will have to consider how this should be done. Frequently, although such findings are not necessarily accepted by the party concerned, that party will accept that a challenge to them in later proceedings will be futile. The court may then simply rely upon the findings made earlier. Sometimes, the party concerned or some other party will wish to challenge them. In such an event, it seems to me that the court may wish to be made aware, not only of the findings themselves, but also of the evidence upon which they were based. It is then for the court to decide whether or not to allow any issue of fact to be tried afresh. There are no doubt many factors to be borne in mind, among them the following…”