Mimics of child abuse: Can choking explain abusive head trauma?

Edwards, George A.

doi:10.1016/j.jflm.2015.06.012

Cited by 23 publications

(15 citation statements)

References 40 publications

(23 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Dysphagic choking type of ALTE mimicking AHT was described in a Barnes et al [136] case report and also in a review [137]. The case report was criticized for failing to disclose the source of information, the author's role as defense expert witness, omission and misrepresentations of certain facts and legal outcome, lacking proper evidence base and use of inaccurate information to support speculative explanations [138,139]. ALTE, which has been replaced with the new terminology brief resolved unexplained events (BRUE), has been shown to have a low prevalence of retinal hemorrhage or SDH and cannot be considered to be the cause of SDH or retinal hemorrhage [140][141][142].…”

Section: Unsubstantiated Alternative Theories Proffered In the Court mentioning

confidence: 99%

Consensus statement on abusive head trauma in infants and young children

et al. 2018

View full text Add to dashboard Cite

Abusive head trauma (AHT) is the leading cause of fatal head injuries in children younger than 2 years. A multidisciplinary team bases this diagnosis on history, physical examination, imaging and laboratory findings. Because the etiology of the injury is multifactorial (shaking, shaking and impact, impact, etc.) the current best and inclusive term is AHT. There is no controversy concerning the medical validity of the existence of AHT, with multiple components including subdural hematoma, intracranial and spinal changes, complex retinal hemorrhages, and rib and other fractures that are inconsistent with the provided mechanism of trauma. The workup must exclude medical diseases that can mimic AHT. However, the courtroom has become a forum for speculative theories that cannot be reconciled with generally accepted medical literature. There is no reliable medical evidence that the following processes are causative in the constellation of injuries of AHT: cerebral sinovenous thrombosis, hypoxic-ischemic injury, lumbar puncture or dysphagic choking/vomiting. There is no substantiation, at a time remote from birth, that an asymptomatic birth-related subdural hemorrhage can result in rebleeding and sudden collapse. Further, a diagnosis of AHT is a medical conclusion, not a legal determination of the intent of the perpetrator or a diagnosis of murder. We hope that this consensus document reduces confusion by recommending to judges and jurors the tools necessary to distinguish genuine evidence-based opinions of the relevant medical community from legal arguments or etiological speculations that are unwarranted by the clinical findings, medical evidence and evidence-based literature.

show abstract

Section: Unsubstantiated Alternative Theories Proffered In the Court mentioning

confidence: 99%

Consensus statement on abusive head trauma in infants and young children

et al. 2018

View full text Add to dashboard Cite

show abstract

“…The Barnes 2010 report of a child with dysphagic choking was included because, according to the authors of table 1, choking and resuscitation of this child could explain subdural, subarachnoid and retinal haemorrhages. The authors of table 1 did not mention the subsequent published analyses of this report, especially the 2015 paper by Edwards . Edwards stated that Barnes was involved in this case as a defence expert and that Barnes et al had omitted important clinical data that indicated that the findings in the child were inflicted.…”

mentioning

confidence: 99%

“…)’ . Edwards concluded: ‘ The use of scientifically unsupported alternative explanations for abusive head trauma based on inaccurate and biased information constitutes further victimization of the abused child and represents a travesty of justice’ .…”

mentioning

confidence: 99%

Using the table in the Swedish review on shaken baby syndrome will not help courts deliver justice

et al. 2017

View full text Add to dashboard Cite

“…In this case, hypocalcemia was not the cause of the fractures and intracranial injuries but rather developed after massive blood product transfusion, and interaction between ionized calcium and the preservative citrate. In response to "dysphagic choking theory" (Barnes et al, 2010), used to refute a diagnosis of abusive head trauma, it had been contested by Dr. Edwards who alerted to the fact that, "A case report that proposes choking as an alternative explanation of death of a child diagnosed with abusive head includes omissions and misrepresentations of facts" (Edwards, 2015). In simple terms, when a healthy baby chokes on a little milk, he just coughs and clears his airway.…”

mentioning

confidence: 99%

Invited commentary: His life was lost but his heart still beats: In honor of children harmed by child abuse

Shur

Hinds

Shalaby‐Rana

et al. 2019

American J of Med Genetics Pt A

View full text Add to dashboard Cite

Jonathan was a beautiful 6-month-old with bright eyes and a big smile whose parents described him as a happy and easy baby, content with life. There were no prior concerns about his growth and development by his parents or pediatrician. It was therefore completely unexpected when he presented to the hospital in full arrest with a history of choking during a feeding while at daycare. 1 When the ambulance arrived at the daycare, the caregiver was performing cardiopulmonary resuscitation. At the hospital, it was noted that his pupils were fixed and dilated, and he had bruising of his face and neck, not reasonably explained by resuscitation. Subsequent medical evaluations included detailed history taking (history of present illness, past medical history, and family history), physical examinations, and premortem diagnostic testing. American Academy of Pediatrics and American College of Radiology guidelines (Christian, 2015; Wootton-Gorges et al., 2017) were followed. These guidelines are based on decades of the best available medical evidence, designed to appropriately diagnose and differentiate child abuse from other medical conditions. Jonathan died 3 days later despite the best efforts of physicians and nurses at a Level I Pediatric Trauma Center. At the hospital and ultimately upon autopsy, he had extensive bruising to his right forehead, left cheek, right jaw, left lateral neck, right posterior neck, and

show abstract

Mimics of child abuse: Can choking explain abusive head trauma?

Cited by 23 publications

References 40 publications

Consensus statement on abusive head trauma in infants and young children

Consensus statement on abusive head trauma in infants and young children

Using the table in the Swedish review on shaken baby syndrome will not help courts deliver justice

Invited commentary: His life was lost but his heart still beats: In honor of children harmed by child abuse

Contact Info

Product

Resources

About