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Bone Disease Defense Given Credence by Courts in Rib Fracture Case

By Attorney Elisabeth K.H. Pasqualini, Child Abuse Defense Lawyer; Dependency Appellate Counsel, Harrisburg, PA

I recently wrote that some child “abuse” detected by children and youth agencies and their cooperating doctors can easily be linked to non-abusive reasons, such as metabolic bone diseases, low vitamin D, Ehlers-Danlos syndrome, rickets. (See December 10, 2018 article). I know that the doctors and folks that treat infants and children for medical reasons often do see traumatic injuries that are related to abuse. There should be agencies and doctors in place to protect the weakest and most vulnerable of our society. However, mistakes can be made and experts can disagree as to causation.

In a case originating out of Lackawanna County, the Superior Court recently affirmed the trial court’s determination that more testing of a child was needed in order to determine the source of the rib fractures. In Interest of M.M.-A., 2017 WL 5953545 (Pa. Super. December 1, 2017; non-precedential memorandum opinion), the Superior Court gave weight to the trial court’s findings that experts who testified for the defense required that the child be subjected to further testing. There, several doctors that examined the child, looked at the baby’s records and x-rays and found that the child had clinical explanations that were not caused by abuse. A pediatrician, pediatric radiologist, a doctor that was an expert in child abuse and an expert in endocrinology each provided testimony that the child suffered from bone fragility and rickets; there were “absolutely no objective criteria that there was abuse;” osteogenesis imperfecta existed; and Ehlers-Danlos hypermobility type 3 existed in the child and the family, making the child 75% more likely to suffer such fractures without abuse.

As a result, the trial court found that the testimony of the defense experts was more compelling that the child’s injuries were not the result of non-accidental trauma; ie: abuse. In coming to this determination, the court found that the parents regularly took their child to a pediatrician that never found any issues, despite being a mandated reported. Also, that the medical determination and explanation of the defense experts was more compelling and therefore, the agency could not meet its burden of “clear and convincing evidence.”

As suggested in our prior article, there is usually little to no valid evidence to support rib fractures in very young children and infants. They simply do not happen the way that some doctors on the staff of children and youth agency think they do. There is abundant evidence now that such “injuries” can occur in non-accidental or unintentional ways. Again, I am not suggesting that any doctor is knowingly providing false information to support an otherwise, bogus theory. Experts may disagree.

If you have been accused of abuse, charged with aggravated assault of an infant, or held to an indicated or founded finding of abuse, please contact an attorney as soon as possible. There are resources available to assist you.

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