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Child Abuse or Medical Misdiagnosis?

Posted on March 27, 2013 at 12:15 AM

(guest blogger: Jen Coburn of Michigan)


On October 3rd, 2012, a local man rushed his girlfriend’s 8-month-old daughter to the Helen Devos Children’s Hospital after she had suffered from a seizure. The attending physicians found that she had a skull fracture and that her brain was swelling. He spent the next two days getting questioned relentlessly by medical professionals and detectives. They were accusing him of injuring the infant accidentally. A week after the incident occurred, they arrested him and are now charging him with child abuse in the first degree. This charge carries a heavy prison sentence of 7 to 35 years. He was not the only one home with the baby, and they did not perform all the necessary medical tests to rule out any underlying medical conditions. His trial is just in the beginning stages. This has left everyone that is close to him wondering: why him? What really happened on that day, and the preceding days, to that child? Prosecution of innocent parents for child abuse is increasing in our society due to the difficulty defining child abuse, biased medical opinions, and the lack of proper investigations.


When defining the term “abuse”, particularly in reference to child abuse, a person will run into difficulties. There are various perspectives on what the true term is. In Child Abuse, Physical (United States), Pinto and Schub (2012) state:


The United States Child Abuse Prevention and Treatment Act defines child abuse as any intentional act or failure to act by a parent or caretaker that results in a child’s death, serious physical or emotional harm, or sexual abuse or exploitation. (para. 1).


However, when you look up the word “abuse” in the dictionary, there is no one clear definition; but multiple definitions are found to explain the meaning. According to Elmer (1966), “the definition of abuse is by no means clear and commands no consensus – even among knowledgeable professional people”. If the incident is not witnessed by any other than the accused, who is to say that it is abuse in the first place? Many signs of medical conditions found in infants can be misinterpreted as abuse if the proper medical tests are not performed. One of these conditions is known as rickets. This is a deficiency of Vitamin D, which causes bones to be brittle. With the possibility of underlying medical conditions being misinterpreted, it is nearly impossible to clearly define child abuse without further testing taking place.


When a child is taken to a hospital’s emergency department with injuries, no matter what the severity, the attending physician should do a complete examination. This includes testing for such things as vitamin deficiencies. With child abuse prevention and treatment laws being put into practice, physicians have to determine if these injuries were caused by child abuse so that the abuse can be reported to the proper agencies.


For the purpose of reviewing medical procedures in examining an infant/child with injuries, let’s focus on one case as an example. Alice and Miguel Velasquez took their daughter to a Maryland medical center for some x-rays after Alice had noticed some bumps on their daughter’s left ribs (Shannon, 2007). Shannon (2007) reports that after getting the results back, “Doctor Reed states, ‘These injuries are non-accidental,’” (para. 6). There were no tests done to rule out medical conditions in the family’s history that could explain these broken ribs. Allison pleaded for her daughter to be tested for osteogenesis imperfecta, also known as brittle bone disease; but the proper testing was never done. They accused Miguel of child abuse, and the couple temporarily lost their daughter to the state.


This caused tremendous stress for the Velasquez family. Allison lost so much weight; she weighed less than most fifth graders. She could not focus on her tasks at work and was forced to take a leave of absence. This was a financial burden for them. Their suffering was based on one statement, and one statement alone; there were no other signs of child abuse, such as bruises, lack of appetite or always seeming hungry, and the distaste for being touched (Department of Human Services, 2013). She was a happy, normal-developing infant. The professionals that Allison pleaded with said that she was just making excuses to help her husband get away with this horrendous crime (Shannon, 2007). The Velasquez’s court appointed attorney later asked for an order to be put in motion to have the infant tested for osteogenesis imperfecta. It took months for the test results to come back; however, when they did, the infant tested positive for the disease. This was Miguel’s ticket to his freedom! However, he was not free from the ridicule this incarceration evoked from the public. He could not find a job to help with the financial difficulties that developed because of these horrendous accusations. Due to the biased medical examiner stating that these injuries were caused by abuse, the proper medical tests were not performed. If the testing would have been done during the initial examination, these parents would have been saved from the stress of being forced to separate from the daughter and being accused of child abuse.


As you can see in the above example, once it has been suspected that child abuse is the cause of such injuries, there is a lack of proper investigation. Neither the medical staff nor the law representatives took in to account the patient’s family health record. This happens more frequently than not. Without reviewing the family’s history of illnesses, it is difficult to know what tests should be done to rule out underlying medical conditions. It seems that when a child is involved, everyone becomes extremely close-minded. In Panel One: What Empirical Research Tells Us, and What We Need to Know about Juries and the Quest for Impartiality, Judge Abner Mikva states (Rowen, 1991):


I do not think you can get a fair child abuse trial before a jury anywhere in the country. I really don’t…I don’t care how sophisticated or how smart jurors are, when they hear that a child has been abused, a piece of their mind closes up, and this goes for the judge, the jury and all of us. (p. 564-5)


This leads to the mentality that someone has to pay for what has happened to someone so innocent and helpless. All of the sudden, the accused is looked at as a monster. The prosecution is given the ability to take circumstantial evidence, such as broken ribs, and create a circumstantial situation to explain the injuries. In cases that involve the injury or death of a child, the accused is considered guilty without reasonable doubt until they can prove their own innocence. This is not what the principles of our judicial system are supposed to be based on. Whatever happened to the presumption of innocent until proven guilty? In the Velasquez’s case, it took years for them to regain custody of their daughter; but it only took a short time for their lives to be completely destroyed by that one doctor’s statement.


Society needs to push for changes to be made to the procedures regarding child abuse investigations. Finding a definite definition for child abuse will be absolutely impossible, because it is so easily interpreted differently depending on an individual’s way of perceiving the information provided by each specific case. Because of the difficulty of defining child abuse, there needs to be more thorough medical examinations completed. This would ensure that all underlying medical conditions can be ruled out before accusations are made towards parents. Therefore, it is the responsibility of the attending physicians to rule out all other possible causes of such injuries. This would enable the detectives who do the legal end of the investigation to be more thorough. There needs to be a home study done, an examination of where the incident took place, and everyone who had contact with the child should be questioned about the incident. If one party is going to be subjected to a polygraph, all parties should. Too many innocent people are spending a large quantity of time in prison, and then spend the rest of their lives receiving judgment and ridicule. While others who are truly guilty are walking away. Children are not receiving proper medical care because their condition has yet to be diagnosed. It is now society’s duty to push for these changes to be made. It is our right to have a fair trial; everyone deserves to have their judicial rights upheld, including the presumption of being considered innocent until proven guilty!


______________________


References

Department of Human Services – State of Michigan. (2013). Potential Indicators of Child abuse and/or Neglect. Retrieved from www.michigan.gov/dhs/0,04562,7-124-7119-50648-15254--,00.html

Elmer, E. (1966). Hazards in Determining Child Abuse. Child Welfare, 45(1), 28-33.

Pinto, S. & Schub, T. (2012). Child Abuse – Physical (United States).

Rowen, Ford. (1991). Panel One: What Empirical Research Tells Us, and What We Need to Know about Juries and the Quest for Impartiality. American University Law Review, 40(2), 564-65. Retrieved from http://www.aulawreview.org/pdfs/40/40-2/panel1-Rowen.pdf

Shannon, S. (2007, January). A Parent’s Worst Nightmare. Reader’s Digest. Retrieved from http://rd.com/advice/parenting/parents-wrongfully-accused-of-child-abuse/



***********************************************************

Jen Coburn graciously permitted me to repost her college paper as a guest blogger. Ms. Coburn is a Michigan native studying Business Administration with a concentration in Human Resource Management at University of Phoenix. She first turned to the topic of pediatric head trauma when a friend of hers was falsely accused.

Categories: Problems in Justice System

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