dr karl johnson radiologist, birmingham
Her expertise within paediatric radiology covers the full range of imaging modalities including plain X-ray, ultrasound, fluoroscopy, CT, MRI, and nuclear medicine. She states that they do not occur accidentally and this type of fracture is highly indicative of non-accidental causation requiring a force well in excess of that used in normal day to day handling of an infant. (3) It is not known why some patients with rickets become hypocalcaemic, one of the clinical pictures of rickets or Vitamin D deficiency, and why in some patients with rickets patients have fractures, some have two or three, others have none. I record in relation to the father that I found his evidence and his certain directness in quality with immediate and unhesitating answers suggested a genuine response. Hence attendance at A&E.". Three days of this course provides 18 CPD credits in accordance with the CPD Scheme of the Royal College of Radiologists. hmk0^g? (Orders made included discharge of interim Care Order and approval of revised care plan for phased return of S to the care of her parents. I do not propose to go through all the responses to the various fractures but what I have mentioned sets out much of the content and gist of the father's response and denials of the local authority's allegations.39. 34 0 obj <> endobj Over the next 10 months the Wards were visited by at least three expert witnesses who had been asked by the judge to give their opinions. I accept that the parents have displayed the same level of alertness for S as to her medical needs when they became aware that there was something wrong, as they saw it. The mother, father and grandmother all said that Infacol did eventually help for a time before her crying became worse again.15. When Victoria and Jake Ward saw their baby son crying and refusing to feed, they took him to their doctor. Added to this was the unfortunate position of counsel for the grandmother, who was not present and who had sent a message to the court that her client's public funding certificate had been embargoed for the reasons and with the consequences set out in para. Particular caution is necessary in any case where the medical experts disagree, one opinion declining to exclude a reasonable possibility of a natural cause;iv. In this case the local authority brings proceedings for Public Law orders relating to S, born on 18th July 2011. Ms Soffa has gone to considerable lengths and much detail to expose what are submitted as matters on which I should mistrust the evidence of the parents or confer on their evidence only little weight. Because William's parents were unable to explain the fracture the hospital deemed the case suspicious and called in social services. Their most recent appointment, in our records, was to DR K JOHNSON LIMITED on 2015-08-17. Excellent peer interaction and collaborative learning. He arrived at the preliminary conclusion that the humeral and rib fractures must give rise to 'a high level of suspicion' for non-accidental injury. The court had no expert views on these aspects or on a number of potential issues relating to bone metabolism. The maternal grandmother's position can most usefully be seen as set out in her position statement of 12th March 2012. Metaphyseal bucket-handle fracture of the distal right radius caused when (a) her right wrist had been pulled and twisted by an adult carer; (b) any person present would be immediately aware she had suffered a significant injury. At 22.30, a further medical clinician's note was written, although the authorship is not clear. Our imaging courses are very much an interactive experience. 54. 6. The injuries and range of dates are as follows. Full access to each case with a full toolset to open, view and manipulate each case alongside the faculty but on your own screen! The outcome of the case, in a landmark High Court judgement, has helped to lift the secrecy surrounding England's family courts, where campaigners claim that a lack of openness creates an environment in which miscarriages of justice can go unnoticed. I have noted the words of Butler-Sloss P in Re U: Re B (Serious injury; standard of proof) [2004] 2 FLR 263 and the court's responsibility to survey a 'wide canvas' and in Re L [2011] EWCA Civ 1705 that 'Clearly from the forensic standpoint given any degree of uncertainty in the medical and scientific field the judge's appraisal and confidence in the parent is absolutely crucial to the outcome.' Wanted a review(Under 'P') Discussed with Mum and Dad possible colic will continue withInfacol and see how she gets on over next week. The parents/grandparent who did not inflict the injuries on each occasion to S failed to protect her. Mrs Ward, who at the time worked as a manager for child care strategy for Cambridgeshire, told BBC One's Panorama, in a documentary to be broadcast tomorrow night: "We were absolutely shocked. "Unfortunately the job of social workers is to think the unthinkable because sometimes terrible things happen. 16 the following conclusion was offered, and the parents are referred to as N and D: 'Throughout the assessment period N and D were observed to provide a high level of emotional warmth, mental stimulation and basic care for S and T which they sustained throughout the contact sessions. I note the entry as follows: 'non-tender, baby permits passive manipulation. I draw the conclusion that it is reasonable in S's case to assume that a lesser degree of force would be required if her bones were sub-optimal as a result of Vitamin D deficiency, which I am satisfied on the evidence that S's bones probably were, viz., Vitamin D deficient. Dr Johnson, however, reported "a number of equivocal appearances on radiographs with respect to the left distal femur and proximal left tibia" and suggested further films. The maternal grandmother denied harming S and did not accept that her daughter or son-in-law would not do the same. s Pediatric Diagnostic Imaging textbook is renowned as one of the oldest and most prominent general textbooks in the field of paediatric text consists of two reasonably sized volumes covering all key areas using an intuitive systems-based approach. Dr. Johnson is presently the Chair of the British Society of Paediatric Radiology. Amaka lectures regularly on various radiology, paediatric, genetic, emergency medicine and orthopaedic courses, locally and nationally. Metaphyseal fractures result from pulling and twisting being applied to the limb. S's crying was attributed to colic initially and latterly to her having received her vaccination on 20th October 2011. That aspect is not mentioned. DAY 2: EMERGENCY PAEDIATRIC IMAGING - THURSDAY 10 FEBRUARY 2022 As I identify the main points in the chronology, I note first that Dr Fairhurst regards the 16 October 3 days after S was first seen and x-rayed at hospital as the "earliest date" on which the fracture to the left humerus occurred, and thinks it probably would have occurred before the 19 October. The question arose as to whether genetic abnormality of bones, metabolic bone disease or demineralisation of the bone caused by Vitamin D deficiency gave rise to an increased propensity to fracture. 7. In reviewing the broad canvas of S's family, therefore, I have taken stock of the mother and father's background and employment and the unfortunate medical problems suffered by the couple's first child T with Hirschsprung's Disease and the particular care and attention that this child required. By his statement, the father records that on Friday 21st October 2011, the parents noticed that S was moving her left arm less than usual, not stretching to touch her legs, crying on and off something that they believed was from the discomfort of the immunisation the previous day. N and D appeared able to actively provide a high level of basic care for their children.'. As for that visit on the 22 September, the Health Visitor said that S was not distressed as far as she could recall.18. Several of these fractures are highly specific for non-accidental causation by an adult. Paradoxically, the last fracture-type injury in time to occur (in all probability), the left humeral fracture, was the first to be identified on 22 October 2011. Companies associated with this officer had at least 253,361 shareholder value in recent accounts. Any specialty s Pediatric Diagnostic Imaging textbook is renowned as one of the oldest and most prominent general textbooks in the field of paediatric text consists of two reasonably sized volumes covering all key areas using an intuitive systems-based approach. Reviews aren't verified, but Google checks for and removes fake content when it's identified, Oxford Specialist Handbooks in Paediatrics, Medical / Allied Health Services / Imaging Technologies. It was noted that the parents were unsure how the fracture may have happened and there had been no recent accidents of falls. She was between the 25th and 50th centiles for weight, and maintained the usual track after the usual loss of weight in the first week. She has contributed chapters to several well-respected radiology textbooks, and is co-author of two books, A Radiological Atlas of Child Abuse and Fetal and Perinatal Skeletal Dysplasias: An Atlas of Multimodality Imaging. The Court reminded itself of the guidance in Re U: Re B (Serious injury: standard of proof) [2004] 2 FLR 263 and Re L [2011] EWCA Civ 1705 noting that where there is uncertainty in the medical and scientific evidence the Judge's appraisal and confidence in the parents is crucial. He has extensive experience and a mature knowledge of research done in this field. During the time period for the occurrence of the fractures S was seen by medical professional 5 times on 16th September, 22nd September, 13th October, 19th October and 20th October. She took the view that the two left leg fractures (3 and 4) could have happened at the same time. The Wards were only allowed to take William home with them when they agreed to be supervised 24 hours a day by Mr Ward's parents, who had to relocate from Devon to move into the couple's home. Birmingham Women's Hospital Mindelsohn Way Birmingham B15 2TG . On the balance of probability T could not have caused the injuries to S either by (a) jumping on the family bed whilst S was lying on it or (b) pulling her bouncy chair when she was in it. I have noted the reference to Lancashire County Council v B [2000] AC 147. Birmingham B4 6NH, Questionnaire for parents with children aged 5-9, Monday, Wednesday and Thursday/Friday afternoon, Four to six times per year at Queen Elizabeth Hospital on a Tuesday morning. In his report of 25 October 2011 the Consultant Paediatrician confirms that ophthalmological testing showed no evidence ocular trauma with healthy discs and no retinal haemorrhages seen. However, the medical professionals did not note any problems with S on 20th October 2011 despite Dr Fairhurst's dating of the fracture between 16th October 2011 and 19th October 2011. I therefore come to the conclusion that the local authority has not discharged the burden of proof on the balance of probabilities. I have noted the reported reactions of T to the birth of S. I have considered S's early developmental history after her birth; also the arrival when S was about 10 days old of the maternal grandmother from Sri Lanka to help the mother look after the children. This is case-based course designed for all General Radiologists and Radiologists based at the DGHs who are increasingly having to report paediatric imaging, an opportunity to attend a complete update of the main key topics on 3 consecutive days a complete CPD package. View more radiologists birmingham Consultations Consultations Steelhouse Lane, Birmingham, England. I note his evidence as to the prevalence of Vitamin D deficiency, particularly in Asian sub-groups, and his view that the absence of radiological evidence does not mean that there is 'no rickets' i.e. I have heard the evidence of the experts as follows: (1)Dr Fairhurst, consultant paediatric radiologist, and read her reports, notably that of 13th February 2012; (2) A Consultant Paediatrician and his report of 5th March 2012; (3) I have heard the evidence of Professor Steven Nussey, Professor of Endocrinology, and read his reports of 10th and 22nd July 2012; (4) I have heard the evidence of the mother; the father; and the grandmother, and read their statements filed in this case; (5) I have heard the evidence of the health visitor. Lovely baby." Again I did not get the impression that this was a man seeking to cover up matters or deal other than truthfully to the best of his ability with matters as he remembered them. The report presents what is effectively the high water mark of the extent of the injuries and the existence and extent of these injuries has not been challenged, although Miss Trustman urges the court in respect of the injuries only reported by Dr Fairhurst to approach the existence of such injuries with caution, particularly the torus fracture to the distal femur, since they were not identified by any other clinicians and their identification appears to rest on Dr Fairhurst's own expertise and experience as a consultant paediatric radiologist over 21 years. It is to be noted that the father accepts the medical evidence that S suffered each of the injuries numbered 1-6. Tel: 0121 335 8260 The team Our team is made up of consultant radiologists, sonographers, radiographers, health care assistants and administrative staff. 14. Dr. Karl Johnson is a Consultant Paediatric Radiologist at Birmingham Children's Hospital, and has been there since 1998. Having reviewed the evidence in detail, and after considering the written submissions of all parties, I had reached a position where I had come to my conclusions on the issues of fact. T would often watch attentively as the parents and grandmother would feed S and hold her. He confirmed the presence of the humeral fractures and rib fractures and, following further X-rays, identified what he thought was a healing fracture of the proximal left tibia. British Society of Paediatric Radiology: Paediatric MRI for general radiologists - tips and tricks 16:50 - 17:10 Musculoskeletal (MSK) imaging Dr Karl Johnson, Birmingham Children's Hospital NHS Foundation Trust Learning points In the maturing child, the marrow signal will alter depending on the amount of haemopoietic and fatty tissue within it. 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