Re N (A Child) (Fact Finding)
| Jurisdiction | England & Wales |
| Judge | Willans |
| Judgment Date | 03 January 2024 |
| Neutral Citation | [2024] EWFC 2 |
| Year | 2024 |
| Court | Family Court |
| Docket Number | Case No: ZW23C50245 |
HIS HONOUR JUDGE Willans
Case No: ZW23C50245
IN THE FAMILY COURT AT WEST LONDON
West London Family Court,
Gloucester House, 4 Dukes Green Avenue
Feltham, TW14 OLR
Christopher Archer (instructed by HBB Law) for the Applicant
Nicholas Stonor KC and Hanisha Patel (instructed by Reena Ghai Solicitors) for the First Respondent
Clive Newton KC and Tor Alloway (instructed by Fort & Co Solicitors for the Second Respondent
Rachel Chan (instructed by McCormacks solicitors) for the third Respondent
Hearing dates: 6, 8 & 11–14 December 2023
Summary of Findings
.
.
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Introductory Observations
. This judgment follows a 6-day fact find hearing. I have regard to the documents contained within the hearing bundle (together with a limited number of documents forwarded to me after the completion of the bundle); the live evidence of the medical experts 1, J and M; and the written and oral submissions of counsel for each party. In this judgment I will refer to the first respondent mother as J, the second respondent father as M and the third respondent child as N. This is how they were referred to during the hearing and no discourtesy is intended by using their forenames. I will not reference all of the evidence put before me but will focus on that information which has been central to my decision making. I have kept all of the evidence in mind.
. The hearing proceeded on a remote basis during the expert part of the evidence and was attended thereafter. I am very grateful to the professional and courteous manner in which this case was conducted by counsel. The issues were by their very nature sensitive and highly emotive. I am also grateful for the professionalism of the interpreters who assisted each parent. An effective hearing would not have been possible without their hard work.
Background
. M and J are aged 45 and 35 years respectively. They are both [X] Nationals. Both parents have children from previous relationships who continue to live with their other parent in [X]. The mother recounts a difficult childhood in [X], being abused and growing up in a children's home between around age 8 to 20. J has not had contact with her child from the previous relationship since that child was aged 2 (she is now 15). M had a long term relationship in [X] which ended in 2017. His children out of that relationship were aged 14 and 20 at the time of his first statement. He remains in contact with his children.
. The parents met through mutual friends online in around 2020. They moved in together and were engaged (and remain so) in 2021. I understand they planned a child but J suffered pregnancy complications and had a termination. Between April and August 2022 they separated and for at least part of this time J was in a relationship with R. The parents had lived in a shared household with him and a number of other individuals when they first lived together in this country. In August 2022 the parents resumed their relationship and shortly after this J fell pregnant with N. He was born on 27 April 2023 at gestation week 37/3. It seems there were no complications although he was a relatively small baby. He came home with J, and M took a week off work to help. In the early days he suffered with Jaundice but there were no significant concerns.
. On 28 May 2023 N was admitted to the [X] Hospital with a history of vomiting and irritability. It appears there was an early concern as to meningitis. However, following further investigations bleeding on the brain was discovered and N was transferred to Great Ormond Street Hospital (GOSH). Whilst at GOSH further investigations were undertaken leading to a concern that N may have suffered an inflicted head trauma. In the course of his admission extensive checks were undertaken to ascertain whether N had any underlying conditions or disorders that might explain his presentation. An overall account is given on 20 July 2023:
Taken together, the consensus of the clinical multi-disciplinary team is that N has co-occurring cerebral venous sinus thrombosis and subdural/extra-axial and intraventricular haemorrhage. We have found it difficult to link these findings in terms of underlying cause and will not be able to say definitively whether the two processes are related. So far, we have not found a medical explanation for either finding. The MRI changes indicate bleeding caused by traumatic head injury and the retinal haemorrhages found on Ophthalmology examination are consistent with traumatic head injury. It is important that medical disorders are excluded as far as possible and for completeness we await the final enzyme test for glutaric aciduria (skin biopsy result), a rare condition associated with bleeding tendency. If this test is negative, the medical consensus is that the intracranial and retinal haemorrhages are most likely to be due to a non-accidental injury.
N's medically complex case has been discussed extensively and on multiple occasions with the Neurology and Neuroradiology multidisciplinary team and other clinical colleagues, as is standard practice to support clinical care. There was consensus on the conclusions stated in this report.
. Consequent upon the above child protection measures were undertaken and these proceedings commenced on 15 June 2023.
The proceedings
. On 20 June 2023 the child was placed into the care of the applicant under an interim care order. DNA testing was directed and appropriate directions were given to the case management hearing (CMH). On 7 July 2023 I conducted the CMH. I gave directions for the each of the expert assessments; gave appropriate additional directions and listed both a Pre Trial Review (PTR) and this fact find hearing (FFH). I modified the timetable by a consent order on 3 October 2023.
Findings sought & Response
. The applicant seeks the following findings:
Physical Harm
1. When presenting to …Hospital on 28 May 2023 N was found to have the following conditions:
a. Cerebral venous sinus thromboses
b. Subdural haemorrhages — multifocal seen over each cerebral convexity, within the interhemispheric fissure and in the posterior fossa
c.. Thrombosed subdural bridging veins
d. Traumatic subdural effusions
e. Intraventricular haemorrhage
f. Retroclival blood
g. Encephalopathy
h. Bilateral asymmetric retinal haemorrhages with
i. In his right eye, one clear “dot and blot” intraretinal haemorrhage and a few (<10) possible additional intraretinal haemorrhages
ii. In his left eye, multiple (too numerous to count) “dot and blot” intraretinal haemorrhages, possible “flame-shaped” intra-retinal nerve fibre layer haemorrhages, and pre-retinal haemorrhages
2. The conditions in 1 were sustained between 23 May 2023 and 28 May 2023
3. The cause of the condition in 1 was abusive head trauma and
a. There was most likely just one episode of such trauma but the possibility of “more than one occurring over a limited time period” cannot be excluded
b. The trauma took the form of a shaking mechanism, although “a co-existent impact against a softer more yielding surface cannot be excluded.”
c. “The force required to cause these injuries is unknown but would be high and clearly inappropriate for N”
4. The abusive head trauma was inflicted by one or both of the parents
5. There was a failure by each parent to seek prompt medical attention for N such that:
a. N's pain and suffering was extended, and/or;
b. The optimal treatment for N's injuries was delayed.
6. There was a failure by the inflicting parent to be open with the medical staff, such that:
a. N's pain and suffering was extended, and/or;
b. The optimal treatment for N's injuries was delayed, and/or;
c. N received unnecessary medical treatment.
Emotional Harm
7. The infliction of abusive head trauma by one or both of his carers would have caused emotional harm to N.
8. N was at risk of emotional harm through exposure to domestic abuse in his parents 'relationship:
a. The mother suffered psychological abuse from the father. She was grabbed by him on occasions; by her hair, by her clothes or her hand. He would also be verbally abusive;
b. The father was at times controlling of the mother, checking where she was going, checking her phone or messages;
c. The last incident was when the father grabbed the mother at the beginning of her pregnancy, when he had doubts about whether he was the father of N. On this occasion, he smashed a TV that he had bought and then grabbed her by her hand and tried to remove her from the property
d. In June 2023, the police shared information that neighbours of the parents “reported hearing frequent shouting and banging coming from their address and that a female (which it is assumed was the mother) was heard to be shouting in an angry rather than a scared way.”
9. By virtue of the aforesaid, at the relevant date N was suffering and was likely to suffer significant harm, that harm and likelihood of harm being attributable to the care given to him, and likely to be given to him if an order were not made, not being what it would be reasonable to expect a parent to give to him.
. By closing submissions the applicant asked me to find M responsible; to find both parents responsible for delay in seeking medical assistance, and to make possible findings against J.
. J accepted N had suffered an abusive head trauma but denied she was responsible. She accepted domestic abuse in the relationship and accepted she had delayed in seeking medical assistance.
. M did not accept N had suffered an abusive head trauma and denied being responsible in any event. He accepted there had been domestic abuse in the...
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