N (Children: Fact Finding - Perplexing Presentation/Fabricated or Induced Illness), Re
[2024] EWFC 326
BR & Ors (Three Families: Fabricated or Induced Illness: Findings of Fact)
18 May 2023
[2023] EWFC 326
Family Court
Three kids got really sick in the same hospital. Doctors thought their moms made them sick on purpose. The judge said only one mom actually gave her kid wrong medicine, but the other two were innocent. The hospital needs to improve how it handles these kinds of cases.
Key Facts
- •Three children from separate families presented with chronic gastroenterological illnesses and recurrent central line infections leading to life-threatening sepsis.
- •All three children were treated at Sheffield Children's Hospital (SCH) during 2020-2021.
- •Each child's condition rapidly improved after their mother's arrest.
- •Mothers were accused of inducing illness through unprescribed medication and/or deliberate contamination of feeding lines.
- •The case involved extensive medical records, witness testimonies, and expert evidence.
- •The court considered the RCPCH guidance on perplexing presentations and Fabricated or Induced Illness (FII).
Legal Principles
Burden of proof lies on the Local Authority; standard of proof is balance of probabilities.
Re B [2008] UKHL 35, Re A Local Authority v W and others [2020] EWFC 68
Findings of fact must be based on evidence, not suspicion or speculation.
Re A (A child) (Fact Finding Hearing: Speculation) [2011] EWCA Civ 12
Expert opinions must be considered within the context of all other evidence; experts do not supplant the court's role.
A County Council v KD & L [2005] EWHC 144 Fam
A witness's lie about some matters does not mean they lied about everything.
R v Lucas [1981] QB 720
The test for identifying a perpetrator of harm is the balance of probabilities.
Re SB (Children) [2009] EWCA Civ 1048
Outcomes
Mother in Family R (MR) administered unprescribed ibuprofen, piroxicam, and bisacodyl to BR.
Evidence from urine tests, blood tests, hair strand testing, and residue in feeding tube; implausible explanations from MR.
Mothers in Families S (MS) and T (MT) did not exaggerate or fabricate illnesses, nor induce illness by administering noxious agents or contaminating feeding lines.
Lack of direct evidence, implausible scenarios of independent actions, and misinterpretations of events by clinicians; inconsistencies in clinical reports and records.