dr karl johnson radiologist, birmingham

It is not only the appearance of symptoms, and the timing and description of them with a view to dating the occurrences, even approximately, that has raised a perplexing and indistinct picture with differences in the accounts, and nothing obvious or clear to work on. 57 0 obj <>stream 941-697-3552. Mrs K Oestreich The fractures to the right lower leg took place between 12th September and 10th October. Book reviewed by Sana Ali, ST5 paediatric radiology, and Dr Karl Johnson, 's Hospital. hmk0^g? It was noted that the parents were unsure how the fracture may have happened and there had been no recent accidents of falls. By the time the two-week family court hearing began, Mrs Ward was pregnant with her second child and feared that if William was taken, her new baby would be too. Three days of this course provides 18 CPD credits in accordance with the CPD Scheme of the Royal College of Radiologists. 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. Dr Karl Johnson, Birmingham Children s Hospital Joint tumours Dr Asif Saifuddin, Royal National Orthopaedic . There can be no criticism that it has pursued these allegations as vigorously as it has, even if at the end of the day they have failed to satisfy me that the case is proved. She weighed 6lbs 15 ozs (3.15 kg) at birth and was born by emergency Caesarean section. As it is, her persistent crying which may well have been her response to the injuries can be considered in the light of the reports of the parents about her crying and the possibility of their misinterpretation of her crying emerges as a very real consideration. Dr. Gregory D. Jackson is a Radiologist in Birmingham, AL. Interactive case-based approach using a powerful online DICOM viewer to maximise learning. there is a stage of rickets before it is identifiable radiologically. Karl John Johnson Radiologist Steelhouse Lane, B4 6Nh, Birmingham, England. 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. (2) I note his evidence that there is no uniformity of Vitamin D testing in the United Kingdom and that Vitamin D is difficult to measure. Within each chapter there are three consistent sections. He noted that there is no uniformity of Vitamin D testing and it is difficult to measure. Catch-up service: Paediatric Radiology 2022, Catch-up now with our case-based Paediatric Radiology webinar that took place in February 2022. BSc, MBBS, MRCP, FRCR, PhD, FHEA One or both of the parents, and/or the grandmother knows what has happened to S on all the occasions she has suffered injury. "It was felt that it was a matter of such complexity and range of opinion that it was a matter for court determination.". On 3 August 2011, S and the mother were seen at home by the Community Nurse, and the record shows that the mother had no concerns. In this case the local authority brings proceedings for Public Law orders relating to S, born on 18th July 2011. (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. The father completed a course in tourism management and completed a post-graduate degree in business management. (8) It is not unreasonable to assume that S's levels would have been at 21 nanomls per litre in pregnancy. Left lower leg fracture, a metaphyseal fracture of the left tibia (shin bone) (3rd-10th October 2011). The parents and the maternal grandmother, she asserts, would all take care of S and T throughout the day. 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. The x-ray of the left femur had been reported as showing no bony injury on 13 October 2011 and no obvious metaphyseal infraction. an improved understanding of Paediatric imaging interpretation and reporting skills. Paediatric Radiology opens with a chapter devoted to the different imaging modalities, including radiographs, fluroscopy, ultrasoound, CT, MRI and nuclear scintigraphy before moving on to more detailed, systems-based chapters. But in the light of all that is known about the parents and from my impression of them in evidence balanced against all that is submitted and produced by the local authority it is not likely, in my judgment, that her injuries were caused by non-accidental force. I have considered the findings invited by the local authority as to the evidence of the family members, the inconsistencies, alleged inaccuracies and inferences that I am invited to draw from them. The Judge considered that S was seen five times at medical appointments when she was said to be suffering from fractures and noted that at those appointments not only did they not reveal the fractures but nor did they raise any suspicion about the parents. The local authority place considerable weight on the evidence of Dr Fairhurst as to the interpretation and significance of the X-rays, the report of 13th February 2012 and the evidence as to the mechanism of injury in relation to spiral fractures, metaphyseal fractures, fractures of the antero-lateral aspects of the ribs and a torus fracture raise very serious implications for the family members. Victoria and Jake Ward and William, right. (4) He accepts that in relation to injuries such as these some force has to be applied. I came to the conclusion that I was unable to determine the case without further specialist expert evidence. The father accepts that only he, the mother and the grandmother were caring for S during this time. It is reasonable to conclude that they were lower before then because she was breastfed. Her expertise within paediatric radiology covers the full range of imaging modalities including plain X-ray, ultrasound, fluoroscopy, CT, MRI, and nuclear medicine. The family's nightmare began one night in July 2005 when, at three months old, William woke up in pain. At that point a number of problems faced the court. They both appear to value education and a need to promote this ethos with their children. Country * Panorama's Please Don't Take Our Child is broadcast on BBC One tomorrow at 8.30pm. Since the medical centre was closed, they took S to the local hospital.25. This led them to suspect that he may have caught his right leg between the bars of his cot and the mattress of their own bed, causing him to fracture it as he struggled to pull it clear. courses@infomedltd.co.uk+44(0)20 4520 5081. The Consultant Paediatrician, as the locum consultant paediatrician at the local NHS trust, described himself as a 'relatively recently qualified paediatric consultant.' At times she appeared to have poor recollection, which to my mind was not surprising given the sort of detail that she was required to remember after some considerable time. The history squares rather more comfortably with the account given by the father in his statement than in his oral evidence. I have also had the benefit of the considerable amount of documentation in the bundles to which extensive reference has been made in the course of the evidence. The book is an important revision aid as well as an up-to-date reference. The Health Visitor produced her records in evidence and explained that on such an occasion, the parents would undress the child and lay her on the changing mat or if the baby was being weighed, on the scales. I have noted and examined the oral evidence of Dr Fairhurst. 33. On 19 August 2011, two days later, there is a record in the GP notes confirming a visit by the mother and father with S. She was seen by the GP. I gave a short judgment identifying the difficulties in which the paediatrician found himself in dealing with the analysis of Vitamin D deficiency/insufficiency which was outside his expertise and which presented a substantial difficulty in the case. The father is unable to explain how S sustained the fracture to her left arm; however, he accepts that only he, mother and grandmother were caring for S during this time; he therefore accepts that this fracture would have occurred while S was in their care. Her parents returned with S on 22.10.11 with a swollen arm. There is no evidence of an incident of any kind suggestive or on which an inference could be drawn that either of the parents was responsible for an injury (other of course than the X-rays of the fractures). The mother also worked there.10. 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. However, on 22nd October 2011 the parents again presented S, this time with swelling to her left arm. 5. Angry that parents like themselves could be put through such an ordeal without being able to challenge the credibility of experts called to give evidence against them, the Wards returned to the High Court. The fact finding hearing began on 23rd March 2012, but on the second day of it, on 26th March, I adjourned the hearing having encountered significant problems on two fronts after hearing evidence from Dr Fairhurst, the health visitor, and the Consultant Paediatrician. There are a number of other features of the evidence about the parents which I must take into account as part of the 'wide canvas' of evidence that I have surveyed. He has a special interest in paediatric musculoskeletal disorders, in particular juvenile arthritis and non-accidental injury. 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. This hearing has run over a prolonged period of months in the course of 2012; in particular because it encountered difficulties in the procurement of the services of one of the experts necessary to address the issues in the case, and also because of practical difficulties in the hearing itself in adducing the important evidence of the children's grandmother from Sri Lanka. Read, highlight, and take notes, across web, tablet, and phone. They could offer no explanation as to how the fractures may have happened. Dr. Foster spent two and a half years working in paediatricsbefore moving into radiology. Amaka lectures regularly on various radiology, paediatric, genetic, emergency medicine and orthopaedic courses, locally and nationally. Presentations are kept to the minimum and then you'll be into the fully featured cloud based DICOM viewer, looking at cases, feeding back your findings using our interactive tools. The maternal grandmother denied harming S and did not accept that her daughter or son-in-law would not do the same. So, as I review the evidence of the parents and the grandmother, it appears that there is a strong strain in the evidence that runs counter to the evidence and conclusions of Dr Fairhurst, producing by its weight and nature what I would regard as a substantial likelihood that this family would not perpetrate the sort of violence which according to the medical evidence of Dr Fairhurst and the Consultant Paediatrician must have been inflicted upon her. UK based, CPD accredited, online courses for doctors in all of the major specialties, Navigation: The constellation of findings is highly indicative of non-accidental injury by an adult. After 22 September 2011, S was next seen at the GP surgery on the 13 October 2011. . S's early developmental history, after her birth on 18 July 2011, was unremarkable at first sight: more would come to be known about her Vitamin D deficiency later, with ensuing events. It is not possible to know which incidents or movements caused or gave rise to force sufficient to bring about fractures. Extensive high quality images throughout the book, and additional illustrations, aid the reader with diagnosis and detailed referencing points to further reading. DAY 2: EMERGENCY PAEDIATRIC IMAGING - THURSDAY 10 FEBRUARY 2022 I note in particular the five times when she was seen at medical appointments when she was said to be suffering fractures. The parents' first child T was born on 14th February 2008. On 14 January 2013 I made orders and gave a foreshortened (primary) version of the judgment in this case which had run over a substantial period in 2012 and before, because having reserved judgment in what was on any view a difficult case, delays in preparing the judgment for administrative reasons and with difficulties over my own health meant the process became much longer than I would have wished. He has been able to contribute vital knowledge and information towards understanding S's condition in August, September and October 2011. greater confidence in managing the imaging of an acutely unwell child. He was diagnosed with Hirschsprung's disease, remaining under the care of a London hospital's surgical team with 6 monthly checks. What has emerged is that none of the adults present could provide any instance of anything done to S by themselves or the other adult members of the family, or which had befallen her, which would explain the fractures. It soon became clear that both the police and social services were relying heavily on the evidence of Dr Johnson, who said that William had suffered four fractures which had taken place on at least two or more separate occasions. Yet even after the criminal case collapsed for lack of evidence and a family court finally decided that the parents posed no threat to their son, the couple were astonished to find that the names of the doctors who had given evidence against them were kept secret. S's Vitamin D levels were borderline on 2.11.11 and were never higher than insufficient. I note the entry as follows: 'non-tender, baby permits passive manipulation. Nor is it possible to conclude at what point 'normal day to day handling' a vague phrase at best, and which must include the use of reasonable force and pressure at times crosses over to the point where S's vulnerable bone structure was compromised and exceeded. 03. She was discharged from hospital on 25 July 2011. When S was born on 18 July 2011, T was 3 years and 5 months old. Now the Local authority has promptly and appropriately put into effect a revised Care Plan to give effect to the orders made that day. The family are very close and have a loving relationship. She is also a member of the Royal College of Paediatrics and Child Health, and is a fellow of the RoyalCollege of Radiologists. Her expertise within paediatric radiology covers the full range of imaging modalities including plain X-ray, ultrasound, fluoroscopy, CT, MRI, and nuclear medicine. Dr Caren Landes obtained her medical degree from the University of Birmingham in 1997 and was appointed a Consultant Radiologist at Alder Hey Childrens NHS Foundation Trust in 2006 and has been Clinical Lead for Radiology since 2012. Any specialty The judgment that I gave that day is subsumed into this fuller judgment of the court.02. 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. colic/reflux." The left tibia fracture was likely to have occurred between 3rd and 10th October and the likely time frame for the left humeral fracture was between 16th and 19th October. 11:00-11:30 Imaging of arthritis Dr Emma Rowbotham, Leeds Teaching Hospitals NHS Trust 12:00-12:30 Common paediatric MSK conditions Dr Karl Johnson, Birmingham Children's Hospital NHS Foundation Trust 12:30-13:00 Soft tissue and bone lesions. Dr. Thomas' office is located at 2204 Lakeshore Dr, Birmingham . Earlier records that day mention mother and father being present. This company officer is, or was, associated with at least 1 company roles. The scans were sent for further expert review by Dr Karl Johnson, paediatric radiologist at the Birmingham Children's Hospital. At the time of these proceedings he was employed as a store manager. No local tenderness in leg or hip", S was x-rayed, but nothing abnormal was observed. He has a special interest in paediatric musculoskeletal disorders, in particular juvenile arthritis and non-accidental injury. 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. He said: "It was a clear cut case in that there was no immediate explanation and the parents were not clear how the baby had come by his injuries. It must also raise as a real possibility the potential explanation that T may have brought about one or more fractures, along with the possibility less likely, in my view that S may have been injured when the family slept together in one bed. 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