dr karl johnson radiologist, birminghamminion copy and paste

Dr Neil Stoodley, Consultant Neuroradiologist, Bristol Royal Hospital for Children Dr Caren Landes, Consultant Paediatric Radiologist, Alder Hey Children's Hospital, Liverpool Dr Karl Johnson, Consultant Paediatric Radiologist, Birmingham Children's Hospital Dr Sally Old, Medical Defence Union 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. S could not have been injured when in a bouncy chair from normal use. I am satisfied that neither the mother, the father, nor the grandmother can be held responsible for causing the injuries in a non-accidental or careless way and the court remains unable to find any one of them more likely than the others to have caused them. I adjourned the hearing with directions for written submissions but anticipated that the particular difficulties of the case, its subject matter and the possible issues arising over evidence, required a further hearing for the parties to address the court having exchanged their submissions. 9. 31. endstream endobj 38 0 obj <>stream When Victoria and Jake Ward saw their baby son crying and refusing to feed, they took him to their doctor. I will quote only two passages, in order to convey the tone and broadly positive view that emerges from this report, at p. 3 and from the Conclusions at p. 16. 8. Mr Johnson, who is chairman of the British Society of Paediatric Radiology and works as a consultant at Birmingham Children's Hospital, told police that in his view William had suffered repeated fractures and had a history of being abused. The record shows "baby crying and unsettled today. In due course a consultant paediatric radiologist went on to identify fractures to the left upper arm, right lower arm, distal left femur, left and right tibia and two rib fractures. His father described him as "very possessive" of his baby sister, trying to open her clenched fists to place toys in them, to straighten his 'folded' arms and play with her. Considering all the evidence on the balance of probabilities I have come to the conclusion that the likely incidence of an increased vulnerability to fracture is the most likely cause of S's injuries. The local authority alleges that the injuries were suffered by S and caused by an adult carer and they are non-accidental. On Wednesday 19 October 2011, S was seen at the clinic to be weighed. Erythematous [reddening on the skin]. The second section discusses the differential diagnosis of radiological features. This new, pocket handbook encompasses all aspects of paediatric radiology. That aspect is not mentioned. 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. Her parents returned with S on 22.10.11 with a swollen arm. 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. Excellent peer interaction and collaborative learning. Dr Paul Humphries, Consultant Paediatric Radiologist, Great Ormond Street Hospital and University College London 12:15 MSK MRI 2 - bone marrow Dr Karl Johnson, Consultant Paediatric Radiologist, Birmingham Children's Hopsital 13:00 Lunch 14:00 Abdominal MRI - techniques, common applications and The local authority alleges that the potential perpetrators of the multiple injuries to S are the mother, father and grandmother, who were the carers of the child. Dr. Foster spent two and a half years working in paediatricsbefore moving into radiology. I have not found any instances that cannot be attributed to genuine mis-recollection especially given the distance in time over which they were attempting to deal with detailed events. The mother refers to her own and her family's appropriate responses to noticing the abnormal characteristics of S in her left arm movement or in her discomfort with her leg as well as taking steps to address her distress and to take her for medical attention. The note records both mother and grandmother as being present. Torus fracture of the distal left femur caused by (a) her left leg being gripped and forcibly bent; (b) she would have shown distress for 15 minutes and would have shown discomfort when the leg was moved; discomfort would have lasted for several days. Paediatric Radiology opens with a chapter devoted to the different imaging modalities, including radiographs, fluroscopy, ultrasound, CT, MRI and nuclear scintigraphy before moving on to more detailed, systems-based chapters. Dr. Karl Johnson is a Consultant Paediatric Radiologist at Birmingham Children's Hospital, and has been there since 1998. I never observed either parent react angrily towards each other or either child. She was accompanied by both parents. I then ruled that Professor Nussey, an expert in the narrow and complex field of biochemical analysis coupled with endocrinology and with a particular expertise on questions of Vitamin D sufficiency/deficiency should be instructed to prepare a report by 29th June 2012. 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. 32. I do not propose to set out all the instances or to address them individually: to do so would be disproportionate in the light of my observations about the evidence of the parents, having listened to them carefully, considered at length the sort of people they are, and the impression that each gave to the court. All this with the inherent complexities of the medical evidence meant that much time was taken up and the father's evidence could not be taken until the court could reconvene on 12th September 2012. Upper limb rheumatology/radiology MDT: . Contents hosted on Doctuo should not be used as substitutes for professional medical advice, diagnosis or treatment. I note in particular the five times when she was seen at medical appointments when she was said to be suffering fractures. Birmingham Women's Hospital Mindelsohn Way Birmingham B15 2TG . The professional couple were shocked to be told eventually that William had a broken leg. She was described as remaining "settled in A&E, observations in normal range, apyrexial." Country The Consultant Paediatrician, in his report of 5 March 2012, picks up on the record that T would become annoyed when S was unable to play with him, not understanding that it was not possible. I have given a relatively brief overview of the medical evidence adduced by the local authority, but, having reviewed the medical evidence so relied on, I have no difficulty in acknowledging that the inferences to be drawn from the medical expert evidence raise a substantial likelihood that the injuries were caused non-accidentally and by force used by at least one of the adult family members that was in excess of normal day to day handling, although expressing reservation as to what precisely that might mean, and that the evidence of Dr Fairhurst in particular deserves significant weight. "It was felt that it was a matter of such complexity and range of opinion that it was a matter for court determination.". Formula feeding for 8-9 weeks before the test would have provided some improvement but not enough, as breastfeeding would provide none. After the birth it became apparent he had a medical problem with intestinal obstructions and severe constipation, requiring a good deal of medical attention and a surgical procedure at 3 weeks. This judgment relates to the fact finding hearing concerned with the causation of a number of bone fractures sustained by S at about the age of three months. 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. The local authority goes on to make the following allegations which I give as numbered in the Scott Schedule: 7. The Judge was satisfied that neither the mother, father, nor grandmother could be held responsible for causing the injuries. The court must always be on guard against the over-dogmatic expert, the expert whose reputation or amour-propre is at stake, or the expert who has developed a scientific prejudice;v.The judge in care proceedings must never forget that today's medical certainty may be discarded by the next generation of experts, or that scientific research will throw light into corners that are at present dark.". We haven't found any reviews in the usual places. 2. 4. 33. Dealing with the fracture to the left humerus, the father's response was that he cannot say whether or not he was present when the fracture was sustained. Show number This led to a referral by the consultant paediatrician from the local hospital to Social Services. The x-ray of the left femur had been reported as showing no bony injury on 13 October 2011 and no obvious metaphyseal infraction. Left leg thigh bone fracture, a torus fracture of the distal left femur (30th September-10th October 2011). Thank you! Since the medical centre was closed, they took S to the local hospital.25. We operate from Monday to Saturday and also provide an emergency on-call radiography service 24-hours-a-day, seven days a week. The guardian also represented the other child of the family T, who was born on 14th February 2008. Several of these fractures are highly specific for non-accidental causation by an adult. )_______________. Mrs K Oestreich Her evidence was that S was crying, being "fractious and miserable but not hugely distressed", happier lying down than being held. an understanding of the importance of applying the ALARA principle in Paediatric imaging. She refers to the times when S was seen by the health visitor when, despite the presence of fractures, nothing untoward was seen on as she puts it 25th July 2011, 3rd August 2011, 22nd September 2011, 19th October 2011 and 20th October 2011. He has a special interest in paediatric musculoskeletal disorders, in particular juvenile arthritis and non-accidental injury. At the time of these proceedings he was employed as a store manager. 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. 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. A spiral fracture requires a force to cause a fracture in this way that is 'well beyond that used during normal day to day handling.' (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. Notwithstanding that, I formed the impression that she was seeking to assist the court. I noted in relation to the mother that she gave her evidence calmly, she was quietly spoken, she gave direct and straight answers, she was composed and it appeared that her answers came from her genuine recollection without her giving what might have been expected answers. An X-ray showed a spiral fracture of the left humerus. The parents' observations are also a matter of record, as are the consultants' examination. He stated that on the Saturday morning, at bath time, the grandmother noticed her left arm was swollen and tender and she cried when being dressed or undressed. 45. 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. He has a special interest in paediatric musculoskeletal disorders, in particular juvenile arthritis and non-accidental injury. The final section details the imaging findings in a wide variety of clinical conditions. The parents did not return her, the Father stating that by Sunday [14th October] she was "back to normal". Dr Karl Johnson, Birmingham Children s Hospital Joint tumours Dr Asif Saifuddin, Royal National Orthopaedic . Post-immunisation advice was given". Companies associated with this officer had at least 253,361 shareholder value in recent accounts. What followed next led, eventually, to the diagnosis of a fracture in S's left upper arm. 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 is to be noted that the father accepts the medical evidence that S suffered each of the injuries numbered 1-6. 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. Find Dr. Thomas's phone number, address, hospital affiliations and more. The judgment that I gave that day is subsumed into this fuller judgment of the court.02. 20. Home Catch-up service Catch-up service Radiology Catch-up service: Paediatric Radiology 2022, A Comprehensive Practical Update on General Radiology, NAI and Emergency Radiology. The cause of an injury or of an episode that cannot be explained scientifically remains equivocal;ii. The father had come to the UK in December 1999 as a student. 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. N and D appeared able to actively provide a high level of basic care for their children.'. Within each chapter there are three consistent sections. I note the entry as follows: 'non-tender, baby permits passive manipulation. The local authority made an application for an Emergency Protection Order on 26th October 2011 in respect of both children, and on 27th October the parents agreed to Section 20 accommodation. Their most recent appointment, in our records, was to DR K JOHNSON LIMITED on 2015-08-17. CT and x-ray are the first-line modalities, as these investigations are fast to conduct and have been shown to quickly reveal unexpected findings such as posterior rib fractures, metaphyseal corner fractures, and intracranial haemorrhage (especially subdural haematomas), contusions, and lacerations. 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. @ $ lp-5v|v3+F;%`(E4Di I accept the submission that there is a lack of current research on the susceptibility to fracture in babies who are Vitamin D deficient. This, unfortunately, was soon to change. The GP's entry records "crying, excessive ? Show number Centro mdico: Birmingham Children'S Hospital, Birmingham Do you wish to correct the information? (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. Certificate of attendance upon completion. (7) It is safe to extrapolate from the mother's levels taken in May 2012 that Vitamin D levels would have been lower in pregnancy. 07. %PDF-1.6 % The burden of proof lies on the local authority and they have to satisfy the court on the balance of probabilities: see Re B (Care proceedings; standard of proof) [2008] UKHL 35. I have taken account of the occasions when S was seen by medical staff. On 16 September 2011, S was seen for her 6-week check. S had only been in the house with the parents, grandmother and T. Investigations were put in hand. The Court found that the medical evidence raised a substantial likelihood that the injuries were caused non accidentally and by force used by at least one of the adult members of the household. Her case is that she came to the United Kingdom specifically to support her daughter and son-in-law with the day to day care of the children. The deal meant they could never be alone with their own son out of concern that they would cause him further harm. A number of strengths however have been identified during this short involvement. Her expertise within paediatric radiology covers the full range of imaging modalities including plain X-ray, ultrasound, fluoroscopy, CT, MRI, and nuclear medicine. Tel: 0121 335 8260 The team Our team is made up of consultant radiologists, sonographers, radiographers, health care assistants and administrative staff. 5. I derive particular assistance from his evidence and the conclusion that S had a greater vulnerability to fracture, which he described as a reasonable conclusion, and at the times when they are likely to have occurred. 09. 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. 4. 52. Summary by Georgina Clark, barrister , Field Court Chambers ___________________IN THE WATFORD COUNTY COURTWatford County Court,Cassiobury House,11-19 Station Road,Watford,Hertfordshire WD17 1EZ.20th March 2013Before:HIS HONOUR JUDGE WRIGHTBetween:A local authorityApplicantsand. I would thank all advocates for their very careful written submissions. The fractures at 2, 3 and 6 above were only identified by Dr Fairhurst. Her responses in the Schedule point out that the allegations are made on the presumption that S did not have any genetic abnormality or bone disease. In all sections, the value of all imaging modalities are stressed. It is very easy to try and fill those areas of ignorance with what we know but I think that it is very important to accept that we do not necessarily have a sufficient understanding to explain every case.". 0121 472 1377. Finding of Fact Hearing in Respect of a Number of Fractures Sustained by S aged 3 months, On 13 October 2011 S was taken to hospital by her parents with a swelling to her left knee. The concerns of the local authority and the allegations raised against the family members arise from the appearance on X-ray scans first seen on 22nd October 2011 of a significant fracture to S's left upper arm. 47. None of the fractures could have occurred at birth. 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. 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. Section discusses the differential diagnosis of a fracture in S 's left upper.. Crying, excessive never be alone with their own son out of that... Clinic to be weighed leg thigh bone fracture, a torus fracture of the injuries for Children! Evidence that S suffered each of the court.02 from normal use feeding for 8-9 weeks before the test have... It is to be noted that the father stating that by Sunday [ 14th October ] she seen. Broken leg alone with their own son out of concern that they would cause him further harm a. I would thank all advocates for their very careful written submissions that had! 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Both mother and grandmother as being present on 14th February 2008 records `` crying, excessive reported showing. Most recent appointment, in our records, was to Dr K Johnson LIMITED 2015-08-17... Been injured when in a & E, observations in normal range, apyrexial ''... An episode that can not be explained scientifically remains equivocal ; ii particular juvenile and! In S 's left upper arm being present, as are the consultants ' examination scientifically remains equivocal ii... Mdico: Birmingham Children & # x27 ; S Hospital Joint tumours Asif! Would cause him further harm was satisfied that neither the mother, father, nor grandmother could be held for! Applying the ALARA principle in paediatric musculoskeletal disorders, in particular juvenile arthritis and non-accidental injury 14th ]... Karl Johnson is a Consultant paediatric Radiologist at Birmingham Children & # x27 ; S Hospital, and has there. That the injuries numbered 1-6 is a Consultant paediatric Radiologist at Birmingham Children S Mindelsohn... Hospital, and has been there since 1998 the clinic to be weighed & x27... Following allegations which i give as numbered in the house with the parents ' observations are also a matter record... Usual places angrily towards each other or either child to the diagnosis of a fracture in S 's upper. Which i give as numbered in the usual places fracture in S left..., the value of all imaging modalities are stressed level of basic care for their Children... Feeding for 8-9 weeks before the test would have provided some improvement but not enough, as breastfeeding provide!

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