Judicial handling of cases of non-accidental head trauma in infants: Review and analysis of expert assessments |
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| Institution: | 1. Forensic Department, AP–HM, La Timone, 264, rue St-Pierre, 13385 Marseille cedex 05, France;2. Aix-Marseille University, CNRS, EFS, ADES, Marseille, France;3. Department of Paediatric Neurosurgery, CHU Timone Enfants, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France;4. Paediatric Department, CHU Timone Enfants, 264 rue Saint Pierre, 13385 Marseille cedex 05, France;5. Department of Paediatric Surgery, CHU Timone Enfants, 264 rue Saint Pierre, 13385 Marseille cedex 05, France;1. Department of neurosurgery, CHU Limoges, 2, avenue Martin-Luther-King, 87042 Limoges, France;2. Department of urology, CHU Limoges, 2, avenue Martin-Luther-King, 87042 Limoges, France;1. Neurointervention Center, Beijing Tiantan Hospital, Capital Medical University, 100050 Beijing, China;2. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 100050 Beijing, China;3. Department of Neurosurgery, Beijing, Chao-Yang Hospital, Capital Medical University, Beijing, China;4. Emergency department, Beijing Haidian Hospital, Haidian Section of Peking University Third Hospital, 100080 Beijing, China;5. Department of Neurosurgery, Gatot Subroto Central Army Hospital, Jakarta, Indonesia;1. Department of Neurosurgery, St. George''s Hospital, Blackshaw road, Tooting, London, SW17 0QT, UK;2. Department of Neurology, St. George''s Hospital, London SW17 0QT, UK;1. Département de neurochirurgie, Hôpital Gui-de-Chauliac, Centre hospitalier universitaire de Montpellier, 80, avenue Augustin-Fliche, 34295 Montpellier cedex 5, France;2. Département d’otorhinolaryngologie, Hôpital Gui-de-Chauliac, Centre hospitalier universitaire de Montpellier, Montpellier, France;3. Département de chirurgie maxillo-faciale, Hôpital Gui-de-Chauliac, Centre hospitalier universitaire de Montpellier, Montpellier, France |
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| Abstract: | IntroductionGood practice guidelines help clinicians to establish a suspected diagnosis of non-accidental head injury (NAHI) and help forensic experts to establish a level of certainty for the diagnosis.The objective of this study was to assess how the French Health Authority (HAS) guidelines contribute to the process of producing an expert assessment, on causation and certainty in cases of suspected NAHI.MethodA retrospective study was conducted of the expert assessments that were conducted by a paediatric surgeon and forensic expert attached to our local court between 2002 and 2018, with the aim of determining the causal mechanism of the lesions and express a degree of certainty regarding the diagnosis.ResultsIn our study, we found that, despite the HAS guidelines, a number of documents deemed essential for the forensic expert were sometimes missing, and that, by applying these guidelines, the decisions reached in some expert assessments could been reclassified and certain factors formerly described as risk factors for injury could be excluded. A precise dating of the traumatic event was proposed in half of cases.ConclusionOur study highlights the vital role of the HAS guidelines, not only for patient management but also to ensure high-quality expert assessments. Unfortunately, guidelines were not yet being properly adhered to by medical teams. |
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| Keywords: | Non-accidental head injury Expert assessment Good practice guidelines Child abuse Shaken baby syndrome |
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