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17th Jan 2025 | Cases
Nick Goodwin KC leading Sian Cox, instructed by the Joint Legal Team on behalf of the local authority in Re N (Children: Fact Finding – Perplexing Presentation/Fabricated or Induced Illness) [2024] EWFC 326; a fact-finding hearing in care proceedings concerning allegations that a mother had fabricated and induced illness in her two children.
The allegations came to light in May 2022 when the younger child (B) was discovered to have unprescribed morphine in her urine during an inpatient hospital admission. It was subsequently discovered that various medical professionals had concerns about the mother inducing or fabricating illness in both children, although others did not share these concerns. Both children experienced extensive medicalisation throughout their lives, including multiple hospital admissions, invasive procedures and daily use of a CPAP machine in the case of B. Upon removal to foster care, neither child required any medical treatment other than occasional use of an inhaler.
During the subsequent proceedings, parties received over 35,000 pages of medical disclosure reaching back over the entirely of the children’s lives and involving six different hospitals. Phone and police disclosure brought the total evidence to nearly 90,000 pages. The fact-finding hearing lasted 37 days and involved 33 witnesses, including four of the nine jointly instructed experts. A further dimension was added when findings were sought and made against the children’s consultant, Dr K.
HHJ Moradifar, sitting as a deputy judge of the High Court, made extensive findings against the mother in respect of both children, including that she had covertly administered morphine to B, covertly withdrawn blood from B resulting in multiple blood transfusions, deliberately sought to damage the CPAP ventilator and played professionals off against one another. Covert blood removal was not something the expert paediatrician Dr Ward or paediatric haematologist Dr Keehan had ever seen before, another highly unusual aspect of this case.
In addition to making the findings against mother and Dr K, HHJ Moradifar included lessons learnt when dealing with perplexing presentations at the conclusion of his judgment.
Link to earlier fact finding in this case Re N (Children: Findings Against A Professional Witness: Joinder or Intervention) [2024] EWFC 17 (B).