(Family Division, Eleanor King J, 25 June 2013)
Care proceedings – Fact-finding hearing – Mother’s somatisation disorder – Salt poisoning
Please see the attached file below for the full judgment.
Care proceedings were initiated in relation to the two children, A and O. O suffered from quadriplegia, secondary cerebral palsy and was visually impaired. A had no disabilities but had been exposed to frequent invasive medical treatment which meant that he had been artificially fed throughout his life and had spent protracted periods of time in hospital.
A was admitted to hospital with a suspected thigh infection and remained in hospital for a number of weeks during which time blood tests revealed he had an unexpectedly high level of sodium in his blood leading treating medics to be concerned that he had been administered sodium by a third party.
Care proceedings were initiated and the mother moved out of the family home leaving the child in the care of the father and paternal grandmother. Pending a fact-finding hearing reports were obtained from a consultant psychiatrist who diagnosed the mother as suffering from a somatisation disorder. The court was asked to determine whether the child had sustained salt poisoning due to the actions of the mother.
It became clear during proceedings that not all of the medical data was available including urine chemistry and weight calculations.
The view of the consultant nephrologist was that the child’s high sodium levels were due to a sodium overload without dehydration based upon the difficulty the mother would have had administering salt orally to the child. However, once he was reminded of the child’s gastrostemy still being in place and the possibility of the mother diluting the salt and putting it in the gastrostemy tube, he was certain that that was the explanation. A consultant paediatric pathologist was less certain of this explanation but as a clinician she was inclined to be more cautious in making such a serious diagnosis where some of the recommended data was missing.
On the balance of probabilities the mother had administered salt to the child on two occasions causing a sodium overload.
The fully referenced, judicially approved judgment and headnote will appear in a forthcoming issue of Family Law Reports. A detailed summary and analysis of the case will appear in Family Law.
Neutral Citation Number:  EWHC 1864 (Fam)
Case No: ER12C00080
IN THE HIGH COURT OF JUSTICE FAMILY DIVISION
Birmingham Civil Justice Centre, 33 Bull Street, Birmingham B4 6DS.
B e f o r e :
MRS JUSTICE KING DBE
DERBYSHIRE COUNTY COUNCIL
A MOTHER And A FATHER
Tape Transcription by Marten Walsh Cherer Ltd., 1st Floor, Quality House, Quality Court, Chancery Lane, London WC2A 1HP. Telephone No: 020 7067 2900. Fax No: 020 7831 6864
MR A HAYDEN, Q.C. and MR G SEMPLE, of counsel, appeared for the Applicant
MISS KNOWLES, Q.C. and MISS HEALING, of counsel, appeared for the First Respondent
MISS CHEETHAM, of counsel, appeared for the Second Respondent
MISS ROGERS, of counsel, appeared for the younger children
MISS BUDDEN, of counsel, appeared for the older children
Derbyshire County Council v A Mother and A Father  EWHC 1864 (Fam)