Tuesday, February 16, 2010

For Love and For Justice / Part 113 / Zabeth and Paul Bayne

What I am hearing from court proceedings …

This present case against the Baynes maintaining custody of their daughter proceeded from injuries for which they brought her to Vancouver Children’s Hospital and which were diagnosed there as indicators of a Shaken Baby Syndrome and only that. That diagnosis presumed a non accidental injury. Any story that the parent or caregiver offered with regard to an accident had to be categorically mistrusted. The hospital had no option and it had protocol which required staff to notify MCFD and/or RCMP. That was done. The RCMP found insufficient evidence to proceed with charges. From the RCMP standpoint the Baynes were exonerated. MCFD now involved in a child protective scenario looked at the Baynes differently because MCFD had more confidence in the medical diagnosis than they had in the Bayne parents’ story of accident. The only long term resolution that MCFD could foresee was an admission by one or both Bayne parents that in fact the baby had been shaken and that they were sorry and would be willing to take any classes that teach them to manage frustration and annoying baby behaviour. Then perhaps the family could be reunited, albeit with some monitoring provisos but such reunion was not assured.

Of course we now know that the Baynes have for well over two years refused to admit to something for which they still maintain their innocence.

The shortcoming in medical procedure that the Bayne camp has argued in court was a failure at that early investigative stage to systematically eliminate all other possible causes for the injuries. This is called a differential diagnosis.

The MCFD camp maintains through the attending health professional who made the initial diagnosis, that SBS was most consistent with the injury details. Bayne’s counsel Doug Christie questioned Dr. Colbourne’s credentials sufficiently that Judge Crabtree ruled that she would not be allowed to offer an opinion as to whether this was an accident or a non accident, or even to state her opinion that it was SBS. Finn Jensen ducked that ruling a following day by having Dr. Margaret Colbourne recite all the alternative causes with which in her opinion, the indicators were not consistent, and she finally landed on the one remaining cause, SBS. Why Judge Crabtree didn’t insist upon his prior ruling remains unanswered.

The differential diagnosis for Subdural Hematoma (SDH) in an infant includes impact trauma; a variety of natural diseases; and hypoxia/anoxia, either as a primary event or as a complication of impact or natural disease. A physician investigates, explicitly considers, and eliminates each before he/she attributes these signs and symptoms to a specific mechanical or physiological cause. The question remains. Will the judge conclude that Dr. Colbourne was qualified to conduct an explicit differential consideration of the numerous potential causes for subdural hematoma and retinal bleeding? That will certainly affect the outcome. The judge will have to determine based upon evidence, whether the Baynes are a risk to their children or was the baby's medical story the result of a family accident, or the baby's pre-existing condition exacerbated by an accidental impact?

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