MEDICAL HISTORY PART 3 of 3 / Part 235 / For Love and For Justice / Zabeth and Paul Bayne/

Part 3 of 3

• Providing it in several parts, this will be as definitive a medical history on the Bayne infant as you will read online.
• At the start of the MCFD hearing for a continuing care order for all three Bayne children, Judge Tom Crabtree in his wisdom ruled that there would be no ban on information presented during the court proceedings. The medical reports are a component of the submissions presented under cross examination. I have access to this information. Medical testimonies have been heard although not all of them have been ruled as admissible by Judge Crabtree.
• This is what I have read. I have chosen not to do a narrative but to cite the medical data factually. I RESTATE OR CAPITALIZE A FEW KEY OBSERVATIONS.

Dr. Poskitt / MR: Requested by Dr. David Cochrane, an MR Head Sedation was conducted by the department of radiology at BC Children's Hospital and Dr. Ken Poskitt on October 19, 2007. The impression given was focal injury to the left occipital lobe with associated bilateral subdural fluid collections of increased signal intensity represented protein and old blood. The injury is remote at least three weeks of age or older. Given the size of the extra-axial fluid collections, Dr. Poskitt suspected that the head had been crossing percentiles for a prolonged period of time and head circumference measurements would provide an estimated time of origin for the injury. There was evidence of trauma however mechanism injury was not obvious from MR examination.

Dr. Degruchy / Chest: On October 19, 2007 at Dr. Cochrane's request a Port Ward Chest was performed by the department of radiology at BC Children's Hospital and Dr. Suzanne Degruchy. She noted that there was hazy increased opacity in both lungs which may reflect pulmonary edema. Pleural spaces were clear and the bony thorax was unremarkable. Atelectasis/ hemorrhage was though unlikely.

Child Removal: October 22, 2007 was D-Day for the Baynes, not Deliverance but Desolation. All three children were removed from Paul and Zabeth.

Dr. Hess / Head Ultrasound: October 22, 2007 an Ultrasound Head exam was done at the department of radiology at BC Children's Hospital and Dr. Thomas Hess, finding that there was significant improvement in the size of the bilateral extra-axial collections when compared with the findings from the October 19, 2007 a pre-shunt insertion MRI and the outside cranial ultrasound done in Chilliwack.

Dr Hess / CT Head: On October 23, 2007 at the request of Dr. Colbourne, with reference to a skeletal survey performed on October 19th, 2007 and the outside CT head scan done at Chilliwack General Hospital on October 18, 2007, a NM Bone Flow test was conducted by Dr. Thomas Hess. Dr. Hess understood that the two month old infant with bilateral subdural hematomas and a right parietal skull fracture was under investigation for NAI (Non-accidental injury). The test result was focal increased activity within the left proximal femur which corresponded with bone injury visualized on the recent skeletal survey.

Dr. Culham / Chest, Limbs: On October 31, 2007 at Dr. Colbourne's request the Department of Radiology at BCCH and Dr. Gordon Culham did examinations of the chest, the right elbow and the left femur of the infant Baby B. No bony injury appeared in the chest examination with nothing to suggest new bone formation suggesting costochondral fractures. THE LATERAL VIEW OF THE RIGHT ELBOW SHOWS WHAT APPEARS AS SUBPERIOSTAL NEW BONE BUT IS IN FACT CORTICAL TUNNELLING BECAUSE THERE IS NO NEW BONE ON THE FRONTAL VIEW. WITH THE LEFT FEMUR THERE IS A HEALING FRACTURE AT THE PROXIMAL END OF THE FEMUR INVOLVING THE MEDIAL CORNER AND THE FRACTURE IS HEALING BY ENDOSTEAL SCLEROSIS.

Sorial report: As causes for her distress were sought, the doctor's note MENTIONS THE BROTHER FALLING ON HER a few days earlier but that she had not cried and was okay after that trauma. The parents reported this event.
Dr. Gardiner wrote a letter to Dr. Ebesh dated January 6, 2009 following a routine examination of Baby B who was brought to the appointment by her social worker because the girl is in foster care as her note indicates “after a presumed non-accidental injury.” She indicates that she also last saw Baby B in April 2008 when her eyes looked normal and there were no concerns with respect to her vision. Dr. Gardiner also makes reference to Dr. Matsuba seeing her on this same January 6th appointment and saying that her vision is good. Dr. Gardiner's examination.

There are many more medical follow-up appointments and reports during the past year and one half which are not part of this mini-series the purpose of which was to recount the initial medical observations and findings, relative to the suspicions, the child removal, the risk assessment and the current continuing care order by MCFD.

Many of you are interested in her progress so regarding Baby B's current health status, I relate here the observations of her birth parents.

1. Social workers have testified that Baby B must wear braces. The Baynes have never seen these on her. She wears sole inserts to correct her arch. She is observed walking better without the inserts.
2. Baby B has recently been discharged from the Sunny Hill Vision Program as her vision is "the low side of normal". 
3. Baby B is developmentally behind in her speech and will need speech therapy. 
4. Baby B understands everything one says to her and responds accordingly. She feeds herself, is now potty training. She loves to read, colour, play ball, dance, sing and clap.
5. The Ministry has made an affidavit statement that she has cerebral palsy. No such medical disclosure to validate this has been submitted to the Baynes or to the court.

MEDICAL HISTORY PART 2 of 3 / Part 234 / For Love and For Justice / Zabeth and Paul Bayne/

Providing it in several parts, this will be as definitive a medical history on the Bayne infant as you will read online.

At the start of the MCFD hearing for a continuing care order for all three Bayne children, Judge Tom Crabtree in his wisdom ruled that there would be no ban on information presented during the court proceedings. The medical reports are a component of the submissions presented during cross exmaination. I have access to this information. Medical testimonies have been heard although not all of them have been ruled as admissible by Judge Crabtree.

This is what I have read. I have chosen not to do a narrative but to cite the medical data factually. I RESTATE OR CAPITALIZE A FEW KEY OBSERVATIONS.

Dr. Anquist: Baby B remained at MSA Hospital from October 6-9 in the care of Dr. Warren Anquist, during which time tests were done and cultures remained negative so she was discharged. His note mentions that Baby B was okay until ten days prior when she was on the floor and seemed to whimper. THERE IS MENTION OF THE BROTHER STUMBLING UPON HER. She vomited and struggled to breath. He says her fontanelle was full but not bulging. He notes poor feeding and regurgitation. He notes some concern about POSSIBLE INTRACRANIAL BLEEDING and suggests observation of serial head circumference. Her overall tone was reasonable. CURIOUSLY (in this medical note) DR. ANQUIST MAKES A NOTE ABOUT PAUL BEING RECENTLY LAID OFF FROM HIS WORK IN A FOUNDRY BUT DOING WEB DESIGN NOW AND ZABETH TEACHING PIANO AT HOME. ( In fact he did not do web design but hand drawn sketches and was offering drawing classes.)

Dr. Ebesh: Dr. Ebesh followed up with Baby B on October 16^th. He noted that her HEAD CIRCUMFERENCE HAD INCREASED TO 40 CM. (up from 33 cm at birth). He made arrangements for a head ultrasound and a CT scan which revealed bilateral subdural hemorrhages and fluid collections.

Dr. Numweiler / CT Scan: On October 18, 2007 Baby B (2 mo and 15 days old) was admitted to Chilliwack General Hospital for a CT/Head scan conducted by Dr. Christine Numweiler. Prior to the scan the doctor was provided with a history of the child's trauma and sub-acute subdural hematomas. She found bilateral pan hemispheric subdural hypo attenuating fluid collections and a left extra-exial cerebellar hypo-attenuating fluid collection that she viewed as consistent with subdural hematomas.

Dr. Colbourne / Paediatrician / Child Protection Service Unit / BCCH

On October 18, 2007 Dr. Colbourne reported her findings to Loren Humeny (MCFD) and Hope RCMP Constable Taylor. She notes that the parents have recounted a mid September episode in which a sibling brother fell on Baby B with heads colliding. Baby B cried but had no signs of bruising or swelling. She was checked by a family doctor the following day. She appeared well. Colbourne records that the family estimated it was a few days later that Baby B vomited and developed an unusual cry. She even appeared to the parents to go limp and pale and in need of mouth to mouth breaths. (Dr. Colbournes summary missed the following detail perhaps because she was not informed about it: Paul performed CPR on Baby B at home and then Zabeth performed CPR in the van on route to the hospital.)  The family took the baby immediately to Hope Hospital. Although shortly she looked well and was discharged, the parents said she did not feed and so they returned with Baby B to the hospital. She was assessed and transferred to MSA Abbotsford. She notes that Paul's father had childhood epilepsy which resolved in adulthood. There's a suggestion of a venous bleeding disorder in the maternal grandfather. Colbourne herself found that Baby B did not follow with her eyes, the fontanelle was bulging and sutures splayed. Head circumference measured 41 cm. She handled well and all four limbs moved well. With the CT scan from MSA Hospital and the ophthalmologic results from Dr. Gardiner and the MRI from Dr Poskitt, Dr. Colbourne concluded that Baby B had VERY LARGE CHRONIC SUBDURAL HEMORRHAGES, EXTENSIVE UNILATERAL RETINAL HEMORRHAGES AND A FRACTURED PROXIMAL LEFT FEMUR. THESE SHE FOUND TO BE INDICATIVE OF INFLICTED TRAUMA AND CONSISTENT WITH A SHAKING TYPE OF INJURY. SHE SURMISES THAT THE COLLECTION OF FINDINGS POINT TO A TRAUMA PRIOR TO SEPTEMBER 26^TH PRESENTATION. SHE REPORTED THIS TO MCFD AND THE POLICE.

Dr. Gardiner / Ophthalmology: Dr. Jane Gardiner, (paediatric ophthalmology) examined Baby B on October 19^th because, as she was informed, there was presumed non-accidental injury. She had retinal hemorrhages on the left side. Her visual attention was questionable. As she wrote this note to Dr. Cochrane on Nov 6, 2007 she had examined the child again that day and stated that she WAS NOT CONVINCED THAT THE CHILD COULD SEE, not responding to bright lights or follow the OKN drum reliably either horizontally or vertically. She still had a subhyaloid hemorrhage temporal to the macula and may have macula damage. There were faint deeper hemorrhages temporal to this. Most earlier hemorrhages had been resolved. SHE CONCLUDED THAT THE CHILD WAS INAPPROPRIATELY VISUALLY ATTENTIVE FOR HER AGE and referred Baby B to Dr. Carey Matsuba.

Part 3 of 3 tomorrow