The District Court declined the Health Service Executive’s application for a full care order for Child 1, finding no basis to make the order after a contested hearing that began on 24 September 2008 and concluded on 12 March 2009.
The HSE’s case relied primarily on medical evidence concerning bruising and suspected fractures identified after the child was admitted to hospital in October 2007 with a fever. Doctors expressed concern that the injuries could indicate non-accidental injury. The father’s account that he may have rolled onto the child while asleep was disputed by medical witnesses and rejected by the judge as an explanation for the rib injuries.
The judge said the court had to decide whether the statutory grounds for a care order were established on proven facts, rather than suspicion. The judge described the medical evidence as inconclusive and examined the competing expert views, including the child’s Kawasaki disease, the appearance of marks while she was under hospital care, and uncertainty about the timing and cause of the fractures.
The judgment records that one paediatrician considered some marks might have been related to Kawasaki disease and said it was impossible to say how the injuries occurred. The judge also noted that medical witnesses differed on whether the proposed explanations could account for the injuries, and criticised the limits of the imaging and the delayed dating of fractures. These were the judge’s assessments of the evidence in this case.
The judge found, on the balance of probabilities, that marks appearing while the child was under medical observation were manifestations of Kawasaki disease. The fractures, the judge concluded, were more likely to have resulted from ordinary handling of a temporarily weak bone structure than from deliberate injury. The judgment did not identify who caused the injuries or make a finding that either parent inflicted them.
The court refused the full care order. It did not make an order directing the child’s immediate return. Instead, the judge said the court would await the HSE’s proposals for the child’s return and details of support to help the parents care for her after their separation from her during the proceedings.