A judge in a rural town made an emergency care order for two children after a consultant paediatrician said that bruising more likely than not was caused by non-accidental injuries. Child A attended a creche and child B was an infant. The judge made the order a week after refusing an interim care order where the reports had not been served on the parents, who were not legally represented.
Initial interim care order hearing
During an interim care order hearing, while the social worker was giving evidence the family GP arrived suddenly into the court to give evidence in support of the parents. The GP had left her surgery and run to the court in her scrubs when she had heard this matter was before it. She gave evidence from the court and not from the witness stand. She said she did not dispute the family and the parents had issues and problems but that she had examined the children that day and they were medically well. She urged the court not to remove the children.
The solicitor for the CFA said that there had been concerns from the creche and the creche manager was outside waiting to give evidence and could be called. The creche manager entered the court. Without going into the witness box or being asked to swear an oath that she would tell the truth, the creche manager started to tell the judge of the concerns the creche had, including that they children had repeated head lice, were hypervigilance, and the creche had concerns regarding A soiling and wetting on return from an unplanned trip. She had also noted deep red marks on A about four months earlier.
The creche had completed social work referrals. The parents started to challenge what the creche manager had said. The creche manager said she was not sure about the reports as she was not on duty at the time.
The judge said: “What is going on here?” She asked the GP if she had seen the report from the hospital paediatrician. The GP replied her understanding was the children only attended the hospital very recently and the paediatrician’s report had not yet arrived at her practice. All parties then started to talk over each other.
The judge told all parties to stop. She said what she had heard was likely to be only the icing on the cake. She said, a GP ran from her busy practice to support the parents. The CFA had not served all these documents on the parents, they had made application for an interim care order when they knew the parents had no legal representation, the CFA must get their act together.
The solicitor for the CFA said they wanted to proceed with the application. The judge said she was very concerned about the allegations that bruises had been covered with make-up, but this matter would take at least two hours to hear. The judge said the CFA could make their case, but the parents needed legal representation. She said she would not make any orders and adjourned the matter to the next date for child care cases. The CFA said they had concerns for the children. The judge replied she also had concerns but there were plenty of avenues open to the CFA to ensure the safety of children.
Emergency care order hearing
When the case came back to court a week later the parents were both in court and had applied for legal aid but had not yet been assigned representation. Evidence was heard from a consultant paediatrician, the deputy manager of the creche and the social worker. The judge invited the parents to ask questions of all the witnesses. She also invited the parents to give evidence, which the father did. The judge explained to the parents what an emergency care order was. She said she must hear the evidence and make a decision that day but was cognisant the parents did not have legal representation.
Evidence of the consultant paediatrician
The paediatrician confirmed he was a general paediatrician and had been in practice for the previous 30 years. He confirmed he had treated A when she was a toddler for a skin issue which required a referral to a tertiary centre but had resolved with no ill effects. To the best of his knowledge there had been some child protection concerns at that time by the tertiary centre. The tertiary centre had organised multidisciplinary meetings and there had been involvement by the CFA. He said as this had happened at the tertiary centre he could not comment further.
He said he had been asked to review child A by the CFA as unexplained bruising, which had been covered by makeup, had been noted whilst the child was in creche. He said he completed a formal examination of the child. He noted that she was growing normally, along her percentile line and was maintaining her height and weight (growth velocity) on the percentile charts. (A child of a specific age should not be a specific height or weight but whatever percentile line they start at as a baby should be maintained as they grow). A was growing along her percentile line.
He noted that A was happy, active, and interactive. She had a normal gait and normal tone. All her vital signs were within normal parameters.
He noted she had five small bruises to her right upper forearm measuring approximately 0.9cm x 0.9cm. He stated that no adequate explanation had been given for these bruises and although an accidental injury was possible it was more likely than not that they were caused by a non-accidental injury. He noted three bruises to the left upper arm of approximately the same size as those on the right arm. Again, he stated that although an accidental injury for these bruises was possible it was more likely than not that they were caused by a non-accidental injury. He noted that these bruises were consistent with the size and spacing of adult fingers.
He noted bruises to her chest and back and the reasons given for these were accidental falls from a trampoline. The paediatrician accepted that this could have been a plausible explanation but felt the explanation did not fit with the bruising pattern. He again stated these bruises were more likely than not caused by a non-accidental injury. He noted bruises to her hip which again could be accidental but were more likely than not non-accidental. He noted bruises to her knee and leg which he believed to be accidental in nature and the result of normal childhood play.
The judge invited the parents to ask the paediatrician any questions. The father said that the bruises to A’s arm had happened because she had run into the road, and he grabbed her to save her. He said that neither he nor the mother had ever hit the child on the arm and these bruises were caused by playing.
Evidence of the creche deputy manager
The creche deputy manager said that they had noted marks on A about four months ago and had reported them to the social worker. She said she noted bruises again recently across A’s arms and shoulders and noted these bruises were covered in makeup. When she asked A what happened A could not say, she said she did not know.
The creche also had reported to the CFA concerns that her behaviour had regressed after a trip A had taken with her parents. She had started to soil and wet herself and it took several weeks but she had been retrained. She said that A was at times very chatty and at other times she could be shy. The judge asked the father if he wanted to ask questions and he said no.
Evidence of the social worker
The social work said the family were known to social services. There had been long and ongoing concerns. The children’s names had been placed on the child protection notification system register (CPNs). She said the family’s accommodation was poor. There was often no electricity in their house or no food. The house was generally in a very unkempt manner. There were often strangers and others in the house.
She said the parents were disadvantaged socially, economically, and intellectually. A parenting capacity assessment had been completed and found the parents did have capacity to parent A and B but needed intensive support and supervision. There had been numerous referrals from the creche regarding A. The creche had noted red marks and bruising on A’s shoulder about four months ago. The creche had also made a referral for regressive behaviour, she had started to soil and wet herself after she had been previously toilet trained. She had also started to ask to use a baby’s bottle to drink from. These behaviours had surfaced after A had returned from a trip taken with her parents.
She said the parents had said there were in another county, but it had come to light they had left the jurisdiction. She said there had been another more recent referral from the creche wherein the creche had noted bruises to A’s arm and shoulders and these bruises had been covered in makeup. The social worker said the creche had called her about this and she immediately attended to it.
She said she had called the parents to notify them of this and before she had arrived at the creche the parents had called to the creche to collect A. The social worker attended at the family’s home. She said the mother did admit to covering the bruises with makeup but neither parent gave a plausible or consistent narrative to explain the bruises. She said this was the second time there had been unexplained marks on A.
When the previous marks had been noted she had advised the parents to take A to the emergency department, but they had taken her to the out-of-hours GP. The parents had often visited the out-of-hours GP for various childhood ailments. She said she had invited the GP to the case conferences and child protection meetings, but the GP had never attended. She had contacted the GP about that day’s application but had not heard back from her. She said the GP had received the consultant paediatrician’s report but she was not in court for today’s application.
The social worker said that she met with the family weekly and there were other supports in place, which included a family support worker who visited daily. The family had worked closely with all professionals but the concern for the children had only increased, and she could no longer stand over the safety of the children.
Extra support had been put in place following the birth of B and while the parents worked well with the support worker things had deteriorated. Since last week when the judge had declined the interim care order, she had asked An Garda Siochana to make welfare checks over the weekend.
The father said he did not want to ask the witness any questions. The judge then invited the father to come into the witness stand, take his time and tell her anything that he felt she should know.
Evidence of the father
The father said that he and the mother of the children had always cared for the children and worked with the social care team. He said they had never hit the children. He said: “As God is my witness, we have never hit the A. I don’t know how those bruises happened. She was running into the road, and I grabbed her to stop her. We have a naughty step, I will admit when she is bold, I will tap on the bum and then put her on the step, but we have never hurt them. We never would.”
He said that both he and the mother of the girls had grown up in care and knew what it was like, and he did not want that for his children. He disagreed with the CFA and the evidence of the social worker. He said they had worked with the family support worker, and she had not a bad word to say against them. He said there had been times when they had had a drink, but they had not touched it since last week when they had been in court. They wanted the children to stay with them and keep their children at home. He was not asked any questions by the judge or the solicitor for the CFA.
The judge left the court to make her decision and returned approximately 30 minutes later. She said she had reviewed all the evidence and that since her appointment as a judge it was the hardest decision she had had to make to date. She said she had no doubt the love the parents had for the children and they had many of their own challenges but that her responsibility was to the children.
She said: “Section 13 of the Child Care Act 1991 states: ‘If a justice of the District Court is of opinion on the application of Child and Family Agency that there is reasonable cause to believe that—
(a) there is an immediate and serious risk to the health or welfare of a child which necessitates his being placed in the care of Child and Family Agency, or
(b) there is likely to be such a risk if the child is removed from the place where he is for the time being,
the justice may make an order to be known and in this Act referred to as an emergency care order. (2) An emergency care order shall place the child under the care of Child and Family Agency for a period of eight days or such shorter period as may be specified in the order.”
“I have to decide I am of the opinion that there is reasonable cause to believe that these children are at risk of immediate or serious harm.”
She said she had heard the evidence of the consultant paediatrician and that could not be ignored. She had read the reports and a parenting capacity assessment had stated these parents, with support, could care for their children. She could not ignore the evidence of the GP in court last week. She was concerned that the bruises to child A had been covered in makeup and that the parents had taken the children out of the jurisdiction but had told the social workers they were in another county.
Parents do not have to be perfect but the evidence of the consultant paediatrician, that there had been no adequate explanation of the bruises and that they had been covered with makeup and that the parents had lied to social workers about their whereabouts led her to the opinion that if she did not make the order the welfare of the children would be at immediate and serious risk.
She then spoke directly to the parents and said that she would make the order as requested by the CFA. She said: “This is not the end of the road, reunification with your children is possible but it is up to you. It is what you now do that will determine what will happen next. “The CFA must make a plan to reunite your children with you and I will make sure they do that, but you are part of that plan. You must do the work with the CFA so that you can have your children home.”
The judge granted an emergency care order for eight days. She asked the solicitor for the CFA to contact the law centre to ensure the parents’ application for legal aid and representation was forwarded as quickly as possible.