Profile: Sir Roy Meadow

17 February 2006

Professor Sir Roy Meadow is one of the most influential and respected paediatricians of his generation. Many experts say his work has saved countless children from unnecessary suffering. However, his distinguished career has been blighted by controversy. After decades as a leading thinker in the field of child abuse, Sir Roy has become notorious as a central figure in three high profile miscarriages of justice. He gave expert evidence in the trials of Sally Clark, Angela Cannings and Donna Anthony. All three women were convicted of killing their children - and all three have subsequently been exonerated by the Court of Appeal after lengthy periods in prison. Mrs Clark, a solicitor, was jailed for life in 1999 for the murder of her two sons Christopher and Harry. At her trial, Sir Roy said the odds of two children from such an affluent family dying of natural causes were one in 73 million. Sir Roy Meadow Educated at a grammar school in Wigan and Oxford University Worked as a GP in Banbury Became a senior lecturer at Leeds University Took up chair in paediatrics and child health in 1980 at St James's University Hospital, Leeds Former president of British Paediatric Association Former president of the Royal College of Paediatrics and Child Health Knighted in 1998 for services to child health His claim was later disputed by the Royal Statistical Society, which wrote to the Lord Chancellor to say there was "no statistical basis" for the figure. Others have said that once genetic and environmental factors are taken into consideration, the odds of a second cot death in the same family are closer to 200 to one. Mrs Clark was eventually freed when she won her appeal in January 2003. Sir Roy stood by his evidence at a General Medical Council hearing into his actions, but he admitted he had been insensitive to compare the odds of both boys dying naturally to those of four different horses winning the Grand National in consecutive years at odds of 80-1. The retired paediatrician was found guilty of serious professional misconduct in July 2005, and was struck off the medical register. But Sir Roy appealed, and the GMC's verdicts have now been overturned. Other cases Angela Cannings served 18 months in prison for the murder of two of her baby sons. She was freed in December 2003. At her appeal QC Michael Mansfield heavily criticised Sir Roy's evidence at the original trial. He argued that, were the trial to take place now, it was unlikely the Crown would call Professor Meadow as a witness, or, if they did, it would "have to be done with a health warning attached to it". Sir Roy's evidence in the Donna Anthony trial was similarly criticised. Ms Anthony was found guilty of killing her daughter Jordan, aged 11 months, and her son Michael, aged four months, in 1998. The prosecution in her case, relying on Sir Roy's evidence, had claimed the babies had been smothered, and that Donna Anthony had been trying to draw attention to herself. Sir Roy, and another expert witness, told the court the chances of two cot deaths in a case such as hers were one in a million. But Ms Anthony had always claimed her children had died of cot death. Munchausen's Sir Roy first came to prominence in 1977 after publishing a paper in The Lancet medical journal on a condition he dubbed as Munchausen Syndrome by Proxy. Sally Clark was also convicted on evidence from Sir Roy Meadow This is a form of child abuse in which a parent induces real or apparent symptoms of a disease in a child. Perhaps the most high profile example was the case of nurse Beverly Allit, who murdered four children and harmed nine others. Professor Meadow worked on this case. But even his work in this field has been subject to controversy. In the House of Lords, Earl Howe, the Opposition spokesman on health, accused the professor of inventing a 'theory without science' and refusing to produce any real evidence to prove that Munchausen Syndrome by Proxy actually exists. Meadow's law Possibly, Sir Roy's most telling contribution is an observation in a book that became universally known as "Meadow's Law". This states that: "One sudden infant death is a tragedy, two is suspicious and three is murder, unless proven otherwise." Over the years he gained a reputation for being particularly severe when confronted with cases of multiple child deaths in one family. Many supporters, however, have championed Sir Roy, calling him a man of great skill and compassion. A spokeswoman for the Royal College of Paediatrics and Child Health "His work has undoubtedly saved the lives of many children. http://news.bbc.co.uk/2/hi/health/4432273.stm

SBS: Shaken baby syndrome guidance issued by CPS

6 January 2011

Shaken baby syndrome came to prominence after high profile cases

Head injuries alone are unlikely to be enough to charge someone with homicide, attempted murder or assault in "shaken baby syndrome" cases, according to new Crown Prosecution Service guidance.

Karen Squibb-Williams, of the CPS, said "careful consideration" would be given to decide if a conviction was possible.
So-called shaken baby syndrome broadly refers to non-accidental injury to an infant resulting from violent shaking.
The guidance updates advice issued five years ago after high profile cases.
Previous advice came after the attorney general ordered a review of all cases in the previous decade which had involved convictions for killing infants aged under two.
It followed concerns over the evidence of the paediatrician Professor Sir Roy Meadow in the Angela Cannings prosecution, which involved sudden infant death, not shaken baby syndrome.
Mrs Cannings was found guilty of smothering her seven-week-old son in 1991 and her 18-week-old son eight years later. These convictions were later overturned.
The Cannings case was one of several which raised concerns that many parents convicted of killing their children were victims of miscarriages of justice.
'Sensitive' cases
The judges who released her ruled that no-one should be prosecuted solely on the basis of medical opinion which was disputed between experts.
Sir Roy was later found guilty of serious professional misconduct and struck off the medical register, but was reinstated after an appeal which overturned the GMC's verdicts.
Sir Roy also gave evidence in the case of Donna Anthony who was freed on appeal in 2005 after being imprisoned for life eight years earlier for killing her 11-month-old daughter and four-month-old son.
Her case was one of the 28 referred to the Criminal Cases Review Commission after Mrs Cannings was released.

In its updated guidance, the CPS also urged prosecutors to challenge defence experts who claim the three head injuries generally associated with shaken baby syndrome may be explained by a lack of oxygen, infection, or raised intracranial pressure.

The defence experts' theory, known as the "unified hypothesis", was rejected by the Court of Appeal as recently as July, said Ms Squibb-Williams, who is the senior policy adviser in the CPS's strategy and policy directorate.
She said shaken baby syndrome cases were "complex and sensitive cases".
"The guidance makes clear that it is unlikely that a charge for a homicide or attempted murder or assault offence could be justified where the only evidence available is the triad of injuries," she said.
She went on to say that, in cases where the three internal head injuries are found, "the prosecutor will always consider all the surrounding circumstances and the evidence in each case before reaching a decision".
The senior policy adviser added: "Each case will have its own individual facts and very careful consideration will be given in deciding whether there is sufficient evidence for a realistic prospect of conviction, and then in considering whether it is in the public interest to bring a prosecution."

SBS: New U.K. Guidelines

Wesley Johnson: Jan. 6 2011
Head injuries alone are not likely to be enough to charge someone with homicide, attempted murder or assault in cases of so-called shaken baby syndrome, the Crown Prosecution Service (CPS) said today.

The CPS also urged prosecutors to challenge defence experts who claim the three head injuries generally associated with the syndrome may be explained by a lack of oxygen, infection, or raised intracranial pressure.

The guidance updates that issued five years ago following concerns over the evidence of the paediatrician Professor Sir Roy Meadow in the Angela Cannings prosecution and other high profile cases.

Karen Squibb-Williams, the senior policy adviser in the CPS's strategy and policy directorate, said: "These are complex and sensitive cases.

"The guidance makes clear that it is unlikely that a charge for a homicide or attempted murder or assault offence could be justified where the only evidence available is the triad of injuries."

In cases where the three internal head injuries are found, "the prosecutor will always consider all the surrounding circumstances and the evidence in each case before reaching a decision", she said.

Ms Squibb-Williams added that prosecutors should strongly resist defence claims that the three specific injuries - bleeding into the linings of the eyes, bleeding beneath the dural membrane of the brain, and damage to the brain affecting function - may be explained by a lack of oxygen, infection, or raised intracranial pressure.

The defence experts' theory, known as 'the unified hypothesis', was rejected by the Court of Appeal as recently as July, she said.

She went on: "The updated guidance makes clear prosecutors should continue to resist defence challenges to the established theory that non accidental head injury (Nahi) cases will usually be diagnosed in children where sufficient force has been used to produce a combination of three internal head injuries, known as 'a triad of intracranial injuries'.

"To prove a Nahi case you will usually require the triad of injuries plus supporting evidence."

Ms Squibb-Williams added: "Each case will have its own individual facts and very careful consideration will be given in deciding whether there is sufficient evidence for a realistic prospect of conviction, and then in considering whether it is in the public interest to bring a prosecution."

Mrs Cannings was found guilty of smothering her seven-week-old son in 1991 and her 18-week-old son in 1999.

But the judges who released her ruled that a prosecution should not be brought when it rested "exclusively" on a serious disagreement between distinguished experts.

Sir Roy has since been found guilty of serious professional misconduct and struck off the medical register.

He also gave evidence in the case of Donna Anthony who was imprisoned for life in 1998 for killing her 11-month-old daughter and four-month-old son. She was also freed on appeal in April 2005.

Mrs Anthony's case was one of the 28 referred to the Criminal Cases Review Commission after Mrs Cannings was released.

Today's guidance updates that issued following Mrs Cannings' case, which involved sudden infant death syndrome (Sids).

It also follows the case of a young mother accused of shaking her eight-month-old son to death who faced two trials before a judge threw out the manslaughter charge against her.

Fatima Miah denied prosecution claims that she had shaken baby Anas in a fit of temper in May 2007, leaving him with the brain injury from which he died, telling police he collapsed after falling off the sofa.

Judge Timothy Pontius ordered jurors at the Old Bailey formally to clear her in July 2009 after he was asked to make a ruling on the conflicting evidence of medical experts about the cause of the child's death.

On the day Anas died, an ambulance was called to the flat and he was found on the floor, not breathing, and his heart stopped for 40 minutes.

Miah, of White City, west London, faced her first trial at the Old Bailey in November 2008 but the murder charge was thrown out by a judge and jurors were unable to agree their verdict on the charge of manslaughter.

The mother faced a second trial but the judge decided to throw it out after hearing both the prosecution and the defence case.

The triad of internal head injuries was at the heart of the case, but the judge said there was a "fundamental conflict of expert opinion" on the cause of death and no "clear evidence" to back one side or the other, so he would have to direct the jury to enter a not guilty verdict.

There was no evidence of external injuries and the mother had no previous convictions or history of abuse.

http://www.independent.co.uk/news/uk/home-news/new-guidelines-issued-on-shaken-baby-syndrome-2177827.html