Medical Child Abuse

Art Papier apapier at VISUALDX.COM
Sun Nov 13 14:54:45 UTC 2016


Mark,
In addition, and related, there are predictable medical diagnoses in
children that have been erroneously diagnosed as child abuse.  In
dermatology, lichen sclerosis which often presents with ecchymoses
(bruising) of the labia, or glans is prematurely closed as abuse.  Parents
have lost their children to social services only 6 months later to be told
"we made a mistake".....

https://www.ncbi.nlm.nih.gov/pubmed/25725976
Arch Pediatr. 2015 Apr;22(4):383-6. doi: 10.1016/j.arcped.2014.12.016. Epub
2015 Feb 26.
[Vulvar lichen sclerosus in children misdiagnosed as sexual abuse].

https://www.ncbi.nlm.nih.gov/pubmed/17666933
Pediatr Emerg Care. 2007 Jul;23(7):482-5.
Lichen sclerosus in the differential diagnosis of suspected child abuse
cases.
Isaac R1, Lyn M, Triggs N.

Bleeding disorders, osteogenesis imperfecta, rickets, Ehlers-Danlos are a
few more examples, but there is a much longer list.   These skin signs of a
bruise, a burn like blister, a broken bone often have very quick momentum
erroneously to being abuse.   Dermatologists collect images of these
diagnoses and the photos are revelatory in helping to understand how this
happens.  These are horrible incidents of diagnostic error when they occur.


Art

Art Papier MD
Associate Professor of Dermatology and Medial Informatics
University of Rochester
CEO VisualDx






-----Original Message-----
From: graber.mark at GMAIL.COM [mailto:graber.mark at GMAIL.COM] 
Sent: Saturday, November 12, 2016 11:59 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: [IMPROVEDX] Medical Child Abuse

This is hopefully not a diagnosis you'll encounter, but the relatively new
diagnosis of "medical child abuse" is taking hold in certain areas of the
country.  Parents so charged can lose custody of their children and be
subject to criminal proceedings.  

The enclosed review by Maxine Eichner studies this issue from a diagnostic
error perspective, and concludes that this diagnosis has no firm criteria,
and may often be incorrect.  Her scholarly article will hopefully shed some
light into this dark and messy area. The review was just published online by
the UC Davis Law Review {50 UC Davis L. Rev. 205 (2016)}

Mark

Mark L Graber, MD FACP
President SIDM







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