Imagine the horrible feeling of taking your five–year-old to the emergency room after a fall or what seems like a stomach bug.  Whether he has a bruise on his head or is nauseous, parents can be filled with anxiety.

But it can get worse, far worse, if the added horror of false accusations of child abuse is heaped on the parents.  It doesn’t take much for the already bad dream to turn into a nightmare of suspicion, insinuations and criminal charges.  In the worst case, the child will be taken from the parents by Georgia’s Department of Family and Children’s Services (DFCS) and the parents can be arrested for abuse.

“It’s a sequence of nightmarish outcomes arising from parents doing exactly the right things for their kids,” says Jason Nohr, a CNO attorney with substantial experience litigating medical malpractice cases and familiar with complex medical issues.  “It happens more often than it should.”

In an age of medical specialties, emergency-room physicians often call for help in complicated cases, or if the causes of the illness or injuries are unknown.   By law they are required to be alert and call for help if child abuse seems even remotely possible.  In the case of a child with certain injuries, physicians may call in a child-abuse pediatrician, who often acts like a detective in search of a crime.  And that is where problems can start.

“Child-abuse pediatricians can provide a valuable service in a valid case of abuse, but too often they come on the scene determined to document abuse,” says Nohr, who has an in-depth understanding of the legal process and issues in these DFCS cases.  “Sometimes, it seems they’ve prematurely reached a conclusion about abuse before considering alternative causes.”

When that happens, the parents are practically helpless.  If the child-abuse pediatrician driving the case concludes –– even based on suspect evidence — that parental abuse is involved, it’s likely that either the police or DFCS will be called to the hospital.  These measures are designed to protect the health and safety of the child, but what if the child wasn’t abused in the first place?  What if the symptoms actually were caused by a fall, the recurrence of an old injury, or an undiagnosed medical condition? The consequences to the entire family are devastating.

In a recent case handled by Nohr, a baby was brought to the emergency room with what was determined to be a subdural hematoma (a collection of blood between the skull and brain) that can be caused by a host of non-traumatic causes, including birth. The condition can also be cause by trauma.  It’s also common in cases of child abuse.  How do you tell the difference?

“Many child-abuse pediatricians have come to believe that every home is rife with child abuse,” Nohr says.  “What happens is that parents already devastated by the injury to their child are now victimized by the arbitrariness of the system.” 

After Nohr’s cross-examination of a child-abuse pediatrician in a recent case, the judge recognized the injustice and concluded that child-abuse pediatrician demonstrated her bias in multiple ways seemed to be a “medical expert with an agenda.”  She dismissed the case, a happy ending to the family’s four-month ordeal. Through the use of medical literature and cross examining DFCS’s own experts, Nohr demonstrated in court that the hematoma was not caused by trauma or abuse.

How can a family in similar circumstances cope with this crisis in an ER?  Nohr advises parents to recognize there is a powerful system in place to deal with child abuse, a system that despite the best intentions of all involved can make new victims in its rush to judgment. The causes of these conditions are often complex and poorly understood even by emergency room physicians and other providers.

If legal advice and support is needed, find an attorney with considerable experience in medical cases.  Medicine and the law are complicated fields in their own right.  When they collide, it’s no place for the inexperienced or faint-hearted. 

“These can be very difficult cases,” Nohr says. “Taking them on requires broad experience in both medicine and the law that governs it. That’s not your garden-variety law practice.

“I’m often contacted by attorneys who are familiar with the law involved, but not comfortable assessing the medical basis for underlying questionable claims of abuse. That’s where we can help.”