The Minister's letter to parents DCFS review - before PACA start crowing

David Southall the DCFS and the clues about what was going on

Oh really David. not more "unnamed" paediatricians - FOI's will reveal names! Stalking the parents for research weren't you!! Oh dear PACA members ... best start taking yourselves off the GMC register now!

Rupert Anthony Risdon "I swear by almighty God ....."

What's it called when you bare face lie on oath, in police witness statements and your CV?

Is it a criminal offence? Would we, mere mortals get away with it?

So, everyone interested in the truth and justice, perhaps you need to ask questions about what the hell is going on - power to the people and all that may I suggest jack Straw first!

Expert witness fees are paid out of our taxes, training for doctors are paid for out of our taxes, the court cases are paid for out of our taxes, we have the right to know why somebody who's statements in court do not tally with the truth, is allowed to carry on working with impunity.

You may recall, that in previous witness statements placed on this blog, that Rupert claims to have obtained his Diploma in Medical Jurisprudence in 1992, I have no idea why he has stated this, when it's not true. I can only surmise that there is something around him having to have it in 1992 to do something else in his career, or to make it appear that he has had qualifications longer than he has, you know "big himself up" in court. It matters not, he is a servant to the court as an expert witness and a Home Office Pathologist and he lied, not for the first time either, which puts into jeopardy everything he has ever said.


Subj: Dr Rupert Risdon
Date: 20/11/2009
14:53:25 GMT Standard Time
From: registrar@apothecaries.org
To: daretocare1@aol.com

Dear Mrs Mellor,

Your email to Mrs xxxx has been passed to me for reply. Dr Rupert Risdon passed the Diploma in Medical Jursiprudence (Pathology) in January 1994.


Yours sincerely,

Mrs xxxxx xxxxxx Registrar, The Worshipful Society of Apothecaries of London 020 7236 1180

www.apothecaries.org

Shaken Baby Syndrome being reviewed by CPS yet again

Well well, here we go again, the CPS are currently reviewing shaken baby and the RC of Pathologists is having a meeting about it all too.

You won't find any public announcement regarding this issue, I found out via FOI apps and I quote!

Although we are having a look at our SBS guidance, this is as a result of a number of challenges to the established hypotheses around SBS that have prompted this trawl/review and not just the Miah case.

Smack of 2004 - you'd better believe it! Still if the job had been done properly in the first place, this wouldn't have happened would it?

You heard it here first folks!

And BTW Rupert Risdon, it isn't just about the evidence, it's about the quality of that evidence and the reliability of who gave the evidence - I see blue flashing lights and experts being in the dock, literally, when I drop the evidence I now have in the lap of the police.

Shall we introduce polygraph tests now? Rupert does Jeremy ....... Oh sorry that wouldn't happen, the man from Debretts, too low brow!

You can all run, but you can't hide!

C U in court boys!

CNEP consent forms forgeries and tampering with records

Does the NHS put the first name of any child that's just been born on anything?


The answer is NO, they don't, because parents change their minds or haven't named them yet, so the regulations state that baby's name is baby followed by the surname of mother.

Can David Southall, Martin Samuels et al and Iain Chalmers and Edmund Hey now explain how it is that the consent forms had the first names of the children on when they were randomised into the trial 2-6 hours after birth given that their first names could NOT have been on there had those forms been originals?

Can they also explain how it is that the first names were all over the medical records from the go get even though in one case the baby wasn't named until it had died and was christened?

Just to let you all know you're not getting away with this! You thought it was over after Henshall, it isn't.

OK we're having a CNEP moment David Southall et al

It's funny how the evidence needed 10 years ago suddenly comes to light, thanks to the dedication of an investigative journo!

So Edmund Hey and Iain Chalmers reckon the consent forms weren't forged do they? There again, given their involvement, that would be the line they followed and as ever they gave themselves away in the BMJ (must stop rhyming my points!)

I know alot of readers won't know what I am talking about, however the RCPCH and PACA will, won't you, corrupt sons of bitches.

Just look at the list, any wonder the RCPCH backed Davey boy and PACA were formed !! Surely not, unconsented research dressed up as clinical treatment ...... Conspiracy? You had better believe it!



We thank Horner and Wells, Huntleigh Technology, Vickers Medical, Vivienne Young of Brunel University, P and M Snowdon, Fisons, Garfield Weston,and the New Moorgate Trust Fund for help in developing this respiratory support system. We thank the nurses who cared for the patients and the doctors who supported us in their management:

D Barltrop,
M Bommen,
J J Bowyer,
J M Bridson,
M J Bruerton,
K Costello,
R Dinwiddie,
D A Ducker,
D J Field,
H R Gamsu,
A Greenough,
P A Hamilton,
D Harvey,
T J Lissauer,
W Lenney,
D J Matthew,
A C Meeks,
N Modi,
M C Peard,
M L Rigby,
R P A Rivers,
S A W Salfield,
E A Shinebourne,
M Silverman,
S A Spencer,
R M Thomas,
B Valman,
J 0 Warner,
and A G L Whitelaw.
MPS is funded by the Clinical Research Committee of the National Heart and Chest Hospitals (NHCH) and DPS by NHCH and the Foundation for the Study of Infant Deaths (United Kingdom).
=

Connective Tissue Disorder Retinal haemorrhaging and Cerebral Infarcts and alleged SBS

Of course, only shaking can cause these sorts of injuries ..... Now do you think the experts will ever bother asking for a full family clinical history? No, they never do.

Here's am idea, how about the family attend one expert wirness meeting and all the experts instructed in the case can ask for a history and ask questions relevant to their expertise BEFORE WRITING A REPORT, rather than writing reports based on other reports without ever having met the family, it then goes to trial and family court at a cost of hundreds of thousands, it may even end up in a conviction and all this might only come out at appeal too late - lives destroyed ... Yes folks, rather than just do this one small and sensible thing, the system ploughs on at huge cost to families and us the tax payer, with no regard to common sense! What was it Leveson said???





PEDIATRICS Vol. 100 No. 4 October 1997, p. e6


ELECTRONIC ARTICLE:

Two Cases of Incontinentia Pigmenti Simulating Child Abuse
Lydia Ciarallo

Division of Emergency Medicine Department of Pediatrics Brown University School of Medicine Providence, RI 02903

Amy S. Paller

Division of Dermatology Department of Pediatrics Northwestern University School oof Medicine Chicago, IL

ABSTRACT
CASE REPORTS
DISCUSSION
ABBREVIATIONS
REFERENCES


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ABSTRACT

In the United States 1.4 million children were maltreated in 1988, resulting in an estimated 2000 to 5000 deaths.1 Largely due to the rising awareness and sensitivity to the horrors of child abuse, the number of deaths declined to approximately 1500 in 1993.2 Guidelines have been published to aid in the identification and management of child maltreatment,3 and reporting of all suspicious cases is mandated by law. In our zealous efforts to protect children, some families are investigated because of misdiagnosed abnormalities, often cutaneous,4 leading to the unintentional injury of both patients and their families.5

In this report, we describe two patients with cutaneous and/or visceral manifestations of incontinentia pigmenti (IP) who were initially thought to be victims of child abuse.

Key words: incontinentia pigmenti, child abuse.


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CASE REPORTS

Case 1

The patient is a 6-day-old girl transferred from an outside hospital for seizures. She was born at 41 weeks gestation by spontaneous vaginal delivery (birth weight 7 pounds), to an 18-year-old primiparous mother who denied chlamydial, syphilitic, or gonorrheal infection, or substance abuse (alcohol, drugs, tobacco). There was no history of premature rupture of membranes or maternal fever. The delivery was complicated by thin meconium requiring oropharyngeal suctioning without intubation. Vitamin K was given intramuscularly. The infant was discharged to home at 24 hours of life.

On the second day of life, the primary care takers (mother and maternal grandmother) noted seizure activity, described as eye deviation to the right, left upper extremity flexion with adduction, and right upper extremity extension with hypertonicity. These episodes lasted approximately 30 seconds each, occurred three times per day and were associated with cyanosis. The patient was noted to have decreased oral intake and three loose stools on day 3 of life. There was no vomiting or fever reported and no history of trauma or medications. The family history was notable for a seizure in a maternal aunt; no history of sickle cell, bleeding or clotting diseases existed. The maternal grandmother was involved with the Department of Child and Family Services, which handles child abuse, when the patient's mother was 6 years old and again at the age of 10 years. Both cases were unfounded and dismissed. The patient was seen by a visiting nurse who advised that the patient be evaluated by a physician.

The patient was seen by a physician on day 5 of life, who transferred the infant to a nearby community emergency department because of brief recurrent seizures. At the emergency department the physical examination was notable for a quiet, seemingly withdrawn infant with stable vital signs, bilateral retinal hemorrhages, hyperpigmented macules, primarily on the anterior thorax and the extremities (lower greater than upper extremities) and ecchymoses over the buttocks and the lumbar spine (Fig 1 and Fig 2). The heart, lung, and abdominal examinations were normal. The evaluation included a lumbar puncture (1 white blood cell[WBC]/mm,3 12 red blood cell [RBC]/mm,3 glucose 86 mg/dL, protein 89 mg/dL), a complete blood cell count (WBC 15 700 k/microL; hemoglobin [Hb] 17.5 g/dL; platelets 87 000 k/microL), coagulation studies (prothrombin time [PT] 12.5 seconds, partial thromboplastin time [PTT] 22.7 seconds) and a computed tomography [CT] brain scan (diffuse cerebral infarcts and edema with sparing of the basal ganglia, thalamus, cerebellum and brainstem) (Fig 3). The patient was given phenobarbital, ampicillin, and ceftriaxone before transfer to a pediatric medical facility. The primary diagnosis was shaken baby syndrome.


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Fig. 1. Linear streak of pigmentation and erythematous vesicles along the pattern of Blaschko's lines on the left arm.
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Fig. 2. The back and buttock region are covered with swirls and streaks of hyperpigmentation and purple discoloration with patches of vesicles, all along the lines of Blaschko.
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Fig. 3. Diffuse cerebral infarcts and edema.
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On arrival to our hospital, the infant was stabilized in the emergency department and admitted to the intensive care unit. Further anticonvulsant therapy as well as endotracheal intubation was required. Neurosurgical and social work evaluations were instituted immediately. Ophthalmological consultation reported bilateral retinal hemorrhages. The initial assessment of the emergency medicine and intensive care physicians was that of nonaccidental injury. A report was filed with the Department of Child and Youth Services. A state investigator for the Division of Child Protection interviewed the family and examined the child 24 hours after the patient's admission to the hospital. The police were notified shortly thereafter and photographed the infant's dermatologic findings.

The diagnosis became clearer with pediatric dermatologic con-sultation that recognized the ecchymoses to be hyperpigmented swirls that followed the lines of Blaschko. Within 24 hours, vesicles appeared with patterning along Blaschko's lines. Further probing of the family history revealed the maternal grandmother had multiple miscarriages; the maternal grandmother and the maternal great grandmother had early-onset cataracts; the maternal grandmother had retinal detachment; and the mother and the maternal aunts had similar skin findings as children (one maternal aunt has persistent skin lesions as an adult). The family history in conjunction with the neurologic, ophthalmologic, and especially the dermatologic findings pointed to the diagnosis of the X-linked dominant genetic disorder IP. Skin biopsy confirmed the diagnosis.

Case 2

The second patient is a 1-month-old Hispanic girl who was brought to the emergency department by her parents because of a worsening skin rash. The neonate was an 8 lb, 3 oz product of a full-term gestation to a 33-year-old gravida 5 para 3 mother after an uncomplicated pregnancy. She was born via cesarean section because of a nuchal cord. There were no problems in the nursery and she went home with her mother. At approximately 2 weeks of age the patient developed vesicular lesions on her back and arms that crusted over shortly thereafter (Fig 4). The patient's pediatrician referred the infant to a dermatologist who made the diagnosis of impetigo. New skin lesions developed in addition to the impetiginous ones over the patient's third week of life. During a visit with her pediatrician at 24 days of life, hyperpigmented linear lesions were noted on the patient's trunk and faintly on the extremities (Fig 5). Poor weight gain was documented (weight 25th percentile, length 50th percentile). The hair, (limited) ophthalmologic, and neurologic examinations were normal. Nonaccidental injury and neglect were suspected and a social worker was notified for consultation. The state Department of Child and Youth Services was contacted for further investigation.
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Fig. 4. Forearm vesicles with overlying granulation tissue.
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Fig. 5. Streaks of hyperpigmentation on the chest and proximal right arm.
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The next day additional hyperpigmented linear lesions were noted by the mother on the infant's trunk and extremities. The family brought the infant to the emergency department for a second opinion and further evaluation. The family history revealed that the patient's mother had two prior miscarriages and the maternal grandmother had three miscarriages as well as three healthy daughters. The mother denied having any dermatologic disorders as a child, though on examination she did have several barely visible areas of decreased pigmentation in linear streaks on the back of her legs. Based primarily on the dermatologic findings, the clinical diagnosis of IP was made by the pediatric emergency physician and confirmed by a pediatric dermatologist. Future evaluations with neurology, ophthalmology, and genetics were arranged; social services was made aware of the diagnosis.


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DISCUSSION

Suspected nonaccidental injury must be reported to the appropriate authorities. Misdiagnosed cases of child abuse also deserve reporting to prevent recurrent misinterpretation by others. Many examples of cutaneous disorders that were misdiagnosed as a result of suspicious findings have been published.8 These are the first published case reports of IP as a potential masquerader of child abuse.

IP is a rare genodermatosis. It is a multisystem, neuroectodermal disorder characterized by dermatologic, dental and, in a minority of patients, ocular and neurologic abnormalities. The name IP describes the characteristic, although nonspecific, histological finding of incontinence of melanin in the superficial dermis.17

The cutaneous manifestations of IP are diagnostic. Although four stages have been described, all stages do not necessarily occur and several stages may overlap.17 The lesions of the first stage, collections of linear vesicles overlying erythema, usually develop within the first 6 weeks of life. This initial inflammatory phase is often accompanied by a marked peripheral blood leukocytosis with eosinophilia.18 These lesions can be mistaken for bullous impetigo, herpes simplex, epidermolysis bullosa, dermatitis herpetiformis, or even second degree burn injury.19 Biopsy sections of lesional skin demonstrate intraepidermal pustules of eosinophils, allowing the diagnosis of IP to be confirmed. By the first few months the second phase is seen, with verrucous plaques, often in a linear configuration.

The lesions of stage 3 are considered the hallmark of IP. The hyperpigmentation can be very localized or extensive, but presents as streaks on the extremities or whorls on the trunk. These pigmented lesions remain static for several years until they fade during childhood or adolescence.19 Some patients have localized areas of persistent pigmentation. In other patients, flares of the vesiculopustular or even the verrucous lesions occur.

The fourth phase of hypopigmented and/or atrophic streaks occurs in 14% and 28% of patients respectively, and may persist into adulthood. Approximately 30% of patients have cicatricial alopecia, which may be the only persistent sign in adult women.18

All of the cutaneous manifestations show patterning along Blaschko's lines, paths of ectodermal cell migration during embryologic development of the skin. This X-linked dominant disorder is generally lethal for affected boys who do not have a normal X chromosome. However, functional mosaicism occurs in affected girls because of random inactivation of the X chromosome at 12 to 16 days gestation. Expression of the IP as streaks occurs with activation of the mutant gene. Within the spectrum of IP are girls with minimal involvement and others with extensive involvement, as in both of our patients.

Central nervous system manifestations probably require fairly extensive activation of the mutant gene or disturbance of critical brain regions. Seizures, as seen in case 1, are the most common disturbance and have been described in approximately 13% of patients.18 The CT scan findings of the brain of patient 1 are consistent with the expected neuropathologic findings of hemorrhagic white matter encephalopathy with massive edema. Atrophy eventually develops.19

Ocular anomalies occur in one third of IP patients, particularly strabismus and cataracts. (Patient 2 was found to have a moderate left eye esotropia on ophthalmologic follow-up examination at 6 months of age.) Retinal vascular changes, as evidenced in our first patient with hemorrhages and cotton wool spots, are the most frequently reported intraocular abnormalities, and can lead to blindness. Pseudoglioma, a fibrovascular retrolental mass, can evolve to retinal detachment, as in the maternal grandmother of patient 1. This mechanism is thought to be analogous to retinopathy of prematurity.20

These two cases stress the importance of disease recognition by pediatric specialists, and of a thorough family and social history. In our first case, the maternal grandmother's previous involvement with the Department of Child and Youth Services was considered to be evidence in favor of nonaccidental injury. Victims of child maltreatment are more likely to become abusive parents.3 Further exploration provided pivotal information against nonaccidental injury, in that it was the mother's characteristic IP skin lesions that had twice (at age 6 and age 10 years) been misinterpreted as possible intentional injury.

IP is rare and is frequently recognized only by pediatric specialists. This illness is vulnerable to misdiagnosis given that the cutaneous findings alone can mimic traumatic injuries. Herpes simplex is the most common misdiagnosis in the neonate with blisters and seizures. The additional findings in IP of hyperpigmented skin streaks and hemorrhagic manifestations of the eyes and brain easily lead one to consider child abuse. IP should be included in the list of childhood diseases that can be misinterpreted as child maltreatment.


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FOOTNOTES


Received for publication Dec 31, 1996; accepted Mar 19, 1997.


Reprint requests to (L.C.) Department of Emergency Medicine, Rhode Island Hospital, 593 Eddy St, Providence, RI 02903.

Quote of the day from the National Police Improvement Agency??..

These people are Police Officers and hold the register for Home Office registered Pathologists and they believe that because a website states that Risdon is a Prof, he is???????? Despite the evidence he isn't?? OK< the system is fucked and stupid! They're confused, so am I, they take a posting by GOSH as evidence over the evidence from the people that could have awarded him a professorship?? Yep that'd be right - Operation Good Guys?

OK people protest your innocence on an official website and the police and CPS will go away .....


There is no evidence that Professor Risdon was not a consultant histopathologist at
Addenbrokes and Barts. In the absence of such evidence I determine that the first
complaint is not valid and it will not be referred to the Board’s Disciplinary
Committee.

The Institute of Child Health at University College London which is part of the
University of London currently describes Professor Risdon on their website:
Name Prof Tony Risdon MD DMJ FRCPath
Job title Emeritus Professor/Honorary Consultant Paediatric Pathologist
Special interest(s) Paediatric Pathology, Forensic Pathology



© NPIA (National Policing Improvement Agency) 2007
have sent me a communication from UCL expressly stating that he was awarded a
Professorship in Histopathology on 27 February 1985

Musical Interlude

http://www.youtube.com/watch?v=zln0wp98LKs



Rihanna - ‘Russian Roulette’ Lyrics

Take a breath, take it deep
Calm yourself, he says to me
If you play, you play for keeps
Take a gun, and count to three
I’m sweating now, moving slow
No time to think, my turn to go

[Chorus -- ]

And you can see my heart beating
You can see it through my chest
And I’m terrified but I’m not leaving
Know that I must must pass this test
So just pull the trigger

Say a prayer to yourself
He says close your eyes
Sometimes it helps
And then I get a scary thought
That he’s here means he’s never lost

(Chorus)

As my life flashes before my eyes
I’m wondering will I ever see another sunrise?
So many won’t get the chance to say goodbye
But it’s too late too pick up the value of my life

(Chorus)

For the Americans your experts in alleged Shaken Baby and some advice

Your experts are:

John Plunkett - Pediatric Neuropathologist Virginia e-mail: plunkettj@frontiernet.net

Professor William Dobyns - Pediatriac Geneticist, Pediatric Neurologist, Pediatric Neurogenics adviser to the World Health organisation on epilepsy and seizure disroders e-mail wbd@genetics.bsd.uchicago.edu

Dr David Ayoub Clinical Radiologist 701 N 1st StSpringfield, IL 62702(217) 788-3245

Some other causes of skulll or body fractures other than abuse:

Erhlers Danlos Syndrome

Birth trauma

Osteogenisis Imperfecta

Vitamin D deficiency

Anemia


You must get a full family clinical history from all family members on both sides of the family. All sudden infant deaths. Any bone problems etc - this information is vital to helping to solve why a child has died.

Finally, despite what the experts are saying, there are recorded cases of fractures where there has been an underlying genetic disroder, in which there has been no sign of bone demineralisation even in high density radiography. I have the case records. Doctors both in the US and UK look at PUBMED and if it isn't on there they say that it doesn't happen - not all medical papers and case reports are on PUBMED - it is not the Holy Grail that they all rely on almost exclusively - lazy researchers! Google google google, that's the way to find the evidence.