This October, we examined the story of a Texas couple who lost custody of their newborn son because physicians misdiagnosed a genetic medical condition as the physical symptoms of child abuse. While this case was devastating for the parents involved, a year-long investigation suggests that loss of custody due to diagnostic errors is occurring with an alarming frequency in the United States.
NBC News teamed up with the Houston Chronicle on an investigative series entitled "Do No Harm." Researchers and journalists spent a year interviewing and investigating cases in which doctors and other health care professionals inaccurately diagnosed child abuse and the resulting trauma experienced by the families affected.
Journalists interviewed more than 300 families hailing from 38 states. The investigation focused on a specific subset of pediatrician: the child abuse pediatrician. This is a relatively new specialty that was only certified about a decade ago by the American Board of Pediatrics. There are currently about 375 child abuse pediatricians practicing throughout the United States. All physicians are required by law to notify authorities when they suspect a child may have been abused. Child abuse pediatricians do more, including documenting a complete picture of the child's injuries, trying to confirm whether abuse has occurred, and diagnosing not only a child's medical condition but also what caused the condition.
Researchers found that the opinion of child abuse pediatricians can have an extraordinary influence over the decisions of state child welfare agencies and dependency courts, resulting in family separations and criminal charges. What is most troubling is the fact that these opinions can be incorrect, leading to unfounded familial separation and criminal charges. Among the families profiled in the series were a couple from Michigan who lost custody of their young daughter based on the findings from an Ann Arbor child abuse pediatrician. The physician said red splotches on the baby's skin and healing rib fractures were each “diagnostic of physical abuse.” Further testings revealed that the child had a significant vitamin D deficiency, making her susceptible to fractures from routine handling. Additionally, other doctors noted that the marks on the child's skin, initially diagnosed as bruises indicative of abuse, did not behave like bruises and appeared to match the straps of the baby's swing.
While the couple was ultimately able to regain custody of their baby, it took seven months and lawyer fees of over $50,000 to do so. Many other families had similar heartbreaking stories, including a Florida family whose brain bleeding was attributed to child abuse (rather than a seizure, the actual cause). The child was removed from the home, and his father, a firefighter paramedic, was charged with felony child abuse. His mugshot was blasted across local news stations for days. Despite the fact that three other doctors, including a neurosurgeon, found no evidence of child abuse, it also took this family seven months to regain custody of their child.
Many families do not have access to the types of resources that might be necessary to fight a misdiagnosis resulting in loss of custody. Some of the parents profiled, including the Michigan couple, are pushing for legislative and policy reforms to prevent these types of drastic responses to what ultimately amounts to little more than diagnostic errors.