For the Defense - Vol. 6, Issue 1 - 29
How Can I Best Assist You? A Child
Abuse Medical Expert's Perspective
on Case Reviews and Testimony in
Child Abuse Cases
Jeffrey Bomze, MD, FAAP
A
ccording to state and federal estimates,
between 700,000 to 1.25 million children in
the United States are abused or neglected
each year, while nearly 3 million children are at risk of
harm.1 Approximately 18% of cases involve physical
abuse. Relatively few cases, as few as 5 percent, are
reported to child protection agencies.2 As many as
2,500 children die each year in the United States of
inflicted injuries.3 The Federal Child Abuse Prevention
and Treatment Act provides certain standards for
defining child maltreatment, but each state has
its own civil and criminal statutes. State laws vary
greatly, and definitions may not be clear or may have
specific meaning in a particular state.4
This article focuses on criminal cases with physical
abuse allegations and applies to cases of neglect
and cases involving sexual abuse allegations. From
a medical standpoint, the signs and symptoms of
physical abuse may be because of other illnesses
and conditions and the role of a medical expert is to
evaluate from the records these potential causes of
the injuries. The differential diagnosis of physical
abuse depends on the body system(s) involved
and the clinical signs and symptoms. In addition,
distinguishing inflicted injuries from accidental
ones is a key role of medical experts. As such, it is
important to have as much medical information as
available to provide the most specific and evidencebased opinions. There are many risk factors that
place a child at a higher risk for abuse, though
children of all ages, ethnicities and socioeconomic
groups are affected. Therefore, having a detailed
background history and other supplemental
records and information is important and their
relevancy will be further explained in this article.
Initial Attorney Contact/Discussion
While medical professionals are identified as
experts by several means such as referrals and
contacted by a variety of individuals including
defendants and their family members, involvement
in a legal case necessitates initial contact by
Vol. 6, Issue 1 l For The Defense
29
For the Defense - Vol. 6, Issue 1
Table of Contents for the Digital Edition of For the Defense - Vol. 6, Issue 1
Contents
For the Defense - Vol. 6, Issue 1 - 1
For the Defense - Vol. 6, Issue 1 - 2
For the Defense - Vol. 6, Issue 1 - Contents
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