Decided not to report

A toumb stone

You scheule Nevaeh for to come back and see you in two weeks. Mother thanks you for seeing Nevaeh without an appointment and for taking the time to “really listen to me.”

A week and half later you are on call when you get paged to the emergency room. You see Nevaeh’s lifeless body laid out in the trauma bay. A neurosurgeon rushes by muttering something about a “massive space occupying subdural” and “missed AHT.”

Later you read that Nevaeh had a number of signs that are concerning for Abusive Head Trauma (aka AHT or Shaken Baby Syndrome) or other physical abuse. Those signs include:

You read a study by Jenny of children with AHT. You find that 31% of children with severe AHT had a prior encounter with a physician with minor symptoms of AHT that were missed. The children returned to medical care after subsequent injury. Unfortunately 9% of the previously injured children, like Nevaeh, died of their subsequent injuries.

That choice didn’t go so well. Why don’t you try again?

Reporting to CPS is an attending responsibility. Let the attending decide what to do.

Call the Center for Miracles – they like that child abuse thing.

Two month old babies don’t roll off beds! I’m reporting to CPS

Photo credit Duane Wessels