Dangerous bitch



A doctor stuck to her own theories when acting as an expert witness in several shaken baby death cases, a disciplinary panel heard today.  Dr Waney Squier, of John Radcliffe Hospital in Oxford, gave advice and evidence at civil and criminal proceedings.

The General Medical Council (GMC) said her 'preconceived and blinkered' approach was 'irresponsible, deliberately misleading and dishonest'.

The hearing is focusing on six cases in which the consultant neuropathologist was involved in, including the deaths of four babies and a 19-month-old child.

In all of the cases the 67-year-old took the view that brain damage caused was not due to inflicted injuries, a Medical Practioners Tribunal Service panel in Manchester was told.

It was said that her views on shaken baby syndrome were in contrast to the opinions of the 'majority of experts' in the field.

Opening the case for the GMC, Tom Kark QC said: 'In each of the cases being considered Dr Squier provided a report and gave evidence in court to the effect that the injury received was either non consistent with non-accidental injury, or was more likely to have been caused by other means.

'Far from doing so in an objective and helpful way, as an expert is expected to, Dr Squier, the GMC says, conducted herself in a way that was demonstrative of her clinging to a theory so that in fact her evidence was misleading and biased, and the GMC say that when analysed the evidence demonstrates that she must have known that what she was doing was misleading and thus it was dishonest.

'To act as she did in such serious cases, the GMC says, was to fall far below the standards expected of a doctor providing expert evidence and was likely to bring the reputation of the medical profession into disrepute.'

Mr Kark said the issue of whether a baby had suffered brain injuries as a result of a non-accident was 'complex'.

He said: 'It is generally accepted by the majority of experts that the so-called triad is a strong indicator of trauma, although not diagnostic of a non-accidental head injury (NAHI).

'It is regarded as an important indicator of shaken baby syndrome or an abusive head injury caused by severe rotational acceleration and deceleration forces.

'Dr Squier has written extensively on shaken baby syndrome and she holds the view that the triad of injuries are not strongly indicative of shaken injuries unless there is other evidence of external or internal injury.

'She has expressed the view that the force to shake a baby hard enough to cause brain injury would inevitably severely injure its neck and/or cause other external trauma. It is also her view that it is not possible to shake a baby hard enough and long enough to cause the sort of brain injury damage leading to death which were seen in these cases.

'The great majority of experts in this field hold that external marks, bruises and fractures are not essential for a reasonable conclusion of shaking to be made and that such shaking can cause brain injuries leading to death or other serious injury.'

Mr Kark said Dr Squier was well within her rights to provide an opinion, but he insisted her opinions needed to be backed up by the facts of the case and also supported by the research they cite.

He said: 'Whilst they (experts) are perfectly entitled to put forward a particular view, they must do so on the basis of the facts of the case, and their view must be properly supported by the research which they cite and by their own clinical experience.

'In a number of cases in which she provided a report and gave evidence, the GMC suggests that Dr Squier went well outside her sphere of expertise and gave evidence and opinions in relation to areas of medicine and physiology in which she was not an expert.

'On occasions she misquoted or mis-stated the facts upon which her expert opinion was said to be founded in order to fit in with her preconceived ideas. On occasions she purported to rely upon medical and other research which upon close examination does not in fact support what she was saying. She failed in her overriding duty to the court to remain objective and to assist the court.

'This case is in essence about whether in these cases Dr Squier lost her objectivity as an expert witness and simply wrote her reports and gave her evidence with a particular goal in mind. The goal being to give her opinion that no non-accidental head injury was involved in each case.

'The GMC submit that Dr Squier took a set position in each case, namely that the child did not receive its injuries through inflicted injury and she deliberately took that position because of her own preconceived and blinkered approach to these cases.

'If that case is made out then the charges that she failed to be objective and unbiased in each case would we submit be proved.'

Dr Squier, represented by Sir Robert Francis QC, denies misconduct.

The barrister told the panel that it was 'important' they avoided the trap of trying to decide the original issues in each case or deciding whose expert opinion was to be preferred.

'That is not the point of these proceedings,' he said.

But he said a question the panel would have to answer was whether Dr Squier's opinions had a 'significant effect' upon the various proceedings between 2008 and 2010.

In most of the cases, Dr Squier - who was said not to have worked in paediatrics for several decades - was the sole expert instructed on one side of the litigation.

Among the allegations she faces is that she provided expert opinion outside her field of expertise and she failed to discharge her duties as an expert by not working within the limits of her competence, not being objective and unbiased, and not paying due regard to the views of other experts.

Her actions and omissions were said to be misleading, irresponsible, deliberately misleading, dishonest and likely to bring the reputation of the medical profession into disrepute.

Dr Squier also denies misconduct in relation to an expert witness report she was said to have submitted in April last year to a Court of Appeal civil case involving a child.

It is said she failed to disclose to those instructing her, or the court, that there were outstanding disciplinary proceedings against her.

The hearing in Manchester is scheduled to last up to six months.

Original report here

Roy Meadow got off so I imagine she will -- B


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