UK child protection services under threat Eminent UK paediatrician Roy Meadow is accused of stepping outside the boundaries of his expertise when he gave evidence during the trial of a mother accused of murdering her two sons. This week, he faces a General Medical Council hearing. Louise Marshall reports. The UK media frenzy surrounding leading paediatrician Roy Meadow reached fever pitch this week, as the General Medical Council heard allegations that he presented “erroneous and misleading” evidence in the trial of Sally Clark, a solicitor who was convicted of murdering two of her sons but was freed by the court of appeal after serving 3 years of a life sentence. In recent years, Meadow has faced widespread condemnation in the press after evidence he gave in several court cases on the likelihood of two or more cot deaths occurring in the same family was brought into question. However, he has also received widespread support from paediatricians. “The way we are being dealt with by the GMC causes huge difﬁculties for recruitment and for child protection”, says Jo Sibert, Head of the Department of Child Health at the University of Cardiff. The GMC hearing, which is due to conclude on the July 15, has been set up to examine evidence that Meadow presented in the trial of Sally Clark in 1999. Meadow was hired by the Crown Prosecution Service, alongside a number of other experts, to give evi-
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Donna Anthony, outside the Royal Courts of Justice, after winning her appeal
dence in the trial in which Clark was convicted of killing 11-week-old Christopher in 1996 and eight-week old Harry in 1998. During the trial Meadow cited evidence from the Conﬁdential Enquiry into Sudden Deaths in Infancy, which suggested the odds of single cot death in a nonsmoking household was 1 in 8543. By squaring the ﬁgure, he calculated the likelihood of SIDS occurring twice in the same family was 73 million to one. This ﬁgure has since been widely disputed by statisticians and the Royal Statistical Society, but at the time the defence team did not question Meadow’s evidence. It was not until Clark’s ﬁrst appeal, in 2000, that the court heard evidence from two statisticians who cast doubt on the ﬁgures. However, the appeal court judges, while accepting Meadow’s statistic had been inaccurate, ruled that there was still an “overwhelming” case against Clark. Clark was eventually freed in January, 2003, on the basis of pathology tests, which had previously been undisclosed to the court. The microbiology results indicated Harry could have died from an infection. The appeal court judges also said Meadow’s statistic was “grossly misleading”, criticisms that led to other mothers who had been convicted on the basis of expert testimony from Meadow to launch appeals. In December 2003, Angela Cannings was freed after being sentenced to life in April 2002 for the murder of seven-week-old Jason in 1991 and 18-week-old Matthew in 1999. Cannings’ daughter Gemma also died at 13 weeks old in 1989 but she was not charged in relation to her death. Meadow told jurors in the original trial that a third death in the
family was a “very unusual, very rare” event. Appeal court judges said Cannings’ conviction was “unsafe” after clinical geneticist Michael Patton suggested there could have been a genetic reason for the deaths and medical statistics expert Robert Carpenter said Cannings’ sons could have been at higher risk of SIDS than previously estimated. The court ruled that no future prosecutions should be brought where medical experts are in dispute and there is no other cogent evidence. In April this year, Donna Anthony was freed after serving 7 years for the deaths of daughter Jordan, aged 11 months and 4-month-old Michael. In the original trial, pathologist Peter Berry and Meadow both gave the opinion that the children had been suffocated. Meadow also suggested that the chance of two cot deaths occurring in the case was one in a million. The appeal court judge said Meadow’s evidence had been “signiﬁcantly undermined”since her trial. Consultant paediatrician Dominic Croft said Meadow probably “overinterpreted” the evidence but that there was other circumstantial evidence in all the cases. “The implications of the GMC case are very serious”, he says. “This is about the protection of vulnerable citizens who have no one else to speak up for them.” “I have the highest respect for Roy Meadow who has been a good colleague to me over many years”, says Sibert. “I am sure that his pioneering work on fabricated or induced illness has saved many lives. Clearly one would need to hear the evidence but I would hope he would be found not guilty.”
Louise Marshall www.thelancet.com Vol 366 July 2, 2005