High Courts defers decision on surgery for two year-old

family life

No decision need yet be made on cosmetic surgery for a toddler who suffered a serious brain injury, the High Court has concluded.

E (A Child) concerned a two year-old boy born in Scotland to a troubled mother unable to look after him. ‘E’ was taken into foster care, then later placed with the mother’s sister in the north-east of England.

In the High Court, Sir James Munby, President of the Family Division, explained events a few months later:

“On 14 April 2016 E was brought to the Royal Victoria Infirmary in Newcastle in what has been described as a near death condition. He was very seriously ill. A CT scan revealed a right subdural haematoma. His condition rapidly deteriorated and became life threatening.”

A subdural haematoma is a blood clot between the brain and its outer membrane. Urgent brain surgery was required to save the toddler’s life. A neurosurgeon removed a small section of the boy’s skull to relieve the pressure on his brain.

E was then examined by a consultant paediatrician in Newcastle. Dr Alison Steele identified an alarming 75 “marks, bruises and lesions” on his body. Unsurprisingly, the toddler was immediately removed from the care of his aunt and taken back into foster care.

He has since made a “remarkable recovery” from the injuries and was described by Sir James as “thriving” with his new foster family.

Formal care proceedings continue with the next hearing scheduled for later this month. No other family members are available to care for E noted Sir James, who suggested an adoption order was the most likely outcome of the case.

Meanwhile the President was asked to consider the legalities of a cranioplasty – surgery to repair the hole in the boy’s skull. Would such surgery be in E’s best interests, or should a decision be postponed?

Evidence presented to the court suggested that a cranioplasty offered certain advantages. E would no longer need to wear a protective skull cap for example, and improvements to the uneven appearance of his head could make it easier for him to make friends and find potential adopters. Although still young, E’s emotional and psychological health could also benefit.

On the other hand, the largely cosmetic procedure carried certain risks and could cause pain and discomfort to the still very young child.

E’s guardian believed it was too early in the care proceedings for such a far-reaching decision to made and it should instead be left to E’s eventual adoptive family.

Sir James accepted this argument, saying:

“The decision is not one I need to take or should take. I agree with [the barrister] when she submits that, on the basis of all the medical evidence, there is no clear cut answer as to the right option at this stage, that it is a personal decision for carers, and that, as the decision can be left, it should be left to whoever is entrusted with E’s long term care.”

Read the ruling here.

Image by Erich Ferdinand via Flickr under a Creative Commons licence


Stowe Family Law Web Team

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