Table 4.

Information Before Surveillance

Case
No.
Documented Medical
History of Note
(Including
Unsubstantiated
Symptoms) and
Concerns of Medical/
Nursing Staff
Key Substantiated Family Issues/Problems With CaregiverPsychiatric AssessmentPrevious Social Services Involvement
1None documentedOverdose ×1; falsely alleged pulmonary embolus in pregnancy88; alleged sexual abuse by grandfather and physical abuse by fatherYes, personality disorderSupport because father of patient (age 49) had angina
2Nosebleed at 7 weeks; rough handling noted by nursesOverdose ×2; convictions for theft and deception; alleged physical abuse by fatherYes, personality disorderNone documented
3Failure to thrive with vomiting and diarrhea (allegedly containing blood)Overdose ×1; multiple complaints of knee injuries; fainting; anorexia nervosaYes, abnormal help-seeking reaction of dissociate kindNone documented
4None documentedSevere conduct disorder during childhood. Alleged sexual abuse.Yes, personality disorderMother in care aged 8–16 years
5Bruising of toe (17 months); 2 episodes of unexplained screaming on the ward (child appeared frightened of mother)Alleged (falsely) apneic episodes and fits at age 13 years; treated with anticonvulsant drugs; theft and lying (age 15 years)Yes, personality disorderNone documented
6None documentedOverdose ×3; psychogenic faints and fits; treated with anticonvulsant drugs; alleged sexual abuse by uncleYes, personality disorderNone documented
7Admission at 5 months when mother dropped child who injured head; mother seen by nurse to handle baby very roughly; seemed unconcerned by baby's crying; baby appeared agitated when with motherOverdoses ×2; self-mutilation; inpatient for 9 weeks during pregnancy with alleged premature labor88; Alleged sexual abuse by stepfatherYes, personality disorderMother in care (age 13–17 years) in multiple institutions/foster homes. When under influence of alcohol tried to remove her baby from foster care
8None documentedAlleged violence by partnerYes, personality disorderNone documented
9Abnormal marks on face and chest; history of vomiting with blood seen on bib (no bleeding point found)Alleged sexual abuse as a child in which mother held her down for stepfather; alleged physical abuse by her father; tried to terminate her own pregnancy88; alleged that husband was abusive; overdoses ×2Yes, personality disorderMother in care as a child-problems with her mother
10Observed to be handling child roughly (when mother was unaware of being observed, before CVS)Violent to pets and sister as a child; smeared feces on wall at school; alleged rape; had faints, no cause found; abducted baby of another family from hospital; alleged fall with hip injury when pregnant88, no injury found on admission; overdose ×1Yes, personality disorderAttended school for behaviorally disturbed children. “Family well known to social services”
11None documentedInvolvement with police at 13 years with soliciting and at 15 years because of pornographic photographs; 2 firebombs at home (unexplained); overdose ×1; falsely alleged rape; unexplained alleged fitsYes, personality disorder20 referrals concerning alleged abuse of the child to Social Services/HV/police; investigated, no action could be taken
12None documented(Child's maternal grandmother) alleged chest pain and hemoptysis; multiple abdominal operations (no known pathology); alleged (falsely) multiple fractures; alleged sexual/physical abuse by her fatherYes, personality disorderNone documented
13None documentedNone documentedNo informationNone documented
14Head injury (age 7 months); failure to thrive with developmental delay (age 11 months), which responded to separation from mother; child disclosed that mother responsible for bruises on neck and red marks after bath; fall with cut lip and chipped teeth and alleged fall out of cot with head injury (age 21 months)Dismissed from 2 jobs Yes, personality disorderAdoption proceedings, which were curtailed by mother when infant aged 5 months
15Fractured rib; nurse worried about mother's bathing technique; mother placed head almost under water;bib tied tightly around neck by motherViolent bully at school; in
care as teenager because
of uncontrollable behavior (alcohol abuse and theft); alleged epilepsy; charged with murder and arson but successfully alleged self-defense against rape; flooded hospital ward; set fire to hospital curtains
Yes, personality disorderOn register for neglect; lied to HV about advice of another; social worker and HV stated “no cause for concern,” “appears to be coping and caring appropriately”
16Severe excoriated diaper rash; screaming (from child) heard while alone with mother on the ward; mother observed by nurse to shout at babyFalsely alleged terminal illness and that a prominent specialist had cured her; falsely alleged rape at bail hostel; falsely reported poison pen letters; falsely claimed that her child was a twin and the other had died88; house exorcised of ghost at her request; fires in the home ×2 (unexplained)Yes, personality disorderMother said to have puerperal psychosis after birth of previous sibling
17Unexplained codeine in urine; severe constipation; unexplained blisters and erythema in diaper area; failure to thrive and anemia (requiring blood transfusion), no cause foundRepeated hospital admissions in pregnancy88 (no problem found); falsely alleged lost one twin during each of 2 consecutive pregnancies; in wheelchair after alleged bilateral hip replacements (but seen to crawl around cubicle under CVS)None documentedMother said to be unable to cope because of arthritis; multiple requests for social services benefits
18Alleged hematemesis, no cause found; paracetamol, phenergan, colic drops administered concurrently resulting in reduction in level of consciousness and admission to hospitalHead banging as an adolescent; self-mutilation; truancy; anorexia nervosa; falsely alleged rape by father; falsely alleged death of twin in pregnancy88; alleged 7 miscarriages and 2 stillbirths (unsubstantiated); fabricated story to obtain 8 years of fertility treatment; alleged numerous knee problems, Raynauds, leukemia, receiving treatment at several NHS and private hospitals; alleged faints, compulsive drinking; galactorrhea, amenorrhea induced by oral contraceptive; falsely alleged to be auxillary nurseYes, personality disorder, Munchausen's syndromeNone documented
19Stridor noted after an ALTE; bruising on cheek at 13 months; failure to thrive; lost tooth and damaged another at 15 months, reported by mother to have fallen on concrete floor (but floor in question carpeted); treated with anticonvulsants for alleged fitsOverdose ×2; slashed wrists (no threat to life); theft from workNone documentedGiven telephone because of ALTE, said it was out of order at time of subsequent event, untrue when checked
20None documentedFall downstairs during pregnancy, thought to be attempt at ending pregnancy88, resulted in bleedingNone documentedLeft home while pregnant; lived in care; alone at birth; problems with mother's parents
21Admitted shaking baby twice to stop crying; unusual mouth-kissing noted by nursesTried to strangle herself with a tie at 13 years; pregnant at 14 years, claimed to have resulted from rape at knife point (police investigation dropped, no evidence); alleged sexual abuse by cousin and babysitter as child; criminal record of theftNone documentedFamily well known to social services
22See case historySee case historyYes, personality disorder and Munchausen's SyndromeSee case history
23None documentedFalsely alleged hospital treatment; falsely alleged assaultNone documentedNone documented
24See case historySee case historyYes, personality disorderSee case history
25Nurses noted that mother handled baby roughlyNone documentedNone documentedNone documented
26Head injury at 9 months, said by mother to have walked into furnitureAlleged sexual abuse as a child; alleged attempted rape; concealed pregnancy, said it was deliberately induced by boyfriend giving her alcohol; falsely alleged father had died in fireNone documentedNone documented
27Injury to right leg at 9 months; head injuries at 13, 16, and 17 months; fell downstairs, bruising head and injuring mouth; tangled in duvet and could not breathe at 17 monthsOverdose ×1; alleged abuse by husbandYes, personality disorderConcerns about earlier born siblings
28Pinch marks noted at 1 year; failure to thrive; excessive GP attendance with minor illnesses and 11 admissions to hospital; sister (age 6 years) described mother hitting baby and called neighborAs a child, falsely reported to mother of her friend that the friend had been killed in a car accident; excessive GP attendance with unexplained symptoms; excessive hospital attendance during pregnancy with unexplained symptoms88; made hoax telephone callsNone documentedPatient investigated for pinch marks, no action could be taken as insufficient evidence of abuse; planned to marry convicted sex offender
29None documentedDisruptive behavior as child; false allegation of rapeYes, personality disorderMother was adopted as infant then abandoned (age 5 years) when parents emigrated, then in care
30Seven fractures of different ages at 4 months, including femur, ribs, and humerusNone documentedNone documentedInterim care order at time of surveillance
31Failure to thrive in infancy necessitating IV feeding; recurrent IV line infections; unexplained diarrhea; falsely alleged (by mother) to have perforated ear drums, meningitis, renal failure, cystic fibrosis, hypoglycemiaAlleged rape as a child, then denied it; alleged rape by her brothers; alleged bitten by rabid dog; alleged celiac disease, petit mal epilepsy, urinary infections (unsubstantiated); close liason with mediaRefused assessmentNone documented
32Severe failure to thrive (7.7 kg at 3.5 years), given growth hormone injections; multiple invasive tests including bone marrow; recurrent abdominal pains and vomiting, hypothermia, hypernatraemia, polyuria (all unexplained); repeated displacement of nasogastric tubesNone documentedNone documentedNone documented
33Rough handling by mother noted by another parent, good handling in front of nurses; sudden unexplained cries; esophageal pH probe repeatedly displaced; seen to breathe cigarette smoke into infant's face; alleged bleeding from infant's earsOverdose ×1; cut wrists; repeated self-mutilation of arms; alleged sexual abuse by her father from age 7 to 13 years; alleged physical assault by husband; threatened husband with knife; falsely alleged contract killer had shot companion; gave false name to hospital; attended hospital with panic attack; repeated admissions for unexplained abdominal painYes, personality disorderMother asked social services if foster care could be provided—this was refused
34See case historySee case historyYes, personality disorderNone documented
35See case historySee case historyYes, personality disorderNone documented
36None documentedOverdose ×1; recurrent symptoms (abdominal pain, fainting and ankle injury)— unexplained; memory loss for 2 days after “breakdown” in 1988; according to psychiatrist “wants to be there when she [her child] dies”; alleged abuse by her first husband; closely involved with mediaNone documentedChild protection team involved after arguments between parents; ALTE ×3 on day father left home
37None documentedNone documentedNone documentedMother threatened to hurt baby if social services did not take her into care; foster care arranged but was canceled; boyfriend kept leaving and returning; on one occasion stating that he would permanently cease contact with mother if the baby came home from hospital
38None documentedHeadaches (age 10 years; no cause found); alleged excessive thirst and drinking (age 25 years; no cause found but responded to tranquilizers); alleged (falsely) she was had been an intensive care nurse; closely involved with mediaNone documentedNone documented
39False allegation of severe immunization response; mother said to nurses she felt like putting pillow over his face; blisters on pulps of left middle and ring fingers at age 2 months, said to have touched oven door; red line circumferentially around base of penis, suspicious of ligature; mark behind pinna noted by GP; unduly upset when face wiped by motherFainting attacks; recurrent unexplained severe abdominal pain; three convictions for obtaining property by deception, forgery, and shoplifting; falsely reported she had a 7-year-old daughter who was dying and obtained blank death certificate; alleged (in the local newspaper) burglary and theft of “dying” child's photo and video; on SIDS program for falsely alleged death of nonexisting sibling; said “baby might not be with her next week”; trained as a nurseNone documentedNone documented