Bristol City Council v A Mother & Ors

In care proceedings alleging non-accidental injury, the local authority bears the burden of proving the relevant facts on the balance of probabilities. The court must assess the whole evidential picture and avoid speculation. Medical opinions must be considered alongside the factual evidence, while remaining within the limits of expert expertise. Lies by a witness do not establish that the witness lied about the central issue; their possible reasons and significance must be assessed. An unknown cause is a relevant factor in deciding causation, particularly where a child has an unusual and poorly understood medical condition. The court declined to find that the injuries were inflicted non-accidentally and dismissed the application.

Following the death of an eleven-week-old child, the local authority commenced care proceedings concerning her surviving sibling. The deceased child had multiple injuries associated with trauma, including rib fractures, intracranial haemorrhages, retinal haemorrhages and scalp bruising. She also had an exceptionally rare combination of genetic abnormalities, brain malformations and severe medical problems. The proceedings were transferred to the High Court for a fact-finding hearing concerning the injuries and death. The central issue was whether the evidence established, on the balance of probabilities, that the injuries had been inflicted non-accidentally by one of the parents or another carer.

1. Burden and standard of proof. The local authority bore the burden of proving the alleged injuries and responsibility for them. The applicable standard was the balance of probabilities, including the assessment of inherent probabilities: Re B [2008] UKHL 35.
2. Assessment of evidence. Findings had to be based on evidence rather than speculation. The court had to consider the medical evidence in the context of all the other evidence and weigh expert opinion against the factual evidence. Experts had to remain within their own fields and defer, where appropriate, to other specialists. The court alone could conduct the overall assessment, consistent with A County Council v K D & L [2005] EWHC 144 (Fam).
3. Credibility and lies. The evidence of the parents and other carers was of particular importance. A witness might lie for many reasons, and a lie about one matter did not establish dishonesty about every matter. The court applied the principle in R v Lucas [1981] QB 720 when assessing the father’s lies about matters including his immigration status, marriage and aspects of the events surrounding the death.
4. Unknown cause. Medical knowledge was capable of developing, and the possibility of an unknown cause had to be considered. That possibility affected neither the burden nor the standard of proof, but was a relevant factor in deciding whether the alleged causation had been established, following the approach described in Re U, Re B (Serious Injuries: Standard of Proof) [2004] EWCA Civ 567 and Re R (Care Proceedings Causation) [2011] EWHC 1715 (Fam).
5. Application. The deceased child’s unique genetic abnormalities, very small size, brain malformations and unexplained medical vulnerability made the causal assessment unusually uncertain. The first group of rib fractures had occurred while she was in hospital, making culpable injury by a parent implausible. The same possibility of vulnerability to injury through ordinary handling could not be excluded for the later fractures or intracranial bleeding. The parents’ evidence and the surrounding circumstances did not establish repeated culpable injury.
6. The local authority failed to prove on the balance of probabilities that the injuries were inflicted non-accidentally. The threshold criteria under section 31 of the Children Act 1989 were not satisfied and the application was dismissed.