B and G (Fact-Finding)

In care proceedings involving alleged inflicted injuries, medical opinions must be evaluated alongside all other evidence. Inconclusive medical evidence does not prevent a finding of non-accidental injury on the balance of probabilities. The court must accurately understand the expert opinions, assess the parents’ credibility and reliability, resolve material evidential disputes and explain its conclusions.

Where an unexplored combination of genetic variants may increase bleeding or bruising, the clinical history assumes particular importance. Disputed evidence of bruising across different care settings must be resolved before conclusions are drawn from the haematological evidence. Assessing a bruising pattern requires consideration of bruises of all sizes and locations, with proper attention to the limitations of selective records.

The mother and father separately appealed against findings made in care proceedings concerning their children, B and G. The proceedings were brought by a local authority after medical examinations identified bruising in both children and chronic subdural haematomas in G. Both children had two genetic variants whose combined significance for bleeding and bruising was uncertain. The expert evidence differed, and the neurosurgeon could not identify the most likely cause of G’s intracranial bleeding.

The Family Court at Luton made interim care orders in April 2025. Following a fact-finding hearing in January 2026, HH Judge Kushner delivered an oral judgment on 20 February finding that the injuries were inflicted by the mother and/or father and that the perpetrator of G’s shaking injury had failed to seek medical attention. The parents challenged the assessment of medical and non-medical evidence and the adequacy of the reasons. The children’s guardian supported their challenge to the perpetrator analysis. Other findings concerning the parents’ relationship, drug use and mental health were unchallenged.

1. The appeals were allowed unanimously. Findings (2) and (3), concerning the infliction of injuries and the perpetrator’s failure to seek medical attention, were set aside. The findings identifying the injuries and the remaining, unchallenged findings remained in place (paras [107]–[113]).

2. Medical opinions in child abuse proceedings must be considered in the context of all available evidence. Medical evidence favouring non-accidental injury does not compel that conclusion. Equally, the absence of diagnostic medical evidence does not prevent the local authority from establishing non-accidental injury on the balance of probabilities through the totality of the evidence. The latter principle in A County Council v K, D and L, [2005] EWHC 144 (Fam), answered the submission that the neurosurgeon’s uncertainty necessarily prevented proof (paras [95]–[98]).

3. A clear assessment of the parents’ credibility and reliability was essential to determining both the cause of the injuries and any perpetrator’s identity. References to their evidence, or acknowledgments that they bore no burden of proof, were insufficient without substantive evaluation. The extensive records of supervised parenting and the protective features of family life required consideration. The judgment failed to explain the assessment of the parents or the basis for concluding that one had deliberately harmed the children (paras [91]–[94], [106]).

4. The uncertainty surrounding the combined genetic variants increased the importance of the clinical picture. The judge failed to resolve whether disproportionate bruising persisted across care settings. The foster carer’s selective logs required scrutiny because a pattern could only be assessed by considering all bruises, whatever their size or location. The judge also failed adequately to explain her preference for the paediatrician’s assessment over the treating haematologist’s clinical evidence and to evaluate the parents’ chronology of bruising (paras [100]–[105]).

5. The judge misinterpreted the neurosurgeon’s opinion as favouring inflicted injury. He had identified four possible causes without selecting the most likely. The absence of retinal haemorrhages and encephalopathy remained relevant to the overall assessment, although it did not undermine the opinion that the bleeding was consistent with shaking. Material points concerning birth trauma, rebleeding and the absence of symptoms had received insufficient consideration (paras [96]–[99]).

6. By way of guidance, amendments to an oral judgment must express the judge’s actual reasons and avoid retrospective rationalisation. Judges retain freedom over judgment preparation, but cases of sufficient complexity should ordinarily receive a reserved written judgment unless good reasons, such as extreme urgency, justify another course. These observations did not establish a procedural irregularity determining the appeals (paras [85]–[90], [112]–[113]).

7. The case was remitted to Arbuthnot J, the Family Presiding Judge for the South Eastern Circuit, to consider whether a rehearing concerning the causes of the injuries was necessary for future care decisions and, if so, its scope (para [111]).

• Court of Appeal (Civil Division): In [2026] EWCA Civ 860 , allowed both parents’ appeals and set aside findings (2) and (3). The remaining findings were preserved. The case was remitted to the Family Presiding Judge to consider the necessity and scope of any rehearing.
• Family Court at Luton: HH Judge Kushner made interim care orders on 16 April 2025. Following a fact-finding hearing on 6–9 January 2026, she delivered judgment on 20 February 2026 finding, among other matters, that the children’s injuries were inflicted by the mother and/or father and that the perpetrator of G’s shaking injury had failed to seek medical attention. She refused permission to appeal.