Opinion ID: 1057682
Heading Depth: 1
Heading Rank: 6

Heading: Testimony of Dr. Sidney Roberts

Text: Dr. Sidney Roberts, a staff radiologist at Children's Hospital specializing in pediatrics, testified that he reviewed the initial x-rays of S.H.'s right ankle on the day following the first report of her injury. At that time, Dr. Roberts could not find any fractures on the ankle. When S.H. was brought back for additional x-rays two days after her first examination, Dr. Roberts examined S.H. and more x-rays of the right ankle were performed. Dr. Roberts described the ankle as very swollen[, t]wo or three times the size of the opposite leg.... He indicated that the ankle was quite both red and bruised looking. In the second x-rays, Dr. Roberts discovered small fractures of the corner of the two bones in the lower leg. Dr. Roberts explained that the fractures were visible in the second x-rays because S.H.'s bones had begun to calcify as part of the natural healing process. After discovering the fractures, Dr. Roberts called Dr. Morris to inform him that the location and appearance of the fractures were suspicious for child abuse or non-accidental injury. When Dr. Roberts read the medical history, he learned that the Defendant claimed to have fallen down the steps with the child. It was his opinion, however, that the fractures were not consistent with a fall. He testified that the fractures were instead consistent only with either twisting or a traction injury, pulling. He explained that a fall would typically be expected to create a fracture of a long bone in the shaft. Dr. Roberts, who also reviewed the full-body, skeletal survey x-rays, taken eleven days after the report of the injury, and found additional corner fractures in the cartilage and bones below S.H.'s right knee, for a total of four distinct fractures in the right leg. He also observed two corner fractures at the ankle in S.H.'s left leg, which were similar to the ankle fractures in her right leg. It was his opinion that all six leg fractures were the result of non-accidental child abuse, having occurred within 24-to-48 hours of July 13. Dr. Roberts further explained that S.H.'s x-rays were not consistent with brittle bone disease, which would have rendered her especially susceptible to fractures, because the amount of calcium in S.H.'s bones was normal. He testified that S.H.'s bones did not show bowing or irregularity of the cartilage surfaces associated with such a condition. During cross-examination, Dr. Roberts conceded that it was at least possible for S.H.'s ankle to have been fractured if her leg had been twisted while she was fallen upon by an adult. He explained, however, that even if it was possible that such a fracture of one leg might result from twisting during a fall, he saw no possible way that it could happen with both legs. He also conceded that it was possible, although unlikely, that the leg fractures could have been the result of someone dropping S.H. and catching her by both legs, but only if it was a severe jerk. It was also his opinion that simply picking S.H. up by her legs would not have caused the fractures. He maintained, however, that such fractures could occur when an individual simultaneously pulled both legs with enough force. Dr. Roberts also testified that the leg fractures could not have been caused by shaking and described them as particularly painful over a prolonged period of time. It was his opinion that the pain would be continuous and last several days and possibly weeks. Dr. Roberts also opined that the rib fractures, which had occurred three to five weeks prior to the full body survey, were the result of a squeezing motion with adult hands of considerable force. It was his belief that fractures of that nature would not arise from the normal handling of an infant.