A specialist children’s doctor who flagged suspected medical child abuse in a young patient says it was a huge call to make. Consultant paediatric gastroenterologist Dr Amin Roberts told the High Court an accusation of medical child abuse was difficult to prove, and could potentially damage the relationship between a doctor and a family, and therefore the child needing treatment. “As medical professionals we need to maintain therapeutic relationships with the families. “It would be very destructive and counterproductive to raise the possibility of medical child abuse, or accuse a family if in fact that was not the case,” Roberts said. Dr Amin Roberts, a paediatric gastroenterologist who diagnosed suspected medical child abuse in a young patient who was referred to him. He gave evidence in the trial underway in the High Court at Nelson, now in its fifth week. Photo / Norrie Montgomery However, in the case of Child X, he alleged there was no other explanation after lengthy and detailed efforts by a string of medical specialists and nursing staff to get to the bottom of what was wrong. Trial enters fifth week Roberts gave evidence on Monday at the start of the fifth week of the trial underway in Nelson, for a mother accused of abusing her child during medical treatment. The mother, whose name is suppressed to protect the child’s identity, has pleaded not guilty to four charges of ill-treating a child and three charges of infecting with disease. The mistreatment was alleged to have occurred over a 19-month period. The allegations arose from medical interventions required for the child’s assisted feeding and treatment for complex intestinal failure. The defence argues the events that formed the charges arose from management of a “medically fragile child living with complicated medical devices” and the actions of a desperate mother trying to help her child, who originally presented with suspected reflux disorder, and failure to thrive. However, in answer to a question from lead defence counsel Marie Dyhrberg, KC, if Roberts agreed Child X was a child with a complex medical condition, he said the child had unexplained symptoms, but ended up being “completely normal” and “not really complex at all”. Child ‘never had intestinal failure’ He said it was his professional opinion that Child X never had intestinal failure, although the child may have had a degree of gastroesophageal reflux to begin with. “After exhausting all possible investigations, I concluded that there was no medical explanation for the symptoms reported by [the mother].” Roberts agreed later in cross-examination there were no reports of the mother directly harming the child while the child was on a ward. He claimed it was not until Child X was in intensive care, when the mother was not by the bedside all the time, that staff were able to detect differences in the child’s condition and behaviour. “It’s fair to say, we never gave up on trying to find medical cause,” Roberts said. Second opinion sought Roberts was also the clinical director of the paediatric arm of the New Zealand National Intestinal Failure and Rehabilitation Service (NZ-NIFRS). He reiterated previous witness statements about observations of Child X and how “symptoms made no sense”, despite interventions at hospitals around the country. Roberts first met Child X in 2019, on admission to the hospital where he worked, of which the name and location was suppressed. The child, named as Child X, first presented at a hospital outpatient clinic with a reported fever, reflux, and blood and mucus in their stools. The mother is on trial in the High Court at Nelson on charges she medically abused the infant, after a string of doctors and nurses could not determine the cause of the constant illnesses and problems with feeding. Photo / 123rf The child had been referred to Roberts’ team for a second opinion after other doctors elsewhere reported the child’s symptoms “did not make complete sense” and there was...