Doctor who misled courts over shaken baby syndrome struck off

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A doctor found to have deliberately and dishonestly misled the courts when giving expert evidence about so-called shaken baby syndrome has been struck off.

Dr Waney Squier failed to be objective and unbiased in six cases in which she gave evidence for the defence, including the deaths of four babies and a 19-month-old child, a disciplinary panel had ruled.

On Monday, a Medical Practitioners Tribunal Service panel ruled her conduct was "fundamentally incompatible with continued registration as a medical practitioner".

Dr Squier, 67, who works at the John Radcliffe Hospital in Oxford, gave expert evidence that the brain injuries involved were either not consistent with non-accidental injury, or were more likely to have been caused by some other means.

Her minority view on shaken baby syndrome is in contrast to the opinions of the majority of experts in the field who argue the so-called triad - swelling of the brain, bleeding between the skull and brain, and bleeding in the retina - is a strong indicator of trauma.

But the tribunal, sitting in Manchester, said she put forward theories "insufficiently founded" upon the evidence in the six cases between 2006 and 2010. They found she gave evidence outside her own field of expertise and by misquoting research and literature so that it appeared to support her opinion when it did not.

It said her expert reports supported "meretricious appeals, giving false hopes to parents" in "very serious cases, based on a highly controversial subject and with great public interest".

It stated: "Your deliberately misleading and dishonest evidence in court had the potential to subvert the course of justice."

 

The tribunal added that Dr Squier had shown "a blatant disregard for the fundamental tenets of the medical profession".

It concluded: "You have breached the requirements of good medical practice not only in terms of your honesty and probity, but also in your failure to respect the skills and contributions of your colleagues and recognising the limits of your knowledge and competence in giving evidence.

"Your attitude towards your colleagues was shocking, openly displaying your disdain for their expertise and opinions. You repeatedly gave evidence both in your reports and in court that fell outside your own field of expertise and competence.

"You deliberately and dishonestly misinterpreted, misstated and misquoted research literature to support your own opinions.

"The tribunal considers all these breaches to be very serious. You have caused harm to the reputation of the profession and the tribunal cannot be satisfied that there would be no repetition of your misconduct."

Dr Squier denied misconduct and maintains she believes she has done nothing wrong.

After her fitness to practise was found impaired last week, her counsel, Sir Robert Francis QC argued that any sanction imposed might discourage other experts from giving evidence.

He submitted that Dr Squier's career in medico-legal work was over as a result of the tribunal's findings but he said she continued to make a valuable contribution to neuropathology, which the panel accepted.

Preventing her from practising would deprive the public of her skills, particularly in terms of her work on the developing brain of the neonate, muscle biopsy, epilepsy and cerebral palsy, said Sir Robert.

But the tribunal said the public interest, in terms of the reputation of the medical profession and the need to declare and uphold proper standards of conduct and behaviour, outweighed the doctor's own interest.

It added that the doctor's continued assertions that she had done nothing wrong was "an astonishing failure of insight".

The tribunal said it had no evidence she had been dishonest in her work as a neuropathologist outside the court environment, and had received many testimonials from practitioners who testified she was "scrupulously honest".

However this was set against her dishonest evidence given in the course of the hearing, the tribunal said.

Explaining that a suspension would not be appropriate or proportionate, the tribunal pointed out that although lawyers may be reluctant to instruct Dr Squier in the future, it may be that parents insist she be instructed because of her particular views.

Niall Dickson, chief executive of the General Medical Council, said: "This case was not about the science - it was about Dr Squier's conduct as a doctor acting as an expert witness. It was brought following criticism of her evidence by no fewer than four senior judges presiding over some of the most serious matters the courts have to deal with.

"A doctor giving evidence in court is bound by the same standards as a doctor in clinical practice and by additional rules set down by the courts. They have a duty to act with honesty and integrity at all times, their work should be rigorous and their opinion presented objectively and fairly.

"Cases involving allegations of injury to children are often complex and the courts must rule on matters that will affect the safety and custody of children and sometimes the liberty of adults - as such judges have the right to expect high standards of accuracy and objectivity from expert witnesses. If it becomes clear that a doctor has lost objectivity - by cherry-picking facts or research to suit their views or by working outside their area of expertise - that is a problem which we must look at.

"What is not always understood is that neither the GMC, which is responsible for investigating doctors,  nor the independent tribunal have any role in resolving differences of scientific opinion."