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Effective: 8/16/2021

2.23 Pediatric Forensic Medicine Consultations

Legal Authority

Introduction

​​​​To determine if an injury appears non-accidental (inflicted) vs. accidental, the SSW may require timely consultation with a qualified medical professional for the assessment of possible abusive injuries.  When a determination cannot be made by medical personnel at the local level, the SSW may request a consultation with the Norton Children’s Pediatric Protection Specialists or Kentucky Children’s Hospital Division of Pediatric Forensic Medicine. ​​

Practice Guidance

Procedure

The SSW:
  1. Reserves consultations for cases in which an expert opinion is required beyond what local medical resources can provide; 
  2. Complies with the following referral guidelines to ensure that this limited resource is used most effectively:
    1. Active physical abuse or neglect investigations, involving a child with a physical injury or physical exam finding that is suspicious for injury may be appropriate for referral if local medical resources are either not available, or are unable to determine if the injury/finding is likely to have been the result of maltreatment;
    2. Active investigations involving a reported method of injury that may not be consistent with the noted physical injury may be appropriate for referral (For example, a child with a fracture that is reported to have fallen off the couch); 
    3. ​Priority should be given to the very youngest, non-verbal children in which it is difficult to determine by interview how the injury occurred;
    4. Norton Children’s Pediatric Protection Specialists or Kentucky Children’s Hospital Division of Pediatric Forensic Medicine may not be utilized merely for the purpose of obtaining evidence for criminal prosecution of non-caretaker abuse; and
    5. It is important to avoid the subpoena of medical professionals from the Norton Children’s Pediatric Protection Specialists or Kentucky Children’s Hospital Division of Pediatric Forensic Medicine to court proceedings when at all possible.   If testimony for custody petitions or dispositional reviews is required, deposition or phone testimony should be utilized;
  3. Discusses the appropriateness of the Norton Children’s Pediatric Protection Specialists or Kentucky Children’s Hospital Division of Pediatric Forensic Medicine referral with the FSOS; 1  
  4. Refers to the link to make a referral to Norton Children’s Pediatric Protection Specialists. 
  5. Refers to the link to make a referral to Kentucky Children’s Hospital Division of Pediatric Forensic Medicine. ​

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​Footnotes

  1. If it is agreed that consultation regarding a physical injury is warranted, options for local or regional medical consultation should be first considered. ​


Documents

Revisions