Paris (AFP)

Can recommendations made to doctors to identify child victims of shaken baby syndrome lead to miscarriages of justice, with parents wrongly accused? It is the controversy that opposes an association with the High Authority for Health (HAS).

In 2011, the HAS drafted recommendations, updated in 2017, which stipulate that when such a syndrome is diagnosed, the child "must receive hospitalization in pediatric intensive care" and the health professional must "imperatively report" to the public prosecutor in order to protect the child ".

On December 2, the Adikia association, which brings together "parents wrongly accused of mistreatment following diagnostic errors", asked him to repeal them.

Reason: "They are far too affirmative on many unproven or controversial medical subjects, when they are not simply false," said the association's lawyer, Me Grégoire Etrillard, in a letter sent to HAS.

These recommendations can "cause a massive number of medical errors leading to as many judicial errors", writes Me Etrillard, who says he defends "more than 50 families broken by false accusations".

Shaken baby syndrome occurs when an adult shakes an infant, usually by exasperation, anger or exhaustion in the face of crying that he can no longer bear. An act that can have dramatic consequences for the child (neurological sequelae or death).

But the lawyer criticizes the recommendations to lead to automatically attributing to the shaken baby syndrome symptoms which he believes can be caused by falls from a low height or genetic diseases.

Consequences: "Infants torn from their families, couples separated for years by obligations of judicial control, persons imprisoned, on the basis of these recommendations", before being "subsequently exonerated".

"Challenging the recommendations is the wrong subject," retorted Thursday the HAS, in a statement co-signed with twenty specialized structures which participated in their drafting, including the French Society of Pediatric Neurology.

These professional organizations and patient associations "refuse to leave without questioning the questioning of the competence and scientific probity of their experts".

- Board of state? -

For HAS, these recommendations are based "on a rigorous analysis of the international scientific and medical literature".

"All the articles, including those questioning the existence or the diagnosis of shaken baby syndrome, have been taken into account," she said on Thursday.

According to her, the "working group of 30 people" from which the recommendations came was composed of members of national professional bodies, associations for the defense of the rights of the child as well as a magistrate and a lawyer.

Not enough to convince Me Etrillard. "There is no response on the merits," he reacted to AFP, saying that the HAS "refuses scientific debate" on the specific points raised by its letter.

The lawyer now intends to seize the Council of State to have these recommendations canceled.

Their first version in 2011 evoked "not specific" symptoms, which made a definite diagnosis difficult. But thanks to scientific progress, health professionals can now "make a clear diagnosis", argued HAS by updating it in 2017.

This diagnosis is based on "neurological symptoms such as certain specific types of subdural hematomas (HSD) and retinal hemorrhages (HR)", which can be confirmed by "brain imaging (CT scan then MRI) and an eye exam. "

Each year "several hundred children are victims" of shaken baby syndrome, according to HAS. 10% to 40% of the children concerned die from it and the others can have lifelong consequences: learning difficulties, epilepsy, visual disturbances, paralysis ...

In the majority of cases, these are babies under the age of six months, most often boys. The responsible adult can be a parent or any other person responsible for looking after the child (nanny, baby-sitter, etc.).

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