In September 2020, Jennifer and Simon seek care for their son Theo at the pediatric emergency room at Sachsska in Stockholm, for the second time in four days.
On the first visit, Theo has fallen from a pillow, he has received a fracture and a bump on the head.
This time he must have fallen out of his parents' bed.
Jennifer learns that there is a strong suspicion that she and Simon caused the injuries.
That their son would fall twice in the space of a few days is considered unlikely, according to the doctor.
- We will be admitted and investigated for child abuse, Jennifer says.
Strong suspicions
The doctors do a new skull X-ray, a full-body X-ray and fundus photography.
They show that Theo, in addition to a head injury and bleeding in the head, has several fractures on his legs and one on his arm.
These are so-called CML fractures, small injuries in joints and growth zones, which are barely visible on X-rays.
But Jennifer and Simon are only told that the injuries were caused by violence.
The parents are called to a meeting at the hospital, with the pediatrician and a social secretary.
There, they learn that their two children must be forcibly taken into care with the support of LVU, the law on the care of young people.
- I'm having a panic attack, I can not breathe.
The feeling of unreality that this is happening, that they are taking our children, it is not possible to take in, says Jennifer.
Theo has so-called CML fractures, which are considered to speak strongly for child abuse according to the diagnostic method used to detect shaking violence.
Photo: Private
During the meeting, three-year-old Louie was picked up from preschool.
Now Jennifer and Simon will also leave Theo.
- Then we go down in an elevator and end up at the back of the hospital as we perceive it, where we have to put him in a car seat.
After that, we can only say goodbye and be completely left in a parking lot, without our child, says Simon.
The report made to the social services states that the pediatrician has strong suspicions of "shaken baby syndrome" - shaking violence.
The parents are detained and arrested, suspected of aggravated assault.
The doctors who investigated Theo have excluded all other explanations for the injuries, show documents that Assignment review has read.
“Shaking violence exists”
Shaken baby syndrome is a controversial diagnosis that had a major impact in Sweden in the early 2000s.
These are three medical findings called the triad and, if any of them are discovered, should mean a high probability of child abuse.
Even so-called CML fractures are considered to speak strongly for it.
But over time, critical voices are raised about how accurate the diagnosis is, including from forensic doctors.
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The research, the cases, the criticism - See a timeline of what happened in the issue of shaking violence.
Photo: SVT / The syndrome
In 2014, the Supreme Court ruled that clearer evidence of abuse is needed than that the child has injuries where no one knows how they arose.
In 2016, SBU, the authority responsible for evaluating medical methods, reviews the science behind the triad.
Over 3700 studies are reviewed.
The report concludes that it is not possible to equate certain medical symptoms with shaking violence.
- There is shaking violence, child abuse exists, no doubt about it.
But here, as we saw then, there was a risk of an overdiagnosis, says Niels Lynöe, professor of medical ethics and SBU's investigator.
"Risking the lives of children"
The conclusions in the report are not accepted by all doctors - and it is the individual doctor's assessment that applies when injuries are detected in a child.
The Pediatricians 'Association believes, among other things, that SBU has excluded important research and not taken into account pediatricians' overall assessments in everyday life.
- You can not just look at these three things that they look at, and it is internationally strongly criticized by many pediatric associations, says Johanna Räntfors, pediatric surgeon and spokesperson for the pediatric association.
The pediatric surgeon Pär-Johan Svensson, who was involved in spreading the theory of shaking violence in Sweden, also thinks that the SBU report has had a negative effect on the work of detecting child abuse.
- It requires a longer way to reach a prosecution because many have taken a step back.
This probably applies to colleagues, lawyers, police officers and everyone who works with this, I think.
The pediatric surgeon Pär-Johan Svensson, SBU's investigator Nils Lynöe and the Pediatric Association's Johanna Räntfors have all been involved in the issue of shaking violence.
Photo: SVT
After several weeks of preliminary investigation with a house search, forensic investigation and almost 20 interrogations of witnesses with relatives and friends, the police investigation against Jennifer and Simon is closed.
Six weeks after the compulsory care, the family is allowed to live together as usual again.
But when Assignment review goes through the case, it turns out that the doctors changed their perception of Theo's injuries - already two weeks after the care.
When prosecutors and the social secretary at a meeting ask questions to understand how Theo may have received his injuries, the pediatrician says that "there are currently no signs that it is shaken baby syndrome".
Diaper changes can be the cause
Theo has not been abused by force and the doctors know that his head injury may have occurred as his parents told him.
The CML fractures that have been discovered can, according to the new assessment, "be caused by changing nappies when parents use the leg as a 'lever' to be able to change nappies."
Jennifer and Simon will not know.
And the children are not allowed to come home.
When you yourself find that suspicions of abuse turn out to be incorrect, do you think that parents need to be informed that you were wrong?
- If we have made a mistake, we need to inform about it, absolutely, says Fredrik Stenius, operations manager at Sachsska children's hospital Södersjukhuset.
The responsible managers do not want to answer questions about the individual case.
Jennifer and Simon have not yet received any feedback on what happened to them.
"We have got our children back - but if we have received an okay treatment and there are those who are worse off, then a debate must be raised about it," says Theo's father Simon.
Photo: SVT
Assignment review has gone through police reports and LVU decisions from recent years and found about ten almost identical cases - where children are separated from their parents after doctors' suspicions of shaking violence.
Later the parents are completely free.
Some children have then been cared for for several months.
SBU has produced a list of other possible explanations for injuries to young children.
The Pediatricians' Association has created its own checklist to systematically investigate other possible causes - if no one is found, the suspicion of abuse is strengthened.
- I think that everyone who works with this does not want someone innocent to be convicted.
What we work for is to understand what we see in front of us, to pay attention to the children who are actually exposed to abuse, says Johanna Räntfors at the pediatric association.
“The price we have to pay”
Both sides in the debate on shaking violence agree that the slightest suspicion should lead to a report of concern.
But they disagree when it comes to how the injuries to infants should be interpreted - and whether the diagnostic method used today to detect shaking violence has sufficient scientific support.
If the methods you used to find those children are not sufficiently grounded in science, will it not be wrong then?
- Then you may have to accept that some cases are reported and continue to be investigated where you find alternative reasons for this, in order to be able to briefly protect children who may have been at risk of being abused, says pediatric surgeon Pär-Johan Svensson.
One can simply assume that some parents will be reported and that some children will be cared for for a while while the investigation is ongoing?
- Yes.
I think so.
That's probably the price we'll have to pay, perhaps to protect the children.
For these children have no advocates unless we are.
Today, Jennifer and Simon live with their children again.
But for Theo's big brother Louie, it's not like before.
- He says that we have forgotten him, that we have left him and that he is afraid that we will not pick him up at preschool.
He is very afraid that we will disappoint him again, says Jennifer.
Watch the full report "Skakvåldet" at 12 on SVT Play.