A world famous scientist now working as an expert witness in court rooms around the world is using a theory he developed to disprove claims of non accidental injury in babies and children going through child protection proceedings.
Non accidental injuries, unlike accidental injuries, are deliberately inflicted by another person, and can include physical damage to children like bruises, burns, or fractures. These injuries are often considered to be synonymous with child abuse.
Dr Michael Holick is the Director of the Bone Health Care Clinic at Boston University Medical Center, and the leading authority on Vitamin D. In the last seven years, Dr Holick says he has consulted or testified as an expert witness in over 300 child-abuse cases in the US, the UK, New Zealand, Australia, Germany, and Canada. And in almost every case, he has diagnosed the child in question with a rare genetic disorder called hypermobile Ehlers-Danlos syndrome.
Considered to be one of the most prominent and sought-after expert witnesses in the US for the defense in child-abuse cases, Holick told The New Yorker that around 50% of the parents he helps have a positive experience, such as getting their children back or having abuse charges dismissed. Sometimes he claims a much higher success rate. “Before I started testifying in these court cases on behalf of the family 100% of these cases had been won by the prosecution…. Now that I am testifying on behalf of the family 90% of the cases have been won by the parents and their children have been returned to them without further incident.”
Holick says children with EDS have weaker bones which can fracture much more easily. He also believes that, “thousands, if not tens of thousands,” of parents around the world have been wrongly accused of fracturing their children’s bones. When he doesn’t diagnose a child with EDS, he concludes that the bone fractures are down to rickets or a Vitamin D deficiency. Holick also believes that in every case he has come across, not one child had been subjected to abuse. Crucially, he also says that parents who approach him for help have never tried to fake an illness in their children in order to avoid prosecution.
Not everyone thinks Holick is right. The National Institutes of Health estimates that EDS affects 0.02% of the population worldwide, at most, and so Holick’s near 100% diagnosis rate for the condition does not sit well within that mathematical probability of chance. That Holick often does not see the children he is diagnosing, choosing to attribute conditions over the phone instead, also gives his critics more leverage to query the accuracy of his findings.
A 2008 case Holick worked on, in which he diagnosed a baby who had sustained 26 fractures, with EDS, later led to the father being sentenced to 24 years in prison. Holick maintains that the sheer volume of fractures could not have been caused by external trauma without resulting in the baby’s death. The heightened levels of flexibility in small children too, make it much harder to diagnose EDS, and almost impossible to diagnose children under the age of five, according to other experts in the field.
There are four studies which Holick uses to support his conclusions, and while the authors of those studies say his approach is not backed by published scientific research, they are not entirely dismissive of his theory. Cristina Eller Vainicher, who is the lead author of one of the paper’s that Holick often references, told The New Yorker that “she can’t entirely discount his thesis, because some studies have suggested that a subset of EDS patients do experience fragility fractures during childhood. Still, she wrote in an e-mail, “This does not mean that we could state all children with hypermobile EDS are at high risk of fractures.””
The current scientific gaps in Holick’s theory have not prevented him from being deeply influential in non accidental injury cases, which is most likely down to his formidable reputation as the man who discovered the active form of Vitamin D, resulting in treatments for bone disease in kidney patients and for psoriasis. He went on to discover that orange juice helped the body absorb Vitamin D, and was invited to consult for NASA, who asked him to examine bone loss in space. That he was called a “legend” at the last annual meeting of the American Association of Clinical Endocrinologists perhaps sums up his powerhouse status in America.
BAILII offers three public judgments in which Holick has been referenced, either as a consultant to the case or because of his 2017 research paper, entitled, “Multiple fractures in infants who have Ehlers-Danlos/hypermobility syndrome and or vitamin D deficiency: A case series of 72 infants whose parents were accused of child abuse and neglect.”
All the cases have been heard in family courts, with the first taking place in Northern Ireland at the end of last year: A Health and Social Care Trust v A Mother and A Father (In the matter of two children: Non-accidental Injury: Causation).
The second case published lists a hearing at the Family Court in East London in March: A, Re [2018] EWFC B34 (16 March 2018).
The final case mentioned, ES (A Child), Re [2017] EWFC B96 (03 November 2017), was heard in the Family Court at Milton Keynes.
His views don’t appear to be well received by judges in the above cases, with one judge even going so far as to say that Holick was unable to produce evidence of any prior cases he assisted on.
You can access Dr Holick’s research papers here, and follow him on Twitter @VitaminD_Holick and Facebook at DrMHolick.
Dr Holick can also be contacted via his website (scroll down to the bottom to access the form) or emailed at mfholick@bu.edu.

Dr Michael Holick. Image Credit: Boston University.
Sounds positive but you can have someone prove their innocence, in that an injury was not deliberate in Crown Court for SS to then lie and have you in Family Court (the parent/s) stating in the threshold statement it’s NAI. What confuses me is why isn’t the Family Court Judge joining the dots?
Also, if SS try second guessing what could have happened, they’re not medically qualified to do this no matter what they tell you.
It would be eye opening to research what happens from said injury, however it applies and see just out of interest….Does it match up with SS theory? My guess is it won’t. Even worse when their manager/ess tries second guessing. Then worse still when a parent recognises it much too late, yet the Judge never did.
Why don’t the evidence/outcome go into Family Court, once Crown/Criminal Court decides an injury was not deliberate? It’s misleading and criminal not to do that when parents are naive on their rights (which many are at the beginning especially)
Things like this are evidence of bad social work practice, malpractice!
xx
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I’m adding some more information on Dr Holick in the post now, as well as links to cases published on BAILII in which he appears.
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Children should not be removed if police drop charges or a criminal court finds the parents not guilty of injuring their child
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Judgements and Judicial Comments relevant to similar cases and which are Case Precedents:
In 2003 and 2004 there were landmark cases in the U.K. Criminal Appeal Courts [Sally Clark/ Angela Cannings/Trupti Patel] regarding the evidence presented by Professor Sir Roy Meadow and which have resulted in his theories regarding Sudden Infant Death Syndrome and MSBP/FII being totally discredited. Judicial comments at these court hearings were that the medical evidence was “manifestly wrong and grossly misleading” and such evidence “should not have been put before a jury”.
Lord Justice Judge – Angela Cannings Appeal Hearing against conviction 2004,
“in cases like the present, if the outcome of the trial depends exclusively or almost exclusively on a serious disagreement between distinguished and reputable experts, it will often be unwise, and therefore unsafe, to proceed”.
In relating the ruling of Justice Judge to civil cases in Care Proceedings, Justice Butler-Sloss has added further rulings that;
i ) The cause of an injury or an episode that cannot be explained scientifically remains equivocal;
ii) Recurrence is not in itself probative;
iii) Particular caution is necessary in any case where the medical experts disagree, one opinion declining to exclude a reasonable possibility of natural causes;
iv) The Court must always be on guard against the over-dogmatic expert, the expert whose reputation or amour propre is at stake, or the expert who has developed a scientific prejudice;
v) The judge in care proceedings must never forget that today’s medical certainty may be discarded by the next generation of experts or that scientific research will throw light into corners that are at present dark.”
In the U.S.A. the Supreme Court has ruled, (Daubert vs. Merrill Dow) that medical evidence presented to a court must have been peer reviewed, generally accepted by the relevant medical community, and appropriately tested scientific evidence should be presented”.
Most recently in June 2004 in an Appeal Hearing, the Supreme Court of Queensland, Australia have made the following findings in regard to MSBP/FII. [R v LM [2004] QCA 192.].
“As the term factitious disorder (Munchausen Syndrome By Proxy) is merely descriptive of a behaviour, not a psychiatrically identifiable illness or condition, it does not relate to an organised or recognised reliable body of knowledge or experience. “ and;
“the diagnosis of Drs. Pincus, Withers, and O’Loughlin that the appellant intentionally caused her children to receive unnecessary treatment through her own acts and the false reporting of symptoms of factitious disorder (Munchausen Syndrome) by proxy is not a diagnosis of a recognised medical condition, disorder, or syndrome. It is simply placing her within the medical term used for the category of people exhibiting such behaviour. In that sense, their opinions were not expert evidence because they related to matters able to be decided on the evidence by ordinary jurors. The essential issue as to whether the appellant reported or fabricated false symptoms or did acts to intentionally cause unnecessary medical procedures to injure her children was a matter for the jury’s determination. The evidence of Drs. Pincus, Withers, and O’Loughlin that the appellant was exhibiting the behaviour of factitious disorder (Munchausen Syndrome By Proxy) should have been excluded.”
The Queensland Judgement was adopted into English law in the High Courts of Justice in Case No. WR03C00142 [A County Council v A Mother and A Father and X,Y,Z children] on 18 January 2005 by Mr. Justice Ryder.
In his final conclusions regarding Factitious Disorder, Mr. Justice Ryder states that :-
“I have considered and respectfully adopt the dicta of the Supreme Court of Queensland in R v. LM [2004] QCA 192 at paragraph 62 and 66. I take full account of the criminal law and foreign jurisdictional contexts of that decision but I am persuaded by the following argument upon its face that it is valid to the English law of evidence as applied to children proceedings.
The terms ‘Munchausen Syndrome by Proxy’ and ‘Factitious (and Induced) Illness (by Proxy)’ are child protection labels that are merely descriptions of a range of behaviours, not a paediatric, psychiatric or psychological disease that is identifiable. The terms do not relate to an organised or universally recognised body of knowledge or experience that has identified a medical disease (i.e. an illness or condition) and there are no internationally accepted medical criteria for the use of either label.
In reality, the use of the label is intended to connote that in the individual case there are materials susceptible of analysis by paediatricians and of findings of fact by a court concerning fabrication, exaggeration, minimisation or omission in the reporting of symptoms and evidence of harm by act, omission or suggestion (induction). Where such facts exist the context and assessments can provide an insight into the degree of risk that a child may face and the court is likely to be assisted as to that aspect by psychiatric and/or psychological expert evidence.
All of the above ought to be self evident and has in any event been the established teaching of leading paediatricians, psychiatrists and psychologists for some while. That is not to minimise the nature and extent of professional debate about this issue which remains significant, nor to minimise the extreme nature of the risk that is identified in a small number of cases.
In these circumstances, evidence as to the existence of MSBP or FII in any individual case is as likely to be evidence of mere propensity which would be inadmissible at the fact finding stage (see Re CB and JB supra). For my part, I would consign the label MSBP to the history books and however useful FII may apparently be to the child protection practitioner I would caution against its use other than as a factual description of a series of incidents or behaviours that should then be accurately set out (and even then only in the hands of the paediatrician or psychiatrist/psychologist). I cannot emphasise too strongly that my conclusion cannot be used as a reason to re-open the many cases where facts have been found against a carer and the label MSBP or FII has been attached to that carer’s behaviour. What I seek to caution against is the use of the label as a substitute for factual analysis and risk assessment.”
In a subsequent Judgement in the Family Division on 8 March 2005, [East Sussex County Council v K and others. BLD 1403051115; [2005] EWHC 144 (FAM)], Mr. Justice Charles set out the role of expert medical witnesses when giving testimony in Courts and most importantly, the areas on which they should give such evidence . i.e.
Per curiam: In civil cases concerning children it might :
(a) assist all involved,
(b) better reflect the roles of the expert and the judge, and;
(c) demonstrate that the expert is not the decision maker as to whether the relevant death, injuries or harm is the result of non-accidental human agency and whether the threshold is satisfied, and does not have all the relevant information,
if the medical experts were not asked to express a view as to the cause of the relevant death, injuries or harm on the balance of probabilities but were asked to:
(i) identify possible causes of the relevant death, injuries or harm setting out in respect of each the reasons why it might be a cause and thus why it should be considered,
(ii) state their views as to the likelihood of each possibility being the cause of the relevant death, injuries or harm and the reasons why they include or reject it as a reasonable (as opposed to a fanciful or merely theoretical) possible cause,
(iii) compare the likelihood of the cause (or causes) identified as reasonable possibilities being the actual cause of the relevant death, injuries or harm,
(iv) state whether they consider that a cause (or causes) is (are) the most likely cause (or causes) of the relevant death, injuries or harm and their reasons for that view, and to state whether they consider that a cause (or causes) is (are) more likely than not to be the cause (or causes) of the relevant death, injuries or harm and their reasons for that view.
In a letter to the British Medical Journal in October 2004 concerning child abuse research, Patrick E. Lantz, a forensic pathologist at Wake Forest University Health Sciences in North Carolina, U.S.A, and forty other physicians and scientists stated that,
“Evidence based medicine is the conscientious, explicit, and judicious use of scientific evidence in making medical decisions and cautions against unsystematic, untested reasoning and institution-based clinical applications”.
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