In the case of Steckler v. First Commercial Trust, the administrator of the estate of a child who died as a result of child abuse, filed a medical malpractice complaint against the child’s family practitioner for failing to report her suspicions that the child was being abused.
Dr. Rheeta Steckler saw the decedent, Laura Fullbright on several occasions prior to her death. On June 12, 1992, Dr. Steckler conducted a physical exam upon Laura, who was then a year old. At that time, she noted a visible angulation on one of Laura’s arms. An x-ray was taken which showed that Laura’s forearm was fractured in two places. When Dr. Steckler pointed out her findings to Laura’s mother, Mary Ellen Robbins, and Ms. Robbins live-in boyfriend, Joseph Rank, they both indicated that they did not know that there was a problem. Dr. Steckler became concerned about possible child abuse and referred Laura to an orthopedic doctor for further evaluation. The orthopedic doctor did not believe that Laura’s fracture was caused by child abuse.
On July 9, 1992, Ms. Robbins reported that she noticed Laura was wobbly and running into things around the house. Dr. Steckler diagnosed the problem as dizziness and concluded that Laura had been drinking too much juice. In addition, she also recognized that Laura’s symptoms were consistent with the possibility of head trauma.
Two weeks, on July 21, 1992, Laura presented at Dr. Steckler’s office with swollen eyelids. Ms. Robbins reported that Laura had been nauseated the day before and had vomited that morning. Ms. Robbins also stated that when Laura woke up there was swelling on the right side of her head in the temple area and over her right eye. Dr. Steckler’s husband treated Laura on July 21.
On July 22, 1992, Laura returned to see Dr. Steckler. This time, Ms. Robbins reported that Laura had fallen down several stairs. Both of Laura’s eyelids were swollen. Ms. Robbins thought her daughter’s lids were swollen due to allergies or a spider bite. When Dr. Steckler confronted Ms. Robbins about the possibility of child abuse, Ms. Robbins was adamant that abuse was highly unlikely. She explained that her five-year-old son had been around the child and may have dropped her. She also stated that her boyfriend did not have a temper. Although Dr. Steckler considered reporting her suspicions of child abuse, she decided that there was not enough evidence to warrant an intrusive investigation by the authorities.
During the month of August, Ms. Robbins had an out of town guest staying in her house and Laura sustained no injuries while he was present. On September 12, 1992, Ms. Robbins found Laura, who she had left in her boyfriend’s care, unconscious. Laura was brought to the hospital where she was later pronounced dead.
At trial, the jury heard expert testimony that Laura’s life could have been saved if the abuser was identified. During cross-examination, Dr. Steckler’s expert admitted that he would expect an abuser to back off if he were under investigation for child abuse. The jury concluded that the doctor should have reported the abuse, and that her failure to do so resulted in the death of the child. On appeal, the Court found that there was sufficient evidence presented to support the jury’s verdict.
In light of the Steckler decision, a physician must be aware of just how broad their duty of care is to their patients. Physicians must be aware of any statutes requiring them to report suspected child abuse to the authorities. Physicians should also be aware of what types of observations may suggest that a child is being abused, and how to approach a parent with such reasonable suspicions. In cases of doubt, it is better for the physician to err on the side of caution and file a report. In fact, many statutes impose immunity for filing a report which is later unsubstantiated if the physician had reason to believe that a child was being abused. In Massachusetts, a physician is required to report suspicions of abuse within forty-eight hours. Failure to do so can result in a fine of up to one thousand dollars. In addition, a physician cannot be held liable for reporting a child abuse claim which is later unsubstantiated unless the report was knowingly frivolous.
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