Suspicious injuries


I want to discuss an interesting forensic case that came through the ER this weekend. An 11-year-old male came in with L wrist pain. He denied any injury and gave an elaborate account of a dream he had the night before where he injured his wrist and woke up with his wrist hurting. There was obvious bruising to the dorsal aspect of his hand and wrist with petechiae inside the bruising. It looked to me like someone had stepped on him or applied a lot of pressure. I asked him what he did before he went to bed. He said he was playing a game with his friend (gamecube). Again denied any injury occurring, couldn’t remember any type of pain before bed. The patient was in the ER with his mother only. On XR his radius and ulna were both broke. We called the sheriff department immediately. We looked up the mothers medical records which also showed multiple hand and arm injuries. The mother was in complete denial and refused to believe he got the injury from something else than a bad dream (she wasn’t an individual with a high IQ). She got upset and called the father who came to the hospital and was also upset. The father has a history of head trauma and is known to have rage outbursts. Anyways, the police came and interviewed all and said he would contact social services the next day. My question is-we took pictures of the child’s injury and bruising noted. We usually need a consent form signed to take and maintain pictures in a medical record. But since the injuries are suspicious and abuse may be suspected by one of the parents, do we still need consent or is it implied since it is a mandatory report to law enforcement?


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