Scalding of an infant - accident or maltreatment

We present the case of a 2-year-old boy who was brought to hospital with ex tensive scalding of the face. The clinicians raised the suspicion of a phys ical maltreatment of the child. Because of the morphological findings the m edico-legal expert came to the conclusion that maltreatment was proven. Dur ing the criminal proceedings at the appeal court contrary opinions on the m orphological findings of the injury between the clinical expert and the med ico-legal expert became obvious. Findings of the physical examination of th e child and the experimental studies on immersion and pouring of water and the influence of clothing in case of wetting with hot water were presented which confirmed that the injury was caused by maltreatment. The opinion of the clinical expert which supported the case of the accused could be refute d. During the final legal proceedings the opinions of the clinical expert h ad been sufficient for the court to justify an acquittal "in dubio pro reo. " Discussion:When assessing the origin of scaldings, not only the morphology of the injury but also the attempts at defence of the person in charge of t he child must be judged. The (photographic) documentation of findings and e xperiments is most important. The problems and the complexity of forensic a ssessment can be demonstrated in th is ca se wh ich is probably characteris tic for the incorrect assessment of the origin of scaldings in children.