Distinguishing between salt poisoning and hypernatraemic dehydration in children

BMJ 2003; 326 doi: (Published 01 March 2003) Cite this as: BMJ 2003;326:497

Errors occurred in this article by Malcolm G Coulthard and George B Haycock (18 January, p 157). The conclusion of case 2 says that the court found the mother not guilty of manslaughter. In fact the case referred to was not the subject of a criminal trial, but a family court hearing concerning the continuation of care orders. This error was partly caused by miscommunication in the BMJ editorial office, for which we apologise. Also, in the description of case 2, the statement that “the odds of a second innocent death were suggested (incorrectly) to be 73 million to 1” could be misread as indicating that this opinion was stated during that court hearing, which was not the case. Two of case 2's siblings had died in infancy and his parents made a complaint about the care that they had received from their general practitioner. As a result of this the medical records of all the children were reviewed by expert witnesses. A paediatrician argued that two infant deaths within the family made infanticide statistically almost certain, and that the episodes of hypernatraemia indicated salt poisoning. As a result of these concerns care orders were obtained on the three surviving children; case 2 was fostered. The subsequent family court hearing determined that the children had not been salt poisoned. The care orders were revoked on two children and sustained in case 2. All the children were returned to the family home, where they remain. In addition the authors wish to declare that they were expert witnesses in the cases referred to in their article and in other cases.


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