Three Members of Chambers instructed in an important case on birth related rib fractures

Ben Clulee, Steven Veitch and Hannah Simpson appeared before Chris Wells sitting as a Recorder in Re K (A Child) (Causation of Rib Fracture) [2025] EWFC 336 (B).

The local authority failed to prove that K’s rib fractures were inflicted injuries and therefore threshold for public law orders were not met.

K was found to have a posterior fracture to his right 6th rib, there was no accepted explanation given by the parents for the causation of this fracture. Although birth related injury was within the radiological window this was excluded on the basis of research into the rarity of such injuries.

The research suggested that rib fracture was commonly associated with risk factors such as shoulder dystocia, high birth weight (macrosomia), complex or difficult delivery, multiple rib fractures or concurrent other fractures (commonly the clavicle), none of which were present in K’s case.

The court embarked on a detailed treatment of the research and identified some similarities to K’s case.

The court went on to consider the limitations of the research in that rib fractures were underrepresented in the data. Ribs fractures are usually clinically silent as there are no symptoms, as a result there are not routine radiological imaging of ribs after birth and those which are identified radiologically are incidental to other injuries. It is also noted that rib fractures are radiologically invisible immediately after causation.

In light of the implausibility of the parents having caused the injury and the lack of clear medical evidence in relation to birth injury the court concluded that threshold was not met.

The court noted the importance of having heard the expert’s cross examined in this case.