She was born in May 1991, the third child of Christopher and Jennifer Attwood of Handsworth, Birmingham. Mrs Attwood spent her adolescence in care, and started living with her husband, a care worker, when she was 18.
She was keen to have children and create the stable home she had missed: 'Emma was planned. We'd always said we wanted lots of children and we cared for all three of them. Our priority is the children. We do not have any luxuries, just the essentials, but we've been very happy.'
Last December Emma was taken ill. Mrs Attwood found her breathless in her pram: 'She'd gone grey and her lips were blue.' A neighbour quickly revived Emma who, the hospital said, had been suffering from bronchitis.
That was the first of seven attacks. Each time, Emma was taken to hospital. Doctors variously diagnosed whooping cough, bronchiolitis and epilepsy. She was prescribed anti- convulsants. Emma's final attack was on 28 January. She never recovered. After emergency admission to Dudley Road Hospital, she was transferred to Selly Oak Hospital for intensive care. Her parents stayed at her side, leaving their other children, Thomas, four, and Lucy, three, at home in the care of a social worker friend.
Three days later, doctors told the Attwoods that Emma had only a 10 per cent chance of survival. Mr Attwood said: 'We were coming to terms with that and with the certainty of brain damage.'
Mrs Attwood saw six uniformed police officers arrive outside the ward.
She said: 'They were holding Emma's medical notes, but we didn't take much notice at the time.' They then entered the ward and started asking the Attwoods questions about Emma's condition. Mr Attwood said a doctor told him his other children had been taken away by the police. He said: 'I went mad. I thought they had been taken into care.'
Mrs Attwood said she was told they would be arrested if they did not co-operate. So they agreed to go 'voluntarily' to the police station. They say they were 'frogmarched' the length of the hospital and, despite their protests, taken there separately in two police cars. From 11pm, according to the Attwoods, they were held incommunicado with messages of advice and support from friends and relatives being kept from them. They say they were too distraught to think of calling a lawyer.
Other officers knocked at the door of the Attwoods' home. Their friend, Hilary Baisley, said she was forced to wake the other two children. She went with them to the police station, where 'the three of us were just left in a canteen without any supervision until after midnight'.
'The children had been asleep in bed and were in no danger. It was the parents they suspected and they weren't there. The police acted illegally. It was abduction and I am making a formal complaint to West Midlands Police.'
Mrs Attwood was questioned by the police about her background and former boyfriends. Mr Attwood was asked about his wife's attitude to Emma. After being held apart from her husband throughout the night, she was taken home at 4am for the police to search her home.
Mr Attwood was released at 6am, by which time both had been without sleep for 24 hours. He said: 'I have never experienced anything like it. We were treated like common criminals. My legs were shaking and I was like jelly. The police could have done anything they liked and they did. You would not think anything had been learned from Cleveland or Rochdale.'
Emma died four days later, on 5 February, after her life-support system was switched off. The next day, social workers held a child protection case conference on the Attwoods' other children, which the Attwoods attended. There they heard that Emma's consultant paediatrician, Dr Robert Sunderland, had mentioned Munchausen by Proxy as a possible cause of Emma's illness.
On 1 February, Dr Sunderland had told the police that doctors had ruled out epilepsy and were investigating a possible insensitivity to lack of oxygen. He said: 'There remains a final possibility of non-accidental suffocation, sometimes known as Munchausen by Proxy or 'gentle battering' . . . there was no evidence of this.'
In June, the inquest at Birmingham coroner's court heard evidence from three pathologists. Each said Emma had died of polymyositis, a muscle-destroying disease that is rare in babies.
But in a letter to the coroner, Dr Jeff Bissenden, consultant paediatrician at Dudley Road Hospital, said: 'Social services have good reason to believe Emma had died as a result of Munchausen by Proxy. Clearly, one option is to accept the pathological findings . . . in which case all child-abuse proceedings against the parents must be dropped and apologies made for false accusations.' He suggested a further analysis by an expert on muscle disease before this 'irrevocable step' was taken.
Professor John Emery of Sheffield University, an eminent paediatric pathologist who assisted in the autopsy at the parents' request, says every sudden infant death should be as thoroughly investigated. Professor Emery has said the case illustrated the importance of establishing the true reason for any sudden infant death. He said: 'This baby had an autopsy more thorough than one in a hundred other cases of sudden infant death. Without it, the polymyositis would never have been diagnosed. The Government should provide money for coroners to have a full paediatric pathologist's autopsy every time.'
From February to July, the Attwoods lived with the fear that their other two children would be taken away from them. Lucy and Thomas were only taken off Birmingham's 'at risk' register last month.
Sue Amphlett, director of Parents Against Injustice, a charity that acts for parents, says: 'The way the family was treated is appalling. It is not acceptable to remove toddlers from their beds when they are already in the care of a responsible person.
'The mere fact that Munchausen by Proxy is now in Department of Health guidelines as a registerable form of abuse may encourage health workers to fall back on this as a diagnosis. The label can scar a family for life,' she said.
Guidelines issued by the Department of Health in October 1991 specifically warn child protection committees to guard against 'unco-ordinated and/or premature action' and the 'harm caused by unnecessary intervention'.
The Social Services Inspectorate is investigating why Birmingham social services failed to provide emergency child protection cover to the Attwoods in January. Its emergency duty team did not respond at a 'crucial' time to co- ordinate the abuse inquiry. In a letter to Frank Attwood, the children's grandfather, an assistant Birmingham social services director, Bob Judges, said the team was overstretched that night. He apologised for the lack of immediate response. He added that West Midlands Police 'appeared to have taken a number of steps independently'. A police spokesman said: 'It is (our) policy to work closely with social services, the regional health authority and other agencies.' The force will not comment on the Attwoods' case because it is the subject of a formal complaint.
Birmingham social services said it was investigating a complaint by Mr and Mrs Attwood and would not comment. The department wrote to them last week to apologise and to offer condolences on behalf of the area child protection committee. The Attwoods say they are not prepared to accept an apology until the matter has been fully investigated and the results made public.
The regional health authority refused to comment yesterday. Dr Bissenden was on holiday.
Professor David Southall, who pioneered the study of Munchausen by Proxy at the Brompton Hospital, London, but who now works at North Staffordshire Hospital Centre, said yesterday: '. . . from what you have told me, Emma Attwood would have been subjected to physiological recordings as soon as she was admitted after the first apnoea attack, and we would have picked up such a major muscular disease very early on. Her parents would not have been suspected of MSBP (Munchausen by Proxy) here.
'I will say that missing a case of MSBP is very serious. Because if you miss it, it could be sudden death for a baby or severe neurological impairment due to lack of oxygen. And MSBP can lead to doctor abuse, where the doctor performs life-threatening interventions as a result of the fabrication of symptoms by a carer,' he said.
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