Distinguished career could end in ignominy

Health Editor,Jeremy Laurance
Friday 12 December 2003 01:00

Professor Sir Roy Meadow, the expert medical witness in the Angela Cannings case, is under investigation by the General Medical Council. His confident, charismatic performance in the witness box in a series of cot death cases is under scrutiny.

His distinguished career as consultant, professor of paediatrics and as the first president of the Royal College of Paediatrics and Child Health before retiring five years ago, could end in ignominy.

Sir Roy, 70, who lives in Yorkshire with his second wife, Marianne has let it be known that he is prevented from answering his criticswhile the investigation is under way. It is left to others to explain why he believed that Angela Cannings and many othermothers had murdered their children.

Three decades ago, the then Dr Meadow saw a six-year-old girl called Kay who had been referred to Seacroft hospital in Leeds with foul smelling, bloody urine. She had been admitted to hospital 12 times, had six examinations been treated with eight antibiotics, vaginal pessaries and other creams. Sixteen consultants were involved in her care but only one, Dr Meadow, realised what was wrong. It was not Kay who was ill but her mother.

It ran counter to all perceived wisdom to suggest that a loving mother might be prolonging her child's agony by subjecting her to repeated medical investigations. But forensic laboratory staff were able to confirm that the mother had been mixing her own urine, contaminated with menstrual blood, with her daughter's. Sir Roy described Kay's case in a paper in The Lancet in 1977. She became the first patient in the world to be diagnosed with Munchausen's syndrome by proxy, the condition in which parents, usually mothers, fabricate illness in their children as a way of gaining attention.

Sir Roy had, from the start of his career, shown an interest unusual among his colleagues in the social aspects of medicine. "He was interested in all aspects of child care and health and in that sense he was ahead of his time. He was genial, personable and a good listener," said Harvey Marcovitch, former consultant paediatrician at Banbury hospital, Oxfordshire.

In the mid-1990s Sir Roy was elected president of the Royal College of Paediatrics. His standing in the profession was high. He was not regarded as a maverick but as a thoughtful, sensitive physician. But, in the past few years, as the cases in which he was involved have collapsed, his reputation has started to crumble.

The case against him rests on his alleged misuse of statistics. The infamous "Meadow's law" that one cot death is a tragedy, two is suspicious and three is murder and his suggestion that the chances of three deaths happening in one family was one in 73 million are now discredited.

His supporters dispute that judgement. A professor of paediatrics at a teaching hospital said Sir Roy had never intended "Meadow's law" - which was first cited by a US paediatrician - to be used as a rule of thumb. "That is where he has been traduced," he said. On the one in 73 million statistic, friends say it was accurate as applied to a randomly-selected woman who had never had a cot death but inaccurate when one or more cot deaths had already occurred.

Friends claim Sir Roy was expecting to be questioned on the figure so that he could elucidate it but the questions never came. In 2000, he wrote a defence of his evidence in the Sally Clark case after her first appeal failed.

Dr Marcovitch said Sir Roy's contribution to child health was undoubted. "There are a large number of children alive today who would not have been but for him." But the Attorney General is now considering reviewing all the cases which could have been affected by Sir Roy's lack of self-doubt.

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