A medico-legal problem of child maltreatment among pediatric cases admitted to the Burn Unit of Alexandria Main University Hospital

Child maltreatment is a significant public health problem. Violence and injuries are serious threats to the health and wellbeing of children, as children are at high risk of disability or even mortality due to these injuries. Childhood victimization has long term negative impacts such as low educational performance, becoming more suicidal prone, fear of other sex and acquiring violent behavior. Child maltreatment by burning is a common means of assault that may be difficult to prove.
The aim of the present work was to highlight the problem of pediatric burn injuries, and to study the recorded cases of these injuries to find out if the recorded data are sufficient for diagnosis of child maltreatment, as well as to investigate a fresh case of child maltreatment and the complex medico-legal problems affecting the management of such cases.
Results: an analysis of records revealed 112 cases of pediatric burn injuries (48.9%) among 229 burned cases admitted to the Burn Unit of Alexandria Main University Hospital during a period of six months from first of January 2013 till the end of June 2013. Scalds were the commonest type especially in children below 5 years (77.3%). Perineal burns were mostly found in females (72.2%). The commonest cause of death was multi-organ failure (63.1%). The records gave no data about the circumstances of burn injuries, thus it was difficult to detect cases of child maltreatment, in spite of finding many clues in the records that may point to this diagnosis. In this work, a case of severe maltreatment was examined, investigated and followed up till discharge. As she was a minor and her caretakers were the main offenders, the question was from whom we would take the consent? This created surgical and medico-legal problems in managing the case.