The Deconstruction of a Complex Case of Medical Child Abuse

Reena Isaac1, *, Lisa Creamer2, Mike Trent3
1 Baylor College of Medicine, Houston, Texas, USA
2 Texas Children’s Hospital, Houston, Texas, USA
3 Law Office of Michael E. Trent, Houston, Texas, USA

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Creative Commons License
© Isaac et al.; Licensee Bentham Open

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (, which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Baylor College of Medicine, 6621 Fannin, Suit A2210, Houston, Texas 77030, USA; Tel: +8328245507; Fax: +8328255424; E-mail:



Medical child abuse (MCA) is a serious and potentially fatal form of child abuse. The condition of medical child abuse has historically been regarded as a “rare” entity. However, the lack of a standardized definition of medical child abuse may have limited our understanding of the true scope of the problem. Cases may straddle the elements of physical abuse, medical neglect, and psychological abuse. Many cases may have been overlooked as medical child abuse or categorized under another form of child maltreatment, when identified as abuse or neglect. There is no one typical presentation. Medical investigations into suspected cases must be carefully and conservatively conducted.

Method and Result:

An illustrative case is described involving three young chronically-ill siblings with various degrees of medical dependencies, medical and surgical interventions, and multiple subspecialists and is deconstructed with the final outcome of three physically healthy children and a criminal conviction of the perpetrating caregiver.


Cases of child medical abuse can be complex and challenging. Potential complications and sequelae of unidentified cases are vast, including: pain and suffering from multiple, unnecessary procedures, diminished quality of life and life potential, and ultimately risk of death. Challenges to medical and social investigations can hinder early identification and protection of the children at risk.

Keywords: Caregiver-fabricated illness, Deconstruction, Medical child abuse, Munchausen syndrome.