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Clinical forensic medicine outpatient department for pediatric patients in Chiba University Hospital

For the purpose of physical examination of abused children, we collaborated with the department of forensic medicine and the department of pediatrics, Chiba University. We formally established a clinical forensic medicine outpatient department for pediatric patients, in Chiba University Hospital, in July 2018.

We started the clinical forensic medicine department in the Education and Research Center of Legal Medicine, Chiba University, in 2014, for the first time in the country. With the aim of objective evaluation and preservation of evidence of living victims, the clinical forensic medicine department receives a consultation from the police, prosecution, and child consultation center (CCC). To evaluate physical abuse and neglect of a child under temporary custody, we are requested by the CCC to perform physical examinations. We are also consulted about evaluations of images, such as a photograph of bruises, and medical images, such as computed tomography (CT) and X-ray images, taken at another hospital.

In forensic medicine, the forensic pathologist who makes the decision about the origin of trauma evaluated the external surface, a forensic radiologist evaluated the medical images, and then, the detailed expert opinion was written with a peer review process in compliance with the CCCfs request. However, because the department of forensic medicine is not a medical institution, satisfactory examination is impossible. We had requested another hospital consultation through the guidance of the child consultation center. By establishing a clinical forensic medicine outpatient department for pediatrics in Chiba University Hospital, an examination (blood examination, nutrition evaluation, evaluation of an intracranial lesion, evaluation of a fracture, dentistry roentgen evaluation, etc.), consultation (ophthalmic or orthopedic), follow-up, and an introduction to other organizations became possible. By liaison of pediatrics and forensic medicine, a forensic toxicological evaluation (a prescription-medicine assay and illegal drug assay) and a forensic odontological evaluation of dental neglect also become a possible.

Although it seems that coping with child abuse is difficult, we will work so that we may be able to help solve this issue.