England and Wales Family Court Decisions (other Judges)

IN THE FAMILY COURT SITTING IN BIRMINGHAM

		8 July 2016

1. This case concerns GH, a little boy, who was born on 29 September 2015 and is now just over eight months old. His parents, who have parental responsibility for him, are the first and second respondents, AB and CD, respectively, to whom I shall refer as the mother and the father. The present hearing is a fact finding hearing to determine the cause and, if relevant, the perpetrator or perpetrators of a serious head injury suffered by AB on or around the night of 30-31 October 2015 when he was just 32 days old. His parents took AB to Good Hope Hospital on 31 October 2015 having noticed abnormal movements or twitching in AB's legs and hand. CT scans showed that AB had bilateral subdural and arachnoid haemorrhages and retinal bleeding. He was then transferred to Birmingham Children's Hospital where his seizures escalated. Following treatment, AB was transferred to Heartlands Hospital on 18 November 2015 from where he was discharged on 1 December 2015 into the care of local authority foster carers pursuant to section 20 of the Children Act 1989 pending a risk assessment of his maternal grandparents. On 11 December 2015 an interim care order was made on the basis that AB would be placed in the care of his maternal grandparents, where he has remained ever since. Fortunately, there are currently no signs that AB has suffered long-term harm as a result of his injuries although he will have to be monitored for some years to come.

Representation

2. All parties were represented by counsel. Mr Payne represented Birmingham City Council, Ms Lewis acted for the mother; Ms Storey-Rea for the father and Ms Lakin for the Guardian. I am grateful to all Counsel for their assistance. Mr Payne also helpfully provided me with written submissions on the relevant legal principles which were agreed by all the other parties albeit with some amplification on behalf of the mother and father.

Issues

3. The issues are:

A) Did AB's injuries arise out of some underlying inherent or congenital condition?

B) If not, could AB's injuries have been caused by his father lifting him forcefully out of his baby seat without supporting his head broadly in the manner shown in a video prepared by the parents showing a reconstruction of the incident;

C) If not how were AB's injuries caused; and,

D) Who was the perpetrator(s) of those injuries; and,

E) Did the other parent fail to protect AB?

Positions

4. Birmingham City Council says that the evidence heard allows the conclusions that the injuries were caused either by the action of the father in the video reconstruction or by some other event or more forceful action of the father's. Alternatively, if I disbelieve both parents' evidence then it is open to me to make what is called, a Lancashire finding: i.e. that both parents are in the pool of perpetrators. Birmingham City Council says that the account given by the father in the video reconstruction was unlikely to have caused the injuries. The mother denies causing the injuries and states that they must have been caused by the father's actions in lifting AB out of his bouncy chair (see below). The father also accepts that he probably caused the injuries in the manner stated but denies any more forceful actions. He, in the alternative, seeks a finding of some inherent or congenital condition although, to be fair, this finding was not pursued with any vigour.

Background

5. It appears that AB was an unsettled baby from birth even immediately after he had been fed and changed. He did not sleep well and caused his parents to have many sleepless or broken nights. The professional view was that the cause of this was colic or something similar. His distress on 15 October 2016 was so significant that the mother took AB to Accident and Emergency. The paediatrician who saw him thought he may have been suffering from reflux or colic but found nothing else wrong with him. AB was seen by his GP on 29 October 2015 which was a follow-up appointment from his visit to A & E. It appears that AB slept through this consultation and therefore the GP did not examine his head. On Friday, 30 October 2015 AB spent some time being looked after by his paternal grandparents while his mother went shopping. His father was at work. AB spent most of the time sleeping while in his paternal grandmother's care although there was one incident where he woke up and cried and his grandmother telephoned his mother. There is no suggestion that AB suffered any injury while in the care of his paternal grandparents.
6. AB accompanied his parents to a Halloween party that night. They arrived at about 7:30pm. AB remained in his car seat as he was sleeping. He slept for most of the evening waking only towards 10.00pm. His parents delayed their departure in order to feed him. They all left the party at about 10:30pm. There were a lot of people at the event and there are no reports of any incident during which AB could have suffered his injuries. Following his feed AB slept for about two hours. Rather than disturb him he was left to sleep in his car seat in his father's care while his mother went to bed. Jenson woke at 12:30am or thereabouts and, as the father had been unable to settle him by 2:30am, the mother then took over. She prepared a bottle for AB which he did not take, spitting it out. It took some time to settle him and it appears that he went to sleep again for about an hour or so before waking. His mother spent some further time trying to settle him and then his father took over again. AB fell asleep in his father's arms but only for a short while. When he again awoke crying his mother tried another bottle but he still would not drink. On this occasion some milk came out of AB's nose. From 2.30am until about 7.00am AB and both parents remained together in the parents' bedroom or just outside it. At around 7.00am his father took AB out for a drive in a further effort to settle him. The drive lasted about an hour during which AB largely slept but he started crying again as he got close to home.
7. At about 9:30am AB took his bottle and evacuated his bowels, something he had not done for some hours, and his mother was hopeful that he would then settle. However, at around 10:30am the mother noticed what she calls "a strange jerking/flinching movement of AB's left leg and possibly his hand". The mother consulted with her sister and the paternal grandmother. Both suggested that she should keep an eye on it and call 111 if there was further cause for concern. The mother rang 111 at around 11.15am. The operator said AB needed to be checked over and arranged for him to be seen at the Badger Clinic at Good Hope Hospital. What happened thereafter is set out in the medical evidence and resulted in the diagnoses set out above and the instigation of child protection procedures which led, ultimately, to these proceedings. The only other matter of note to report is that both parents feel that AB has been much more settled since the events with which I am concerned.
8. Until the first half of May 2016 there appeared to be, at least as far as the local authority, the Guardian and the court were concerned, no explanation at all for AB's injuries. On 10 May 2016, the father filed and served a very brief witness statement exhibiting a video reconstruction of an event he said took place in the early hours of the morning of 31 October 2016. The father stated that he had suddenly taken hold of AB by his armpits and brought him up abruptly or forcefully to his chest without supporting AB's head: as I have said, he provided a video reconstruction of what he said happened using a doll^[1]. The action caused AB to cry more loudly at the time and while the intensity of crying lessened AB was effectively inconsolable and, as was their usual practice, the father sought assistance from the mother. No explanation was given for picking up AB in this manner in the witness statement. The father stated that he had not mentioned the incident before because prior to sight of the expert medical evidence he believed this action could not have caused the injuries suffered by AB. This position changed in oral evidence when he said hadn't told of what he had done because he was afraid that the consequence might be the loss of his wife and child.
9. I was told, and accept, that the father first told the mother of this incident when, for the first time, she asked him a direct question following receipt of Mr Richards' report of 14 March 2016. She told him that if he didn't tell his solicitors about it she would tell hers. I am also told and accept that the father had told his solicitors by 1 April 2016. Mother also informed her solicitors. I, plainly, cannot investigate what passed between the parents and their respective solicitors as it may be privileged but I am astonished at the apparent delay of 6 weeks before anything at all was communicated to the local authority, the Guardian or the court. Nothing was said even at the pre-trial review on 3 May 2016. I entirely accept, as Ms Storey-Rea said, that the father's solicitors would have to explore his disclosure very carefully given the potential consequences for him but I cannot accept that this should properly take 6 weeks: after all, parents are typically given considerably less than this to respond to threshold and file their response to the local authority's initial evidence. There should have been some urgency about the situation particularly, in light of the fact that the experts' meeting was due to take place on 22^nd April 2016 and the disclosure was a matter that needed to be put to them.

Medical Evidence

10. I heard oral evidence from three medical experts: firstly, from Mr Peter Richards, a consultant paediatric neurosurgeon who provided a written report dated 11 March 2016 and two emails of 4 May and 16 May 2016. I then heard from Mr William Newman, a consultant paediatric ophthalmologist, who provided a report dated 25 March 2016, an addendum report dated 1 May 2016 and a further addendum report on 14 May 2015. Finally, I heard from Dr Cartlidge, a consultant paediatrician, who provided a report dated 3^t March 2016 together with an addendum report dated 13 May 2016. I was also provided with a transcript of an experts' meeting held between Mr Richards, Mr Newman, Dr Cartlidge and Dr Andrew Will, a consultant haematologist, who had provided a report dated 20 February 2016 which was not, ultimately, challenged: he concluded that there was no blood condition which would have resulted in the bleedings found in AB.
11. I have also been provided with, and read, reports from various doctors who saw AB following his admission to hospital including those of Dr Robin Tall, a consultant paediatrician, Dr Raes Gabriel, a paediatric ophthalmologist, Mr Solanki, a consultant neurosurgeon, and Dr Meran, a consultant paediatrician. I have also been provided with five additional bundles of other documents including two lever arch files of AB's medical and hospital records, health visitor records and a further two lever arch files of CT scan images, skeletal survey images and MRI images. I have read all the doctors' reports, the health visitor's statement and scanned the medical/hospital records relating to the relevant dates. All the relevant information in these records was contained within the expert reports. I have not looked at the two lever arch files of images as they are incomprehensible without expert explanation. No one took me, or the experts, to those images. When asked, no-one invited me to read into the medical/hospital records any further than I have indicated.
12. The view of all the doctors who examined AB or who gave expert evidence was that the injuries were non-accidental and were probably, or even highly likely to have been, caused by a single event of inappropriate forceful handling. The difference between them, a difference maintained in giving oral evidence, was the degree of shaking or force necessary to cause the injuries. All agreed that it is not possible to state what the minimum level of force to inflict such injuries is. This, unsurprisingly, is because shaking experiments self-evidently cannot be carried out on small children. However, once the father's explanation was proffered in mid- May opinion diverged to a degree. Dr Cartlidge opined that the injuries could have been caused by the father's actions although he would have anticipated more alarming adverse symptoms in AB at the time. Mr Newman on the other hand stated that he thought it was very unlikely that the actions demonstrated would have caused the retinal haemorrhages identified in AB. Mr Richards felt unable to say whether or not the father's actions as shown in the video reconstruction could have caused intracranial injury, for reasons set out below. Arguably, there was not really a difference of expert opinion as both Dr Richards and Dr Cartlidge were addressing the subdural and, per Dr Richards, subarachnoid bleeding while Mr Newman was addressing the retinal and pre-retinal bleeding and it is possible that the force required for the latter is greater than that required for the former, particularly where there is no impact. Even Dr Cartlidge, as I set out below, said that it was possible rather than probable that the father's action caused the injuries.
13. Mr Richards' position on the video evidence was attributable to his view that the reconstruction had little utilty: it was, he said, a reconstruction of a momentary action taking quite literally, a second or two, presumably (we had not heard the father's evidence at this stage) when the father was frustrated or angry and not thinking clearly. It was made about six months after the event when the father's memory would have been less reliable. Mr Richards also observed that nothing was known about the relative weights and elasticity of AB and the doll used in the reconstruction although nothing turned on this. He was, however, 'struck' by the speed of the father's action which is why he couldn't exclude it as a cause in what he said "may have been a momentary loss of control". He opined that the brain injury could have been caused by such an action but that if Mr Newman was correct to say that the retinal bleeding could not have been caused by that type of action then either there was a different causal event or the action was more forceful than shown in the video. He deferred to Mr Newman on the cause of the retinal bleeding. It would not be fair to say that Mr Richards went so far as to say that the injury was probably caused by the action demonstrated by the father.
14. Mr Richards was cross-examined on various other possible causes of the intracranial bleeding such as a chronic condition, something originating in AB's ventouse assisted delivery, raised intracranial pressure, the seizures themselves and inappropriate medication. While he accepted the various possibilities he did not alter his view that the injuries were caused by an event shortly before AB's presentation at hospital largely, he said, because there was no evidence of the other medical conditions, the seizures themselves were not severe enough to cause the bleeding and the medical evidence as to the site, nature and extent of the bleeding led him to his view. In particular, he thought that the CT scan on 31 October 2015 correctly, albeit a little obscurely, identified bleeding on both sides of AB's head which was confirmed by the MRI scan on following days and that there had not been a fresh bleed on the left side of AB's head.
15. Mr Newman, whose view was confined to the cause of the retinal bleeding, was clear that such bleeding, or at least, the retinal haemorrhages were caused shortly before AB's admission to hospital: he could not time the pre-retinal bleeds. He accepted that many intra-retinal bleeds were birth related but maintained his view that AB's were not related to his birth given their type and the length of time since birth. There were only two known cases of birth related retinal bleeds lasting more than 4 weeks after birth and they did not involve the type of bleed seen in AB. He rejected raised intracranial pressure as a likely cause because there were no clinical findings to support such a diagnosis and the retinal haemorrhages were not consistent with those caused by intracranial pressure in any event. He also rejected the seizures as a cause of the bleeds as he himself had never come across it nor was he aware of any colleagues who had come across it and only one such case has ever been reported. He could not find any link between the seizures and the retinal bleeding nor did he have any suspicions in that regard.
16. His view was that the father's actions, as shown in the video reconstruction, could not have caused retinal bleeding because, while AB's head would undoubtedly have fallen backwards when picked up it would not have moved forward past the mid line as it stopped on his father's chest. While he accepted that no one knew how many shakes as in forward and backward motions are required to cause such bleeding and it could be as little as 2, the medical consensus is, he said, that there would have to be forward and backward movement past the midline in order to generate the force and rotation necessary to shear the vitreous jelly from the retina which is what causes retinal haemorrhage. He deferred to the other experts in relation to the other bleeding.
17. Dr Cartlidge was not shaken on his view that there was no congenital or medical cause of the subdural haemorrhages. He explained why AB's initial low white cell count and the subsequent increase in it to 10.4 is not indicative of infection in this case – the rise was not high enough and, in any event, a reading of 10.4 is normal. The initial drop was most likely a reaction to the trauma. He also explained the lack of relevance of AB's triglyceride readings: they simply showed that there was more fat than usual in the plasma derived from AB's blood specimen and that this would not be linked to the injury in any event. He maintained his opinion that the subdural haemorrhages could have been caused by the type of action shown in the video reconstruction. In saying this he was looking at the father's movements and not the reaction of the doll – it is a type of movement that is dangerous and which would have called for intervention by him had he seen it. He said he was not influenced by the movement or lack of movement of the doll but applied his own knowledge of bio-mechanics in a 32 day old baby. The object lifted could have been a book as far as he was concerned. He said AB's head would have dropped backwards as such a child has virtually no control of his head. As he was brought to the vertical there would have been a whiplash movement as his head swung forward combined with sudden deceleration as the head hit or was stopped by or at the father's shoulder. As far as the subdural bleeding is concerned there is no need for the head to move past the mid-point when going forward – there could be enough force in the whiplash from the drop backwards to the swing forwards.
18. Dr Cartlidge based his view on 3 cases where a fall from a low (50cm – 70cm) height had caused subdural bleeding. This is much less force than had previously been considered necessary to cause such bleeding. However, he recognised that each of those cases involved an impact and consequent sudden deceleration of the head. In at least one of these cases the change of view as to level of force was based on findings of fact made by a court. Having said that, Dr Cartlidge said that this case is on the edge of credibility as to cause (by which I understood him to mean on the edge of medical acceptability as opposed to the credibility of the father) but he couldn't rule it out. He said the father's action was a possible cause of the injury but not a probable cause.

Factual Evidence

19. As far as witnesses of fact are concerned I have heard only from the parents who have provided three statements each. The father showed, in my judgment, genuine emotion, distress and regret while in the witness box. I found him largely credible as to the events of the relevant night although there was one area of his evidence that I disbelieved. Further, I am not satisfied that the video reconstruction was an accurate reconstruction of the event or action which caused AB's injuries; however, I do not think the father was deliberately seeking to mislead me in this respect. I will return to this in more detail below. The mother also showed genuine distress and emotion. I found her evidence to be convincing and compelling. It was consistent with everything she had said before, the telephone records and the medical evidence. I have no difficulty in accepting her evidence that she did not cause AB's injuries and that she did not have any reason to believe that the father would have or had caused such injuries. She was eminently credible when she said that she didn't care about her job but only about AB. I accept her evidence to the effect that the father didn't tell her about his actions at the time because he knew she would tell. I believed her when she said that the hardest thing for her was the fact the father hid his actions from her and let AB down: she had consequently lost trust in him.
20. I have also been provided with a large quantity of police disclosure, the contact notes and, somewhat inexplicably for a finding of fact hearing, the special guardianship assessment of the maternal grandparents. I have read the transcripts of the parents' police interviews, the telephone/Whatsapp/instant messaging records and the contact notes but was neither asked to read nor taken to any other documents save for a dozen or so photographs of the family home to which I and the parents were taken in the course of their evidence. Given the four lever arch files of documents not utilised I can only assume that the description of the six bundles as "limited" was ironic.

Law

21. As stated above, I am very grateful for the full summary of the law provided by Mr Payne and the additional materials provided by Ms Lewis and Ms Storey-Rea. It has been very helpful in focussing my mind on the correct legal tests and approach to fact finding and, as some of the advocates will know, satisfies my usual demands in this respect. As there is no dispute about the applicable law I hope they will forgive me if I briefly summarise it rather than set it out more fully and lengthen this judgment unnecessarily in a way disapproved of by the Court of Appeal in Re F (Children) [2016] EWCA Civ 546 endorsing a statement of Mostyn J in SP v EB and KP [2014] EWHC 3964 (Fam), [2016] 1 FLR 228 at para 29.
22. The burden of proof falls squarely on the local authority. The standard of proof is that of balance of probabilities i.e. is it more likely than not that an event occurred and in the manner alleged (Re B (Care Proceedings: Standard of Proof) [2008] UKHL 35, [2008] 2 FLR 141). There is no burden on the parents to prove anything or even to come up with explanations. The local authority must adduce proper evidence which includes proper inferences drawn from direct evidence and neither it nor the court can rely simply on non-specific general hearsay allegations, hypothesis or speculation (Re A (Fact Finding hearing: Speculation) [2011] EWCA Civ 12). As this is a serious injury case I bear in mind the matters set out by Butler-Sloss P in Re U (A Child) (Serious Injury: Standard of Proof) [2004] EWCA Civ 567. Medical evidence, while important, is not conclusive and must be balanced or judged against the background of all the other evidence. It may even be rejected if the court accepts the factual evidence. Pieces of evidence should not be taken in isolation but considered with all the evidence viewed in totality. If evidence does not support a specific finding whether as to cause or perpetrator it is not necessary to identify one. There are cases where such findings are not possible on the evidence.
23. I must remember that inconstancies in evidence, particularly when given in stressful circumstances, may be irrelevant or immaterial. Memory fades with time and people have an unlimited capacity for "honestly believing something which bears no relation to what actually happened". I bear in mind the R v Lucas warning to the effect that that because a person lies about one thing it does not mean that he necessarily lies about another. Further, people have many reasons for lying including shame, panic, fear and even to bolster an otherwise true account.

Findings

24. I am satisfied on the strength of the medical evidence, as set out at paragraphs 12 to 18 above, that AB's injuries were not attributable to any congenital or underlying medical cause. None of the comprehensive series of tests disclosed any such cause and there were no clinical findings on which such a diagnosis could be based.
25. I am satisfied that it was an action of the father's in the early hours of 31 October 2015 that caused the injuries to AB. He showed, as I have said, genuine emotion and, in my judgment both his confession and expressions of regret were also quite genuine. I accept his evidence to the effect that he handled AB in a reckless manner without supporting the head in a momentary loss of control born of frustration tinged with anger. Tiredness, common in parents of new born babies, was, no doubt, also a factor. I have no reason to doubt that the injuries occurred sometime between 12.30 and 1.30am on 31^st October 2015 as the father lifted AB out of his bouncy chair in frustration. That the injuries occurred at this time is also consistent with the mother's accounts of AB's presentation thereafter and the medical evidence both as to what might be expected as to feeding and crying and as to the time-frame for the twitching or seizures. There is no evidential basis for a finding of a more considered violence involving either cannabis or excess alcohol.
26. I believed the father when he told me that he lied to the police, to his own lawyers and, indeed, to everyone because he was, to use his word, petrified of the consequences of admitting the truth; those consequences being the potential loss of AB and his wife. He did not want them to misunderstand or believe that he had done anything deliberately. No doubt, fear of what he had done to AB and denial of the effect of his actions also played a part: he simply couldn't really believe what he had done. It is not unknown and, I would even venture to say that, it may be a common reason for lying in these circumstances.
27. However, I am not satisfied that the video reconstruction accurately demonstrates the father's actions on the night in question. My reasons for this are firstly, that although the father said he remembered the event vividly he had no memory at all of the movement of AB's head when lifted unsupported. Secondly, the bouncy chair used was not the same, in a material respect, as that in use on the night. This was because the police still have custody of that chair. The actual chair in which AB was placed, unlike that in the reconstruction, had, what has been described as, an arch across it from which dangled 3 soft toys. This arch was not at right-angles to the ground but was tilted away from where a child's head would be placed, no doubt, to permit the child to see the toys without craning his neck. In the reconstruction the doll was lifted straight up in a manner which would have resulted in the child hitting his face or head on the arch of the actual chair. In my judgment, the lift must have been somewhat rougher than that demonstrated as it must have involved a lift and a movement towards the father before the second lifting movement giving the opportunity for greater movement or shaking of the unsupported head.
28. When asked about the arch in oral evidence the father attempted to explain this away by suggesting that AB was not placed in the actual chair in the same position as the doll was placed in the chair used in the video but rather was placed lying down along the base of the chair as he was so small he would fit. Alternatively, it was also suggested that head was strangely angled to lie on the bottom end or edge of the head support. The impression given was that this was normal. If this account was correct it is more likely that AB could have been lifted straight up. I did not believe the father's account in this respect because this was not the position in which AB was invariably, in the mother's experience, placed in the chair as she said in her oral evidence. The normal position was further back in the chair in a sitting position, for which the chair was designed, and in which the safety straps could be done up with the head rest enveloping and supporting AB's head. Further, the photographs of the chair taken on 4 November 2015 by the police show the head rest in its normal position, it had not been moved down to support AB's head. A further reason is that in the reconstruction the doll was placed in, what I have described as, the normal position and the father expressly stated in his third witness statement that had tried to be as accurate as possible. Finally, in his police interview given on 5 November 2015 the father said he had, on one occasion that evening, turned on the vibrate function on the bouncy chair. It is inherently unlikely that such an otherwise safety conscious father would have put AB in his bouncy chair in a position which would have been precarious if the chair was vibrating. In my judgment the father was untruthful in this respect as he wished to bolster his account for fear that I would not accept his explanation at all which might implicate the mother. As observed above, it is not unknown for witnesses to add untrue details to bolster an otherwise true account.
29. In my judgment on balance of probabilities, taking all the evidence together, the action which caused AB's injuries was rougher than that shown in the reconstruction and is likely to have involved greater and/or more movement of his head and thus greater forces were exerted although I cannot be more specific about what occurred. I say this not just on the basis of the way in which, in my judgment, AB must have been lifted, as set out above, but also because it is more consistent with the medical evidence which was itself consistent, at least as between Dr Cartlidge and Mr Newman, to the effect that the action in the video reconstruction was not a probable cause of the injuries but only a possible cause – on the edge or cusp of what is believable at all (per Dr Cartlidge). Mr Richards deferred to Mr Newman in relation to the retinal bleeding as, indeed, did Dr Cartlidge, but went no further than saying he could not rule out the action as causative. All agreed that it was more likely that the injury was attributable to a single causative event. I accept that Mr Newman's evidence does not 'trump' that of the other experts as submitted by Ms Storey-Rea and as accepted by Mr Newman himself; but neither of the other experts suggested he was wrong and the consequence of his being right means that there must have been two events, as Mr Richards said, and this is unlikely.
30. It is unfortunate that none of the experts, particularly Dr Cartlidge, were shown a picture of the actual chair during their evidence as it may have helped them to understand the likely forces involved in the father's action. However, this does not affect my findings. For the sake of clarity, I am not suggesting that the father deliberately shook AB in the way usually associated with these sort of injuries but only that AB's head movements are likely to have been more than suggested by the video reconstruction. I also do not suggest that the father has deliberately mislead me - he simply has no proper memory of what happened in a 1-2 second event when he was plainly not thinking clearly and has minimalised the action as he cannot bring himself to think that he did anything more.
31. It follows that I find that the mother did not cause AB's injuries. I am also satisfied that the mother had no reason to believe, or even suspect, that the father would do such a thing. Her accounts of how he had handled AB up until that night, which I accept, gave her no clue of what was to come. There was nothing in the father's history, other than a single incident undoubtedly related to excessive alcohol consumption on a stag night (a level of drinking not since repeated), to foreshadow the events of 31 October 2015. Given AB's previously unsettled behaviour, in my judgment, the mother's actions were wholly appropriate and I find that she did not fail to protect AB.
32. As I have been able to provide a written judgment, contrary to my prediction, I will vacate the hearing on Monday, 20^th June, at 10.30 and will formally hand down judgment at the case management hearing on 8^th July 2016.

Note 1   In fact, an earlier version had been produced using a teddy. There was no material difference in the two videos and I shall only refer to that of the doll.    [Back]