7 The child was taken to the Princess Margaret Hospital and on 12 November 2007 he was examined by a paediatric registrar Dr Tan. Dr Tan had access to records of the Princess Margaret Hospital which revealed that the child had been taken there by the respondents in October 2005. On examination Dr Tan found that the child was suffering from severe malnutrition and failure to thrive. Dr Tan, by reference to records from 2005 concluded that he had stopped thriving and growing at about 4 1/2 years of age, which was when he was examined at the Princess Margaret Hospital in 2005. On 12 November 2007 he was 109 cm tall and weighed only 12.8 kilos. By examining the 2005 records, Dr Tan was able to point out that there had been no significant increase in the victim's height since 2005 and that he had lost 4.3 kilograms in weight since he was weighed on 10 November 2005. His height on 12 November 2007 put him between the first and third percentile for children of his age and his weight on that day put him well below the first percentile. Blood tests showed that he had low calcium, phosphate and potassium levels. Dr Tan reported that this was likely to be due to nutritional deficiency. Diffuse bone demineralisation was demonstrated. The child had a low vitamin D level which suggested either a nutritional deficiency, a lack of exposure to sunlight, or both. The boy had multiple bruises including facial bruises over the right temple, right upper eyelid, left temple and nasal bridge. There were numerous other bruises to other parts of his body, as well as scratches and abrasions. Dr Tan reported that these were more than one would expect from regular, accidental, injury. Dr Tan reported that there was evidence of old fractures of the fourth and fifth right metatarsals which he concluded may have been accidental or inflicted. His opinion was that the latter injuries would have been very painful and limited the child's walking significantly and that medical attention should have been sought in relation to them. The nutritional deficiencies also required medical attention. Dr Tan concluded that the 'cachectic appearance, nutritional deficiencies, and the presence of multiple injuries in this child are in keeping with child abuse in the form of inflicted injury and severe neglect'.