Amitai Moshe

Q. Why were the Board of Deputies and the Initiation Society not included in, and/or represented at, the inquest into the death of Amitai Moshe?

A. The inquest looked at the death of an individual child and not at circumcision in general. This does not fall directly into the remit of these two communal bodies. 

The main “interested parties” in any such inquest are the parents of the child. In this particular instance the Mohel and the Hatzolah First Response service were also termed “interested parties” because they played an active role in the sad events. However, by May 2007 the Board had made enquiries and was informed explicitly that there was no question of any serious allegations or charges being made against them.

As a result, the Board (and the Initiation Society) acted as a source of information and assistance to the parents, Mohel and Hatzolah but could not (and should not) have played any other role.

An example of this is the Board’s “question and answer” document about Brit Milah in general, which was made available widely and the Initiation Society’s detailed document about Brit Milah which addressed issues such as the training and governance of Mohelim and was made available to the Coroner. Both documents are relevant to, but not part of, the actual inquest. 

Q. Why has it taken so long (February 2007-September 2009) to hold this inquest?

A. The first date listed for the inquest was in November 2007. A delay was requested by the Mohel. Then the inquest was listed during ‘Chol Hamoed’, which was not suitable for either parents or witnesses. Later Amitai’s mother was pregnant with her third child.

In the meantime the Board had recommended to the parents that Prof Peter Fleming, who is an international authority on sudden unexpected death in infancy, should be asked to review the documents and provide an expert report, and he was unavailable for several months. Finally, when all the reports were at hand, in February 2009, the Moshe family was leaving for India for six months prior to their return to Israel, and this meant that September was the earliest possible date.

Q.  Did the parents express any particular wishes or concerns to the Board?

A. Amitai’s parents wrote to the Mohel shortly after his death to say that they did not hold him responsible for their son’s death, and that they had full confidence that he had performed the Brit Milah with appropriate skill and expertise. The main concern they expressed to the Board was that they wanted the entire episode to be reviewed by the best expert that could be found. This was to ascertain any possible cause, and to see if there were any possible lessons that could be learned from the handling of their son.

Q. If this is correct, why has there been press comment indicating that Amitai’s death may have been “linked to circumcision”?

A. These comments arise from the pathologist’s report on the autopsy that was performed on Amitai. However, at the time that this was written, the pathologist did not have access to witness statements. The comments were based on misinformation within a summary which was provided to him.

Once he had heard the evidence that Amitai had behaved normally for more than 30 minutes after Brit Milah, the Coroner made the decision that the phrase “immediately after circumcision,” which had been used by the pathologist, was incorrect and should be deleted. This led him to the conclusion expressed in his findings: the death was due to natural causes, and the cause of death was sudden infant death syndrome.  

Q. Surely any “sudden infant death” must have happened in the synagogue not eight days later at University College London Hospital?

A. Prof Fleming explained to the inquest that there are differences in the way that brain stem death is determined in newborn babies. He was explicit that this had only occurred with certainty on 9th February, i.e. in the hospital.  

Q. Did infection contribute in any way to Amitai’s death?

A. Prof Fleming explained to the inquest that the detailed history of the last 12 hours of Amitai’s life was not consistent with infection.  Any bacteria found at the autopsy were ones that are found normally in the environment. 

Q. Did bleeding contribute in any way to Amitai’s death?

A. Prof Fleming noted that there was no bleeding from the circumcision site. He explained that bleeding from the mouth and nostrils was commonly reported in neonatal sudden infant death syndrome. This was because the small blood vessels in the mouth and respiratory tract are very fragile during the time when they are adapting to the environment, and not because of any underlying bleeding tendency. The evidence of bleeding within the lung found at the autopsy on Amitai was also not a significant finding.

If you have any further questions please feel free to contact the Board at info@bod.org.uk