A 6-month-old girl is brought to the ED with fever, cough, and irritability. Both parents appear to be developmentally delayed but act appropriately under the circumstances. The child was born at 34 weeks and had a long, complicated stay in the NICU, during which she had received CPR on 2 occasions. The chest film indicates pneumonia; rib fractures are also noted. Records obtained from the NICU show there was no history of any fractures at time of discharge 3 months earlier.