Because the presentation of children in various ways to different medical institutions often defies detection, extra vigilance and investigative efforts are required to unravel the complexity of actions taken by pathogenic families. In recent years, MSBP has been reported with increasing frequency, and it is now recognized as more common than previously documented. A case in New South Wales is reported that involved collaboration by members of the legal, medical, social work, and psychology professions to establish that the child needed care and should be removed from the high-risk environment of the family home. The case highlights difficulties involved in identifying MSBP. The author proposes that a coordinating body be established in New South Wales to collate retrospective medical records and to provide a pivotal point for the various professionals involved to meet, exchange, and share information. The author also suggests that the Child Protection Services in New South Wales be responsible for this function and that standardized procedures be adopted in evaluating cases of possible MSBP. 15 references and 1 figure