No autopsy of Monroe child despite police requests

Police say examiner's office ignored their concerns about child's death

By Noah Haglund, Diana Hefley and Rikki King

MONROE -- Police say they repeatedly tried to tell the Snohomish County Medical Examiner's Office that a 7-year-old boy who showed up dead at a Monroe hospital had a history of mistreatment and neglect.

Police wanted an autopsy and called at least three times to make their case. They were given "a dismissive 'no,'" Monroe police spokeswoman Debbie Willis said Tuesday.

State officials confirmed that a social worker witnessed at least one of those conversations, and the detective mentioned Child Protective Services' past involvement with the boy's family.

Still, the medical examiner's office ruled the boy's death "low suspicion." His body was released and cremated without an autopsy. Two weeks later, toxicology tests ordered by the medical examiner came back showing the boy died with lethal amounts of what appears to be over-the-counter painkillers in his system.

Police are investigating the death as a potential manslaughter. The case is complicated by a lack of evidence from a body, little cooperation from the boy's parents and possible missteps in how his death investigation was handled. National experts say there aren't clear-cut policies for when a child death investigation requires an autopsy.

The boy, identified in court papers only as "A.J." of Monroe, was pronounced dead Jan. 30. His father brought the boy into the hospital emergency room unresponsive, nearly 40 minutes after he said he found the boy "ash white," the documents showed.

In the days after the boy's death, a detective called the medical examiner's office at least twice to request an autopsy, Willis said. A sergeant called, as well.

The detective attempted to explain that he'd investigated the boy's parents in a reckless endangerment case two years before, she said.

"It was a dismissive 'no,' they were not going to do an autopsy," she said. "They asked if we had documentation of any physical abuse, and we said no."

The medical examiner representative reportedly told the detective that if police wanted to send documents, they'd be reviewed, Willis said. They asked for no additional information.

"The detective felt at that point that we'd had three dismissive phone calls, they're not listening, and we have an investigation to continue here, and did not send any reports to them," Willis said.

The Snohomish County Executive's Office, which oversees the medical examiner, has declined to discuss any specifics of the case, citing the ongoing police investigation.

Police look into deaths that may involve crimes, but the medical examiner's office determines how someone died and whether the death was natural, an accident or the result of someone else's actions.

A determination on the boy's manner of death is pending, meaning there's not enough information.

State toxicologists reported finding lethal amounts of salicylates in the boy's blood. Salicylates are common in aspirin and other over-the-counter drugs.

The tests determine the presence and amount of the drug in the blood, not how it was ingested.

An autopsy would have answered important questions, such as whether there were pills in the boy's stomach. Even without that evidence, authorities still should be able to investigate, said Janice Ophoven, a Minnesota-based pediatric forensic pathologist who has consulted on cases nationally and abroad.

"In this particular case, we have a cause of death -- that's not going to be in dispute," Ophoven said. "Then the question becomes how did that stuff get in there, and is there a reasonable explanation for that?"

Salicylate poisoning generally causes noticeable symptoms that last hours before death, she said. Those include breathing problems, nausea and vomiting.

"Assuming that the numbers are reported accurately and this is a fatal dose, somebody is going to have to answer the question of what the family thought when they saw signs of salicylate poisoning," Ophoven said.

The case ultimately will come down to "good police work in the days and weeks to come," she said.

Job defies policy

There are no policies to tell forensic pathologists in Snohomish County, or anywhere else, exactly when to perform autopsies. Instead, death investigators must rely on their training and experience to make the right call.

"The almost infinite varieties in ways that people die makes it impossible to write a policy to deal with every kind of death," said Dr. Andrew Baker, spokesman for the National Association of Medical Examiners and medical examiner for Hennepin County, Minn.

Baker added: "Whether one is done is only a piece of the much larger puzzle. Whether you do one or not depends on what historical information is available to you."

A former associate pathologist for Snohomish County said the information from Child Protective Services should have made a decision on the Monroe boy's case an easy call.

"To me, it's obligatory to do an autopsy in this case if the medical examiner knew of the CPS reports," said Dr. Carl Wigren, who left Snohomish County in 2009 and now consults with coroners, attorneys and families.

The child's father pleaded guilty in 2010 to reckless endangerment after police discovered his children living in deplorable conditions. The children, then 10 and 5, were removed from the home for three months. Before then, state social workers investigated numerous allegations of mistreatment involving the couple's two sons, including a report that the older boy, now 12, had been given a double dose of anti-seizure medication on at least two occasions.

Both boys were severely developmentally delayed, but doctors haven't found genetic or neurological reasons. The older boy has been removed from the home.

Timeline still unclear

What also remains unclear is the timeline of events between the younger boy having medical trouble and the hospital declaring him dead, police said.

His father said the boy was breathing and alive when they left the home, but the emergency room doctor said when they arrived, the boy appeared to be in the early stages of rigor mortis, which happens hours after death.

Child Protective Services received notice from the hospital about the younger boy's death, said Sherry Hill, spokeswoman for the state Department of Social and Health Services

A social worker was investigating the case by 10 a.m. that morning. That included contacting Monroe police to ask if they would be assigning a detective.

Generally, hospitals contact CPS or law enforcement when the child's death is unexpected.

The social worker was in frequent contact with the detective. The social worker noted that she was there when the detective called the medical examiner's office. During that conversation, the detective conveyed the family's history with CPS. CPS officials never received a request from the medical examiner to see those reports, Hill said.

"We felt assured that the M.E. was aware of the history of this family," Hill said.

The social worker noted that the medical examiner expected to determine a cause of death that day. The social worker noted that the medical examiner planned to complete a toxicology screen and a full body scan to determine if there were any signs of abuse or neglect, Hill said.

Once the medical examiner concluded that the death wasn't suspicious, the social worker talked with the family about the possibility of doing an autopsy. She advised the family that an autopsy could be helpful to determine what caused the boy's seizures, which could be helpful to their care of their older son. The social worker made it clear that the family would need to request a full autopsy.

The social worker reported that the parents said they would consult with their own doctors and "take care of it."

Officials with the Children's Administration plan to convene a child fatality review. The law calls for a review when a child dies of suspected neglect or abuse and has received services from the state in the past year.

Shortly after A.J.'s death, leaders at his school broke the news to students and families.

A.J. was in a first-grade class.

"He faced many health challenges in his short life and we will miss him," Fryelands Elementary School Principal Jeff Presley wrote at the time. "A.J. was a wonderful member of our school family and our thoughts are with his parents and brother."

Source http://heraldnet.com/article/20120307/NEWS01/703079869/-1/News

WA to pay $2.35M in abuse case settlement

OLYMPIA, Wash. (AP) — Washington state will pay $2.35 million to settle a lawsuit filed by a woman who alleged that two state agencies failed to protect her from a sex offender who abused her when she was a child.

The Pierce County Superior Court lawsuit alleged that a paroled child rapist named Danny Dorosky Sr. was allowed to live with the victim's family, despite a Parole Board order that required intensive management and supervision because of the prior sex crime.

One of the woman's lawyers, Jason Amala, said Dorosky ingratiated himself into the victim's family and eventually moved into the home, where he abused the girl for almost three years. She was 10 when the abuse started, Amala said.

The woman also contended that the Department of Social and Health Services' Child Protective Services failed to protect her after school officials in Shelton reported the girl might be a sexual abuse victim.

Corrections spokeswoman Selena Davis confirmed the settlement and its amount late Wednesday. She said she could not immediately comment on case details.

DSHS spokesman Thomas Shapley referred inquiries to a lawyer with the state attorney general's office who did not immediately return a call.

The woman's lawyers say the abuse began in 1990. After the victim's father contacted law enforcement about the man in 1993, Mason County officials eventually arrested Dorosky. He was convicted of child molestation and rape. He died in 2004, Amala said.

In a phone interview Wednesday with The Olympian, the now 31-year-old woman said she had buried her awareness of what had happened until recently, when her own daughter turned 10.

She said she looked up Dorosky's court records and eventually hired a lawyer.

She said "it makes me sick" that state employees could have prevented what had happened to her and didn't.

The plaintiff, a state employee, added that she would appreciate an apology from the state. Beyond that, she said she hopes her lawsuit will lead to policy changes that will prevent supervision failures.

Source http://www.seattlepi.com/news/article/WA-to-pay-2-35M-in-abuse-case-settlement-2713424.php

State officials investigating several cases of abuse of adopted children

By Barbara LaBoe

An alleged child starvation case near Longview is one of more than a dozen cases — including one death — that have state officials reviewing how adopted children are placed and treated.

The number of abuse cases is small compared to all adoptions. But a string of high-profile child starvation cases last year — including one from May accusing Jeffrey and Rebecca Trebilcock of starving their five adopted children at their Bunker Hill-area home — has state officials alarmed.

"Starting in the beginning of 2011 we started seeing a cluster effect of these types of cases," said Mary Meinig, director of the state's Family and Children's Ombudsman office, who included a section about adoption abuse in her annual report, released last week.

Many of the cases include starvation. "We have so many great adoptive homes in the state, but then we also have these. ... I think it's apparent that it needs to be looked at."

"We want to jump start this as quickly as possible," said Denise Revels Robinson, assistant secretary of the state Department of Social and Health Services. "There's a sense of urgency here. Not crisis, but urgency, because these are very serious issues."

One adopted child, 13-year-old Hana Williams of Sedro Wooley, died in May from hypothermia and starvation after being left outside as punishment. The Trebilcock's adopted son, then 13, landed in emergency room in March so severely malnourished that he weighed just 49 pounds, according to court documents.

Officials are concerned at the severity of these cases, the apparent spike in them and that so many seem to involve adopted children. The adoption cases are particularly concerning because screening by the state or private adoption agencies should catch unfit parents before children are placed.

Dr. Frances Chalmers, a Mount Vernon pediatrician who consults with DSHS, began to get a "nagging feeling" that something was up and started tracking starvation cases herself. Meinig started doing the same, finding 15 adoption or guardianship cases since 2009 that involved starvation or severe abuse. Eleven of those cases were in 2011.

Not all the cases listed in Meinig's report became public because, unlike the Trebilcocks, not all the parents were criminally charged. All are horrific, though, including cases where children were beaten with wooden boards embedded with nails, sexually abused and severely malnourished.

While Hana Williams' death is the most serious and disturbing case, "even the kids who don't die are significantly traumatized," Chalmers, said.

Adoptions, concerns increasing

Officials aren't sure if the surge of cases in 2011 is the start of a disturbing new trend — but they're working to find out. A work group of child experts - ordered by Gov. Chris Gregoire — will look at adoptions, including foreign adoptions, as well as abuse by withholding food.

Among other topics, they'll investigate:

• Are neglect and abuse — including withholding food — on the rise and are they more prevalent in adoptive homes?

The state hasn't tracked withholding food cases before. Anecdotally, though, the number of cases seems to be rising. Of the five criminal withholding food cases statewide in 2011, four involved adoptions.

It's also possible that increased social worker training — and publicity about the most horrific cases — may have led to more cases being reported last year, said DSHS Spokeswoman Sherry Hill.

• Did a rapid increase in adoptions let some unfit parents slip through the cracks?

In recent years, state and federal law encouraged quicker adoptions to move children out of foster care and into permanent homes. Meinig said they need to examine if it's also lead to unfit parents being approved for adoption.

In 2002, there were 1,074 adoptions of Washington children in foster care or other child welfare programs. By 2009 that number nearly doubled to 2,091. The increase from 2008 to 2009 alone was 66 percent. Nationally, the increase from 2002 to 2009 was only 12 percent.

• Does the adoption process itself need to be reworked?

Child welfare officials screen parents adopting through the state foster care system and license private adoption agencies, but state workers do not screen private adoptions or adoptions in other states or countries. Some of the cases highlighted by Meinig included non-Washington adoptions or families who had no prior contact with state Child Protective Services. The state group will investigate if more oversight is needed.

• Does age, race or gender play a role in abuse of adopted children?

Some of the cases highlighted by Meinig involved foreign and/or cross-race adoptions. Officials don't know if that played a role in these cases, but want to examine it further. Three of the Trebilcock's five adopted were from Haiti.

There isn't one simple answer, though, because abuse itself is so complex.

"Nobody's going to say during screening that ‘If I don't like them, I'm not going to feed them,' " Meinig said. "And I don't think anyone actually envisions that they're going to do this. I think it's a progression thing that happens."

Local case, common threads

The Trebilcocks deny they starved their children and are fighting the charges in both the criminal and child dependency courts. (See related story.)

But Meinig said the allegations in the case bear several of the hallmarks common in all the cases she reviewed.

The five adopted Trebilcock children, ages 8 to 14, told investigators they were denied food. Kitchen cabinets had alarms on them and the children were punished for "stealing food," they said. Other family members, though, appeared well-fed, according to investigators.

"There was plenty of food" in all the cases, Meinig said. "These were really purposeful withholding and punishment and control. ... Food is kind of the ultimate control."

The Trebilcock children also told investigators they were beaten and made to stand outside, isolated from the rest of the family - another commonality Meinig found in many of the cases. The Trebilcocks also were home-schooled, which some officials say can be a way hiding the signs of starvation.

"Food withholding as a form of abuse has been around forever, from its mildest form of a misbehaving child being sent to bed without dinner to really severe cases of withholding that lead to medical problems," said Dr. Chalmers, who helps train social workers to look for signs of abuse. "So I've been trying to think about ways we could identify these kids before they die or end up in the hospital for malnutrition."

Reluctance to call

State officials hope the group of child experts can meet by early February and complete its work by May.

Any recommendations will be forwarded to DSHS, which will brief the governor's office as well as the Legislature, Revels Robinson said.

The state's budget crunch doesn't leave much extra money for new programs or enforcement, but Revels Robinson said she believes many of the recommendations could be relatively inexpensive. Some of the changes could be a change of emphasis in screenings, for example. Additional or substitute training also could provided to social workers at little cost, she said.

Officials also stress one of the best defenses against child abuse is for people to speak up when they suspect it. Too often people are afraid to "cause trouble" and then live to regret it, they said. And while there may not be immediate action from one report or call, that doesn't mean the calls are ignored, they said.

"We really do rely on the eyes and ears of the community to alert us," Revels Robinson said.

Hana Williams — the 13-year-old who died in May — "had a number of friends and family who now say ‘I wish I'd called earlier,'" Chalmers said. "We really need to encourage people to be less reluctant to make those calls."

Source http://tdn.com/news/local/state-officials-investigating-several-cases-of-abuse-of-adopted-children/article_7fac29c2-3f25-11e1-b980-0019bb2963f4.html

State agrees to pay $4.6 million to victims in Carnation starvation case

Blog authors note:
How can CPS possibly be this incompetent and grossly negligent that this kind of thing happens, let alone happens frequently across the US? Aren't they supposed to be trained professionals?
-----

Posted by Matt Kreamer

The Department of Social and Health Services has agreed to pay $4.6 million to two children who were abused by their father and stepmother three years ago in their Carnation home.

A girl, who was so emaciated she wore a size 2 shoe and weighed 48 pounds at age 14, had begged a social worker to put her in foster care more than three years before her father and stepmother were arrested in 2008, according to a King County Superior Court lawsuit filed against the state.

The civil suit claimed the girl's "nightmare of abuse and torture" extended to her younger brother, who was forced to participate in the abuse of his sister and was "essentially her jailer."

Because the plaintiffs are minors, the settlement will not be final until approved by the court, according to a DSHS news release.

"We deeply regret that these children had to suffer at the hands of the two adults they trusted to love them and keep them safe," said DSHS Children's Administration Assistant Secretary Denise Revels Robinson.

The case, and the subsequent arrest and guilty pleas of both parents of first and second degree criminal mistreatment in October 2008, received broad media attention at the time.

When law enforcement arrived at the children's home in August of 2008, they did not take the children into protective custody but referred the case to DSHS Child Protective Services, who went to the home the next day and directed the parents to seek immediate medical attention for the girl. She was subsequently transported to Children's Hospital by ambulance, where doctors found her to be suffering from extreme malnutrition and other abuse and neglect, according to the news release.

Child Protective Services received one previous referral on this family in March 2005 -- more than three years earlier -- in which the girl told a public school teacher she was frequently locked in her room and was given little to eat. Child Protective Services, working with local law enforcement, found that the stepmother's locking the child in her room constituted negligent treatment and maltreatment. The stepmother agreed to stop doing so. At the time, when interviewed by Child Protective Services, the girl indicated she was provided adequate food to eat every day, according to the release.

Source http://seattletimes.nwsource.com/html/theblotter/2016439296_state_agrees_to_pay_46_to_vict.html

4 sue state over abusive Tacoma foster home

Four former foster children sue the state Department of Social and Health Services, saying their foster parents beat, drugged and sexually abused them.

By Christine Clarridge

Seattle Times staff reporter

The state Department of Social and Health Services has been sued by four former foster children who say they were beaten and sexually abused in a Tacoma foster home that never should have been licensed, according to a lawsuit filed Tuesday.

The victims were "sexually, physically and psychologically terrorized for the pleasure and profit of their foster-care providers."

"It was not a home," said Jeremy Johnston, an attorney for plaintiffs, who are now adults and living in Tacoma. "It was a house of horrors."

Thomas Shapley, a spokesman for the Department of Social and Health Services (DSHS), declined to comment on the suit, which was filed in Pierce County Superior Court.

The lawsuit alleges that the former foster parents, Jose and Juanita Miranda, were both on welfare and collecting disability payments when the state licensed them to operate a foster-care home between 1997 and 2003.

Jose Miranda died behind bars in 2009 after he had been sentenced to more than 10 years in prison for raping and molesting foster children. His wife died of a drug overdose in Tacoma's McKinley Park in 2006, according to the lawsuit.

The lawsuit alleges that the children were routinely drugged with sleeping pills and forced to engage in sexual acts with Jose Miranda, and the other foster children, in a padlocked room in the basement dedicated to that purpose

The suit also alleges that the Mirandas forced the children to wear diapers and pretend to have bed-wetting issues to increase their foster-care benefits, to eat expired food and consume their own vomit when they were sick.

The foster children were beaten with broomsticks, frying pans and nail-studded sticks, the suit alleges, and forced to clean their foster father after he had used the bathroom. One of the children was forced to wear a dog leash and walk around naked on her hands and knees, the lawsuit alleges.

The lawsuit charges that DSHS ignored years of complaints from social workers, guardians, teachers, neighbors, relatives, coaches, family friends, parents of the foster children and the children themselves.

According to the lawsuit, DSHS approved Juanita Miranda as a foster parent despite a long history of drug use and criminal violations. Her own two biological children were taken from her by Child Protective Services in California because of drug use and neglect, and she was arrested in that state more than 50 times, the suit alleges.

The suit claims that Juanita Miranda was also under the supervision of Washington's Department of Corrections when she was granted her foster-care license and that DSHS failed to revoke her license even after later receiving reports about her criminal history.

She was never charged with a crime in connection with the abuse, the lawsuit claims.

According to the lawsuit, the abuse began when the children were as young as 5 and continued through their teens.

Tacoma police began an investigation in 2005 after Jose Miranda confessed his crimes to a nurse while he was hospitalized, according to the suit.

Court documents indicate that Jose Miranda was charged in 2007 with three counts of first-degree child rape, two counts of first-degree child molestation and two counts of third-degree assault of a child.

The lawsuit claims Jose and Juanita Miranda should never have been licensed and that their personal histories and their physical and financial circumstances should have made them ineligible to become foster parents.

"There were multiple opportunities for the state to save these children from this nightmare," said Johnston, the attorney for the four former foster children. "But they failed to act."

Christine Clarridge: 206-464-8983 or cclarridge@seattletimes.com.

Seattle Times news researcher Miyoko Wolf contributed to this report.

Source http://seattletimes.nwsource.com/html/localnews/2015990609_dshslawsuit24m.html