Boston Children’s Hospital to be Investigated by Department of Public Health

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The Massachusetts Department of Public Health is set to investigate a complaint filed by a Boston Attorney against Boston Children’s Hospital and its “Bader 5” Psychiatric Unit.

According to a January 31 posting by reporter Beau Berman – who broke the story leading to the complaint – the Department of Public Health has confirmed that it is assigning an investigator to review the complaint

For the benefit of those unfamiliar with the case, in February 2013, 15-year-old Justina Pelletier was checked into Boston Children’s Hospital with flu-like symptoms by her parents. Prior to her admission, Justina had been undergoing treatments for Mitochondrial Disorder at Tufts Medical Center in Boston.

Over three years ago, Justina had been diagnosed with the rare genetic condition of Mitochondrial Disease. Her 25-year-old sister, Jessica, also suffers from the disease. Both girls were treated by a specialist at Tufts Medical Center, Dr Mark Korson. The hospital was only a two-and-a-half-hour drive from their home in West Hartford, Connecticut.

At the recommendation of her doctor at Tufts Medical Center, Justina was admitted to Boston Children’s Hospital to see a gastro-intestinal specialist, Dr. Alex Flores, who had recently transferred from Tufts to BCH.

Almost immediately, a different team of doctors swept in. delivering a different diagnosis, questioning the original diagnosis of mitochondrial disease, explains Beau Berman, Investigative Reporter with FOX News in Connecticut.

The Hartford-Courant explains what happened next:

Within 24 hours of being admitted to Boston Children’s in February, physicians came up with a different diagnosis for Justina: somatoform disorder, a psychologically induced condition that has physical symptoms.

Justina’s parents, Linda and Lou Pelletier, objected to the diagnosis and sought to discharge her from the hospital and take her to Tufts Medical Center, where she was originally diagnosed with mitochondrial disease.

But hospital officials refused and reported suspicions of medical child abuse to the state in February, according to a source familiar with the situation and media reports. Shortly afterward, the state assumed custody of Justina.

“They told me that Mitochondrial Disease did not exist,” her father, Lou, explained in an interview with the United Kingdom’s Daily Mail. “Instead, they said she had Somatoform Disorder, which is effectively a stress-related mental problem.

“They said she had been misdiagnosed, overmedicated and forced to undergo unnecessary procedures. It was as though they were accusing us of needlessly harming our daughter.”

Justina’s parents sought to remove her from Children’s Hospital to take her to a prearranged appointment with her usual physician at Tufts Medical Center, however the astonished parents were told that they could not remove their daughter from the Hospital. Children’s Hospital had filed a form 51A – a mandated report of child abuse or neglect – with the Department of Social Services.

Within 24 hours, a judge ruled in favor of the Department’s motion, ruling not only that Justina had to stay at Boston Children’s Hospital, but also that the Massachusetts Department of Children and Families had legal custody of her.

Just how this came about is worth mentioning. A social worker with the Department of Children and Families filed an affidavit with the juvenile court, about which the Boston Globe provides these details:

The affidavit showed considerable deference to Children’s. It quoted liberally from hospital records and interviews with staff members there, including accusations that Justina’s parents were obstructing her care. It said the Children’s doctors “do not know where the parents picked up the current diagnosis and they are hard to disprove.” It included negative comments from Justina’s Connecticut pediatrician about how Linda and Lou had “fired” multiple doctors and “encouraged” the diagnosis of multiple medical problems.

However, the affidavit failed to mention that the social worker had interviewed Korson, and that Korson had explained the origins of the working diagnosis of mitochondrial disease that he had given Justina. Internal state records show that Korson had explained that the disorder sometimes runs in families and that he had also been treating Justina’s older sister for it.

In plain English, the social worker did what social workers do. She distorted the truth; she lied by act of omission; and she came within an inch or so of perjury, but then, what else is new?1

It is not as if the court would have minded anyway. Paula J. Owen of the Worcester Telegraph Gazette recently wrote an article entitled DCF removing kids at an unprecedented rate, in which she explains: “The Department of Children and Families is removing children at risk of abuse from their families at an unprecedented rate, according to court data as the governor cracks down on the agency following the disappearance of a 5-year-old Fitchburg boy in DCF care whose social worker failed to carry out required home visits.”

They say the new directives err on the side of caution, but they err on the side of job protection.

The article notes: “‘They say the new directives err on the side of caution, but they err on the side of job protection,'” says social worker Khrystian E. King, who works in DCF’s Worcester East office.”2

Here is the social worker’s observation of note: “The judge is actually questioning giving emergency custody to the department because it is so borderline.”3

Previously, the article explains, when Care and Protection petitions were filed in court, “the state was almost always awarded custody of the children. Now, judges are questioning if emergency custody is necessary.”

THE GUIDELINES

On February 13, 2013, “guidelines” for Justina’s care were drafted by Boston Children’s Hospital. The hospital’s approach to her care, according to the document, would be to: “Set strict limitations on medical discussions with the family and eliminate interaction with providers outside our hospital, except as indicated by medical team in relation to clinical picture and collaborative information.”

The Guidelines continue on to state:

Both parents are to be supportive of their daughter and not be involved in the medical management:

i Parents may not administer and medications of flushes to patient. No discussion of diagnostic test results, consulting team recommendations or past medical issues with (on-call residents

ii Limit Communications exclusively through neurology team;

iii No medical discussion to be held in the room or within patient’s hearing.

iv No dictation of care or calling in consult teams or second opinions on own accord.

As if that weren’t enough, the Goals of Admission state that Children’s Hospital intended to: “Reduce the number of providers to a core team in order to reduce potential confusion from use of multiple providers across many institutions and state lines.”

A subsequent report written in April by one of the hospital’s staffers, states that doctors took Justina off many of the medications that she was taking at the time that she was admitted, adding that:

Due to concerns regarding Justina’s regressive behavior changes around her family, the multiple medical procedures and care episodes she has been through – and both parents’ resistance towards recommended treatment plans for Justina – a child protection team was convened.

PULLING THE PIN

It was Dr. Alice Newton who examined Justina’s chart. Newton, who ran the Child Protection Team at Children’s Hospital at the time, never met Justina or her parents face-to-face. This has been reported as being consistent with her usual practice in such cases.4

Dr. Newton – who had worked in child protection for a dozen years – holds a rather unusual dual-appointment, leading the child protection teams at both Children’s Hospital and Massachusetts General. It was Dr. Newton’s “team” at Children’s Hospital that filed the “51A” report with the Department of Social Services, bringing the Department into the case.

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To the extent that confirmation bias may play a factor in her decision-making, her fields of research are listed as “child abuse” and “radiographic evidence” on the Boston Children’s Hospital web site.

On average, at least one family is reported to Child Protective Services by Children’s Hospital every day.

It bears mentioning that Dr. Newton’s team at Children’s Hospital files an estimated four hundred child abuse or neglect reports with DSS per year – an average of over one per day. The majority of the reports allege parental neglect, while a small percentage reportedly involve the more difficult medical cases such as Justtina’s.

“Newton estimated that only 2 to 4 percent – or 8 to 16 cases a year – involved allegations of medical child abuse,” journalists Swidey and Wen of the Boston Globe explain.

Neither graduating from an ivy league college nor being associated with a prestigious medical institution serves as an impediment to publication. Indeed, as recently as April 2012, Newton was published in the journal Current Opinion in Pediatrics, her article being most authoritatively entitled Child abuse pediatrics: prevention, evaluation, and treatment.

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The abstract explains, in part, that: “The field of child abuse pediatrics continues to engender controversy in both medical journals and courtrooms. As scrutiny about the basis for the diagnosis increases, clinicians and researchers work to build a solid base of scientific evidence with thorough and well-designed studies.”

The summary concludes: “Child abuse pediatrics is a well-established and credible medical field. Although child physical and sexual abuse are age-old problems, public acknowledgement and intervention models are relatively new, and medical literature continues to reflect an increasing and deeper understanding of the impact of abuse throughout the world.”

She is indeed a prolific writer. Her Harvard Catalyst Profile lists her as having contributed no less than 22 articles to the literature with various co-authors since 1988.

The Boston Globe explains that, “Alice Newton, the pediatrician who had served as medical director of the Children’s child protection team during much of Justina’s hospitalization, left the hospital to work full time at Mass. General.” Newton said that when children who are victims of alleged medical child abuse are removed from their parents’ care, the picture can improve quickly. “In a number of cases where we’ve actually done that, you see the child just blossom in front of your eyes,” she said.

This is clearly not the case under the current set of circumstances, for Instead of watching their child blossom, Justina’s parents continue to document how the young girl who’d once flourished on ice skates has deteriorated to the point that she can barely manipulate her wheel chair.

“Although it’s been impossible to obtain an independent assessment of her current state, descriptions of her condition in state and hospital records – such as the former figure-skater’s ability to lock and unlock her wheelchair – attest to the modest nature of any improvement,” journalists Swidey and Wen explain in their December 16, 2013, Globe article. In short, Justina’s condition has been worsening, the “parentectomy” that she’d received at the hands of hospital staffers notwithstanding.

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The Child Protection Consultation Team trains new intake workers for the Department of Children and Family Services. From left, Drumm, Lipton and Newton

To the extent that anyone is flourishing, it would appear to be Dr. Newton in her now full-time role as a child protection specialist at Massachusetts General Hospital.

According to an online article dated April 12, 2013, in MassGeneral Hospital for Children News, Dr. Alice Newton and her colleagues Debra Drumm, LICSW, and Susan Lipton, LICSW, round out the Hospital’s three-member “Child Protection Consultation Team.”

According to Lipton, 30 percent of the team’s consults come from the Pediatric Service and are most often related to issues of medical neglect, ingestions, fractures, head trauma and suicide attempts. “Neglect is on the rise and registers more than 60 percent of consultations annually,” the article cites her as saying.

THE COZY RELATIONSHIPS

The cozy relationship between the hospital’s Child Protection Consultation Team and the Massachusetts Department of Children and Families is clear, as the article explains: “Aside from their role aiding clinicians and families at the MGH, the team also works within the Boston community to help with cases and evaluations for organizations including the Children’s Advocacy Center of Suffolk County, the Children’s Trust Fund and the Massachusetts Department of Children and Families, where they also train new intake workers and daycare providers.”

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Nor would Ioana Simona Bujoreanu – who reportedly played a major role in the decision to involve the Department in Justina’s case – appear to encounter any major difficulties in having her opinions published in the peer-reviewed medical journals, particularly in light of considering just who her peers actually are. The August 2013 edition of Seminars in Pediatric Surgery describes her as having co-authored a piece in conjunction with none other than her colleague David R. DeMaso, MD., the Head of the Department of Psychiatry at Children’s Hospital.

Ironically, the article in question, Enhancing working relationships between parents and surgeons, describes a treatment modality – or perhaps soewhat more precisely a treatment ethic – that is diametrically opposed to the reality being exprienced by the Pelletier family. The abstract continues on to explain:

The working relationship between parents and surgeons is fundamental in providing excellent health care to children and adolescents. The breakdown of this working relationship has a significant potential for detrimental effects on individual well-being and adverse systemic outcomes. Collaborative, deferential, and problematic partnership types of family participation in medical decision-making are important models to understand in enhancing and maintaining successful working relationships. A pragmatic approach involving prevention, recognition, and resolution steps is outlined that can help surgeons to avoid as well as to respond effectively to difficult and stressful interactions with parents.

THE CIVIL RIGHTS ISSUES

According to Basic Rights At Inpatient Mental Health Facilities In Massachusetts, a flyer prepared by the Mental Health Legal Advisors Committee in October 2012, patients at inpatient mental health facilities have certain basic rights that are protected. Some rights are protected by the U.S. Constitution, while some are protected by state law.

According to the Committee, patients at inpatient mental health facilities have five specifically enumertated rights, which are required to be conspicuously posted in all such facilities. According to the Committee, all persons in public or private settings have the following rights:

  • The right to “reasonable access” to a telephone to make and receive confidential calls, unless making the call would be a criminal act or cause an unreasonable infringement of another’s access to the telephone.
  • The right to send and receive “sealed unopened, uncensored mail.” If the person is present, staff may open and check mail for contraband, but may not read it.
  • The right to receive visitors of your “own choosing daily and in private, at reasonable times.” Visiting hours may be limited only to “protect the privacy of other persons and to avoid serious disruptions in the normal functioning of the facility or program and shall be sufficiently flexible as to accommodate individual needs and desires.”
  • The right to a humane environment including living space which ensures “privacy and security in resting, sleeping, dressing, bathing and personal hygiene, reading and writing and in toileting.”
  • The right to access legal representation.

Bearing in mind that Justina’s visitation with her parents has been restricted to one hour per week, and that her brief telephone calls are reportedly closely monitored, consider that the Committee explains that: “The facility’s superintendent, director, acting superintendent or acting director may temporarily suspend the right to use the phone if there is a substantial risk of serious harm to you or others and less restrictive alternatives would be futile. Any suspension must be documented in your record and may last no longer than the time necessary to prevent the harm.”

THE HAPPY HOLIDAY

On December 28, 2013, the West Hartford News announced that:

After nearly a year of forced separation from her family, Justina Pelletier, 15, was barred from going home with her family to their West Hartford home for Christmas this year. A postponement in a ruling has ensured the family’s legal battles will continue through the holidays.

Judge Joseph Johnston postponed his final custody decision until Jan. 10, leaving the teen in the state custody in Massachusetts, but also appointed an independent investigator to take a new look at her case.

“I don’t understand how they can do this. I didn’t do anything wrong,” her mother, Linda Pelletier, said as she left the courtroom, sobbing, according to a report published by the Boston Globe.

A gag order originally imposed by judge Johnston continues to prevent all parties from discussing the case with the media.

EXPERTS PROVIDE DISSENTING OPINIONS

“Some child-protection doctors, whose field has recently been elevated to a board-certified specialty, are beginning to draw criticism – even from some unlikely quarters,” explained Boston Globe journalists Neil Swidey and Patricia Wen.

They cite Dr. Eli Newberger – the very pediatrician who founded the child protection team at Children’s Hospital in 1970 running it for three decades – cautioning that “doctors in this new specialty have enormous and really unchecked power.”

Swidey and Patricia Wen explain that as an expert witness in cases around the country, Newberger said he’s seen a tendency for state child-welfare agencies to be “overly credulous to hospitals” and for some child protection teams to show a “reflexive willingness to label and to punish,” especially educated mothers who are perceived as being too pushy.5

barry pollack

Former federal prosecutor Barry S. Pollack is highly critical of the intervention by Children’s Hospital.

Far more critical of Children’s Hospital is Barry S. Pollack, a former federal prosecutor, and the longest-serving board member of the Massachusetts Society for the Prevention of Cruelty to Children. As a lawyer, he has represented several families in cases similar to Justina’s.

In a letter dated December 21, 2013, Pollack wrote to the Commissioner of the Massachusetts Department of Public Health demanding the closure of Bader 5, Harvard’s psychiatric ward at the children’s hospital, “unless and until the Commonwealth can confirm the safety of children there.”

Pollack did not mince words when it came to his criticism of the psychiatric ward:

As reported in the growing number of cases in which allegations are becoming public, Bader 5 healthcare providers, including Gary Gosselin and Colleen Ryan, along with an in-house counsel named Ellen Rothstein, appear to favor hasty accusations of medical child abuse or the like against parents who challenge them. Based on allegations by multiple families, Gosselin and/or Ryan have even taken harsh stances to avoid second opinions that parents wish to seek from other facilities. In my view, one of Gosselin’s Ryan’s, and Rothstein’s biggest weaknesses appears to be an unwillingness to consider the possibility that they have made mistakes, which is a major deficiency in professionalism. A former Children’s Hospital nurse and whistleblower, Katie Higgins, has publicly reported these sorts of problems at Bader 5. As a result of, among other things, arrogance, professional mediocrity, and/or a rush to judgment, Bader 5 appears virtually synonymous with abuse for many children. While Gosselin, Ryan, and Rothstein may deflect blame for malpractice and abuse onto parents, Bader 5 emerges as a serious risk of abuse.

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Nurse Katie Higgins wrote a letter accusing the Children’s Hospital of medical child abuse.

Former Boston Children’s Hospital nurse Katie Higgins, who has followed the case from the start, wrote a scathing letter on January 8, 2014, addressed to Massachusetts Gov. Deval Patrick, Attorney General Martha Coakley, and Massachusetts Department of Children and Families Commissioner Olga Roche.

Higgins’ letter charges that Children’s Hospital is guilty of committing “medical child abuse” by pulling Justina off most of her previous medications for mitochondrial disease. Higgins also asserts that Justina’s health has deteriorated as a result.

Higgins wrote: “As advocate for the family, I informed Department of Mental Health licensing director, Liz Kinkead of the breach of law regarding Justina’s commitment to a locked psychiatric unit and was told that DMH was deferring to the medical expertise of Boston Children’s Hospital.”

Higgins continued on to explain that:

From the perspective of the teen whose life has been derailed, she is the ward of a state devoid of compassion and conscience, prohibited from contact with every facet of her life that holds meaning for her. I am submitting this information, which has been made public, in the form of a complaint against Judge Joseph Johnston, Dr. Colleen Ryan and the Massachusetts Department of Children and Families for the emotional and medical abuse Justina Pelletier has suffered for nearly a year. It would be far more accurate to call the “treatment” forced on Justina by its more proper term, “torture.”

“Acute psychiatric hospitalization is intended as an emergency intervention for a child at risk of harm to self or others. Judging from the article, Justina has never fit this description. She should never have been moved to a psychiatric ward,” Marion Freedman-Gurspan explains in a letter to the editor of the Boston Globe published on December 22, 2013.

As a former director of policy and planning for child-adolescent services for the Massachusetts Department of Mental Health, she provides credible – and highly critical – commentary regarding the Justina Pelletier case, writing:6

No hospital or state agency should be allowed to use hospitalization as a weapon to resolve disagreements about diagnoses, nor should disagreements be a cause for terminating parental custody and denying a child daily access to her parents. Independent physicians, unaffiliated with Children’s Hospital, should have been called in early on.

The excuse that the DCF does not have a medical director is bogus. The Department of Mental Health could have been called in to assist, or Medicaid could have turned to its cadre of independent psychiatrists who staff its Child Psychiatry Access Project. This seems not to have happened.

Instead, Children’s Hospital has been allowed to bully the child and family. The state, which took over as a parent, has failed to protect the child from this bully.

NOT THE ONLY ONES

Cristy Balcells, executive director of Mito-Action, a Boston-based nonprofit group supporting mitochondrial disease patients and their families, told Boston’s National Public Radio affiliate WBUR on Morning Edition that this is not the first time that children have been taken from their parents because of a dispute with doctors about how to treat the disease.

In commenting on the WBUR broadcast, a spokesperson from the Boston-based advocacy organization Coalition for Diagnostic Rights explained:

People wonder whether what’s happened to Justina and her parents happens to others, and the answer to that question is a resounding yes.

It is appallingly common for doctors to deny basic rights to patients and parents when somatoform disorder is considered. It is appallingly common for doctors to mistakenly deny medical care to those who need it based on reckless diagnosis of somatoform disorder.

Journalists Neil Swidey and Patricia Wen of the Boston Globe explain: “These cases are rare, but not as rare as one might think. In just the last 18 months, Children’s – which given its reputation attracts many of the toughest cases from across the Northeast – has been involved in at least five cases where a disputed medical diagnosis led to parents either losing custody or being threatened with that extreme measure. Similar custody fights have occurred on occasion at other pediatric hospitals around the country.”

The Hilliard family’s nightmare began in 2006, when their daughter, Eithene, was born with multiple birth defects. By age 2 1/2 her condition worsened, and she suggested to doctors at Boston Children’s Hospital that her daughter should be tested for mitochondrial disease.

When she and her husband approached Children’s Hospital with the possibility that she had mitochondrial disease, they were immediatly met with resistance, particularly from the hospital’s genetics and metabolism departments, Jessica Hilliard explained in an interview to The Blaze.

Reporter Liz Klimas notes that the Hillard family kept pressing and eventually had a tissue sample taken from their daughter’s thigh. The mitochondria in the cells of this tissue and other genetic aspects were analyzed. This test, Hilliard said, was the “gold standard” for a mitochondrial diagnosis at the time that it was conducted on her daughter. Liz Klimas explains what happened next:

Hilliard said the genetics department that had analyzed her daughter’s muscle sample “didn’t believe the results,” which favored a diagnosis of mitochondrial disease. Instead of telling the Hilliards of this initial finding, the mother said doctors withheld the information for three months while they got another specialist elsewhere to test the sample as well. That specialist eventually agreed with the mito diagnosis.

In March of 2011, the Hilliards’ daughter took a turn for the worst, and it was recommend by some at the hospital that they prepare for end-of-life care. At this point, the same team that had originally diagnosed Eithene with mitochondrial disease revoked their diagnosis, a course that her everyday care specialists disagreed with.

“When the metabolism team learned the Hilliards would be preparing for hospice care, they accused the parents of not taking steps to help her daughter when these doctors believed she could actually be treated and live,” Klimas explains.

But it did not end there. The hospital’s child protection team had been advised of the Hilliard’s situation, and their younger son had been admitted to the hospital with a long fever and an antibiotic-resistant ear infection. At some point during his care, he also took a turn for the worse, exhibiting symptoms that were indicative of mitochondria malfunction.

Gabriel was diagnosed with mitochondrial disease in 2011, and his parents were accused of medical child abuse by Boston Children’s Hospital.

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Jessica Hilliard with son Gabriel.

“My husband and I knew what was happening. As soon as we understood that child protection was getting involved, we immediately understood that they were going to try to take custody from us because that was their pattern. By this point I had met several families who had gone through this at Boston Children’s,” Jessica Hilliard told FOXCT News in December 2013.

Far less publicity has been provided to Elizabeth Wray, who was held in Boston Children’s Hospital’s Bader 5 unit under remarkably similar circumstances. As Neil Swidey and Patricia Wenof the Boston Globe explain it:

The day before Justina had been moved into Bader 5, a 16-year-old girl named Elizabeth from upstate New York had been discharged from that same unit, after she had been in state custody at Children’s for more than six months.

Elizabeth’s case had also hinged on a dispute over whether her problems were physical or psychiatric. However, in her case the disagreement involved a different controversial illness, something called PANDAS or PANS, an autoimmune neuropsychiatric disorder believed to cause obsessive compulsive disorder. That dispute had led to allegations of medical interference being filed against the girl’s parents and to the state taking custody of the girl. And the representative from the Children’s psychiatry service who played a key role in Elizabeth’s case was the same psychologist who had pushed to change Justina’s diagnosis to somatoform disorder, Simona Bujoreanu.7

The Wray family was allegedly told by doctors that Elizabeth was clear to be transferred to another hospital, however, the following Monday they learned that the hospital contacted the Department of Children and Families child protective services unit, urging them to file for temporary custody of Elizabeth and to admit her to the Bader 5 psychicatric ward.

The family was told to appear in court for a custody hearing “based on allegations made by BCH,” their lawyer said in an email sent to supporters.

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Protestors rally in support of Elizabeth Wray and to promote awareness at Children’s Hospital.

Just as in Justina’s case, a gag order was imposed by the court preventing the family or their attorney from discussing the case outside the courtroom. As Steve Annear, Staff Writer with with BostInno explains it, the family’s lawyer, Beth Alison Maloney, wrote on her Facebook page: “The court has issued a temporary gag order necessitating no further comments or discussions by my clients or me, and the deletion of prior references on my facebook fan pages, to a child in the care of Boston Children’s Hospital. Both my clients and I will comply with the order.”8

According to a posting on the Free Elizabeth Wray Facebook page: “After 10 months as a ward of the State of Massachusetts, Elizabeth returned home in August 2013.” Her condition is reported as improving.

The tragic story of young Chelsey Cruz was well detailed by the Hartford-Courant.

“When Kimberly Castro buries her only daughter next week, she’ll do so with a clear conscience, but with fury in her heart,” wrote Courant staff writer Hilary Waldman.

Chelsey became embroiled in a series of events involving Boston Children’s Hospital that remarkably mirror those of the Pellitier and Wray families, suggesting the possibility that part of Boston Children’s Hospital’s modus operandi may be to target families from out-of-state.

Her mother testified before a Connecticut committee investigating its own department of social services on December 18, 2008, detailing her experience with Boston Children’s Hospital, saying:

We sought help from the Boston Children’s Medical Center. And at first, they agreed and began to wean her off the medications. She began to look and feel better. However, one fatal visit occurred when a chief doctor came on the scene. He demanded that Chelsey be put back on the experimental medications and threatened to call DCF if I resisted. I asked to seek a second opinion and was immediately dismissed. My daughter was forcibly admitted and guards were placed outside her door, keeping me from my child.

Massachusetts Department of Social Services and the Department of Children and Families in Connecticut worked to entrap us, and an order of temporary custody was obtained in Boston. I was told by the Boston Department of Social Services that I was no longer able to make any medical decisions for Chelsey. I went to the local newspapers with my story, sharing my pain and my hope to gain justice.

The Boston Globe explains with respect to the Pellitier family that: “When the judge decided to maintain temporary custody of Justina with the state, the Pelletiers were furious. They took their complaints to every authority they could think of: the district attorney, the attorney general, the governor’s office, even the FBI.” No one intervened to help the family.

According to Kimberly Castro’s submission to the committee, she contacted Drs. William Harmon and Nancy Rodig – both nephrologists at Boston Children’s Hospital – Clarissa Lebron, a supervisor at the Department of Children and Families, as well as Richard Blumenthal, Attorney General of Connecticut at the time. In addition, her daughter wrote a letter to the judge presiding over her case pleading for his intervention on her behalf.

It was all to no avail. On March 12, 2008, the Hartford-Courant reported that Chelsey had died of kidney failure – precisely the condition that her mother had sought to prevent.

Castro said she will never believe that her daughter died of lupus or kidney failure. “I’m 100 percent sure that my daughter died of adverse side effects of the drug called Cellcept,” Castro said. “Regardless of that, they had no right to force her to take a drug she didn’t want.”

Castro told DCF that this would happen. “I tried to warn them,” she said.

“And they never listened.”

 

This posting is an extract of a more comprehensive article that is currently being written for posting at Lifting the Veil.


1. Account of court proceeding drawn from Neil Swidey and Patricia Wen, “Frustration on all fronts in struggle over child’s future,” Boston Globe, (December 16, 2013). See also for example Rafferty v. Massachusetts Department Of Children And Families, Civil Action No. 10-40114-FDS. United States District Court, D. Massachusetts. (2011) (DCF caseworker falsified report while others “collaborated in, approved, furthered, or acquiesced in this conduct”); Howard v. Malac, 270 F.Supp.2d 132 (2003) (DSS investigators allegedly signed “false affidavits,” communicated “through a hospital social worker, that she would never see her children again if she did not reinstate the restraining order”); Matt Murphy, ” Social worker in Jeremiah Oliver case failed to provide basic support, Massachusetts Department of Children and Families commissioner says,” MassLive.com, (December 30, 2013) (Commissioner admits supervisor provided “false information” indicating children were taken care of; “misled the department to believe this was a family that was stable” even though evidence was to the contrary); David Armstrong, “Step Falsified in Abuse Citations,” Boston Globe, (March 27, 1997) (caseworker founds case “after visiting with you and your children and talking to other people who know your family,” however doctor was in another state at time of alleged incident); David Armstrong and Doris Sue Wong, Boston Globe “State Cuts Ties With Agency Over Scalding,” (February 17, 1994) (private agency “case workers falsified reports, claiming to visit some families when they had not”); Commonwealth v. Newman, 32 Mass. App. Ct. 148 (1992) (caseworker for Department of Youth Services alleged to have taken money from a family member of a youth committed to DYS); Commonwealth v. Carp, 47 Mass. App. Ct. 229 (1999) (evidence suppressed as DSS “investigator misrepresented to the defendant that the interview was not a criminal investigation, stated that Miranda warnings were not required and that the defendant did not need an attorney, and failed to inform the defendant until the end of the interview that incriminating evidence would be passed on to the police”); Pamela Ferdinand, Boston Globe, “Charges Put Curb On Agency Adoptions,” (March 2, 1995) (“nonprofit adoption agency that has placed more than 500 children has been ordered to stop accepting new clients, amid allegations of overbilling, falsifying birth mothers’ medical records and diverting funds for personal use”).

2. Paula J. Owen, “DCF removing kids at an unprecedented rate,” Telegram And Gazette (January 19, 2014). For a better understanding of this phenomenon see generally my article Defensive Social Work at Lifting the Veil.

3. That juvenile court judges frequently rubber stamp decisions by departments of social services is beyond dispute. See e.g., Mark R. Brown, Rescuing Children from Abusive Parents: The Constitutional Value of Pre-Deprivation Process, 65 Ohio State Law Journal 913 (2004)(“Remarkable as it may sound, Florida’s judges found that DCF correctly estimated probable cause in ninety-eight out of every one hundred cases”); Daniel Leddy, “Our Foster-Care System Fails Kids And The City,” SILive.com, (July 27, 2010) (“judges were the real culprits for having allowed the court to be reduced to the status of a rubber stamp for whatever the agencies wanted”); William M. Brooks, The Tail Still Wags the Dog: The Pervasive and Inappropriate Influence by the Psychiatric Profession on the Civil Commitment Process, 86 North Dakota Law Review 259 (2010) (“When judges defer to psychiatrists at a rate between ninety and one hundred percent of the time the psychiatrist experts actually become the decision-makers in the civil commitment process”): Martin Guggenheim, Nevada Law Journal, Spring (2006) {“studies have consistently criticized the Family Court judges in New York City for their strong tendency to ‘rubber stamp’ agency recommendations to remove children from their parents”); California State Auditor, Bureau of State Audits, Los Angeles County: The Department of Children and Family Services Can Improve Its Processes To Protect Children From Abuse and Neglect, October (1996) (California State Auditor noting that the Los Angeles juvenile court follows the recommendations of DCFS is 98 percent of the cases it hears).

4. Neil Swidey and Patricia Wen, “A medical collision with a child in the middle,”Boston Globe, (December 15, 2013). This is a very common phenomenon in the fields of child abuse and domestic violence. See for example an early case involving a former Child Protective Services case worker charged with the death of her adopted child involving allegations of Munchausen’s Syndrome by Proxy, People v. Phillips (1981) 122 Cal. App.3d 69 [175 Cal. Rptr. 703] (“Dr. Blinder had not examined appellant, nor had he treated patients who displayed the syndrome which was the subject of his testimony. Rather, his testimony was based upon various reports in professional journals, copies of which were made available to the jury”); United States v. Fitzgerald, No. 02-4978 (4th Cir. Nov. 17, 2003)(unpublished) (testimony from FBI clinical forensic psychologist such that child molesters commonly often begin with innocuous behavior to gain child’s trust and then proceed to borderline behavior to test whether child is receptive excluded as being unreliable, and because it would not assist trier of fact); Mickens-Thomas v. Martinez, No. 04-3843 (3d Cir. July 7, 2005)(unpublished) (in case involving rape and murder of 12 year old child, state offers testimony from psychologist Dr. Veronique Valliere, who opines generally on risks of recidivism but disclaims knowledge of parolee’s particular case); United States v. Dixon, 413 F.3d 520 (5th Cir. 2005), cert. granted, 126 S. Ct. 1139 (2006) (criminal defendant offers testimony on battered women’s syndrome from Dr. Toby Myers, domestic violence expert, but trial court excludes testimony as irrelevant and jury convicts); Shields v. Dretke, No. 04-70008 (5th Cir. Feb. 17, 2005) (unpublished), cert. denied, 126 S. Ct. 28 (2005) {“Even though we are somewhat troubled by the absence of a personal interview of Shields by Dr. Gripon, we cannot say that counsel was ineffective in failing to make a Daubert objection to Dr. Gripon’s testimony”); United States v. LeBlanc, No. 01-1517 (6th Cir. Aug. 28, 2002) (unpublished) (Charged with sexual assault of minor step-daughter, defense offers testimony from psychologist Dr. Terence Campbell regarding unreliability of evidence gleaned from child interviews. District court excludes testimony, jury convicts, exclusion affirmed on appeal); United States v. Mamah, 332 F.3d 475 (7th Cir. 2003) (Experts may have been qualified in their respective fields, and their research may have been methodologically sound, but they relied on insufficient facts or data to link their theories to facts of case); United States v. Young, 316 F.3d 649 (7th Cir. 2002) (Man charged with interstate domestic violence; victim recants allegations at trail such that he abducted and beat her. Prosecution calls psychiatric mental health nurse, Dr. Ann Wolbert Burgess, who opines over defendant’s objection that victim’s recantation is typical behavior pattern for domestic abuse victims. Jury convicts, defendant appeals, case affirmed on appeal); United States v. Bertling, 370 F.3d 818 (8th Cir. 2004) (Proposed expert was not psychologist or psychiatrist and had not examined defendant, but merely proposed to testify on general issues involving domestic violence); Hellums v. Williams, No. 00-2100 (10th Cir. Aug. 8, 2001) (unpublished) (In child molestation case, prosecution introduced expert testimony from psychologist Dr. Robert Zussman and counselor Julia Barker. Jury convicted, however in federal habeas corpus proceedings, case was reversed as rules hold that expert opinions on victim’s credibility are beyond scope of experts’ specialized knowledge); United States v. Martinez, No. 00-2054 (10th Cir. Mar. 26, 2001) (unpublished), cert. denied, 534 U.S. 881 (2001). (Defendant accused of sexual assault of ten-year-old girl. victim’s mental health counselor, Dr. Judith Tyler, testifies as prosecution expert, opining without objection that victim’s symptoms are consistent with trauma. Jury convicts, admissibility affirmed on appeal); United States v. Velarde, 214 F.3d 1204 (10th Cir. 2000), cert. denied, 541 U.S. 1069 (2004) (In prosecution for sexual abuse of child on Indian reservation, government offers testimony from two psychologists such that child’s statements and behaviors are consistent with episode of abuse. Reversed, as court erred in failing altogether to exercise gatekeeping function, and error was not harmless).

5. Reference to Dr. Newberger sourced from Neil Swidey and Patricia Wen, “A medical collision with a child in the middle,” Boston Globe, (September 15, 2013). Newberger and his Child Protection Team at Boston Children’s Hospital enjoy a long reputation of working hand-in-glove with Massachussetts’ child protection agency. See e.g., Custody Of Two Minors, 19 Mass. App. Ct. 552 (1985) (“The Department offered as evidence the March 31, 1983, medical report which consisted of a letter to the Department from Dr. Eli Newberger of the Children’s Hospital Medical Center incorporating reports from him and others concerning the February 24, 1983, visit. The mother objected, claiming that the letter and reports were hearsay and had not been provided to counsel prior to the hearing in accordance with counsel’s request under the Department’s rules. Her objections were overruled. Dr. Newberger’s letter and the accompanying reports were devastating, and the judge, on the Department’s recommendation, committed the children to the Department”).

6. Marion Freedman-Gurspan, letters, Boston Globe, (December 22, 2013). Marion Freedman-Gurspan is a former director of policy and planning for child-adolescent services for the Massachusetts Department of Mental Health. She also held tenure on the Steering Committee of the Massachusetts Consortium for Children with Special Heath Care Needs, and is listed as a member of the Massachusetts Society for the Prevention of Cruelty to Children in Massachusetts All-Payer Claims Database: Setting Expectations for Preliminary Data Release, a research paper published by the Division of Health Care Finance and Policy on May 22, 2012.

7. Neil Swidey and Patricia Wen, “Frustration on all fronts in struggle over child’s future,” Boston Globe, (December 16, 2013).

8. Steve Annear, “Parents Claim They Lost Temporary Custody of Child During Battle with Boston Hospital Over Proper Treatment,” BostInno (October 12th 2012).

4 responses

  1. Hannah Poling also has mitochondrial disorder. Her parents were awarded a multi-million dollar settlement after she had nine vaccines in one day, then immediately developed symptoms of severe autism. Public health officials said that her symptoms were a result of her ‘rare mitochondrial disorder’.

  2. What is the Dr’s educational background? I was under the impression that a psychologist did not have to have a medical degree first, but that a psychiatrist DOES need to be a medical doctor first. Is that correct? She is listed on Boston’s website as attending university and getting her medical degree at “Titu Maiorescu of Bucharest. The only Doctoral studies program I saw listed was for dental medicine. How does a Doctoral studies in Dental Medicine qualify you for evaluating mental health? They also offer “distance learning” in psychology. Just asking. I thought the purpose of the medical background for psychiatrist was to avoid mistakes like this. The university was founded in 1990. I haven’t seen a lot of information listed about it.

  3. An astute observation, and a good question raised by our anonymous contributor. Curious to learn more about Titu Maiorescu, I found my way to its web site, where a number of medical specialties are on offer. Constrained to Google’s translator, I have yet to determine what doctoral degrees are available, however Bujoreanu’s bio at Boston Children’s Hospital Brazelton Institute lists her as having but a Master of Arts degree.

    Specifically, “She obtained her Master of Arts degree in Child Clinical Developmental Psychology at Tufts University and her Bachelor’s degree in Educational Psychology from the Titu Maiorescu University in Bucharest, Romania. Simona’s clinical experience relates to her current work at Tufts University, in the Home-School Connection Program, as the Research Coordinator.”

    http://www.brazelton-institute.com/bujorbio.html

    Although precise details of her admission remain unclear, the most recent information is that Justina was “diagnosed” within 20 minutes of entering BCH.

  4. This is very sad. my family went through the same thing but in ri. our 3 week old daughter had a cold and was sent to Hasbro in ri. for some tests by her pediatrician after waiting 3 hours and the tests coming back negative we decided we was going to leave. the doctors said no and wouldn’t give us a reason so we took our daughter and our other three kids and left. we got home by this time it’s 10:30pm and dcyf was at our house saying they have a 72 hour hold on our child. i went back to the hospital willingly and the next day they tell me i have to leave that they are taking my daughter from me. what a nightmare . dcyf and the doctors are out of control. my daughter was born with broken blood vessel in her eyes due to a rapid delivery i explained that to them was called a lier. after the next day my obgyn sent the papers saying my daughter was born like that. by this time it was to late and because i flipped out on them.for taking my new born they said i was mentally uncapable of caring for her but not our other three. we are hard working married couple who don’t drink don’t smoke don’t do drugs don’t party and this has happen. why don’t they worry about the kids who have no food who are getting beating or left alone for days.

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