In re Nathaniel A., No. 2850

• Decision Date: 03 January 2005
• Docket Number: No. 2850
• Citation: 160 Md. App. 581,864 A.2d 1066
• Parties: In re: NATHANIEL A., Madeline C., and Shirah A.
• Court: Court of Special Appeals of Maryland

864 A.2d 1066

160 Md. App. 581

In re: NATHANIEL A., Madeline C., and Shirah A.

Nos. 2850, September Term, 2003, 610, September Term, 2004.

Court of Special Appeals of Maryland.

January 3, 2005.

Peter F. Rose (Nancy S. Forster, Public Defender on the brief), Baltimore, for Appellant.

C.J. Messerschmidt, Nancy C. Hopkins (J. Joseph Curran, Jr., Atty. Gen. on the brief), Baltimore, for Appellees.

Panel: DAVIS, SHARER, CHARLES E. MOYLAN, JR. (retired, specially assigned), JJ.

DAVIS, Judge.

On October 20, 2003, the Montgomery County Department of Health and Human Services (Department) filed shelter care petitions concerning Nathaniel A. and Madeline C. A hearing was held on that same date and on November 3, 2003, the Department filed its first amended child in need of assistance (CINA) petition. On November 14, 2003, the maternal grandparents filed a motion to intervene, which was subsequently granted by the court on December 10, 2003. On December 9, 2003, the Department filed its second amended CINA petition and four hearings ensued on January 28, 29, and 30, as well as on February 2, 2004. The Circuit Court for Montgomery County (Savage, J.) found both children CINA.

Shirah A. was subsequently born on April 14, 2004 to appellant mother and was immediately placed in the care of the Montgomery County Department of Health and Human Services (Department) by Child Protective Services. The Department filed a child in need of assistance (CINA) petition on April 15, 2004. A hearing was conducted on May 13, 2004 and the circuit court (Boynton, J.) found Shirah a CINA. We have consolidated appellant's two timely appeals where she presents one question for our review, which we rephrase as follows:

1. Did the circuit court err in adjudicating Nathaniel, Madeline, and Shirah CINA?

We answer in the negative. Accordingly, we shall affirm the judgment of the circuit court.

FACTUAL AND LEGAL BACKGROUND

Officer Darley of the Montgomery County Police Department's Family Crimes Division testified that on the night of October 18, 2003, after he was informed of a report of a child abuse incident, he proceeded to the Shady Grove Hospital. He subsequently interviewed appellant and she explained that on October 17, 2003, her son, Nathaniel, had been "acting up" and decided to go to bed in the clothes he wore that day. During the night, she changed his soiled pants; Nathaniel refused to use the toilet and was generally uncooperative. When she grabbed and pulled his left arm by the wrist, he began to cry. Appellant consequently applied Bengay to the child's arm, gave him Children's Tylenol, and sent him to bed. Appellant told Officer Darley that Nathaniel complained of arm pain the following day and she decided to take him to Night Time Pediatrics, which referred her to Shady Grove Hospital.

After admitting to Officer Darley that she had initially told the doctors that Nathaniel had been hurt at the playground, she admitted that she had caused the injury. Officer Darley explained that appellant told him when she pulled on Nathaniel's arm and fractured it, it was out of frustration and anger due to a difficult day. Appellant apologized for her actions and explained that she had lost her temper.

Jennifer Knotts, of the Department, testified that she interviewed appellant at the hospital. Appellant stated to Knotts that Nathaniel was being difficult and she pulled on him to stop him from moving so she could change his pants. She also explained to Knotts that her son had acid reflux problems.

Dr. Julian Orenstein, the treating physician at the hospital, stated that Nathaniel told him that appellant "grabbed his arm, twisted, then crack." Dr. Orenstein revealed that the x-ray of Nathaniel's arm showed a transverse fracture of the humorous bone, and this type of injury could only result from a "high degree of force."

Department caseworker Sandra Lopez testified that appellant had described Nathaniel's acid reflux issues, as well as prior medical problems to her. She explained that the father's whereabouts were unclear and at best, his contact with the children was "on-and-off." Lopez asserted that appellant was exceptionally concerned with the health of Nathaniel and relayed to her that he had a history of vomiting, stomach problems, and was lactose intolerant. Lopez testified that Nathaniel appeared to be a "healthy" child and appellant acted overly concerned with his medical condition.

Dr. Muriel Wolfe of the Children's Hospital testified that she examined Nathaniel and Madeline on March 13, 2003; appellant complained that he had been vomiting. Dr. Wolfe described Nathaniel's numerous doctor visits and noted that appellant continually insisted on further referrals. Dr. Wolfe concluded that Nathaniel had no serious condition and saw him for a follow-up visit one month later. At some point in 2003, Dr. Wolfe stated that appellant urged her to declare that Nathaniel's "disability" qualified her for "SSI" benefits, but she declined to accept the doctor's advice. Dr. Wolfe concluded that Nathaniel was in general good health, although an endoscopy revealed a slight irritation of the esophagus. She also expressed her concern that she felt appellant exaggerated Nathaniel's condition and was exceptionally worried about Nathaniel's health. Appellant complained to Dr. Wolfe that Madeline had crooked legs and, although Dr. Wolfe doubted this assertion, she referred Madeline to an orthopedist due to appellant's insistence.

Esther Herman, a therapist in Rockville, Maryland, testified that she met appellant and her children in August 2003 when Madeline was referred to her for speech therapy. Appellant also brought Nathaniel in the hopes of having Herman assist in rectifying his health and behavioral issues. Herman noted that Nathaniel had been in treatment for his behavioral problems since October 2003 and she believed appellant was consumed with his purported health problems.

Pediatrician Dr. Allison Jackson testified that she reviewed Nathaniel's and Madeline's medical file and stated that Nathaniel had been subjected to numerous medical visits, diagnoses, and various treatments for his health issues. She testified about his prior behavioral and health problems and asserted that the symptoms of which appellant complained concerning Nathaniel did not match the ultimate diagnoses. Dr. Jackson concluded that Nathaniel's medical treatment was "excessive," and consequently, "abusive." Although she noted that appellant did not invent symptoms for Nathaniel, Dr. Jackson stated that Nathaniel was "at risk" because of the fractured arm incident.

Psychiatrist Dr. Joanne Brant testified that Nathaniel had thirty-seven doctor visits in twenty-seven months and they generally related to Nathaniel's feeding problems, vomiting, sensory food aversion, dependency on a bottle and milk, and inability to calm himself. Dr. Brant concluded that appellant was likely an overanxious parent.

Both maternal grandparents testified that Nathaniel and Madeline were currently living in their homes and were of general good health and doing well. The circuit court engaged in an in-depth review of the CINA petition line by line and declared which facts were sustained, using the preponderance of the evidence standard, and, based on the testimony, which facts it did not believe had been established. She found that appellant fractured Nathaniel's arm when she pulled on it out of frustration and anger and his numerous doctor visits and treatments disclosed no serious medical conditions. The hearing judge explicitly credited the statements that the injury was non-accidental. She also credited the testimony of Officer Darley and Knotts that appellant stated her anger and frustration led to the incident. The circuit court concluded:

There were and are significant issues that this mother faces in her own life that have had huge influences on her children ... What I can find by a preponderance of the evidence is that Nathaniel was in fact abused and injured by virtue of the arm fracture. I also find by a preponderance of the evidence that he was subjected to unnecessary and excessive medical interventions, which amount legally to abuse.

* * *

But the picture of the mother that was so vivid in my mind or is so vivid in my mind, call it what you will, it's someone that is I guess obsessed in a way, and I don't mean that in a clinical way, with health concerns. And the health concerns of the children. In a way that is detrimental to them. And that's the key.

Of course, we want parents to be worried about their children's health. But when it comes to visits in the numbers of 40s, 44 visits. And after all of that, what you come out with is mild esophagitis and treat with Prevacid. I mean I shutter to think what this child was subjected to over and over and over again. Sort of seeking another opinion, wanting something to be wrong. And endoscopy, which is a very invasive procedure. The trips to an allergist which for a very young child to have blood drawn and have skin pricks, to what end, to what end?

He goes to their great grandparents and the grandparents and by their testimony he's fine. He's fine. And Dr. Jackson's testimony in a nut shell, how did he get fine so fast? ... I mean is that coincidental? I don't think so. I don't think so.

[t]his is Dr. Wolf's words, "she wanted to make sure there were problems with these children." [w]e're talking about two very young children here. And I will grant you that Nathaniel has been dragged through a whole lot more than Madeline has. But there is enough of a pattern here that when you, look at all of Nathaniel's visits and then when you look at Madeline's at a mere two years that it gives rise in the Court's mind and by a preponderance of the evidence a finding that she is at significant risk for having this repeated for her.

I have read Andrew A. It does come out of this county. I've read William B., and also Dunstin [Dustin] T.

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