In re [Redacted

• Decision Date: 30 July 2015
• Docket Number: Case No. 2014 NEG 000293
• Parties: IN THE MATTER OF [Redacted] (DOB: [Redacted] RESPONDENT.
• Court: D.C. Superior Court

IN THE MATTER OF [Redacted] (DOB: [Redacted] RESPONDENT.

Case No. 2014 NEG 000293

SUPERIOR COURT OF THE DISTRICT OF COLUMBIA FAMILY COURT JUVENILE AND NEGLECT BRANCH

July 30, 2015

Social File No. 2014 JSF 001448

Magistrate Judge S. Pamela Gray

FINDINGS OF FACT, CONCLUSIONS OF LAW, AND ORDER

This matter came before the Court on March 23, 25, 26, and 27, 2015 for a fact-finding hearing on the neglect petition filed in the above-captioned matter on September 2, 2014, by the Government of the District of Columbia. The Government alleged in its petition that the respondent, [Redacted] is a neglected child pursuant to D.C. Code § 16-2301(9)(A)(i), (ii), and (iii). Specifically, the Government alleged that the respondent is the victim of medical child abuse, in that his parents, [Redacted] and [Redacted] exaggerated, fabricated, and/or induced symptoms, resulting in excessive and unnecessary, harmful, or potentially harmful medical care, leaving his medical needs and overall care unmet. The Government further alleged [Redacted] suffers from a mental incapacity that prevents her from meeting [Redacted] needs and has caused her to engage in the medical child abuse.

The following counsel and parties were present at the neglect trial: (1) Lynsey Nix, Esq., Assistant Attorney General for the District of Columbia; (2) Cynthia Jefferson, Esq., Guardian ad litem; (3) [Redacted] , birth father; (4) Howard Margulies, Esq., counsel for the birth father; (5) [Redacted] birth mother; and (6) Pamela Satterfield, Esq., counsel for the birth mother.

The Government presented six witnesses:

Dr. Jackson Peyton, Licensed Psychologist, Department of Behavioral Health (DBH) Assessment Center, [Redacted] mother of respondent, Dr. Allison M. Jackson, Child Abuse Pediatrician/Attending Physician, Freddie Mac Foundation Child and Adolescent Protection Center at the Children's National Medical Center (CNMC), [Redacted] father of respondent, Dr. Kelechi Uduhiri, family physician, Providence Hospital (Providence), and Christian Greene,¹ Child and Family Services Agency (CFSA) Ombudsman and Medical Abuse Specialist.

[Redacted] testified on her own behalf, and she and [Redacted] presented four additional witnesses: [Redacted] maternal grandmother of respondent, Dr. Kelechi Uduhiri, family physician, Providence, Dr. Eric Levey, Medical Director, Pediatric Feeding Disorders Program, Kennedy Krieger Institute, and Dr. Avram Mack, psychiatrist from Georgetown University Hospital.

The Court admitted the following exhibits on behalf of the Government, without objection:

1. Exhibit 1: Dr. H. Jackson Peyton's Resume,

2. Exhibit 2: Psychological Evaluation of [Redacted]

3. Exhibit 3: CV of Allison Jackson,

4. Exhibit 4: CAPC Consult Note,

5. Exhibit 5: Emergency Documentation,

6. Exhibit 6: Emergency Documentation,

7. Exhibit 7: Consults,

8. Exhibit 8: Social Work Psychological Assessment dated 8/22/14,

9. Exhibit 9: Emergency Documentation,

10. Exhibit 10: History & Physical,

11. Exhibit 12: Transfer & Discharge Documentation,

12. Exhibit 13: Medical Records from Providence Hospital dated 7/10/14,

13. Exhibit 14: Medical Records from Providence Hospital dated 7/23/14,

14. Exhibit 15: Medical Records from Providence Hospital dated 7/30/14,

15. Exhibit 16: Medical Records from Providence Hospital dated 8/14/14, and

16. Exhibit 17: Christian Greene's Resume

The Court admitted the following exhibits on behalf of the Mother:

1. Exhibit 6: Emergency Discharge dated 7/22/14 (over objection),

2. Exhibit 7: Emergency Discharge dated 8/24/14 (over objection), and

3. Exhibit 8: Curriculum Vitae for Dr. Abram Mack (no objection)

The Court admitted the following exhibits on behalf of the Father, without objection:

1. Exhibit 5: Curriculum Vitae for Eric Levey

Having considered all the evidence, weighed the arguments of counsel, and the credibility of the witnesses, the Court finds that the Government has failed to prove, by a preponderance of the evidence, that the respondent, [Redacted] , is a neglected child within the meaning of D.C. Code § 16-2301(9)(A)(i), (ii), and (iii). The Court makes the following findings of fact and conclusions of law.

FINDINGS OF FACT

1. [Redacted] is a male child, born [Redacted] is his birth mother and [Redacted] is his birth father.

2. [Redacted] was born premature at 30 weeks and as a consequence, received care in the Neonatal Intensive Care Unit (NICU) at Providence for several weeks. While in the NICU he received medical treatment for jaundice; retinal and intraventricular hemorrhaging; respiratory distress syndrome; apnea and bradycardia; and anemia. He was discharged from the hospital a month after his birth.

3. After his release from the hospital, [Redacted] was taken to the emergency room by his parents on four different occasions. He was seen by emergency room physicians on July 22, 2014 for excessive gas, vomiting and diarrhea; On August 4, 2014 for rectal prolapse or hemorrhoid; August 22, 2014 for a fall in the bathroom; and August 25 2015 for a possible seizure.

Government's Evidence

4. Dr. Jackson Peyton was the first witness to testify for the Government. He is a licensed psychologist and testified as an expert witness in the areas of Psychology and Parenting Capacity. In the past ten years, Dr. Peyton has performed approximately 1,000 psychological assessments, he has not treated any patients, he does not work in a medical or pediatric setting, he is not affiliated with any hospitals or clinics, and he is not board certified.

5. On October 28, 2014, Dr. Peyton met with [Redacted] for a court-ordered psychological assessment. He spent approximately two and one half to three hours with [Redacted] and performed psychological screening and diagnostic tests. Dr. Peyton described [Redacted] as "polite" and "respectful, but indicated that she had trouble finding words. She was engaged, cooperative, and appeared forthcoming, although sometimes she was reluctant to admit minor faults. During the assessment, Dr. Peyton learned of [Redacted] health issues, including her history of seizures, drug encephalopathy, conversion disorder, rehabilitation, and her "complex pregnancy." He also learned that [Redacted] was born prematurely, that he spent time in the NICU and had medical complications. Dr. Peyton also questioned [Redacted] regarding the four times she brought [Redacted] into the Emergency Room (ER) and she explained the reason for each visit.

6. Upon completion of his assessment, Dr. Peyton diagnosed [Redacted] with one condition, Factitious Disorder on Another, based on history. He defined the term, based on history, as accepting as true the information provided to him by the Government in this case, including a report prepared by Dr. Allison Jackson.² Dr. Peyton testified that [Redacted] judgment may be impaired based on the four ER visits, that she was fabricating symptoms when she and [Redacted] brought [Redacted] to the ER, and that she was likely to commit medical child abuse in the future. He reached these conclusions without reviewing a single medical record, [Redacted] or [Redacted]

7. The Government called [Redacted] to testify in its case-in-chief.³ She is the biological mother of [Redacted] and is 33 years old. [Redacted] received an associate's degree in pre-med from Central Florida Community College and a bachelor's degree in Anthropology from the University of South Florida. She is pursuing a master's degree program in Homeland Security from the University of the District of Columbia but is currently on medical leave due to drug encephalopathy, a condition which caused her brain to swell and left her impaired. She testified extensively about her own medical issues and her difficult pregnancy.

8. She went into pre-term labor and was admitted to the hospital until she gave birth. [Redacted] as born prematurely via C-section on June 5, 2014, at 30 weeks. [Redacted] had many concerns about [Redacted] health because he was "so small" and "frail" and had medical complications.

9. Once home, [Redacted] noticed that [Redacted] had excessive gas, vomiting, and diarrhea. From the time [Redacted] was discharged until the date of the first ER visit on July 22, 2014, he had a bowel movement "almost every time he took a bottle, at least four times a day." Both [Redacted] and [Redacted] reported their observations to the ER doctor, Dr. Saleh. [Redacted] was diagnosed with gastrointestinal reflux and Dr. Saleh gave the parents a handout which explained this condition. Dr. Saleh told them to split the feeding, give Nikko one ounce of formula at a time, burp him, and feed him while he was sitting it. It was also advised to bring [Redacted] in for a follow-up visit with is primary care physician, which they did.

10. On August 4, 2014 [Redacted] was seen in the ER for the second time. [Redacted] reported seeing blood in his stool in two diapers. During one bowel movement, he was straining and [Redacted] saw something red coming out of his rectum. She talked to her sister who suggested that it may be a condition known as "rectal prolapse."⁴

11. On August 21, 2014, [Redacted] fell off a bench in the bathroom. Neither [Redacted] nor [Redacted] was certain how he fell. They each described what they believedhappened to medical and CFSA personnel. Upon observing a flat spot on [Redacted] head, which she did not believe was there prior to the fall, a call was made to 911 and he was taken to the hospital.

12. On August 25, 2014 [Redacted] was taken to the hospital for seizure activity. [Redacted] was on [Redacted] chest when he started shaking, losing consciousness, and salivating. [Redacted] testified that there was a post-dictal period where he was non-responsive for about ten minutes. She reported to the medical personnel that he had a tonic-clonic seizure. It was during this visit to the hospital that doctor's noted elevated levels of potassium in [Redacted] blood.

13. [Redacted] testified that she never asked any of the medical staff at CNMC to perform any medical

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