Names: Hazel and Joseph
Allegation: Non-Organic Failure to Thrive
Penalty Avoided: 20 Years on the State Registry
When their son Peter was born, Hazel and her husband, Joseph, were elated to finally begin building the family they had dreamed of for so long. Hazel took Peter for regular well-baby check-ups at a clinic she had selected based on location and acceptance of her State-subsidized insurance plan. At his two-month and four-month check-ups, Peter’s doctor, Dr. O., found no deficiencies in Peter’s weight, height, or development. However, Dr. O. transferred to another clinic and, at Peter’s sixth-month appointment in May of 2013, he was examined by the office’s pediatric nurse practitioner.
The nurse practitioner expressed concern regarding Peter’s weight and height, which were falling below the third percentiles. This was the first time that Hazel had heard concern regarding Peter’s growth. The nurse practitioner instructed Hazel that Peter would need an immediate follow-up appointment with Dr. A., who was from a nearby clinic. Upon Dr. A.’s instruction, the nurse practitioner called the Illinois Department of Children and Family Services (DCFS) to report Hazel for alleged child neglect. Unaware that the office had reported her for child neglect, three days later, Hazel brought Peter to see Dr. A. The doctor, who was not a board-certified pediatrician, concluded that Peter was not receiving enough calories from breast milk, though Peter was, by that point, eating solid foods in addition to being nursed regularly. She recommended that the family begin introducing dairy and meat protein foods, and supplement the nursing with formula.
At the exam, Dr. A. never referred Hazel to a lactation consultant or nutrition consultant, never provided instructions for how Hazel could monitor the volume of her milk production, and did not provide a referral to a specialist to rule out potential medical causes for Peter’s growth delay. Nonetheless, Dr. A. later told the DCFS investigator that she had diagnosed Peter with “non-organic failure to thrive” and, even though she suspected that Peter’s slow growth rate was the result of Hazel not producing enough breast milk, opined that Peter had been neglected. By DCFS’s own rules, this diagnosis should only be made after possible organic or medical explanations, such as Down’s Syndrome and Turner Syndrome, have been eliminated; Dr. A made no effort to investigate these cause, and failed to consider Peter’s normal stool and urine patterns, that he hit all of his developmental milestones, and that medical staff and family witnessed Hazel feeding Peter frequently.
In mid-May, DCFS officially “indicated” Hazel for child neglect pursuant to Allegation #81—“Non-Organic Failure to Thrive.” This decision meant that Hazel’s name would be registered in the State Central Register for twenty years, unless she could successfully appeal.
After being indicated, Hazel came to The Family Defense Center for assistance with her appeal. The Center recruited Dr. C., a highly qualified, board-certified pediatrician, who generously agreed to review the case and provide her opinion free of charge. Dr. C. testified to the rigorous clinical process necessary to decide if a child has non-organic failure to thrive. The child’s growth must be inconsistent over a period of time, but Peter’s height and weight were growing proportionally and he met all developmental milestones. Dr. C also testified that no doctor should diagnose “non-organic failure to thrive” based on a single examination, which was exactly what Dr. A did in the case of Peter. At the DCFS hearing, the DCFS Administrative Law Judge concluded that Dr. C. was more credible than Dr. A. due to the length of her pediatric practice and her superior knowledge of pediatric medicine.
The Administrative Law Judge determined that DCFS had failed to prove that the evidence supported the claim against Hazel. In addition to improperly relying on an inadequate medical opinion, DCFS did not present any evidence of neglectful conduct on the part of Hazel. The DCFS Director affirmed the Administrative Law Judge’s recommendation that the finding be expunged.