Almost poisoned by Poison

A two-year-old child was brought to the emergency room of Jersey Shore Medical Center.

The ER physician, Dr. Daniel Yu, noted her mouth smelled like cologne.

After the doctor did tests, a blood test showed she had a blood-alcohol concentration of 0.035, which is elevated.

Her father gave the staff a bottle of cologne that had an odor similar to the child’s breath.

The doctor diagnosed her with accidental cologne ingestion and did not report the matter as suspected child abuse.

Subsequent events in the child’s life resulted in a finding that she had been subjected to separate incidents of child abuse.

According to the New Jersey Law Journal, April 28, 2014, page 5, three months later the Division of Youth and Family Services received reports that the child had been burned and beaten. She was removed from her father’s care the next month after she was found to have chemical burns on her vagina, foot, leg, and buttocks, along with bruises and belt marks.

She was adopted. Her adoptive parent filed a medical malpractice action against the physician and hospital, asserting that the doctor failed to report suspected child abuse.

The trial court dismissed the claim and said that no reasonable jury could find the doctor had reasonable cause to believe the child had been abused.

The Appellate Court reversed this decision, concluding that the physician should have seen this as a probable case of abuse.

The case went up to the Supreme Court of New Jersey, which concluded that the circumstances around the child’s presentation at the hospital were insufficient to lead to a conclusion that the doctor behaved unreasonably.

L.A. vs New Jersey Division of Youth and Family Services, decided April 23, 2014

The Federal Child Abuse Prevention and Treatment Act defines child abuse and neglect as any recent act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse or exploitation, or an act or failure to act which presents an imminent risk of serious harm.

Abuse Can be Physical, Sexual, Emotional or Financial

Physical Abuse

Physical abuse is the use of force to injure or threaten to injure another person. It is nonaccidental and may range from bruises to fractures, burning or otherwise harming a person. The injuries may result from biting, kicking, beating, shaking, stabbing, throwing, choking, or hitting.

Sexual Abuse

Sexual abuse is defined primarily in terms of what an adult does to a child, but others in a household may be sexually abused. It consists of fondling or penetration, incest, rape, sodomy, indecent exposure, exploitation through prostitution or production of pornographic material.

Emotional Abuse

Emotional abuse consists of verbal attacks, rejection, isolation, threats, or belittling comments. It also includes constant criticism, or withholding love, support or guidance. It is almost always present when other types of abuse are identified.

Financial Abuse

Financial abuse involves stealing from another person, forcing changes in a will, or misusing another person’s money.

Neglect

Not providing another person with basic needs is neglect. Neglect may be physical, such as failure to provide necessary food or shelter or supervision. It may be medical, such as failure to provide needed medical or mental health treatment.

It may be educational, such as failure to make sure a child attends school or receives the education. It may be emotional, such as not attending to another person’s emotional needs, not providing psychological care, or allowing a child to use alcohol or other drugs.

Abandonment

A mother goes into a Florida casino and leaves her two-year-old and four-year-old alone in the car on a hot August day. They have no food or water and are discovered 7 hours later. After being treated for dehydration, the children are taken away from their mother and placed in foster care. Many states define abandonment as a form of neglect. This involves leaving a vulnerable person in circumstances where the person suffers serious harm.

The key issue in the New Jersey case is whether Dr. Daniel Yu should have suspected child abuse instead of an accidental ingestion of cologne.

Considering the definitions of child abuse that I have already cited, it is clear to me that the physician accepted the premise that the child had suffered an accidental ingestion of cologne. To be mandated to report every accidental ingestion of a household item would create an unwieldy situation for healthcare personnel.

Tragically for the child, subsequent events revealed the abusive nature of her father’s care.

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