Troy’s ordeal started in 2015 when her infant son suffered a small, unexplained brain bleed. A child abuse pediatrician at an Austin hospital overlooked an underlying medical condition and said the boy was a victim of shaken baby syndrome. That diagnosis led the state to take both of Troy’s children.
The children spent five months in foster care, and Troy’s husband, Jason, was charged criminally before another doctor reviewed the baby’s medical records and found that the excess fluid in the child’s head was actually the result of the undiagnosed neurological condition.
“How would you feel if this type of situation were to happen to you?” Troy said to members of the Texas House of Representatives committee that oversees the state’s child welfare system.
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“We’re here to learn from past mistakes,” Frank said at the start of the hearing, which also featured testimony from child welfare officials, prosecutors and doctors.
Committee members peppered officials with broad questions about the enormous weight given to the opinions of child abuse doctors, and how to weigh child safety against the possibility of an unnecessary removal.
The elected officials zeroed in with more targeted questions about the appropriateness of the current legal standards for taking children, the agency’s wildly varying removal rates across the state, and concerns about whether child abuse specialists can accurately evaluate children they didn’t personally examine.
Dr. James Lukefahr, a child abuse pediatrician based in San Antonio, testified on behalf of the Texas chapter of the American Academy of Pediatrics. Lukefahr defended the work of child abuse pediatricians, a new and growing medical subspecialty of doctors who work closely with child welfare agencies to identify signs of abuse and protect children from additional harm. Lukefahr said child abuse pediatricians are also trained to find underlying conditions that can mimic abuse, so they can prevent needless removals.
But, he said, nobody is perfect.
“Working in this field I’ve seen terrible things, babies with a dozen broken bones, children maliciously burned, teenagers beaten to the edge of their lives,” Lukefahr said. “I’ve also seen mistakes, processes not followed, errors in judgment, and decisions that were based more on emotion than science.”
Parents whose stories were detailed in the NBC News and Chronicle series were among those who spoke.
But soon after, a child abuse pediatrician entered the hospital room and said she disagreed. She believed the baby had been shaken, and her concerns led Child Protective Services to take custody. Later, the doctor reported that the child’s injuries were “certainly inflicted.”
Three outside medical experts reviewed the case and concluded the baby suffered from an underlying medical condition, but seven months passed before the Timmermans regained full custody. They spent more than $200,000 to defend themselves, Timmerman told lawmakers, who appeared shocked.
“I urge this committee to put yourselves in the shoes of my family or one of the many other families here today,” he said. “Think about how you would feel if your child or grandchild was taken out of your arms with no standard of proof other than the opinion of a single individual.”
James choked back tears as she described her ordeal. She told lawmakers that, as far as Child Protective Services was concerned, the opinion of the child abuse pediatricians were all that mattered.
“In this process,” James said, “you are guilty until [proven] innocent.”
Lukefahr said he and his colleagues are open to finding ways to improve the system, but he warned lawmakers against making changes that could hinder the state’s efforts to protect vulnerable children.
“We pediatricians pledge to work diligently to improve the things we can improve,” he said. “But we also ask everyone to remember what can happen when the pendulum swings too far in any one direction.”
Frank, the committee chairman, said he intended to call additional hearings in the coming months in order to develop ways to improve the system and protect parents. Some legislators have suggested creating a way for courts, child welfare workers or accused families to request a second medical opinion before the state removes a child from a home.
“The vast majority of the time, we’re talking about trying to make sure we prevent every child death,” Frank said. “We understand the tremendous impact of missing it on the other side, but it is a careful balance that we need to have.”
Mike Hixenbaugh is a national investigative reporter for NBC News, based in Houston.
Keri Blakinger is a Houston Chronicle reporter specializing in criminal justice.