Danita Carol Thetford v. State

CourtCourt of Appeals of Texas
DecidedJanuary 28, 2021
Docket02-18-00488-CR
StatusPublished

This text of Danita Carol Thetford v. State (Danita Carol Thetford v. State) is published on Counsel Stack Legal Research, covering Court of Appeals of Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Danita Carol Thetford v. State, (Tex. Ct. App. 2021).

Opinion

In the Court of Appeals Second Appellate District of Texas at Fort Worth ___________________________

No. 02-18-00488-CR ___________________________

DANITA CAROL THETFORD, Appellant

V.

THE STATE OF TEXAS

On Appeal from the 432nd District Court Tarrant County, Texas Trial Court No. 1558380R

Before Sudderth, C.J.; Womack and Wallach, JJ. Memorandum Opinion by Chief Justice Sudderth MEMORANDUM OPINION

Danita Carol Thetford appeals her convictions for attempted murder and injury

to her son, C.T., allegedly due to Munchausen syndrome by proxy.1 Thetford raises

three points on appeal: (1) whether the trial court erred by denying her motion to

quash her attempted-murder indictment for failure to state an offense; (2) whether

Thetford’s punishments for attempted murder and injury to a child violate the federal

Double Jeopardy Clause; and (3) whether the trial court erred by instructing the jury

with a coercive Allen charge. Because Thetford failed to preserve her complaint as to

the indictment, because multiple punishments are authorized under express statutory

language, and because the trial court’s Allen charge was not coercive under the

circumstances of this case, we will affirm the judgments of conviction.

I. Background

It is undisputed that, during the first five years of his life, C.T. suffered from

numerous medical conditions, including difficulty eating and constipation, due in part

to his premature birth. But according to Thetford, these conditions lingered well

beyond his fifth year, hindering his ability to properly eat, digest, and excrete food.

1 Munchausen syndrome by proxy is also known as Pediatric Condition Falsification disorder and is a form of medical child abuse. See, e.g., In re A.G.K., No. 04-16-00315-CV, 2016 WL 6775590, at *4 (Tex. App.—San Antonio Nov. 16, 2016, no pet.) (mem. op.) (recognizing Pediatric Condition Falsification disorder as another name for Munchausen syndrome by proxy).

2 In 2012, Thetford took then-10-year-old C.T. to Cook Children’s Medical

Center and reported that he was constipated, was retching and gagging after eating,

and was not gaining weight. Over the next four years, doctors prescribed numerous

medications for C.T. and performed multiple surgeries to address the gastrointestinal

issues Thetford reported.

A. Surgeries

Initially, the doctors at Cook Children’s attempted to treat C.T.’s reported

constipation with prescription medications. But in 2013, after Thetford claimed the

drugs were not working, C.T. underwent an appendicostomy.2 And in 2015, after

Thetford continued to report that C.T. was painfully constipated, medical providers

performed an ileostomy on C.T.3 During this same time period, Thetford began

reporting that C.T. refused to eat and again complained that he was retching and

gagging after eating. Ultimately, these reports led C.T.’s doctors to place a

gastrostomy button (“g-button”) on C.T. to allow direct feedings into C.T.’s

2 Dr. John Uffman—C.T.’s pediatric surgeon at Cook Children’s—described an appendicostomy as “sew[ing the appendix] to the skin of the abdomen. The purpose of it is to give a flush in the large intestine to essentially help empty out the intestine much like you would give an enema from the rectum.” An appendicostomy is also known as a cecostomy, ACE, or MACE. 3 Dr. Uffman described C.T.’s ileostomy by stating, “we essentially brought the small intestine to the skin and bypassed the large intestine, essentially tak[ing] it out of the equation so the small intestine just empties to a bag instead of going through the large intestine.”

3 stomach.4 C.T. gained approximately six pounds in his three-day stay in the hospital

following placement of his g-button. But after C.T. returned home, Thetford

continued to report that her son could not tolerate food—even through the g-

button—and that eating caused him pain. Consequently, C.T.’s doctors placed “a

special IV called a central line”—known as total parenteral nutrition (“TPN”)5—to

provide C.T. with intravenous sustenance. But because Thetford still claimed C.T.

was retching and that, despite the g-button and central line, feedings caused C.T. pain,

his doctors recommended hospice care—not because C.T. was dying but so that

C.T.’s insurance would pay for at-home assistance with his feedings.6

4 The record indicates that the gastrostomy button placement procedure is also known as a “percutaneous endoscopic gastrostomy (PEG)” placement or “g-button” placement. Dr. Uffman described a g-button as “a little tiny plastic tube that goes through the . . . skin and through the muscle directly into the stomach. . . . So instead of feeding through the mouth, you’re giving feeds directly into the stomach.” 5 C.T.’s health care providers described TPN to the jury as “a bag of fluid that has a hundred percent of the calories, protein, carbohydrates[,] and fat that you’re supposed to take that would be in our normal diet. . . . broken down into its smallest components.” The nutrition goes “directly into the bloodstream,” bypassing the intestines and digestive tract. The nutrition is so concentrated that it can cause scarring if given through the peripheral veins in the arm, so it “requires a special IV called a central line” in “one of the subclavian veins or the jugular vein, one of the major veins in the neck.” 6 The State presented testimony that it is not uncommon for doctors to recommend hospice care for nonterminal pediatric patients to trigger insurance coverage for treatments.

4 B. Hospice

In early March 2016, Angel Unaware began providing hospice care to C.T. At

that time, C.T. was 13 years old but weighed only 51 pounds. While receiving help

from Angel Unaware, Thetford continued to claim that the intravenous TPN and g-

button feeds were making C.T. retch in pain, although Angel Unaware staff witnessed

no retching and minimal pain. But since C.T. was a child and Angel Unaware staff

did not live with him, they trusted Thetford’s reports of C.T.’s condition.

Angel Unaware staff also noticed that Thetford shortened C.T.’s TPN feedings

due to his alleged pain, and Thetford began requesting increases in the strengths and

dosages of C.T.’s pain medications, claiming C.T. could not even walk, get a sponge

bath, or be repositioned during his sleep—much less eat or digest food—without

pain.

In April, C.T. was transferred to Angel Unaware’s inpatient suite at the Ronald

McDonald House. Thetford had discontinued C.T.’s TPN and g-button feedings

prior to the transfer, and C.T. did not receive any such feedings while there. While

C.T. was at the Ronald McDonald House, Thetford took steps to prevent C.T. from

receiving solid food, claiming that she discouraged feeding C.T. because it caused him

pain and would “prolon[g] the inevitable.” Thetford requested a sign to be placed on

C.T.’s door indicating that no food or drink should be brought into his room. She

also asked Angel Unaware staff members to “give [C.T.] something that [would] make

him go to sleep and not wake up.” By this point, the Angel Unaware staff had grown

5 concerned that they had not witnessed the symptoms Thetford reported, noticing that

C.T.’s alleged outcries of pain were consistently relayed through or prompted by

Thetford, while C.T.’s vital signs and facial expressions rarely indicated pain. Because

C.T. was due for hospice recertification, the Angel Unaware staff told Thetford that

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