In Interest of MH

859 S.W.2d 888, 1993 Mo. App. LEXIS 1159, 1993 WL 276467
CourtMissouri Court of Appeals
DecidedJuly 27, 1993
Docket18292, 18293
StatusPublished
Cited by51 cases

This text of 859 S.W.2d 888 (In Interest of MH) is published on Counsel Stack Legal Research, covering Missouri Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
In Interest of MH, 859 S.W.2d 888, 1993 Mo. App. LEXIS 1159, 1993 WL 276467 (Mo. Ct. App. 1993).

Opinion

GARRISON, Judge.

This is an appeal by both natural parents (hereafter referred to as Father and Mother) from the juvenile court’s order terminating their parental rights to M.H. and N.H. (their two minor children). The order of termination was entered pursuant to § 211.447.2(2). 1

Father and Mother, in a joint brief, allege the juvenile court erred because there was insufficient evidence to establish grounds for termination of their individual parental rights under § 211.447.2 and to establish that termination was in the best interests of the children, considering the factors contained in § 211.447.3.

M.H. was born August 12, 1989, and N.H. was born July 7, 1991. There was no evidence of direct physical abuse or any injuries sustained by M.H. All such evidence related to N.H., who was born six weeks premature and who first experienced documented apnea (cessation of breathing requiring external stimulus for resumption) at one month of age.

On September 6, 1991, N.H. was apparently in the bathtub with Mother when he stopped breathing. She summoned Father, who revived the baby by using mouth-to-mouth resuscitation and CPR. N.H. was taken to St. John’s Regional Health Center in Springfield, Missouri, where 100 cc’s (approximately three and one-half ounces) of clear liquid was extracted from his stomach. A physician specializing in pediatric critical care testified that one of the main findings was low sodium “which could best be explained by water intoxication, swallowing water while in the bathtub.”

Mother at first denied that N.H.’s head had gone under the water. The pediatrician’s initial concern was the possibility of an intentional submersion and he caused the situation to be “hotlined.” The “hotline” report was investigated by a Division of Family Services (DFS) worker. Mother originally told the DFS worker she did not believe N.H. had gone under the water, and said the fluid could have come from a diluted formula. Five days later, Mother told her N.H. had been lying on top of her in the bathtub, he had slid down when she reached for the soap, and his head went partially under the water. This explanation was initially found acceptable by the physician and N.H. was released to his parents when discharged from the hospital. As will be seen, the doctor later changed his opinion about the cause of the water intoxication.

N.H. was again taken to St. John’s Regional Health Center on September 18, 1991, by ambulance. At that time, his diagnosis included a subdural hematoma, a contusion of the right hemisphere, seizures, several bruises, and peteehiae (fine, red, dot-like appearances caused by rupture of blood vessels) on the top of the head and under the chin. The hospital personnel, as *891 well as DFS workers, were told that Father had left Mother and the two children at the home of his mother-in-law while he looked for work. When he returned approximately two hours later, Mother had taken N.H. to the hospital. Mother said that N.H. had an apneic episode in which he stopped breathing, turned pale, and his arms and legs stiffened. She called her mother and N.H. was shaken and his foot was pinched in an effort to revive him.

The same pediatric critical care specialist again cared for N.H. during the second hospital admission. He testified the conditions were life-threatening and that N.H. may very well have neurological injuries as a result. He further testified that the physical stimulus necessary to cause resumption of breathing during an episode of apnea could include shaking, pinching or even striking; that all of the cerebral injuries could have resulted from striking, shaking or strangulation; and he did not recall whether N.H.’s apnea monitor indicated an apneic episode had occurred that day. 2 While he said the bruise in the ear was caused by striking, he gave his opinion that a single accidental blow could not have caused all of the cerebral injuries he diagnosed. He concluded that the injuries resulted from multiple events.

The doctor discounted the possibility that N.H.’s injuries occurred as a result of being struck during an apneic episode because, unlike most parents in that situation, neither parent here claimed that form of stimulus was used. One account was that N.H. had stopped breathing and the grandmother had shaken him in an effort to revive him. The pediatrician testified that the grandmother’s demonstration of how she shook N.H. did not include the type of shaking that would account for all of these injuries. The doctor also said the Father’s statement that M.H. may have thrown a toy and struck N.H. would not account for all the injuries. He concluded that the second hospitalization resulted from shaking and battering injuries. The second hospitalization also caused him to believe that the water intoxication incident causing the first hospitalization had been intentional. He testified, for instance, that one big gulp would not account for 100 cc’s of fluid in the baby’s stomach, but rather it would take six to thirty minutes for a newborn to ingest that much fluid.

A pediatric neurologist was consulted concerning N.H. on September 19, 1991. At that time, N.H. was critically ill, in a coma, and having seizures. He testified that N.H. had the “classical symptoms of a shaken baby syndrome”; a violent shaking would be required to cause injuries of this nature; and that in his opinion these injuries did not occur during attempts to revive him from an apneic episode. When he talked with Father and Mother, neither admitted to having shaken N.H., but he admitted that he really could not recall exactly what they told him except that he had just quit breathing and was stiff on the right side of his body.

A “hotline” investigation was also conducted in connection with the second hospitalization. It was during the second hospitalization that Father told DFS workers that Mother had sniffed nail polish for about two years, but that it stopped on the day N.H. was discharged from the hospital for water intoxication because he removed the nail polish from the home.

M.H. was placed in the temporary legal custody of the Division of Family Services on September 23, 1991, and N.H. was similarly placed on October 17, 1991 when discharged from the hospital. At the request of the DFS, both Father and Mother were evaluated by a psychologist, who had a Ph.D. but was not yet licensed in the State of Missouri. He was of the opinion that Father made a genuine effort to cooperate fully in the psychological evaluation, has average intelligence, makes impressive efforts to do well, but has the potential to exclude information to fit his conceived notion of reality. Mother was diagnosed as being severely disturbed and evidencing *892 minimal understanding about her need for help. The psychologist was of the opinion that Mother was in need of treatment intervention, without which her ability to take care of herself and her children would be in jeopardy.

A petition was filed on September 24, 1991 alleging that M.H.

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Bluebook (online)
859 S.W.2d 888, 1993 Mo. App. LEXIS 1159, 1993 WL 276467, Counsel Stack Legal Research, https://law.counselstack.com/opinion/in-interest-of-mh-moctapp-1993.