In re D.K.

58 Pa. D. & C.4th 353, 2002 Pa. Dist. & Cnty. Dec. LEXIS 195
CourtPennsylvania Court of Common Pleas, Northumberland County
DecidedJuly 10, 2002
Docketno. JU-02-205
StatusPublished
Cited by1 cases

This text of 58 Pa. D. & C.4th 353 (In re D.K.) is published on Counsel Stack Legal Research, covering Pennsylvania Court of Common Pleas, Northumberland County primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
In re D.K., 58 Pa. D. & C.4th 353, 2002 Pa. Dist. & Cnty. Dec. LEXIS 195 (Pa. Super. Ct. 2002).

Opinion

SAYLOR, J.,

The unusual question in this proceeding as to whether the minor should be adjudicated as a dependent child arises from the fact that the referral was originally received by Northumberland County Children and Youth Services from a physician at Geisinger Medical Center due to the minor’s morbid obesity, with its physical and psychological consequences, including depression and social isolation. At the time of the referral in early April 2002, the 16-year-old minor weighed 451 pounds, even though he was only 5' 3" tall. Moreover, he was in the unfortunate circumstances where he was being raised alone by his mother, who had herself become homebound as the result of her own obesity, allegedly in the 600-pound range, and as a result, she had obvious limitations as to any type of usual activity.1 In fact, she did not even attend medical appointments with her son because of her own obesity.

[355]*355Although the minor had a long history of being overweight back into his infancy, the minor was never taken by his parents to see a dietician. In the past year, he had gained over 100 pounds. As the result of concern on the part of school officials, not only as to his weight but also his poor performance and absenteeism, the minor was evaluated on April 8, 2002, in the pediatric gastroenterology department of Geisinger Medical Center. The minor’s health situation had reached, in the terms of his examining physician, a “life threatening situation,” which required his admission to the hospital. The principal diagnosis was that of morbid obesity, with the following resulting complications:

(1) An enlarged liver as a precursor to cirrhosis of the liver;
(2) Hypertension;
(3) Respiratory problems to the extent that he required oxygen at night;
(4) Insulin resistance that places him at a high risk for diabetes;
(5) Sleep apnea; and,
(6) Knee pain.

It was also confirmed that he was suffering from a depressive disorder. He reported spending nine hours a day sitting before the television or a computer screen, with few friends.

Upon receipt of the referral on April 12, 2002, from the physicians at Geisinger Medical Center, CYS obtained from the mother a voluntary entrustment agreement placing D.K. in the care and custody of CYS. The [356]*356minor was placed on a very specific, physician-supervised diet, as well as a directive to engage in regular exercise, such as walking.2 This is all now being accomplished in the home setting of his foster parents. By the time of the hearing held by this court on July 2, 2002, the minor had lost 50 pounds in three months.

The minor has now expressed a strong desire to return home, as he now relates that his new eating habits are now ingrained; that he believes he could now shop and prepare his meals, with some assistance of his mother; and that there are more recreational activities near his home than where his foster parents reside. He also wants to be reunited with friends at his former school. His mother also would like to see him return home at this time, and she stated that she would keep him on his diet.

The medical testimony, by a board certified pediatric nutritionist, is that the diet is one that could be monitored in a home setting; however, he did not believe that the mother here with her limitations as noted above would provide the necessary help and support the minor needs in order to avert a return to his former lifestyle, and if this occurs, the minor then has a “guarantee” of a short life span of only reaching his 30s, with physical problems of liver and heart disease, diabetes and sleep apnea. According to this specialist, it was of critical importance for the minor to have the proper support and reinforcement from his caretaker.

[357]*357As we turn to the Juvenile Act, the most common category of the definitions for a “dependent child” is set forth in 42 Pa.C.S. §6302(1), as follows:

“A child who (1) is without proper parental care or control, subsistence, education as required by law, or other care or control necessary for his physical, mental, or emotional health, or morals.”

This has been further explained to mean that “the Act limits the Commonwealth’s coercive interference with the family unit to those cases where the parents have not provided ‘a minimum standard of care for a child’s physical, intellectual and moral well-being.’... [P]arental care which is both ‘necessary’ and ‘proper’ is not the best care possible but that care which (1) is geared to the particularized needs of the child and (2) at a minimum, is likely to prevent serious injury to the child.” In the Interest of Pernishek, 268 Pa. Super. 447, 458, 408 A.2d 872, 877-78 (1979). As further explained in In the Matter of Yeager, 309 Pa. Super. 491, 496, 455 A.2d 717, 719 (1983), “the compelling consideration is the ability and willingness of the parent or parents to provide necessary and proper care according to the special needs of their child or children.” Thus, it does not require a finding by this court of parental fault prior to an adjudication of dependency. The question here is not the capability of the parent for caring for a normal child, but whether she can provide the required level of support and reinforcement required for her child’s specialized needs. In the Matter of Yeager, supra.

The specialized needs of the minor here are to lose sufficient weight to take him out of the morbid obesity [358]*358category, and thus alleviate his related physical and mental problems. This is an extreme case, and certainly CYS would not be justified by intervening simply because a child was overweight, or did not simply engage in a healthy and fit lifestyle. Rather, the obesity must be of a severe nature reaching the life threatening or morbid state, which has also manifested itself in physical problems, such as those present here, or mental problems.

If a child does not receive necessary medical care for a health problem, there is usually no difficulty in a court making a finding of dependency, and especially in the situation where a child was malnourished to the point of near starvation. Cf. Commonwealth v. Cottam, 420 Pa. Super. 311, 616 A.2d 988 (1992). This situation here is on the other end of the nourishment spectrum, but it is no less dangerous to the child’s physical and mental well-being. In light of the medical testimony presented as to the present physical condition of the minor, this court finds that CYS has established by clear and convincing evidence that he is a dependent child at this time.

The inquiry now turns to whether the minor should continue to remain separated from his mother under these circumstances. The standard to guide this determination was set forth in In the Interest of Whittle, 263 Pa. Super. 312, 316, 397 A.2d 1225, 1226 (1979):

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Bluebook (online)
58 Pa. D. & C.4th 353, 2002 Pa. Dist. & Cnty. Dec. LEXIS 195, Counsel Stack Legal Research, https://law.counselstack.com/opinion/in-re-dk-pactcomplnorthu-2002.