In re: K.L. & J.A. II

CourtCourt of Appeals of North Carolina
DecidedJune 16, 2020
Docket19-800
StatusPublished

This text of In re: K.L. & J.A. II (In re: K.L. & J.A. II) is published on Counsel Stack Legal Research, covering Court of Appeals of North Carolina primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
In re: K.L. & J.A. II, (N.C. Ct. App. 2020).

Opinion

IN THE COURT OF APPEALS OF NORTH CAROLINA

No. COA19-800

Filed: 16 June 2020

Durham County, Nos. 18 J 114-15

IN THE MATTER OF K.L., J.A. II

Appeal by Respondents from order entered 29 April 2019 by Judge Shamieka

L. Rhinehart in Durham County District Court. Heard in the Court of Appeals 27

May 2020.

Senior Assistant County Attorney Elizabeth Kennedy-Gurnee for Petitioner- Appellee Durham County Department of Social Services.

Garron T. Michael for Respondent-Appellant Mother.

David A. Perez for Respondent-Appellant Father.

Christopher J. Waivers for Guardian Ad Litem.

BROOK, Judge.

Respondent-Mother and Respondent-Father (collectively “Respondents”)

appeal from an order adjudicating their son Joseph abused and neglected and

Respondent-Mother’s son Kenneth neglected.1 On appeal, Respondents argue that

1 “Joseph” and “Kenneth” are pseudonyms used by the parties to refer to the juveniles in this case. IN RE K.L. AND J.A. II

Opinion of the Court

the trial court erred in adjudicating Joseph abused and neglected and Kenneth

neglected. After careful review, we reverse the order of the trial court.

I. Background

A. Factual Background

Early in the morning on 29 May 2018, around 1:00 a.m., Respondent-Mother

woke up to feed three-month-old Joseph and afterward started to bounce him as she

usually did after a feeding. However, she noticed that Joseph was not putting weight

on his left leg. Respondent-Mother then woke Respondent-Father to tell him that

Joseph was “not jumping like he usually does.” Joseph was not crying, nor did he

appear to be in any distress, so Respondent-Father suggested that they wait and see

how Joseph was feeling in the morning. When Joseph woke up at 5:00 a.m., he “didn’t

seem to be in any pain,” but he still was not jumping when he was held up.

Respondent-Mother dropped Joseph off at the babysitter and checked in with the

babysitter regularly to see how Joseph was doing. The babysitter reported that

Joseph appeared to be fine, but Respondent-Mother was still concerned, so she

scheduled an appointment with his pediatrician for the following day, 30 May 2018.

The pediatrician examined Joseph and said that his leg looked “normal to her”

and that “babies sometimes change their habits.” Respondent-Mother asked the

pediatrician if “she was sure,” and the pediatrician told Respondent-Mother that she

could order an X-ray if Respondent-Mother was still concerned. Respondent-Mother

-2- IN RE K.L. AND J.A. II

asked for the X-ray but did not receive the results until she arrived home with Joseph.

The pediatrician called Respondent-Mother and told her that fractures had been

identified on Joseph’s legs and that she needed to take Joseph to the emergency room

at the University of North Carolina hospital. Respondent-Mother went to Duke

University Medical Center since it was closer. She called Respondent-Father on the

way and told him what the X-rays had revealed and that she did not know how the

fractures could have happened. Respondent-Father told her that two days prior, on

28 May 2018, he had placed Joseph on the couch, and, when he turned around, Joseph

had fallen about two feet onto carpeted floor.

When Respondent-Mother arrived at Duke Emergency Center, she told the

intake nurses what Respondent-Father had told her and gave them a letter from the

diagnostic center that had taken the X-rays. The letter read that the center had

identified fractures on Joseph’s leg and that “non-accidental trauma should not be

excluded.” At the hospital, four classic metaphyseal lesion fractures were identified

on Joseph’s left and right legs, and, according to the doctors, these types of fractures

were “highly concerning for non-accidental trauma or child abuse.” Furthermore,

they were not consistent with injuries from the short fall off the couch that

Respondent-Father had reported but rather with force generated by “traction, torsion

and/or shearing of the leg.” After doctors at Duke read the X-rays, they admitted

Joseph and decided to call child protective services.

-3- IN RE K.L. AND J.A. II

Joseph was discharged from Duke Hospital on 1 June 2018 and placed in a

kinship placement with his paternal grandparents. On 4 June 2018, DSS filed a

juvenile petition alleging abuse as to Joseph and neglect as to eight-year-old Kenneth,

Respondent-Mother’s son from a previous relationship who lived with Respondents.

B. Adjudication and Disposition

The adjudication hearing began on 18 December 2018 with Judge Rhinehart

presiding. Dr. Deanna Adkins testified first for DSS as an expert in pediatric

endocrinology and offered testimony as to her treatment of Joseph during his hospital

stay. Dr. Adkins testified that she had performed an evaluation on Joseph on 30 May

2018 to identify whether Joseph had a bone disorder known as rickets because tests

revealed that Joseph was vitamin D deficient with corresponding elevated

parathyroid hormone (“PTH”) levels.2 Despite initially believing that Joseph had

rickets in his left rib, Dr. Adkins testified that Joseph did not exhibit signs of rickets.

Dr. Adkins further testified that vitamin D deficiency is common in infants like

Joseph who are exclusively breastfed.

Next, Dr. Gary Schooler, the pediatric radiologist who interpreted Joseph’s X-

rays, testified that six fractures were identified on Joseph—two were not visible on

2 Dr. Adkins testified that rickets is “a bone mineral problem” of which there are multiple types. She further testified that in Joseph’s case, doctors evaluated him for “vitamin D deficiency rickets . . . where bone is formed without being calcified at the growth plate. And so the growth plate’s widened and that area is not as hard as the other parts of the bone because there is not the calcium in it.”

-4- IN RE K.L. AND J.A. II

the initial X-rays—but all were healing by the time of Joseph’s follow-up visit on 18

June 2018. Dr. Schooler testified that Joseph would not have had the ability to

generate the force to create his injuries on his own. Dr. Schooler also testified that,

at the time he interpreted Joseph’s X-rays, he was not aware that Joseph had vitamin

D deficiency or PTH issues.

Dr. Lindsey Terrell, who worked at the Duke Child Abuse and Neglect Medical

Evaluation Clinic (“CANMEC”), then testified. Dr. Terrell performed medical

examinations of Joseph on 31 May 2018, 1 June 2018, and 18 June 2018. Dr. Terrell

collected a complete patient history from Respondents—questioning them together

and separately—to try to determine the source of Joseph’s injuries. Dr. Terrell

testified that Respondents were cooperative, answered her questions, and provided

the information that she requested. Dr. Terrell also testified that she spoke with

Joseph’s primary care provider at Chapel Hill Pediatrics, and the providers at the

practice told her they had seen Joseph for his newborn, two-week, one-month, and

two-month wellness checks and they had no concerns about him or his family.

Dr. Terrell testified that when a child under the age of one has a fracture, it is

recommended that their whole body be assessed and their brain, skull, organs, bones,

and eyes be examined for other injuries. Dr. Terrell testified that those tests were

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