In the Int. of: G.R., Appeal of: K.M.

2022 Pa. Super. 136
Superior Court of Pennsylvania·Decided August 9, 2022·No. 242 EDA 2022·Published·Cited by 1 cases

Opinion

2022 PA Super 136

IN THE INTEREST OF: G.R., A : IN THE SUPERIOR COURT OF MINOR : PENNSYLVANIA :

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APPEAL OF: K.M., MOTHER :

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: No. 242 EDA 2022

Appeal from the Order Entered January 12, 2022 In the Court of Common Pleas of Philadelphia County Juvenile Division at No(s): CP-51-DP-0000227-2020

IN THE INTEREST OF: G.R. , A : IN THE SUPERIOR COURT OF MINOR : PENNSYLVANIA :

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APPEAL OF: B.R., FATHER :

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:

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: No. 370 EDA 2022

Appeal from the Order Dated January 12, 2022 In the Court of Common Pleas of Philadelphia County Juvenile Division at No(s): CP-51-DP-0000227-2020

BEFORE: BOWES, J., LAZARUS, J., and STABILE, J. OPINION BY LAZARUS, J.: FILED AUGUST 9, 2022 K.M. (Mother) and B.R. (Father) (collectively, Parents) appeal from the trial court’s order reunifying their daughter G.R. (Child) (born August 2019) with Parents, finding that Child was the victim of child abuse, and concluding

that Mother and Father were the perpetrators of the abuse.1 See 42 Pa.C.S.A. § 6302; 23 Pa.C.S.A. §§ 6303, 6381(d).2 After careful review, we affirm.

On February 12, 2020, Father took then-five-month-old Child to the emergency room at St. Christopher’s Hospital where she was treated by Dr. Norell Atkinson, MD, an attending physician in the Department of Pediatrics, Child Protection Section, and an expert in child abuse pediatrics. Following a skeletal survey, genetic testing, and a full medical examination, Dr. Atkinson diagnosed Child with three acute3 leg fractures—an oblique right femur (thigh bone) fracture and two lower left leg buckle fractures.4 Mother and Father reported to a DHS caseworker that, on the evening of February 10, 2020, while they were getting ready to take Child to paternal grandmother’s (M.M.) home, Child had rolled off their bed and onto the

1 We have sua sponte consolidated Mother’s and Father’s appeals, as the orders appealed and questions involved are essentially the same. See Pa.R.A.P. 513 (consolidation of multiple appeals).

2 The order also terminated the court’s supervision of Child, ended Child’s court-ordered services from the county, and discharged Child from Philadelphia Department of Human Services’ (DHS) temporary legal and physical custody.

3Doctor Atkinson defined an “acute” fracture as a new injury. See N.T. Abuse Hearing, 10/6/21, at 8.

4 Doctor Atkinson testified that St. Christopher’s emergency room doctors would have first stabilized Child and taken x-rays before she was seen by Dr. Atkinson for a full evaluation. Id. at 34.

carpeted floor. Mother and Father also reported that hours after this happened, they took Child to M.M.’s home, where Child stayed for two days while Parents went out of town, and that before leaving for their trip, Parents told M.M. that Child had rolled off their bed and to contact them while they were away if “there was anything different or unusual about her.” N.T. Abuse Hearing, 10/6/21, at 11-12. Parents told Caseworker Butler that they had no concerns leaving Child with M.M. Id. at 81.

Doctor Atkinson testified that Parents reported while they were away, M.M. never called Parents to tell them that there was anything “different” regarding Child’s behavior, id. at 12; however, when Parents picked Child up at M.M.’s house on February 12th, they noticed that something was distinctly different about Child’s leg. Id. at 12 (Doctor Atkinson testifying Father told her he recalled when he picked Child up from M.M.’s home, Child’s “leg appeared to be hanging—her right leg appeared to be hanging, and that it looked as if it was broken. . . So, they brought her into the hospital at that point[.]”); id. at 69 (DHS case worker testifying Father reported Child’s leg looked “flimsy as it was dangling. She looked uncomfortable” when they went to pick her up at M.M.’s house); id. (DHS caseworker testifying Mother reported when she touched Child’s wrist, Child “tensed up” and when Mother tried to bounce Child on her leg, Child could not put weight on her leg).

Upon picking Child up from M.M.’s, Parents took Child to St.

Christopher’s. See id. at 14 (Doctor Atkinson testifying Child was brought in

by parents to hospital “with a concern that the leg was injured and they were potentially attributing that to the fall”). Doctor Atkinson testified that “[i]t was later . . . reported that a fall [off of the bed] had happened also, in [M.M.’s] care.” Id. at 21.

Doctor Atkinson was unable to opine as to how or exactly when the injuries occurred.5 See id. at 16 (doctor testifying “given the kind of narrow time frame of three different caretakers over a short period of time, and not being able to precisely say all the fracture is on x-ray, it makes it somewhat difficult to say when exactly the injury was sustained”). Doctor Atkinson, however, testified that Child’s leg fractures could not have been sustained, as Parents and M.M. had reported, from falling off of a bed. Doctor Atkinson also opined that Child’s injuries did not result from bone abnormalities or genetic diseases, and that they were non-accidental and not self-sustained. Id. at 18-22, 29. Doctor Atkinson noted that the most common injury resulting from a short fall from a bed is a skull fracture, not a leg injury, let alone multiple, bilateral leg fractures. Id. at 15-16. The oblique fracture Child sustained, Dr. Atkinson opined, most likely occurred from a compression or “twisting or torsional force or bending force to the leg.” Id. at 9. The other type of

5 Doctor Atkinson testified that although acute fractures are difficult to date, this injury was probably sustained “up to around three days” from when she was diagnosed. Id. at 13.

fracture Child sustained, a buckle fracture, is caused by force being applied to either end of the bone. Id.

Child’s legs were casted and she was placed in a Pavlick harness;6 Child fully healed within one month. Id. at 41. Child had no record or signs of previous injuries and Parents had no prior history with DHS. Child Protective Services (CPS) prepared three reports detailing the alleged abuse inflicted on Child, describing Child’s injuries, and listing Mother, Father, and M.M. as alleged perpetrators of the abuse.7 On February 14, 2020, DHS obtained an order of protective custody (OPC) for Child. Child was discharged from the hospital and placed in temporary care with her maternal grandmother, E.M.

After a February 17, 2020 shelter care hearing, the trial court found it was not in Child’s best interest to return Child to Parents’ care and that to allow Child to remain in Parents’ home would be contrary to her welfare. However, Parents were granted supervised visitation with Child. On February 21, 2020, DHS filed a petition alleging that Child was a dependent child and

the victim of child abuse. See 42 Pa.C.S.A. § 6302; 23 Pa.C.S.A. § 6303.

6“A Pavlik Harness is a device used . . . for babies with a broken femur (thigh bone). The harness helps to keep the bone in position while it heals.” https://cdn.ymaws.com/www.apsna.org/resource/resmgr/Teaching_Sheets_ PDF_2015/Pavlick_Harness.pdf (last visited 6/29/22).

7 In one of those CPS reports, dated March 2020, M.M. was added as an alleged perpetrator of Child’s abuse. N.T. Abuse Hearing, 10/6/21, at 50-52.

Following a hearing held on October 7, 2020, Child was adjudicated dependent and legal custody of Child was transferred to DHS.

After a March 26, 2021 permanency review hearing, Child remained in kinship care with E.M., but Parents were granted unsupervised visitation, with overnight visits by agreement of the parties. The court continued the child abuse hearing until M.M. was appointed counsel. On July 14, 2021, the court granted Parents liberal, unsupervised and weekend overnight visits. DHS found the report of child abuse to be indicated with regard to Parents and M.M.

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In the Int. of: G.R., Appeal of: K.M., 2022 Pa. Super. 136 (Pa. Ct. App. 2022).

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In the Int. of: G.R., Appeal of: K.M.
2022 Pa. Super. 136 (Superior Court of Pennsylvania, 2022)