In the Int. of: N.B.-W. & D.A.-S., Appeal of: V.A.

Superior Court of Pennsylvania·Decided July 1, 2022·No. 1355 EDA 2021·Unpublished

Opinion

NON-PRECEDENTIAL DECISION - SEE SUPERIOR COURT I.O.P. 65.37

IN THE INTEREST OF: N.B.-W. AND : IN THE SUPERIOR COURT OF D.A.-S., MINOR CHILDREN : PENNSYLVANIA :

:

APPEAL OF: V.A., MOTHER :

:

:

:

: No. 1355 EDA 2021

Appeal from the Order Entered June 25, 2021 In the Court of Common Pleas of Philadelphia County Juvenile Division at No(s): CP-51-DP-0001116-2020, CP-51-DP-0001268-2020

BEFORE: LAZARUS, J., KUNSELMAN, J., and STEVENS, P.J.E.* MEMORANDUM BY LAZARUS, J.: FILED JULY 1, 2022 V.A. (Mother) appeals from the trial court’s order, entered in the Court of Common Pleas of Philadelphia County, on two separate dockets,1 after a finding of dependency, the existence of aggravating circumstances, and a determination that Mother is a perpetrator of child abuse. After careful review, we affirm.

These dependency actions arose from the death of Mother’s four-year-

old child, A.A., while in the care of Mother’s older child, ten-year-old N.B.-W. (born 12/2009). In September 2020, Mother was admitted to the hospital due to pregnancy complications. During her month-long hospital stay, Mother

left A.A., who suffered from, among other conditions, cerebral palsy and

* Former Justice specially assigned to the Superior Court. 1 See CP-51-DP-1268-2020 and CP-51-DP-1116-2020.

needed a medically-trained caregiver to attend to his needs full-time, in the care of E.S. (Stepfather)2 and N.B.-W., who were living in an Extended Stay Hotel. Mother testified that, although she left A.A. primarily in Stepfather’s care, she did so knowing that Stepfather was not a trained caregiver for A.A.’s significant medical needs and that Stepfather had to work outside of the home three days a week. As a result of Stepfather’s work schedule, N.B.-W. ended up caring for A.A. for ten to twelve hours a day for up to four days a week.

On the day that Mother was discharged from the hospital, Stepfather left the hotel to pick her up and did not return until more than five hours later, leaving N.B.-W. alone to care for A.A. Mother and Stepfather decided to go to a restaurant for dinner before returning home after Mother’s discharge. When Mother entered the hotel room, she found A.A. unresponsive; she immediately administered CPR, unsuccessfully, to A.A. Stepfather then called 9-1-1. An autopsy performed on A.A. listed his cause of death as aspiration pneumonia due to his cerebral palsy, as well as a respiratory, viral infection. Experts could not agree on A.A.’s manner of death.

2 In October 2020, Mother gave birth to another child, D.A.-S, A.A.’s and N.B.- W.’s half-brother. A.A. and N.B.-W. are also half-siblings with different biological fathers. E.S. is Mother’s paramour. Although E.S. is the stepfather of A.A. and N.B.-W., and D.A.-S.’s biological father, for ease of reference we refer to him as Children’s “Stepfather” for purposes of this appeal. Stepfather was also found to be a perpetrator of child abuse. He filed a separate appeal from the trial court’s June 25, 2021 order. Our Court affirmed the trial court’s order on appeal. See In the Interest of N.B.-W., 1351-1354 EDA 2021 (Pa. Super. filed Feb. 23, 2022) (unpublished memorandum decision).

On October 6, 2020, the Philadelphia Department of Human Services received a general protective services report (GPS) alleging that N.B.-W. had been left alone to care for his four-year-old, medically needy brother, A.A., for extended periods of time, three to four days a week. On October 9, 2020, DHS received a child protective services (CPS) report alleging that Stepfather left N.B.-W. and A.A. alone when he went to pick Mother up at the hospital following her discharge and, upon their return home, A.A. was deceased.

DHS obtained an order of protective custody (OPC) for Mother’s two other children, N.B.-W. and D.A.-S. (collectively, Children), finding that it would not be in Children’s best interests to remain in Mother’s care. Children were removed from Mother’s care and placed in kinship care with maternal uncle. Mother was permitted to have weekly supervised visits with Children at the agency; visitation was modifiable by agreement of the parties. The placement goal remained return to parent.

On November 25, 2020, the court held a shelter care hearing, after which the OPC was lifted and Children were temporarily committed to DHS. Children remained in maternal uncle’s care. On December 4, 2020, DYS filed a dependency petition. On June 25, 2021, a virtual adjudicatory and child abuse hearing was held before the Honorable Vincent W. Furlong. At the hearing, the court heard testimony from Dr. Renee Turchi, Dr. Lindsay Simon, Ms. Tierra Dunn, Mother, and Stepfather.

Doctor Turchi, a Pediatrician-in-Chief and Medical Director of the Center for Children and Youth with Special Healthcare Needs at St. Christopher’s

Hospital for Children, was recognized as an expert in pediatric medicine. N.T. Adjudicatory/Abuse Hearing, 6/25/21, at 11-12. Doctor Turchi testified that she treats children with medical complexities, works with grants related to children’s special needs in conjunction with home care and coordination and, most relevantly, was one of the doctors in the pediatric practice treating A.A. “shortly after he came out of the NICU [and for] his entire life.” Id. at 13.

Doctor Turchi testified that A.A. had been born with a condition known as “small gestational age,” had underlying brain abnormalities, a cystic lesion in part of his cerebellum, hydrocephalus, cerebral palsy, seizures, difficulty swallowing, vision problems, moderate asthma with underlying chronic lung disease, eczema, global developmental delay, and hip issues. Id. at 14-15. After undergoing surgery to “tighten” his stomach in order to prevent regurgitation and aspiration, A.A. had a feeding tube inserted in 2017. Id. at 14. Special formula and medications were released through the feeding tube at specified intervals four to five times a day; A.A. required the assistance of someone trained in the specialized care associated with an individual using a feeding tube. Id. at 15, 17, 19-20. Doctor Turchi testified that A.A. required the care of at least ten specialists at various times in his life to manage his conditions and medications. Id. Finally, Dr. Turchi testified that A.A. required a trained caregiver and skilled nursing to meet his around-the-clock medical needs and that a 10-year-old would not be an appropriate caregiver for A.A. Id. at 24, 29-30.

Doctor Simon, an Associate Medical Examiner for the Philadelphia Medical Examiner’s Officer, who was qualified as a medical examiner, testified that she performed A.A.’s autopsy and determined that A.A.’s cause of death was aspiration pneumonia, due to his cerebral palsy, and that A.A.’s manner of death was undetermined.3 Id. at 41. Specifically, Dr. Simon testified that, in her opinion, A.A.’s manner of death was not by accident, id. at 43, that she could not “say with certainty”4 if A.A.’s manner of death was homicide or from natural causes, id. at 42, but that A.A.’s manner of death was not suicide. Id. Doctor Simon, however, stated that “the circumstances surrounding [A.A.’s] death . . . concern[ed her with regard to] the possibility of neglect contributing to his death.” Id. at 43.

DHS investigator and social worker, Tierra Dunn, testified that she prepared a CPS report noting that Mother told her that Stepfather and N.B.- W. had been taking care of A.A. while she was in the hospital for approximately one month.5 Id. at 54. Ms. Dunn also testified that the CPS report noted that ten-year-old N.B.-W. was left alone to care for his “medically needy sibling

[A.A.] for 10 to 12 hours a day, three to four days out of the week” when

3In Pennsylvania there are five possible manners of death: natural causes, accident, suicide, homicide, and undetermined. Id. at 41.

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In the Int. of: N.B.-W. & D.A.-S., Appeal of: V.A., (Pa. Ct. App. 2022).

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