in the Interest of A. D. N., M. D. N., D. J. N. and M. M. T. N. , Children

Court of Appeals of Texas·Decided February 7, 2017·No. 01-16-00785-CV·Published

Opinion

Opinion issued February 7, 2017

In The

Court of Appeals

For The

First District of Texas

Background

A.M.N. (“Mother”) is the mother of four children who are the subject of this suit—a six-year-old daughter, M.D.N., a four-year-old son, A.D.N., a two-year-old son, D.J.N., and a 23-month-old son, M.M.T.N. In March 2015, DFPS sued Mother seeking conservatorship and termination of her parental rights with respect to A.D.N. based on medical neglect. DFPS supported the allegations in its petition with the affidavit of DFPS investigator Heather Pohl and a physician’s statement from Dr. Michael Braun, Chief of Nephrology at Texas Children’s Hospital.

According to Pohl’s affidavit, DFPS received four reports of Mother’s child neglect between March 2014 and December 2014. DFPS received the first report in March 2014, after Mother’s urine tested positive for marijuana at the birth of D.J.N. in Tulsa, Oklahoma. Two days later, DFPS received a second report after A.D.N., who was not yet two years old, was taken to a Houston hospital with a high fever by his maternal grandfather (“Grandfather”). Grandfather could not provide the hospital any identifying information about A.D.N. or Mother.1 The hospital was uncomfortable discharging A.D.N. to Grandfather and ultimately discharged A.D.N. to his step-grandmother (“Grandmother”).

1 Mother told DFPS that she is estranged from Grandfather but he was the only person she could ask to take A.D.N. to the hospital because she was out of town and the person watching A.D.N. could not drive or accompany him to the hospital because she was caring for two other children.

The events that formed the basis of the third report of neglect took place in late 2014 and culminated in the hospitalization of A.D.N. on December 1, 2014. In the fall of 2014, A.D.N. was hospitalized and diagnosed with nephrotic syndrome— a condition which causes his body to produce excess fluid, overloading his kidneys. A.D.N. was readmitted to a different hospital a week later, after Mother noticed scrotal swelling. The hospital discharged A.D.N. days later, re-educated Mother regarding A.D.N.’s fluid and sodium restrictions, and scheduled a follow up appointment for late October. After his discharge, Mother spoke to the hospital by phone and reported that A.D.N.’s urine protein and edema was up and that his weight had increased by approximately seven pounds. Based on his symptoms, she stated that she would bring A.D.N. to the hospital, but she failed to do so. In mid-October 2014, A.D.N. again had to be hospitalized for three days. When the hospital discharged A.D.N., Mother was instructed to restrict A.D.N.’s fluid and sodium intake, test A.D.N.’s urine daily and record the results, and update the hospital staff weekly on A.D.N’s urine protein levels. Mother did not contact the hospital until he had to be hospitalized again on December 1, 2014.

That day, Mother called 911 and reported that A.D.N. had been swelling for 5 to 7 days, not urinated for 2 days, had watery diarrhea for 3 days, and increased difficulty breathing. Emergency Medical Services transported A.D.N. to the hospital and A.D.N. was in crisis when he arrived. His symptoms were so severe that he was

admitted to the pediatric intensive care unit, about 14 pounds over his appropriate weight. In a Physician’s Statement Regarding Injury to a Child, A.D.N.’s physician noted that “the severity of symptoms at presentation indicate significant delay in seeking care and resulted in harm to patient.” The physician further noted that the severity of A.D.N.’s symptoms were consistent with medical neglect. A.D.N. remained in the hospital for months.

In mid-December 2014, DFPS received a fourth report of Mother’s neglect after police found then four-year-old M.D.N. and nine-month-old D.J.N. alone in Mother’s residence. According to the report, Mother’s roommate was present when the deputy arrived but fled when asked for identification, leaving the children alone. The house was cluttered with garbage, clothing and toys. There was an exposed heater on the floor, though it was 70 degrees outside. Nine-month-old D.J.N. was laying on the bed, and there were pill bottles in the room and a steak knife on the floor. Pohl’s affidavit describes the condition of the home as unsafe for small children. That same day, Mother, who was approximately six to seven months pregnant with M.M.T.N., tested positive for cocaine and marijuana.

According to Pohl’s affidavit, Mother then agreed to work with Family Based Services and to place her children outside of the home until she completed services. At Mother’s request, DFPS placed D.J.N. and M.D.N. with Grandmother and

Grandfather. Mother gave birth to her fourth child, M.M.T.N., in February 2015 and he was also placed with Grandmother as a Parental Child Safety Placement.

A.D.N. was still in the hospital in March 2015. According to DFPS’s petition, upon his release from the hospital, A.D.N. would “require daily medical intervention.” He would need to receive outpatient infusions five times a week and each infusion would take four hours. Additionally, A.D.N. would require oral medications, a low sodium diet, fluid restrictions, blood pressure monitoring, and urine protein testing.

The trial court granted DFPS temporary managing conservatorship of A.D.N in March 2015. In April 2015, DFPS removed D.J.N., M.D.N., and M.M.T.N from Grandmother’s home following an altercation involving a gun between Grandfather and another person in front of the home. Grandmother and Grandfather were evicted and the children were placed together in a foster home. DFPS filed a first amended petition seeking termination of the parental rights of Mother with respect to all of her children and emergency conservatorship for the protection of M.D.N., D.J.N., and M.M.T.N., asserting that Mother committed one or more of the following acts or omissions:

15.1 knowingly placed or knowingly allowed the children to remain in conditions or surroundings which endanger the physical or emotional well-being of the children, pursuant to §161.001(1)(D), Texas Family Code;

15.2 engaged in conduct or knowingly placed the children with persons who engaged in conduct which endangers the physical or emotional well-being of the children, pursuant to §161.001(1)(E), Texas Family Code;

15.3 constructively abandoned the children who have been in the permanent or temporary managing conservatorship of the Department of Family and Protective Services or an authorized agency for not less than six months and: (1) the Department or authorized agency has made reasonable efforts to return the children to the mother; (2) the mother has not regularly visited or maintained significant contact with the children; and (3) the mother has demonstrated an inability to provide the children with a safe environment, pursuant to §161.001(1)(N), Texas Family Code;

15.4 failed to comply with the provisions of a court order that specifically established the actions necessary for the mother to obtain the return of the children who have been in the permanent or temporary managing conservatorship of the Department of Family and Protective Services for not less than nine months as a result of the children’s removal from the parent under Chapter 262 for the abuse or neglect of the children, pursuant to §161.001(1)(O), Texas Family Code.

The trial court granted DFPS temporary managing conservatorship over M.D.N.,

D.J.N., and M.M.T.N. the same day.

In May 2015, DFPS filed a family service plan detailing goals, tasks, and services for Mother to complete. The family service plan required Mother to:

 Complete a drug and alcohol assessment and follow any and all recommendations;

 Participate in and successfully complete an 8-week parenting class and provide DFPS with certificate of completion;

 Participate in individual therapy sessions;

 Complete random urine analysis throughout the duration of the case;

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in the Interest of A. D. N., M. D. N., D. J. N. and M. M. T. N. , Children, (Tex. Ct. App. 2017).

in the Interest of A. D. N., M. D. N., D. J. N. and M. M. T. N. , Children (in the Interest of A. D. N., M. D. N., D. J. N. and M. M. T. N. , Children) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.

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