in the Interest of T.T.F., a Child

Procedural entryThis page is a short order in in the Interest of T.T.F., a Child. Read the opinion of the Court — 2010 Tex. App. LEXIS 9599
Court of Appeals of Texas·Decided December 2, 2010·No. 02-09-00382-CV·Published

Opinion

COURT OF APPEALS SECOND DISTRICT OF TEXAS FORT WORTH

NO. 02-09-00382-CV

IN THE INTEREST OF T.T.F., A CHILD

------------

FROM COUNTY COURT AT LAW NO. 1 OF WICHITA COUNTY

OPINION ---------- I. Introduction

Appellant S.M. appeals the trial court‘s judgment terminating the parent-

child relationship between herself and her son, T.T.F. In four issues, S.M.

contends that she was denied due process of law and that the evidence is legally

and factually insufficient to support the trial court‘s judgment. We affirm.

II. Background

Child Protective Services (the Department) removed T.T.F. from S.M. for

the second time on March 5, 2008. The Department first removed T.T.F. in March 2007 and returned T.T.F. to S.M. in September 2007; T.T.F. was placed

with the same foster parents after each removal.

After a jury trial in September 2009, the jury found that S.M.‘s parental

rights to T.T.F. should be terminated, and the trial court found that S.M. had

engaged in at least one activity described in subsections (D) and (E) of family

code section 161.001(1) and that termination was in T.T.F.‘s best interest. 1 The

following witnesses testified at trial.

Dr. Leslie Hollis

Dr. Hollis is a board-certified pediatrician. She testified that she first saw

T.T.F. on March 6, 2008, the day after his removal, and that T.T.F. was thirteen

and one-half months old at the time. Dr. Hollis testified that T.T.F. was ―acutely

ill‖ but stable at the time. She said that T.T.F. had been diagnosed in February

2008 at the hospital with an ear infection, pneumonia, and RSV, which she

described as ―a common cold virus that can make kids wheeze.‖ T.T.F. had

been discharged from the hospital on breathing treatments to help open his

airways, and Dr. Hollis testified that she could not tell whether T.T.F. had been

given the breathing treatments at home. Because T.T.F.‘s foster mother reported

that he had not gained any weight since he was six months old, Dr. Hollis

testified that she put T.T.F. on concentrated formula and asked that he return

one week later to be weighed. Dr. Hollis testified that she made a working or

1 See Tex. Fam. Code Ann. § 161.001 (Vernon Supp. 2010).

2 ―rule out‖ diagnosis of failure to thrive at the initial visit and that she requested

T.T.F.‘s past medical records because failure to thrive is a ―trend over time‖ that

cannot be diagnosed on a single visit or a single weight.

Dr. Hollis testified that failure to thrive is caused by a child not receiving

adequate calories for growth and that there are several reasons it occurs; it can

be caused by not receiving an appropriate amount of food or calories, by the

body not properly absorbing the calories given, or by a metabolic problem such

as a thyroid condition. She explained that failure to thrive is dangerous because

the majority of brain growth occurs in the first year of life and that failure to thrive

means that the body does not have adequate calories for muscle, bone, and

brain growth. She also testified that failure to thrive can cause a child to die.

Dr. Hollis testified that failure to thrive is usually diagnosed for any child

whose weight falls below the third percentile, meaning that if ―you line up a

hundred kids their age[,] . . . they [will] weigh more than three of them and . . .

less than 97 of them.‖ Dr. Hollis testified that failure to thrive is also commonly

diagnosed in children that fall from the fiftieth percentile at six months old to the

third percentile at nine months old. Dr. Hollis explained, ―When kids cross lines

like that, that‘s very concerning that they‘re not getting adequate calories for

bone and muscle growth or for brain growth.‖

Dr. Hollis testified that she determined T.T.F. was ―around the third

percentile,‖ even though he had been at the fiftieth percentile at birth and through

3 his first six months.2 T.T.F. was thirteen and one-half months old at his initial visit

with Dr. Hollis, and fully-clothed, he weighed nineteen pounds. One week after

the initial visit, without clothing and while living in foster care, T.T.F. weighed

eighteen pounds, four ounces.3 A week later, he weighed nineteen pounds

without clothing. Over time, T.T.F. gained weight and reached a point between

the tenth and twenty-fifth percentiles in July 2009.

Dr. Hollis testified that not getting enough nutrition is a non-organic cause

of failure to thrive. She testified that non-organic failure to thrive is diagnosed by

removing the child from the current living situation, providing the child with

adequate calories, tracking the number of calories taken in, and monitoring the

child‘s growth. She explained that children will typically grow very rapidly once

they are given concentrated calories. Dr. Hollis testified that, in her opinion,

T.T.F. had non-organic failure to thrive caused by his environment. Dr. Hollis

testified that she could not say if T.T.F.‘s failure to thrive was caused by not

getting enough food, not getting the appropriate type of food, or not being given

sufficient time to eat, but she agreed that all three relate to the nutrition T.T.F.

was given by S.M. And after being given the legal definition of endangerment,

Dr. Hollis testified that T.T.F.‘s failure to thrive meant that he had been

2 Dr. Hollis testified that T.T.F. was returned to S.M. after his first removal at about the time of his sixth month visit. 3 Dr. Hollis testified that the drop in T.T.F.‘s weight between the first and second visits was most likely attributable only to the difference between being clothed at the first visit and in only a dry diaper at the second visit.

4 endangered. She testified that T.T.F. was in danger of severe bodily injury or

death at the time she first saw him in March 2008. She also testified that she

considers it medical neglect for a child to lose weight or fail to gain sufficient

weight such that the child weighs the same at six months and one year. And

from treating T.T.F. and reviewing his records, Dr. Hollis testified that there is not

a ―normal‖ reason that T.T.F. would weigh the same at six months and one year.

Dr. Hollis testified that in addition to failure to thrive, T.T.F. had recurrent

ear and sinus infections and upper respiratory infections that quickly became ear

infections. Those occurred both before and during the first six months that she

treated him. She explained that untreated ear infections can cause hearing loss

and that children with five to six ear infections within one year are referred for

surgery to have tubes placed in the ears. T.T.F. had tubes placed in his ears and

has not had any ear infections after the procedure. Dr. Hollis testified that she

believes it is medical neglect for a person to allow a child to develop a significant

ear infection but not take the child to the doctor.

Dr. Hollis also testified that as of the time of trial, T.T.F. no longer had a

failure to thrive diagnosis and was between the tenth and twenty-fifth percentile

but that she could not know until much later if he would develop learning

disabilities or other deficiencies associated with poor brain growth. Dr. Hollis

testified that T.T.F. was ―a very healthy little boy‖ at the time of trial.

5 S.M.

S.M.

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