WHITE PLAINS, N.Y. -- More than two years before the Jan. 23 death of a 5-year-old in New York, the Florida Department of Children and Families opened an investigation into the boy's mother, based on a phone call to its child abuse hotline, the agency has confirmed.
Two years before that, in Alabama, Garnett Spears almost died when he suffered seizures and was airlifted from Decatur General Hospital to Children's Hospital of Alabama in Birmingham. That episode in 2009 prompted a call to the state's Department of Human Resources, as did a series of other hospital visits that year that raised the suspicions of medical staff.
But despite reaching the attention of social services, none of those reports resulted in any action that may have prevented future harm to the boy who'd been in and out of hospitals throughout his short life.
Not until mid-January, when the boy was airlifted to Westchester Medical Center after suffering more seizures, did police initiate a criminal investigation. Authorities are now trying to determine whether Garnett was poisoned by sodium. They're focusing on his mother, Lacey Spears, looking at the possibility that she suffers from Munchausen by proxy, a psychiatric disorder in which parents harm their children to seek sympathy. Spears, 26, has not been charged and has denied doing anything to harm her son. Her attorney, David Sachs, has declined to comment on the investigation but has said his client is "merely a mother in mourning."
The Florida Department of Children and Families told The (Westchester County, N.Y.) Journal News last week that it opened an investigation into Spears and her son in 2011, and that it is now sharing details with investigators in New York.
"We're working with them, sharing the reports and investigations that we have so that they can include that in their investigation," said the agency's spokeswoman Natalie Harrell.
Harrell would not discuss details, but a source said suspicions were raised about Spears' care of Garnett. The source said the case was closed after the Florida agency found that the boy was receiving adequate medical care.
It's not known who called the Florida hotline but women who were in a parenting group with Spears had deep misgivings about her. Members said she shared tearful, contradictory stories about personal hardship and her son's health.
Ginger Dabbs-Anderson, a former nurse at Decatur General Hospital who helped treat Garnett and befriended Spears, said the Alabama Department of Human Resources was called in once when medical staff grew concerned over Spears' questionable claims that her infant son couldn't keep food down. Spears was briefly monitored and given parenting assistance as a result, she said. But the June 2009 incident was far more alarming.
"We were totally in shock about the seizures, because he had never presented with seizures and they were so severe that he coded," she said. "Then he was med-flighted."
The county reported to the Department of Human Resources that Garnett was bleeding from his eyes, nose, mouth and ears and was being airlifted to Birmingham. However, department spokesman Barry Spear said there was no follow-up because hospital officials in Decatur and Birmingham did not report any suspected abuse or neglect. That information was shared with Westchester investigators, Spear said.
Dabbs-Anderson said she is upset more wasn't done for Garnett during those earlier hospital visits.
"I was surprised that (the Department of Human Resources) doesn't have reports because (doctors) even did what they call a 'baby scan' on (Garnett) when he was an infant," she told The Journal News. "This is where they X-ray every bone in his body to look for old, unrepaired, unreported breaks. ... They didn't find any, but obviously (the doctor) had a reason for ordering the test."
Also perplexing to friends, authorities and others is the gastric feeding tube that Garnett had since he was a baby — what's meant to be a last and temporary resort, but one without an apparent medical reason in his case.
Dr. Anthony Porto, an assistant professor of pediatric gastroenterology at Yale School of Medicine who treats children at Greenwich (Conn.) Hospital, said he would take several steps if a 4- or 5-year-old child who was able to eat and swallow and without any underlying medical condition walked into his office for the first time with a feeding tube. One of them would be to wean him off it and increase food by mouth if the child was gaining weight and free of other problems.
It's not clear why Garnett's tube was still there or how his mother's dealings with doctors may have skewed his care.
"If the (child's medical) history is erroneous, everything that follows is erroneous," saidDr. Jose R. Maldonado, a psychiatry professor at Stanford University School of Medicine and expert in factitious disorders.
Physicians may fear making a false allegation against a parent suspected of medical abuse. They also may worry that they might be implicated in the abuse.
The law should make an exception for a doctor caught up in a parent's medical child abuse, argued Corey Perman in a 1998 paper in the Journal of Urban and Contemporary Law.
"Physicians who are blindsided by parental deception and abuse should not be held to a typical standard of care," he wrote.
"Physicians can provide the first line of defense in countering parents' attempts to harm their child."