[By Debbie Maimon – Yated]

Columbia Presbyterian medical records for a baby who suffered brain damage after being infected with herpes (HSV-1) tell a shocking story of parents being threatened with trumped up criminal charges, unless they turned over information to authorities about the baby’s mohel.

The threats came veiled as concerns by Department of Health [DOH] officials over possible “criminal neglect” in the parent’s treatment of the sick baby.

Some of the sinister facts surrounding the DOH’s actions in this case were reported by Yated a number of weeks ago. The article was based on a live interview with the baby’s father, Mr. R., and on a sketch of the case drawn from the baby’s Discharge Summary in December 2005.

The Summary outlined a plan by health officials to resort to child neglect charges as a means of pressuring the parents to disclose information about the mohel and the bris milah.

Since then, an even more macabre picture of DOH manipulation has emerged. Chilling revelations about the lengths to which DOH officials were willing to go to extract information about a mohel’s identity have surfaced in medical records recently released to the parents of the baby.

The baby’s full medical file was also made available to their lawyer, Mr. Yerachmiel Simins, who shared portions of it with Yated. Combing through the records, Mr. Simins discovered an alternative plan by the DOH, if the threat of child neglect charges failed to produce results.

The alternative was to build a criminal case against Mrs. R., which would mean fomenting charges that she had harmed her baby through willful neglect.

THREAT OF GOING TO JAIL 

In cases where parents are found to be negligent, authorities may remove the children from the home. In cases where the neglect qualifies as willful or “criminal,” the parents can land up in jail. This was the threat health workers leveled over Mr. and Mrs. R, as they pressured them for information.  

“There are continued concerns from CAC (Child Advocacy Coordinator) that mom is not forthcoming with information [regarding the circumcision],” the records state. “As a collective team, we have agreed to gather further information from the dad and/or the family’s rabbi. If that is not productive, the CAC may pursue this case with the ACS vs. District Attorney in terms of neglect vs. criminal.”

[In other words, the CAC will discuss the potential of turning this into a case of criminal neglect.]

To achieve the maximum mileage from the threat, the DOH gave the family 14 days to rethink its position of refusing to share information about the mohel and the milah.

“The DOH [Dr. Susan Blank] and I [Dr. Jocelyn Brown, the Child Advocacy Coordinator] agree to postpone reporting and give family time to give us the information until Dec. 16,” Dr. Brown wrote.

MORAL BANKRUPTCY

The jaw-dropping irony here is that in the same breath that Dr. Brown discusses the plan to report Mrs. R. to authorities for child neglect, she also notes that “the mother has appeared to be …appropriately concerned with the baby’s care. The father is reported to be concerned as well. There is no concern that the parents are in any way inappropriate or neglectful. [Emphasis added.]

In other words, despite the complete absence of grounds to allege child neglect, if the parents refuse to divulge the mohel’s identity and whether MBP was performed, the DOH will go after them anyway. 

Frozen in time, Dr. Brown’s handwritten notes lift the veil on a culture of moral bankruptcy in the Department of Health in which a political agenda overrides moral scruples and basic decency.  

That agenda, on whose altar the DOH threatened to sacrifice a young mother and her family, is a running campaign to demonize the practice of metzitzah b’peh by casting it as life-endangering to newborns.

No direct evidence in the medical literature supports the DOH allegation. In addition, it flies in the face of clear  evidence of an impressive record of safety over thousands of years of practice. 

Nonetheless, the DOH has embarked on a rabid offensive aimed at deceiving the public that MBP is a serious public health issue. This legitimizes a “state of emergency” of sorts, where individual rights and ethical norms can be wantonly violated. 

In such a climate, refusing to give the DOH ammunition for its witch hunt against mohelim can be equated with “criminal neglect.”

In pursuit of this agenda, the 27-year old Mrs. R. was hounded by DOH’s Dr. Susan Blank and other health officials enlisted by the DOH in extracting from her information they were certain she had but was unwilling to share.  

SUBJECTED TO PSYCHIATRIC EXAM

These doctors subjected the mother to a psychiatric exam and made her “mental status” the subject of one of their conferences. They tried to trump up a case of parental incompetence by citing Mrs. R’s “flat affect” [lack of motherly affection] for her baby, and her “defensiveness” and “guardedness” while being questioned. 

When Mr. and Mrs. R. began catching on to the doctors’ agenda and avoiding their invasive questions, one of the caseworkers, Shannon Tansey, made a note of the mother’s unwillingness to be interrogated. By referencing her baby’s herpes infection in the context of  “signs of abuse,” Tansey hints that Mrs. R’s unwillingness to meet authorities might spring from wanting to hide something from them.  

“This writer [Shanon Tansey, CSW] was informed by the resident that the parents stopped coming into the hospital around the time DOH started asking questions…There are no other signs of abuse, other than the herpes and the child was admitted due to seizures [connected with the infection].”

In this hostile climate, Dr. Blank finally cornered Mrs. R., who according to the records, “was not forthcoming with information regarding details of circumcision: date, who performed it, how it was performed, etc.”

The same day, November 21, 2005, the notes indicate an ominous pattern began to unfold. Steps were taken by hospital staff and/or health workers to cast the mother as incompetent.  

One maneuver was to hold up the baby’s discharge while “an assessment” of the mother was made.  The medical record notes that plans were discussed to have the baby placed in a “therapeutic nursery” while the mother would be required to attend “infant-care-giver therapy,” to teach Mrs. R., a mother of four, how to bond with her baby.  

The baby’s discharge was then made conditional on a VNS [Visiting Nurse Service] arrangement, whereby outsiders would evaluate and monitor conditions in the home and decide on whether the baby was receiving proper care.

To justify these extraordinary measures that reinforced the impression of  Mrs. R. as a deficient parent, the young mother was subjected to an extensive interview by Dr. Brown from CAC (Child Advocacy Coordinator).

In notes describing the interview, one can almost hear the insinuating, invasive questions. 

“Mom denied a personal or family history of feeling overwhelmed or depressed. Mom also denied a history of domestic violence or substance abuse. Mom stated she had a good relationship with her husband and has support from her family,” the caseworker stated. 

“Mom presented as defensive and continued to question whether Dr. Brown and myself worked for this hospital. She wrote down our names and professions and became cautious in her answers as the interview progressed. Dr. Brown will speak to the DOH and a decision of abuse/neglect will be addressed.”   

EXTRAORDINARY HARPING ON CIRCUMCISON

From Shannon Tansey’s notes in the medical record over several weeks, one can also see the extraordinary harping on circumcision, with the constant mantra, “Mom is not forthcoming with information.”

“When asked about the circumcision, mom denied knowing where it was or who was there,” the caseworker wrote. “When asked if the same person did the circumcision for her older boys, mom stated ‘I don’t know.’ When asked gain about the exact time of the procedure she stated, ‘I don’t know.’”  

The persistent preoccupation with the circumcision is even more bizarre in view of  Mrs. R. having informed Dr Brown in this interview about a bout of mouth sores she had around the same time she noticed “bumps” (blisters) on her baby. Mrs. R. shared her intuition that she may have inadvertently transmitted the herpes infection to him. 

“Mom stated she may have given the baby the herpes,” the medical records note. “She denied her other children or her husband having the illness.”

This is the lone reference, in dozens of pages of medical records, to a highly significant piece of information; that the baby very likely contracted the herpes infection from his mother.   

Instead of following up on this clue either through blood or DNA tests, health officials appear to have brushed it aside as irrelevant, preferring to cling to groundless suspicions about the mohel having infected the baby. 

FATEFUL CONFERENCE

Following the interview with Dr. Brown, medical records indicate, the harassment escalated. A high-level meeting was organized which included  Dr. Brown, the DOH, two ID doctors (Infectious Diseases), two neurologists, and a social worker. 

It was at this conference that the outrageous plan to take the case to the DA was proposed, due to  “mom not forthcoming with information about circumcision,” the record notes. The infections diseases doctors and the neurologists were given the task of disarming the family’s suspicions about the behind-the-scenes scheming.

“The neuro and ID teams will emphasize to the family that our primary responsibility is to care for the patient,” caseworker Tansey wrote in the records. 

In other words, these doctors were to convey the message to the parents in effect that “we may have to report you for criminal neglect for not disclosing the mohel’s identity, and in the worst case scenario, you could lose custody of your children and land up in jail, but remember, it’s only because we care so much about your baby.”  

Mr. R. in an interview with Yated recalled one of the doctors divulging to him the true purpose of the meeting–to intimidate him and his wife into releasing the desired information about the mohel. He was also advised by a second doctor to make a copy of the signatures of the doctors who attended the meeting, but failed to follow up on that. 

Mr. R. understood the escalation of harassment has a single purpose: “They let me know my life would be a lot easier if I just gave up the name of the mohel,” he told Yated.

STARTLING TURNAROUND

For reasons unknown, the “criminal neglect” agenda formulated at the meeting was never implemented. 

In addition, between the Nov. 30 conference when the “neglect” scheme was proposed and a Dec. 4 entry in the medical records by Pediatric Resident Dr. Daniel Weiser, the hospital staff’s dealings with Mrs. R. appear to have considerably softened.     

Perhaps the DOH had overplayed its hand and some of the doctors objected to being roped into a scheme where a case of criminal neglect was being concocted out of thin air. Perhaps they realized the DOH’s harassment of the parents was interfering with their responsibility to care for a very sick baby. 

In any case, according to the records, the doctors dropped their adversarial pose and actually became supportive of Mrs. R. Comments by Dr. Weiser  on the medical record capture this turnaround.  

The doctor noted a discussion with Mrs. R. in which “she expressed a lot of concern” about being cast as incompetent by hospital psychiatrists and CAC Dr. Brown. 

Dr. Weiser tried to reassure her that she had nothing to fear from these people “I told Mom that CAC would be stepping back because there is little or no concern for abuse or neglect. I emphasized that the physicians [on the case] do not think she is a bad mother.”

Dr. Weiser noted Mrs. R’s relief at these words: “Mom appreciated the conversation. She feels as though the medical team has made an active effort in the past week to align ourselves with her, rather than alienate her and make her feel isolated as she has felt for the past two weeks.”

Dr. Weiser went on to say that the DOH issue (investigating transmission of HSV) should remain a DOH issue and the physicians here… should not be involved.”

Two days later, the turnaround in the case is even more dramatic, with entries in the medical records noting that “there is no concern that mom is not capable and no reason to pursue concerns of neglect any further.”

In addition, “earlier recommendations that infant care-giver therapy and therapeutic nursery” (temporarily removing baby from mother’s custody) were now “deemed not necessary after further assessment by medical team.”

Lastly, the plan to permit the baby to be discharged only with VNS [Visiting Nurse Services] was now abandoned. “No need for VNS home evaluation and mom with good social support,” the records note.

AN UGLY STAIN ON A PROUD INSTITUTION

Without testimony from any of the hospital officials in this saga, it is impossible to know for sure what convinced them to end the cruel hounding of innocent parents whose only “crime” was refusing to implicate the mohel in their baby’s illness.

What is clear, however, is that the DOH, far from backing off, carried on their crusade against Mr. and Mrs. R. outside the hospital. As reported in a previous Yated article, the DOH subpoenaed both the mother and father for questioning, relentlessly pressuring them for information about the mohel and whether metzitzah b’peh was performed. 

With the collapse of their scheme to use medical “evidence” to trump up a case of criminal neglect with which to intimidate the parents, however, Drs. Blank and Shillinger were left largely impotent.  

But the havoc and torment they and their colleagues injected in the lives of Mr. and Mrs. R. cannot be minimized, and leaves an ugly stain on the Department of Health’s record. 

Who could have imagined when the couple rushed their baby to the hospital, feverish and suffering seizures, that they were walking straight into an orchestrated nightmare? For three weeks, DOH officials traumatized the young mother with threats of removing her children from her custody in the name of an unholy agenda.  

Even when she shared with hospital and health workers that she was the likely source of transmission of the herpes infection, DOH officials virtually ignored the information, continuing their blind pursuit of the mohel as the culprit.

The young parents were still reeling from the knowledge that their precious baby who had been born healthy was now ill and irreversibly brain damaged. Instead of being shown compassion, they were the butt of threats and intimidation.   

Department of Health officials want us to believe their campaign against MBP is motivated by purely by health concerns. The saga told by the medical records cited above cast serious doubt on that claim.  

If the agency is indeed driven by health concerns, why have they not poured their efforts into alerting the public to the most likely mode of HSV transmission–an infected mother or caregiver? 

Hyping up a myth about metzitzah b’peh being dangerous to newborns, and dressing this up as a public health issue while shutting one’s eyes to evidence that explodes this myth, does nothing but erode public confidence in an erstwhile upstanding institution.