Dr. John Cox. Wisconsin: Child abuse pediatricians: NBC investigation leads to backlash over handling of suspected child abuse case as doctors at the Wisconsin hospital call for changes... "In the days after an NBC News investigation revealed problems with a major hospital’s handling of a suspected child abuse case, members of the hospital’s medical staff criticized senior administrators and demanded changes, according to several people who attended a series of internal staff meetings. The article, published last week, detailed the case of Dr. John Cox, a former emergency room physician at Children’s Wisconsin, who was charged with abusing his 1-month-old daughter, based largely on medical reports from child abuse specialists at his own hospital. More than 15 other medical experts who treated the baby or later reviewed the case concluded that the hospital’s child abuse team made serious errors, but Child Protective Services took her anyway, NBC News reported. The reporting sparked public backlash aimed at Children’s Wisconsin and state child welfare authorities — including from within the hospital. Several physicians told administrators during a series of staff “listening sessions” held in response to the reporting that they had serious concerns about the work of the hospital’s child abuse specialists, and some asked for an external investigation of their practices, according to four Children’s Wisconsin doctors who attended the meetings and spoke to a reporter on the condition of anonymity. Numerous physicians from across the hospital have spoken out at the meetings, attendees said, including cardiologists, neonatologists and infectious disease specialists."
BACKGROUND: “Dr. John Cox knew as soon as he heard the baby’s cry that he had hurt his 1-month-old adopted daughter. He’d accidentally fallen asleep while cuddling the girl in bed early one morning last May, he said, and must have turned on top of her. Cox, 39, a pediatric emergency room doctor at Children’s Wisconsin hospital, sat up, panicked. His hands shook as he assessed the baby, he said, fearing that he’d smothered her. She wasn’t in distress, but he said he could tell from the way she was moving her left arm that he might have broken her collarbone, a common injury in infants that typically heals on its own without medical treatment. Cox called his wife, Dr. Sadie Dobrozsi, who was out of town with their two older children, and cried as he explained what had happened. Dobrozsi, a pediatric oncologist at the same hospital, said she told him to calm down and asked to video chat. The baby appeared fine to her, but to be safe, Dobrozsi suggested that Cox take her to see her pediatrician. “That’s what normal parents who aren’t doctors would do,” she told him. What followed, according to more than 15 medical experts who later reviewed Cox’s case, was a series of medical mistakes and misstatements by hospital staff members that has devastated Cox’s family and derailed his career. A nurse practitioner on the hospital’s child abuse team confused the baby’s birthmarks for bruises, according to seven dermatologists who have reviewed the case. A child abuse pediatrician misinterpreted a crucial blood test, four hematologists later said. Then, two weeks after the incident, armed with those disputed medical reports, Child Protective Services took the child. “In hindsight,” Cox said in a recent interview, “taking her to our own hospital was the single most harmful decision that we made for our baby.”
QUOTE OF THE DAY: “The
tragedy is that John and Sadie will probably never see their daughter
again,” the doctor said. “All we can do now is try to make something
good out of this terrible situation and stop this from happening to any
other families."
PASSAGE ONE OF THE DAY: "
At one internal meeting this week, some Children’s Wisconsin doctors told
administrators from the Medical College of Wisconsin — which employs
physicians who practice at the hospital — that without swift policy
changes, they would hesitate to bring their own children to the hospital
following accidental injuries, fearing that a medical mistake or
overreaction could lead Child Protective Services to break their
families apart. At another meeting last
week, hospital executives committed to conducting an external review of
the hospital’s child abuse team, according to interviews and staff
emails shared with a reporter. But three doctors who attended the
meeting said they worry the investigation won’t be truly independent. So
far, the message from senior administrators has been, “trust the
system, trust the process,” according to physicians who attended the
meetings. “It’s felt very much like damage
control,” one doctor said. “Every step of the way, it feels like they
are just working to minimize corporate liability.”
PASSAGE TWO OF THE DAY: "Their
story highlights the remarkable power granted to child abuse
pediatricians, a small but growing subspecialty of doctors who work
closely with child welfare agencies across the country and whose work
was the subject of an NBC News and Houston Chronicle investigation
last year. Some of the doctors have at times overstated the certainty
of their conclusions, the investigation found, and child welfare
agencies and law enforcement officials often rely on their reports as
the sole basis for removing children and filing criminal charges. Eight
months after Cox brought his daughter to the hospital, after Child
Protective Services hired a child abuse pediatrician in Minnesota who
agreed with the initial assessment that the baby had been abused, a
Milwaukee County prosecutor charged Cox with felony child abuse. Cox’s
lawyer filed a motion to dismiss the case last week, arguing that the
state lacked evidence to bring charges. A hearing on the motion is
scheduled for Feb. 12. Regardless of what
happens in court, one Children’s Wisconsin emergency room physician said
he hopes public attention on Cox’s case will lead to meaningful changes
at the hospital. In a show of solidarity with their embattled
colleague, several ER staff members have begun wearing a tiny cartoon
image of Cox’s face attached to their hospital ID cards.
STORY: "Doctors at Wisconsin hospital call for changes amid backlash over child abuse cases," by National Investigative Reporter Mike Hixenbaugh, published by NBC News on February 6, 2020.
SUB-HEADING: "NBC News found problems with the hospital's handling of child abuse investigations, leading to a family's separation.
PHOTO CAPTION: "Dr.
John Cox and his wife, Dr. Sadie Dobrozsi, haven’t seen their daughter
since Child Protective Services placed her in foster care eight months
ago."GIST: "In the days after an NBC News investigation revealed problems with a
major hospital’s handling of a suspected child abuse case, members of
the hospital’s medical staff criticized senior administrators and
demanded changes, according to several people who attended a series of
internal staff meetings. The article, published last week, detailed the case of Dr. John Cox,
a former emergency room physician at Children’s Wisconsin, who was
charged with abusing his 1-month-old daughter, based largely on medical
reports from child abuse specialists at his own hospital. More than 15
other medical experts who treated the baby or later reviewed the case
concluded that the hospital’s child abuse team made serious errors, but
Child Protective Services took her anyway, NBC News reported. The
reporting sparked public backlash aimed at Children’s Wisconsin and
state child welfare authorities — including from within the hospital. Several
physicians told administrators during a series of staff “listening
sessions” held in response to the reporting that they had serious
concerns about the work of the hospital’s child abuse specialists, and
some asked for an external investigation of their practices, according
to four Children’s Wisconsin doctors who attended the meetings and spoke
to a reporter on the condition of anonymity. Numerous
physicians from across the hospital have spoken out at the meetings,
attendees said, including cardiologists, neonatologists and infectious
disease specialists. At
one internal meeting this week, some Children’s Wisconsin doctors told
administrators from the Medical College of Wisconsin — which employs
physicians who practice at the hospital — that without swift policy
changes, they would hesitate to bring their own children to the hospital
following accidental injuries, fearing that a medical mistake or
overreaction could lead Child Protective Services to break their
families apart. At another meeting last
week, hospital executives committed to conducting an external review of
the hospital’s child abuse team, according to interviews and staff
emails shared with a reporter. But three doctors who attended the
meeting said they worry the investigation won’t be truly independent. So
far, the message from senior administrators has been, “trust the
system, trust the process,” according to physicians who attended the
meetings. “It’s felt very much like damage
control,” one doctor said. “Every step of the way, it feels like they
are just working to minimize corporate liability.” In
a statement Wednesday, a Children’s Wisconsin spokesman confirmed that
the hospital will review how it handles suspected child abuse cases, and
officials plan to consult outside experts as part of that process. The
statement did not address the internal meetings this week. “This
will help us objectively examine how we collaborate to accomplish this
work and ensure we are meeting widely accepted standards and best
practices,” the statement said. “We’ll share any opportunities for
improvement and act quickly on them.” Cox’s story has consumed thelocal mediain Milwaukee,
where an AM talk-radio host recently took calls for more than an hour
from listeners who said they were outraged that a baby could be taken
from her parents based on questionable medical opinions. Doctors fromacross the countryhave rebuked
the hospital for its role in the allegations against Cox, including
some who’ve written letters to hospital board members. And late last
week, a top state lawmaker publicly called for an investigation of the state’s handling of the case. Angry commenters have also bombarded the hospital’s social media accounts, including on Twitter, where hospital staff members have been repeatedlyclickingtohideposts from people expressing outrage over Cox’s case. Meanwhile,
hospital officials have worked to assure members of the medical staff
that they are committed to addressing these concerns. “We
truly need your insights to help us understand where improvement
opportunities may exist,” hospital President Scott Turner and Executive
Vice President Bob Duncan wrote in messages to staff members this week.
“The input we receive from you will help to focus the internal and
external review process we are undertaking.” But
documents reviewed by NBC News show that senior hospital executives
were made aware of alleged mistakes by the child abuse specialists in
Cox’s case more than six months ago. At that time, administrators
repeatedly rebuffed calls for an external investigation. Cox
and his wife, Dr. Sadie Dobrozsi — also a physician at Children’s
Wisconsin — reported misstatements by child abuse specialists to
hospital executives last year in a series of letters and in-person
meetings, according to documents and audio recordings made by Cox, which
he shared with NBC News prior to the issuance of a gag order in his
criminal case. Cox
and Dobrozsi pointed out as early as June that a nurse practitioner had
declined to consult a Children’s Wisconsin dermatologist before
confusing their baby’s birthmarks for bruises. They also provided
hospital executives with reports, including from four Children’s
Wisconsin hematologists, showing that a child abuse pediatrician had
misinterpreted a key test result that pointed to a possible bleeding
disorder that could have predisposed the baby to easy bruising. And Cox
and Dobrozsi reported to administrators that the child abuse team had
violated its own policies when the nurse practitioner refused to speak
with them before drawing her conclusions. The
hospital repeatedly defended the child abuse team’s handling of the
case in letters to Cox and his lawyer. Leslie Tector, the hospital’s
vice president and general counsel, wrote to Cox’s lawyer on Aug. 30,
dismissing each of their concerns. “In
reflection, we believe that we are adhering to existing best practice
... and based on the information provided to date, do not believe an
external review would yield any new or pertinent information,” Tector
wrote. Hospital officials did not answer questions about why they previously resisted an outside investigation. Other
Children’s Wisconsin physicians said they also brought concerns about
the practices of child abuse specialists to hospital leaders in recent
months, according to interviews with more than a dozen members of the
medical staff. But the physicians said no action was taken. The
doctors described an “out of control” child abuse team that is too
quick to report minor injuries to authorities and that is too closely
aligned with state child welfare investigators. Three
of the physicians recalled being pressured by some child abuse
pediatricians to alter medical records in order to sway the outcomes of
Child Protective Services investigations, removing passages where they
had initially reported having little or no concerns about abuse, though
there’s no evidence that happened in Cox’s case. Cox’s
ordeal began in May when he took his daughter, adopted only the month
before, to the doctor after he said he’d accidentally fallen asleep with
her in bed and turned on top of her. He feared he had injured her
collarbone, so he brought her to see her pediatrician. What
followed, according to the experts who later reviewed the case on Cox’s
behalf, was a series of medical mistakes and misstatements by hospital
staff members. “In hindsight,” Cox said in
January, “taking her to our own hospital was the single most harmful
decision that we made for our baby.” Cox and Dobrozsi haven’t seen the girl since Child Protective Services placed her in foster care eight months ago. Their
story highlights the remarkable power granted to child abuse
pediatricians, a small but growing subspecialty of doctors who work
closely with child welfare agencies across the country and whose work
was the subject of an NBC News and Houston Chronicle investigation
last year. Some of the doctors have at times overstated the certainty
of their conclusions, the investigation found, and child welfare
agencies and law enforcement officials often rely on their reports as
the sole basis for removing children and filing criminal charges. Eight
months after Cox brought his daughter to the hospital, after Child
Protective Services hired a child abuse pediatrician in Minnesota who
agreed with the initial assessment that the baby had been abused, a
Milwaukee County prosecutor charged Cox with felony child abuse. Cox’s
lawyer filed a motion to dismiss the case last week, arguing that the
state lacked evidence to bring charges. A hearing on the motion is
scheduled for Feb. 12. Regardless of what
happens in court, one Children’s Wisconsin emergency room physician said
he hopes public attention on Cox’s case will lead to meaningful changes
at the hospital. In a show of solidarity with their embattled
colleague, several ER staff members have begun wearing a tiny cartoon
image of Cox’s face attached to their hospital ID cards. “The
tragedy is that John and Sadie will probably never see their daughter
again,” the doctor said. “All we can do now is try to make something
good out of this terrible situation and stop this from happening to any
other families.""
PUBLISHER'S NOTE: I am monitoring this case/issue. Keep your eye on the Charles Smith Blog for reports on developments. The Toronto Star, my previous employer for more than twenty incredible years, has put considerable effort into exposing the harm caused by Dr. Charles Smith and his protectors - and into pushing for reform of Ontario's forensic pediatric pathology system. The Star has a "topic" section which focuses on recent stories related to Dr. Charles Smith. It can be found at:http://www.thestar.com/topic/charlessmith. Information on "The Charles Smith Blog Award"- and its nomination process - can be found at:http://smithforensic.blogspot.com/2011/05/charles-smith-blog-award-nominations.htmlPlease send any comments or information on other cases and issues of interest to the readers of this blog to:hlevy15@gmail.com. Harold Levy: Publisher: The Charles Smith Blog;
FINAL WORD: (Applicable to all of our wrongful conviction cases): "Whenever there is a wrongful conviction, it exposes errors in our criminal legal system, and we hope that this case — and lessons from it — can prevent future injustices."
Lawyer Radha Natarajan:
Executive Director: New England Innocence Project;
Two Blogs Now: The Charles Smith Blog; The Selfless Warriors Blog: I created the Charles Smith Blog in 2007 after I retired from The Toronto Star to permit me to keep digging into the story of the flawed pathologist and the harm he had done to so many innocent parents and caregivers, and to Ontario’s criminal justice system. Since then it has taken new directions, including examinations of other flawed pathologists, flawed pathology, and flawed science and technology which has marred the quality of justice in courtrooms around the world. The heart of the Blog is my approach to following cases which raise issues in all of these areas - especially those involving the death penalty. I have dedicated 'The Selfless Warrior Blog’ (soon to appear) to those exceptional individuals who have been ripped out of their ordinary lives by their inability to stand by in the face of a glaring miscarriage of justice. They are my ’Selfless Warriors.’ Enjoy!
