In re A.D.W., ___ N.C. App. ___ (April 16, 2025)
Held:
Affirmed
- Facts: The child at issue was diagnosed with Type 1 Diabetes at thirteen months old. When the child was approximately nine years old, DSS received a report alleging improper care of the child’s medical needs after the child was admitted to the ICU with a dangerously high blood sugar level. DSS found the child had been hospitalized three times in the prior six months for diabetic ketoacidosis, had been determined to have another condition impacting his body’s ability to move insulin, and that the parents expected the child to manage his diabetes on his own and blamed the child’s poor eating habits for his hospitalizations. Following this hospitalization Father repeatedly missed the child’s medical appointments, despite recommendations and support offered by DSS that included transportation and substance use treatment for Father. The child was subsequently hospitalized again. Father entered into a Family Services Agreement and agreed to temporary safety placement of the child with their neighbor. After this placement, the child was subsequently hospitalized three times in the same month due to diabetic ketoacidosis and elevated blood sugar. A Child Medical Exam (CME) found the child had many admissions secondary to medical neglect and that the child’s life was at risk because of mismanagement of his diabetes. Father was present for the CME but appeared to be under the influence of substances and could not answer simple questions. That same day, DSS received another report alleging improper discipline, improper medical and remedial care, injurious environment and domestic violence stemming from an incident at the home where Father hit, grabbed, slapped, threw, and yelled at the child when his blood sugar reading was high. At a later Child and Family Team meeting Father refused to take responsibility for the management of the child’s condition, again blamed the child, refused to discuss other placement options for the child, and was unaware of the child’s next medical appointment when asked. Father contacted DSS and agreed to reengage in substance use treatment, drug screens, and comply with medical appointments. When DSS visited with the neighbor and the child a few days later, the child again had a dangerously high blood sugar reading. Father was contacted and initially refused but eventually called EMS at the request of the DSS supervisor. The child was again hospitalized. After this hospitalization, Father was to take the child to his diabetes management appointment scheduled for three days after the incident but rescheduled the appointment. At this time the neighbor returned the child to Father. DSS conducted a school visit the following week and learned of concerns for the child’s elevated blood sugar levels after returning home, and new concerns at school, including the child missing the school bus and calling the school for someone to get him, appearing “shut down”, and writing a note asking God to kill him. Father was contacted by DSS and again blamed the child for not taking care of his diabetes, stated his need to reschedule his substance use and mental health assessment that DSS had referred him to, and refused a drug screen, admitting he had used cocaine the previous day. DSS filed a petition alleging the juvenile abused and neglected and obtained nonsecure custody. The child was adjudicated abused and neglected. Father appeals.
- Appellate courts review an adjudication of abuse or neglect “to determine whether the findings of fact are supported by ‘clear and convincing evidence,’ and whether the trial court’s findings support its conclusions of law.” Sl. Op. at 10. Unchallenged findings are binding on appeal. Conclusions of law are reviewed de novo. Father did not challenge any findings of fact on appeal and therefore they are binding.
- An abused juvenile is one “whose parent . . . [c]reates or allows to be created a substantial risk of serious physical injury to the juvenile by other than accidental means.” Sl. Op. at 11 quoting G.S. 7B-101(1)b. (emphasis in original). Appellate precedent holds that when “a parent is aware of the existence of the risk and ‘fail[s] to take the necessary steps to protect [the] minor” the parent has allowed a substantial risk to be created. “Serious physical injury” is not defined by G.S. Chapter 7B. The court of appeals has looked to the definition provided in the felony child abuse statute, G.S. 14-318.4, defining the term as “an injury that causes ‘great pain and suffering.’ ” Sl. Op. at 12 (citation omitted). The court of appeals also looked to Black’s Law Dictionary, defining “physical” injury as “[p]hysical damage to a person’s body.” (12th ed. 2024). “When a parent is aware of their child’s serious medical issue and fails to provide or acquire the necessary medical care, which causes injury to the child and places the child at risk of serious physical harm or death, this failure can constitute both abuse and neglect of the child.” Sl. Op. at 18.
- The findings of fact support the trial court’s conclusion that the child is an abused juvenile. Evidence, including testimony from medical providers and DSS staff, demonstrate Father was aware of the risk to the child’s life and health associated with the child’s diabetes being unmonitored by an adult and failed to take any necessary steps to protect the child. The child was repeatedly admitted to the ICU for multiple days, at times near death, and suffered acute kidney damage due to Father’s inaction, refusal to take responsibility for monitoring and managing the child’s diabetes, and blaming the child for his inability to care for himself. The CME determined the child was at high risk for death and further organ damage due to mismanagement of the child’s diet, blood sugar, and medication administration. The court of appeals likened these facts to In re K.B., 253 N.C. App. 423 (2017) and In re D.L., 213 N.C. App. 217 (2011) (unpublished), where the court affirmed abuse adjudications where the parent failed to medicate and supervise their child, resulting in the child inflicting serious self-harm (In re K.B.), and when the parent realized their child was severely malnourished and did not seek health care for the child, resulting in the child suffering a heart attack (In re D.L.).
Category:
Abuse, Neglect, DependencyStage:
AdjudicationTopic:
Abuse