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.
- A neglected juvenile is one “whose parent . . . “[d]oes not provide proper care, supervision, or discipline[;] [h]as not provided or arranged for the provision of necessary medical or remedial care[;] or “[c]reates or allows to be created a living environment that is injurious to the juvenile’s welfare.” G.S. 7B-101(15). There must be evidence of current circumstances that present a risk to the child to support a conclusion that the child lives in an injurious environment. Additionally appellate court have required there be “some physical, mental, or emotional impairment of the juvenile or a substantial risk of such impairment as a consequence of the failure to provide ‘proper care, supervision, or discipline.” Sl. Op. at 14-15 (citation omitted) (emphasis in original). Neglect can be found where there is “a pattern of conduct either causing injury or potentially causing injury to the juvenile.” Sl. Op. at 15 (citation omitted). “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 support the trial court’s conclusion that the child is a neglected juvenile. Father was repeatedly informed of the risk associated with the child’s diabetes not being monitored by an adult, was educated how to monitor and medicate the child, witnessed the child’s repeated hospitalizations for diabetic ketoacidosis and refused to accept responsibility for monitoring and managing the child’s diabetes, including missing the child’s medical appointments and failing to continuously monitor his diet, blood sugar levels, and medication administration. The child suffered acute kidney damage and was determined to be at high risk for further organ damage or death due to the mismanagement of his diabetes. The findings establish Father’s pattern of conduct caused the child injury and placed the child at risk for serious injury or death.
Category:
Abuse, Neglect, DependencyStage:
AdjudicationTopic:
Neglect