In the Int. of: T.G., Appeal of: Phila Dept.(DHS)
208 A.3d 487
Pa. Super. Ct.2019Background
- T.G., born extremely premature in 2009, has severe disabilities (cerebral palsy, feeding/swallowing dysfunction requiring specialized enteral formula and extensive specialty care) and cannot speak or walk.
- From 2013–2018 T.G. missed the majority of scheduled specialty appointments; between 2013 and March 2018 she attended 25 of 92 appointments and was drastically underweight (eight‑year‑old weight equivalent to an average three‑year‑old).
- St. Christopher’s pediatric team, led by Dr. Renee Turchi, concluded T.G.’s failure to thrive and contractures resulted from caregiver neglect (mother not providing prescribed fortified formula, missed therapies, missed dental care, refusal of early intervention and school placement efforts).
- DHS investigated after a CPS report (Dec. 2017), the report was indicated for serious physical neglect, and DHS filed a dependency petition seeking a finding that Mother was a perpetrator of child abuse under the CPSL.
- The juvenile court adjudicated T.G. dependent for medical neglect but declined to find Mother a perpetrator of child abuse, citing T.G.’s preexisting conditions, Dr. Turchi’s prior delay in contacting DHS, and Mother’s health/stressors.
- The Superior Court reversed in part: it affirmed the dependency adjudication but held the record supports a finding that Mother’s conduct constituted reckless, serious physical neglect tantamount to child abuse and remanded for proceedings consistent with that determination.
Issues
| Issue | Plaintiff's Argument (DHS) | Defendant's Argument (Mother) | Held |
|---|---|---|---|
| Whether Mother’s neglect of T.G. (missed appointments, failure to provide prescribed fortified formula, refusal of services) constitutes "serious physical neglect" and a finding that Mother is a perpetrator of child abuse under the CPSL | Uncontroverted evidence shows Mother recklessly disregarded a substantial and unjustifiable risk to T.G.’s health and development by failing to provide adequate nutrition and medical care; clear and convincing evidence supports a child‑abuse finding | Mother argued missed appointments and care gaps were caused by extreme personal hardship (husband’s death, stage III colon cancer/chemotherapy) and disputed some attendance/formula claims; contended preexisting conditions explained T.G.’s state | Superior Court reversed juvenile court’s denial of child‑abuse finding: mother’s omissions and refusals amounted to reckless serious physical neglect; evidence supports finding Mother a perpetrator of child abuse. Juvenile court’s dependency adjudication otherwise affirmed |
| Whether the juvenile court properly weighed Dr. Turchi’s delay in reporting and lack of a prior medical "child abuse" diagnosis when declining to find Mother a perpetrator | DHS: delay in reporting and absence of a prior abuse label do not undermine the uncontradicted medical opinion that Mother’s neglect caused malnutrition and impaired development | Mother: delay and absence of a formal abuse diagnosis indicate ambiguity about causation and culpability; medical conditions and timing of Mother’s illnesses mitigate culpability | Held: Trial court erred to import significance into delay/absence of prior abuse label; Dr. Turchi’s testimony and other record evidence adequately support causation and culpability for reckless serious physical neglect |
Key Cases Cited
- In re R.J.T., 9 A.3d 1179 (Pa. 2010) (standard of review in dependency/child‑abuse matters; appellate deference to factual findings but plenary review of legal conclusions)
- In the Interest of L.Z., 111 A.3d 1164 (Pa. 2015) (court may find parent a perpetrator of child abuse as part of dependency adjudication; serious physical neglect can support child‑abuse finding)
- In re Bosley, 26 A.3d 1104 (Pa. Super. 2011) (trial court may accept or reject expert testimony; credibility determinations are for the factfinder)
- Nomland v. Nomland, 813 A.2d 850 (Pa. Super. 2002) (a court’s conclusions must be supported by competent evidence even when discounting uncontradicted testimony)
- A.B. v. Dep’t of Pub. Welfare, 869 A.2d 1129 (Pa. Commw. Ct. 2005) (contrast: minor weight loss without other medical evidence may not constitute serious physical neglect)