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GERINGER v. IOWA DEPT. OF HUMAN SERVICES9/21/1994
Ellen Geringer, the mother of Kelsey Geringer, appeals from a judgment upholding an adverse determination by the Iowa Department of Human Services (DHS) with respect to her efforts to have a child abuse report, which had been filed against her with regard to Kelsey, officially expunged from DHS's central registry. At the time of the abuse report, Kelsey was a few days more than one year of age. After reviewing the arguments presented, we affirm the judgment of the district court.
In September 1988, Dr. Richard Stevenson, a fellow in training in pediatrics at the University of Iowa Hospitals and Clinics, signed an affidavit alleging that Kelsey Geringer was a victim of Munchausen Syndrome by Proxy and that her mother, Ellen, the petitioner, was the perpetrator. Munchausen Syndrome by Proxy is a form of child abuse in which a parent repeatedly presents their child for unnecessary medical treatments [521 NW2d Page 731]
by simulating or producing symptoms in the child. In Kelsey's case, this diagnosis was based on a review of the mother's actions both before and after her child was brought to the University of Iowa Hospitals and Clinics from her home in Arizona for treatment.
Ellen and Kelsey were residents of Arizona. The motivation for selecting the Iowa facility as a treatment provider was its specially acclaimed program for weaning infants from tube feeding to oral feeding. Kelsey had experienced an unusually difficult birth as a result of her mother's involvement in an automobile accident approximately four months before the birth occurred.
Following her birth via induced labor on September 30, 1987, Kelsey was confined to the pediatric intensive care unit of a hospital in Phoenix, Arizona, for approximately a week. Thereafter, she continued to be evaluated and treated by specialists with respect to feeding problems, neurological delays, and suspected hearing loss. She experienced a failure to thrive. Prior to June 15, 1988, she received most of her caloric intake by gastrostomy tube feedings.
A June 15, 1988 medical evaluation in Arizona indicated that Kelsey was capable of taking on more oral nourishment, and her mother was encouraged to make more effort toward oral feedings. Staff notes from the Arizona medical facility indicate that Ellen was under much stress at this time and experiencing some problem in accepting the opinion of the Arizona medical care providers that, overall, Kelsey was not a sick child and had a very good prognosis. Counseling for Ellen was recommended.
Kelsey's evaluation and treatment at the University of Iowa Hospitals and Clinics commenced on September 19, 1988. Ellen expressed many concerns regarding Kelsey's health to the staff at that facility, many of which were unverifiable. These related primarily to unverifiable vomiting episodes and the alleged presence of blood in the disgorged matter.
On September 28, 1988, Dr. Stevenson completed an affidavit to be included in a child abuse report. It asserted that Kelsey was the victim of Munchausen Syndrome by Proxy as the result of Ellen's staging of baseless vomiting and bleeding incidents with respect to her daughter. The affidavit indicated that discussion with Kelsey's Arizona health care providers indicated that they too were strongly considering a diagnosis of Munchausen Syndrome by Proxy.
Dr. Stevenson's affidavit further concluded as follows:
I and the staff feel very strongly that there would be imminent danger to Kelsey's life or health if she were in the unsupervised care of her mother. We are therefore recommending that Kelsey be removed from the care of her mother and hospitalized at the University Hospit
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