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February 19, 2020 by Robert Franklin, JD, Member, National Board of Directors

The horrifying case of Dr. John Cox is far from over (NBC News, 2/6/20).  I first wrote about it here and here.

Cox is the Milwaukee emergency room physician who made the mistake of taking his one-month-old adopted daughter to the Children’s Wisconsin hospital due to his concern that he might have inadvertently harmed her.  Cox had fallen asleep with the baby beside him and, when he awoke, he had rolled partially onto her.  The child exhibited no pain or distress, but to be on the safe side and after consulting his wife who’s also a doctor, he took her to the hospital.

There the child was the subject of a string of medical errors, some obvious, some less so.  One physician’s assistant insisted that a birth mark was a bruise.  A child abuse pediatrician decided that a bruise on the sole of the child’s foot was suspicious for abuse when in fact it had been caused by a pin prick done at the hospital for diagnostic purposes.  In all, some 15 doctors who either examined the child at the time or who reviewed her treatment later have said that no abuse occurred.  One called the proceedings against Cox “preposterous.”

But, based on those medical errors and the insistence of child abuse pediatricians, the baby was taken by child protective services and has been separated from her adoptive parents for eight months, i.e. about 90% of her life.  Incredibly, Dr. Cox has been criminally charged with abusing the child, a charge that requires the showing of intentional injury, something that no one appears to claim happened.

The latest is that, apparently scenting the acrid smell of civil liability, Children’s Wisconsin has taken a defensive posture about the case.

[T]hree doctors who attended the meeting [with hospital administrators] 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.”

But doctors there are working to make future investigations into possible child abuse more in line with medical standards and less in thrall to child abuse pediatricians who tend to work hand-in-glove with state child protective officials.

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.

That’s precisely what I worried about in my first two pieces on the Cox case.  The entire theory supporting the existence of child protective agencies and child abuse doctors is that they’ll help keep children from harm.  But day after day, the news brings us stories of the most outrageous overreach by those state agencies.  More recently, a series of articles by Mike Hixenbaugh for NBC and the Houston Chronicle, has focused on so-called child abuse pediatricians, who, like CPS, often find abuse where there is none.

Given all that, sensible parents may well hesitate to- or refrain altogether from- taking injured children to doctors for fear that doing so may be the last thing they do as parents.  Indeed, that’s exactly the conclusion Dr. Cox has drawn.

“In hindsight,” Cox said in January, “taking her to our own hospital was the single most harmful decision that we made for our baby.”

That’s not what anyone wants to say about their experience with the health-care system.  It’s a message that, I suspect, many parents have heard loudly and clearly.  In short, overreach by CPS and child abuse physicians may be making matters worse, not better.

Meanwhile, Children’s Wisconsin is under the gun.

It turns out that hospital administrators have been stonewalling calls for reform almost from the day the baby was taken from Cox and his wife, Dr. Sadie Dobrozsi.

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.

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.

But now that stone wall is breaking down.

Cox’s story has consumed the local media in 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 from across the country have 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.

So the hospital has agreed to an external investigation of what happened in Dr. Cox’s case.  Exactly who performs that investigation and how remain unknown.

But beyond the outcome of that investigation, we can only hope that justice prevails in Cox’s criminal case and that he’s acquitted of the charges.  Assuming that happens, he and his wife need to bring a lawsuit against the hospital and the child abuse pediatricians who’ve done so much to damage a little girl and the adoptive parents who wanted only to love and care for her.

The case goes on and I’ll continue to update it as event unfold.  But I do want to mention one last thing that I love about Hixenbaugh’s articles.  Scroll to the top of the article.  There, unobtrusively off to the left of the headline, in tiny print, are the first words of the Hippocratic Oath, “first do no wrong.”

They’re words child abuse doctors often seem to forget.  They’re words CPS officials should be required to remember.

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