Consider emergency removal through your state’s child protection agency. In most cases, a child is removed from an unfit home by a court order. However, when the child is in imminent danger and there is insufficient time to follow this procedure, the child may be removed from the home by the state’s child protection agency without parental consent. (New Jersey, where this case occurred, is one such example; see NJSA 9:6-8.29[a].)
Know your state’s rules for emergency removal, and have the child abuse hotline number handy. If evidence of child abuse is present, contact the appropriate agency in your state and insist that emergency removal is warranted.
The local police department may be another option. Many states’ emergency removal procedures authorize and require local authorities to remove a child who is in imminent danger. Explain your evidence of abuse and the need for emergency action.
Lastly, if your state’s protective agency or your local police will not remove the child from the dangerous situation, another option is inpatient admission. Yes, beds are limited and costs are high. But far higher is the cost of a seriously injured child when we fail to act.
In this case, the New Jersey Division of Youth and Family Services was involved. The social workers only performed a background check and missed some 20 arrests on charges of assault and other crimes that the father had logged in Florida.
The first emergency physician who identified abuse faced liability exposure for returning the child to the abuser. He pursued a work-up for child abuse and made a diagnosis of child abuse, yet he did not adopt a disposition consistent with his work-up and diagnosis.
The second physician failed to recognize the significance of a lacerated labial frenum in a 2-month-old. This type of injury is particularly suggestive in children who are not independently mobile and thus incapable of accidental injury. Force sufficient to rip a 2-month-old’s lip away from his mouth should have been recognized as abusive force. There is no evidence in the case report that the second physician identified the abuse or acted to stop it.
IN SUM
Recognize and report abuse. Know your state’s emergency removal law, and marshal your evidence of abuse to impel state agency workers to act on their power to remove a child from an abusive situation. Above all, do not return a child to his or her abuser. —DML
