How can the diagnosis of a stomach flu turn into losing custody of your children? By a chain of misdiagnosis and failures in the medical and child welfare systems. In 2015, Jason and Lorina Troy had just welcomed their second son, JJ, into the world. His older brother was four years old when Lorina gave birth to JJ. Within months, the Troys would have both their children removed from their home and placed in foster care.
JJ had been born with a medical condition called Benign External Hydrocephalus, but this wasn’t noticed by doctors at the time. After JJ was taken home and started vomiting did Lorina notice that his head was growing at an alarming rate. At first, she took JJ to their pediatrician who diagnosed JJ with a simple stomach flu. He did not get better. Lorina then took him to urgent care clinics and finally a children’s hospital.
All of his doctors continued to diagnose a stomach flu and ignored JJ’s large head. Eventually, she convinced a doctor to give JJ an MRI. It found fluid built up in his cranium. This is the main symptom of Hydrocephalus, but it can also be the result of head trauma. Without further medical evaluation, the doctor misdiagnosed JJ as the victim of child abuse and called Child Protective Services (CPS). This resulted in CPS removing the Troy children from Lorina and Jason.
Each year in the United States, CPS agencies investigate more than 3 million reports of suspected child maltreatment, 18% of which involve concerns of physical abuse. After investigation, more than 650, 000 children are substantiated as victims of maltreatment, and over 1500 child deaths are attributed to child abuse or neglect annually. The majority of these deaths (80%) occur in children who are under 4 years of age. But that leaves over 2 million reports that were not substantiated.
A portion of the abuse reports sent to CPS come from doctors or other medical personnel. When abuse is suspected as the cause of an injury, the doctor may conduct tests to screen for other injuries or underlying medical causes that can contribute to the finding or be considered in the diagnosis of abuse. The extent of diagnostic testing depends on several factors, including the severity of the injury, type of injury, and age and developmental level of the child.
In general, the more severe the injury and younger the child, the more extensive is the need for diagnostic testing for other injuries or underlying medical conditions. This did not happen in Lorina’s case. Reportedly, the doctor dismissed the Troy’s denial and request for a second opinion. “I told him, my son has never been hurt in any way, could this be anything else? And he told me, yes, but since he’s a baby and can’t talk, we are just going to go with abuse and walked away,” Lorina Troy said.
When a doctor suspects abuse, it is important to include diagnostic impressions in the medical record that address the likelihood of nonaccidental injury. In cases with multiorgan, severe, or obvious injuries, abuse may be clear, and a strong diagnostic statement is warranted. Some injuries, while suspicious, are less diagnostic and may warrant further medical evaluation by a child abuse pediatrician, a specialist in pediatric radiology, neurology, orthopedics, surgery, or other specialties, and/or a CPS investigation. While a CPS investigation did occur in the case of the Tory family, they did not receive further medical evaluation, as requested.
The CPS investigation was another point of failure for Lorina and her family. Although the Troy family tried to get second opinions on JJ’s condition, CPS would not evaluate any of the reports. CPS did not try to get a second opinion during the investigation at all. The investigation rested on the word of one doctor in one hospital. As has been described, this is not how the system is supposed to work.
After the removal of Lorina and Jason’s children from their home, Jason was charged with felony child abuse. This resulted in the loss of his job. To pay for legal costs, the Troys had to sell their home. And all this time they were paying for medical investigations into JJ’s case. All told, they lost over $80,000 in lost wages, attorney fees, and medical costs. It took 2 and a half years to get JJ the correct diagnosis, but when they did, charges against Jason were dropped.
The Troy family is far from alone in this situation. Families all over the country have suffered due to doctors misdiagnosing medical conditions as child abuse. There is no exact accounting of home many families have gone through this because there is no official agency that tracks this issue. There is also no legal requirement to get a second opinion after a diagnosis of abuse is given.
Since her family’s experience, Lorina Troy has become an advocate for families like hers that have experienced the devastating results from a child’s misdiagnosis. She has also written a book, titled “Miracles of Faith,” that goes into the details of her family’s journey through the medical and legal systems and how their faith saw them through it all. It is available directly through the publishing company, Westbow Press, A Division of Thomas Nelson & Zondervan
When a doctor misdiagnoses abuse, it is called malpractice. The result of that malpractice is that families are ripped apart, parental rights are terminated, children are removed from their homes and parents are even sent to prison. This causes irreparable harm to many families. Families with a sick or injured child are under immense stress already. When a forensic doctor enters the hospital scene everything changes. Those children who have the misfortune of having a doctor accuse their parents of abuse will likely suffer the consequences of that misdiagnosis for years to come.