The opinion
MEMORANDUM DECISION
Pursuant to Ind. Appellate Rule 65(D),
this Memorandum Decision shall not be FILED
regarded as precedent or cited before any Oct 07 2020, 9:00 am
court except for the purpose of establishing CLERK
Indiana Supreme Court
the defense of res judicata, collateral Court of Appeals
and Tax Court
estoppel, or the law of the case.
ATTORNEYS FOR APPELLANT D.T. ATTORNEYS FOR APPELLEE
(FATHER) Curtis T. Hill, Jr.
Valerie K. Boots Attorney General of Indiana
Marion County Public Defender Agency David E. Corey
– Appellate Division Robert J. Henke
Daniel G. Foote Deputy Attorneys General
Indianapolis, Indiana Indianapolis, Indiana
ATTORNEYS FOR APPELLANT K.J.
(MOTHER)
Valerie K. Boots
Marion County Public Defender Agency
– Appellate Division
Danielle L. Gregory
Indianapolis, Indiana
IN THE
COURT OF APPEALS OF INDIANA
In re the Matter of N.T. (Minor October 7, 2020
Child) and Court of Appeals Case No.
20A-JC-502
D.T. (Father) and K.J. (Mother),
Appeal from the Marion Superior
Appellants-Respondents, Court
v. The Honorable Marilyn A.
Moores, Judge
Court of Appeals of Indiana | Memorandum Decision 20A-JC-502 | October 7, 2020 Page 1 of 20
Indiana Department of Child The Honorable Marcia J. Ferree,
Services,1 Magistrate
Appellee-Petitioner. Trial Court Cause No.
49D09-1907-JC-1670
Mathias, Judge.
[1] D.T. (“Father”) and K.J. (“Mother”) appeal the Marion Superior Court’s order
adjudicating N.T., their minor child, a Child in Need of Services (“CHINS”).
Father and Mother (collectively “Parents”) argue that the Department of Child
Services (“DCS”) failed to prove by a preponderance of the evidence that N.T.
is a CHINS.
[2] We affirm.
Facts and Procedural History
[3] In June 2019, the parents and twenty-three-month-old N.T. resided together in
an apartment in Beech Grove, Indiana. N.T. has several medical conditions
that require specialized care and medical attention.
[4] On June 18, 2019, parents took N.T. to Peyton Manning Children’s hospital
where she was admitted due to her failure to thrive. N.T. weighed
approximately fourteen pounds when she was admitted. During DCS’s
1
DeDe K. Connor filed an appearance on behalf of Appellee-Guardian ad Litem, Child Advocates, Inc., but
did not file a brief on appeal.
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investigation of N.T.’s welfare, N.T.’s primary care physician expressed
concern about N.T.’s inability to gain weight while in the primary care of her
parents. When she was admitted to the hospital, Dr. Cortney Demetris, the
Child Abuse Pediatrician, concluded that N.T. was severely malnourished and
suspected medical neglect.
[5] Because N.T. was able to gain weight during her hospital admissions but was
not able to maintain or gain weight while in Parents’ care, in July 2019, DCS
filed a petition alleging that N.T. was a CHINS pursuant to Indiana Code
section 31-34-1-1. Specifically, DCS alleged that N.T. was not receiving
necessary medical treatment and that her parents were not following N.T.’s
physicians’ instructions and recommendations.
[6] In the petition, DCS noted that it had previously investigated a similar report of
neglect of N.T. in 2018. The prior CHINS proceeding was dismissed because
DCS believed that N.T.’s growth hormone deficiency could be contributing to
her inability to gain weight. When DCS filed the July 2019 petition, N.T. had
been prescribed growth hormone for several months but was not gaining weight
while in the parents’ care.
[7] CHINS fact-finding hearings were held on August 16, September 27, and
October 7, 2019. The trial court adjudicated N.T. to be a CHINS. The trial
court issued the following comprehensive findings of fact on January 16, 2020.
7. [Child] has multiple diagnoses that include schizencephaly,
septo-optic dysplasia, diabetes insipidus, dysphagia requiring G-
tube feeds, and failure to thrive.
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8. [Child’s] medical care includes the treatment by multiple
disciplines, including endocrinology, ophthalmology,
gastroenterology, neurology, pulmonary, occupational and
physical therapy, vision therapy and nutrition. [Child] has 8-9
specialty doctors.
9. In 2018, [Child] was the subject of a DCS [CHINS] Petition
where [Child’s] failure to thrive was a safety concern.
10. According to Father, there was a Child and Family Team
Meeting (“CFTM”) held prior to the dismissal of that 2018
Petition, and at CFTM it was discussed and agreed to by DCS
and Parents that [Child’s] medical care would be transferred to
Cincinnati Children’s Hospital and that [Child] would be
weighed twice weekly by an agency to ensure that she gained
appropriate weight.
11. [Child’s] medical care was transferred to Cincinnati
Children’s Hospital. For the time that [Child] received her
medical care from Cincinnati Children’s Hospital, Parents did
not miss any appointments except for a few that were missed
because of car accident that occurred on 3/22/2019, and
according to Father, those appointments were rescheduled.
12. Parents scheduled [Child’s] appointments on the same day
and close in time so that [Child] could make multiple
appointments in the same day.
13. [Child’s] formula, medication for her salt and water
imbalance and her growth hormone formula were shipped to
Parents’ home.
14. Father would pick up diabetes medicine and sometimes
miraLAX for [Child] from the pharmacy.
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15. On or near 1/18/2019, [Child] was admitted to Cincinnati
Children’s Hospital for failure to thrive. She was released 28 days
later (on 2/15/2019), having gained weight in those 28 days.
16. Interim HealthCare was one of the agencies that weighed
[Child] in her home. James Engelking is a registered nurse and
case manager at Interim HealthCare and he first weighed [Child]
on 4/18/2019. Interim was hired to do twice weekly in-home
weight checks and “check-in” with the family, as ordered by Dr.
Jain.
17. RN Engelking weighed [Child] 10-12 times in 9 weeks (from
4/18/2019-6/11/2019), and in that time the [Child’s] weight
fluctuated around 13-14 pounds and she gained only 1 pound 2
ounces.
18. Parents did not make [Child] available for weighs twice
weekly. The weighs were scheduled for Tuesdays and Thursdays.
The weighs were missed because Parents did not answer or
return RN Engelking’s phone calls.
19. Mr. Engelking weighed [Child] using an electronic scale that
auto calibrates and weighed her wearing her diaper only. Mr.
Engelking[] observed 2-3 boxes of Pedia[S]ure at the house,
unopened and he never saw [Child] on her feeding machine.
20. Mr. Engelking said [Child] was cranky, fussy [and her] arms
and legs were constricted about half the time he weighed her. On
two separate occasions, [Child] lost weight between weighs. Mr.
Engelking expressed his concern for this weight loss to Father.
Father said okay and did not appear to be concerned.
21. [Child] also has a licensed physical therapist and
occupational therapist through First Steps, Inc. Parents have
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maintained these appointments and the therapy provided to
[Child] is designed to improve her range of motion, strength,
ability to sit, ability to reach, motor skills and the like. Both the
physical therapist and occupational therapist have not had a
problem with communicating with parents and parents have been
open to the therapists’ suggestions.
22. In addition, [Child] has a vision specialist. [Child] has optic
nerve hypoplasia where the nerves are under developed, it is an
under lying [sic] condition [of] her [] septo-optic dysplasia. The
Vision Specialist specifically works with [Child] on visual
attention and to help her to use the vision that she has.
23. First Steps, Inc. is an early intervention program for delay in
any area for children up to 3 years old. First Steps is a
community resource not tied to DCS’ intervention which
provides occupational, speech, and vision services.
24. During this time that [Child] was at home, Carol Glander, a
Registered Dietician and a Pediatric Dietician with First Steps,
worked with [Child]. The Court found her to be qualified as an
expert in dietetics.
25. She testified that [Child’s] needs are growth and feeding
tolerance and the medical team makes all decisions about her
feeding.
26. She began seeing [Child] in June 2018 and has continuously
provided care for [Child] except for the month that [Child] was
hospitalized in January 2019 at Cincinnati Children’s Hospital.
27. Ms. Glander saw that [Child] lost weight and recommended
that [Child] take Duocal. Duocal is an additive made with carbs
and fats to provide additional calories. She recommended to
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Parents that they talk to [Child’s] medical providers about adding
[duocal] to add calories to [Child’s] diet. She attempted to
contact [Child’s] providers herself to make that recommendation
but was unsuccessful, and she believes that Mother asked the
medical team about adding Duocal.
28. Duocal was not added to [Child’s] diet until June 2019 when
she was hospitalized at St. Vincent and [Child] continues to
receive it, but in a much lower amount than she was at St.
Vincent.
29. Further, Ms. Glander recommended that [Child] have a scale
so that she could be weighed by the same scale each time for
accuracy.
30. Ms. Glander has observed that [Child] tolerates the current
feeding regimen well versus her feeding regimen up to her
admission at St. Vincent. She testified that with the feeding
regimen prior to [Child’s] admission at St. Vincent, she would
see [Child] was fussy, and her belly [distended]. She
recommended to Parents to keep a written log of [Child’s]
tolerance for feeding.
31. She found that the Parents were not difficult to work with
and that they asked questions and followed her
recommendations.
32. Ms. Glander observed that Parents would have trouble
getting [Child] to take the total volume per day because of
[Child’s] reactions of vomiting, crying, and her belly sticking out.
33. Ms. Glander was concerned for [Child’s] weight and
nutrition for over a year and assessed that [Child] was not
growing according to her trajectory.
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34. Ms. Jenna Admundson is an assessment Family Case
Manager ("FCM") for DCS and she received three 310-reports,
on 6/17, 6/18 and 6/29, regarding [Child] and her parents. FCM
Admundson had recent contact with parents during a 310
Assessment in April 2019.
35. On 6/17/2019, Parents drove to Cincinnati Children’s
Hospital for [Child’s] scheduled doctors’ appointments.
36. During the course of [Child’s] appointments with her medical
providers, her doctor strongly recommended that [Child] be
admitted immediately because she was not gaining weight as she
should.
37. Instead of following that recommendation, Mother and
Father chose to take the [Child] home and then to Peyton
Manning Children’s Hospital at St. Vincent Hospital, hereinafter
referred to as “St. Vincent”). If [Child] was going to be admitted
to the hospital, the parents wanted her close to home.
38. When Parents left Cincinnati, they knew that [Child] needed
to be admitted to the hospital because she was severely
underweight and they knew that in the 9 weeks or more leading
up to this recommendation, that [Child] had gained roughly one
pound.
39. As of the next afternoon, Parents had not taken [Child] to St.
Vincent or any other hospital.
40. Ms. Camille Drake is a DCS FCM and she met with Parents
at their home sometime in the afternoon on 6/18/2019.
41. When she arrived, [Child] was feeding via G-tube and
Parents were packing items to go the hospital.
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42. Mother told her that she told Cincinnati Children’s Hospital
that they would be taking [Child] to St. Vincent when they got off
work the following day, despite St. Vincent strongly
recommending admission on the same day. FCM Drake told
Parents to take [Child] to the hospital between 5:15-5:30 p.m.
Parents and [Child] arrived at St. Vincent around 5:30 p.m. They
waited in the ER waiting room until [Child] was admitted to the
Hospital at 11:23 p.m.[]
43. At the time of admission, [Child’s] home feeding regimen
was 1050 calories per day of Pedia[S]ure Peptide fed over 15
hours.
44. According to Father, the current feeding instructions from
Cincinnati Children’s Hospital were to increase rate of flow and
decrease the hours of feeding weekly and her hours of feeding
were down to about 15 hours.
45. Upon admission, St. Vincent started [Child’s] feed at the
same number of calories that the parents reportedly were giving
her at home and adjusted the feeding rate.
46. [Child] was admitted to St. Vincent Hospital on 6/18/2019 at
11:23 p.m. and was discharged at 2:47 p.m. on 8/12/2019 (9
weeks later).
47. When [Child] first arrived in her hospital room, RN Hannah
Raspopovich observed Father pick up and carry [Child], with one
arm without supporting [Child’s] head and body, to her hospital
bed and carelessly set her in her bed. Given [Child’s] medically
fragile state, this concerned RN Raspopovich and she noted it in
the medical records.
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48. On 6/22/2019, Parents stayed overnight in [Child’s] hospital
room. At 2:00 a.m., on the 23rd, RN Shelby M Nolot observed
that [Child’s] feeding pump was placed on the side of the crib
closest to the door and was running appropriately. When RN
Nolot returned to the room 2 hours later, the feeding pump had
been moved to the opposite side of the crib and was turned off.
The hospital staff denied entering room and turning off the
feeding pump.
49. Pursuant to doctor’s orders, the feeding pump was to be on
and continuously feeding [Child].
50. At approximately 9:00 a.m. on 6/23/2019, RN Catherine
Schwab, entered [Child’s] hospital room and the feeding pump
was off again. RN Schwab turned the feeding pump on to resume
feeding. Parents were in the room sleeping.
51. On 6/23/2019, Dr. Large discussed with Parents about them
turning off the feeding pump. Dr. Large explained that [Child]
was to be feeding continuously for 24 hours. Parents did not deny
turning off the feeding pump and expressed that they did not
want [Child] to be on continuous feed without breaks. Mother
was upset that [Child] was being fed 24 hours a day and she felt
her stomach needed a break.
52. Mother and Father told Dr. Large that they thought [Child]
should be discharged from the hospital because she was doing
fine at home with them. Parents were adamantly opposed to the
24-hour feeding schedule.
53. Dr. Large explained that the plan was to condense feeds to
run over 15 hours per day as per home schedule, but that the
current order is for 24 hours. Physician discussed with Parents
the importance of continuous feeds at that time considering
[Child] was severely malnourished and needed to gain weight.
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54. Mother and Father both testified that they did not turn off the
feeding pump.
55. On 7/31/2019, [Child] weighed 7.39 kg or 16 pounds 4
ounces. From 6/18/19 to 7/31/19, [Child] gained 2 pounds and
3 ounces. On average, she gained 24 grams/day.
56. On 8/4/2019, RN Megan Kilma unhooked [Child] from her
feeding pump at the request of the parents so that they could
bathe her. Parents agreed they would turn the feeding pump back
on when they were finished bathing her, but they did not and left
the room. RN Kilma hooked [Child] back up to her feeds and
parents returned while she was doing so. RN Kilma left the room
again and when she returned the parents were gone and [Child’s]
tubing was clamped off and her feed was running into her
farrel[l] bag, causing her not to receive feed for 2 hours.
57. Doctor Courtney Demetris is a part of the Child Protection
Team at St. Vincent and Riley Hospitals. She is a pediatric
hospitalist at St. Vincent Hospital.
58. She is board certified in pediatrics and child abuse pediatrics.
The court qualified her as an expert witness in the areas of
pediatrics and child abuse pediatrics.
59. During [Child’s] admission at St. Vincent, Dr. Demetris
cared for [Child] when she was on duty as a hospitalist. In her
expert opinion, [Child] suffered from medical neglect and the
basis for that opinion was her review of medical records and her
personal care of [Child].
60. Dr. Demetris’ expert opinion is that at the time of admission
to St. Vincent, [Child] was severely malnourished. The Z score
reflects the severity of a patient’s malnutrition and it takes into
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consideration a patient’s weight and length. [Child’s] Z score
reflected severe malnutrition. Specifically, her Z score was
negative 3.0, anything below 5, is an indicator of severe
malnutrition.
61. Dr. Demetris explained that severe malnutrition can result in
death. Further, it prevents a patient from standard growth and
development.
62. According to Dr. Demetris, [Child] does gain weight when
she is given proper calories and her malnutrition is secondary to
her other conditions. In her expert opinion, there is no medical
reason for [Child] not gaining weight.
63. In Dr. Demetris’ review of the medical records, there were
several incidents when parents were not following medical
advice.
64. Dr. Demetris believes that the Parents failed to follow
medical professional advice and that failure resulted in the
[Child] becoming malnourished. According to Dr. Demetris, the
home feeding regimen that included 1050 calories a day, if
followed, would have provided [Child] with the calories she
needed to gain weight.
65. [Child] gained significant weight at the hospital on the same
calorie intake that she was reportedly receiving at home which
was about 1050 calories per[] day.
66. While at St. Vincent she gained an average of 25 grams/day
and the goal for [Child] is 10-15 grams/day.
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67. In fact, as of 7/31/2019, [Child] was receiving fewer calories
that what she was supposed to receive at home and she
continued to gain weight in excess of the goal.
68. According to Dr. Demetris, any changes made to her feeds
during her stay at St. Vincent provided less total calories than she
was getting at home and would not explain why she was not
gaining weight at home.
69. At admission to St. Vincent, 6/18/2019, [Child] weighed
6.39 kg (14.08 pounds). At discharge, [Child] weighed over
17.5 pounds.
70. [Child] gained over 3 ½ pounds in the 9 weeks she was at St.
Vincent and in the 9 weeks at home leading to her admission, she
gained only about 1 pound.
71. Sheila Grimm began supervising parenting time in the middle
of July until 8/12/2019 at St. Vincent. She went every day and
the Parents arrived at the hospital with her for supervised
parenting time.
72. Once supervised parenting time started, there were no further
reports by the hospital that Parents disconnected the feeding
tube.
73. Ms. Grimm has never found parents to be difficult to work
with and she describes both parents as well researched in
[Child’s] diagnoses and that they are there for [Child] 100%.
Mother and Father have never been resistant to her suggestions.
74. During supervised parenting time, she has observed Parents
work together as a team, and display great nurturing and comfort
to [Child], including bathing her, painting her nails, applying
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lotion, massaging her hair. At that time and currently she has no
safety concerns for [Child] in parents’ care. Currently, she is
working with parents regarding gaining employment.
75. [A.J.] is [Child’s] maternal grandmother. In 2018, [Child]
was in her home when [Child] was about 7 months old and she
was with her for a month. The reasons for the placement were
the same issues of [Child] struggling to gain weight. [Child] was
inpatient at Riley and she was released to her. [Child] is now
with her again, about 3 days a week, Friday-Monday morning
and [Child] is with [L.B.], paternal grandmother, 5 days a week,
Monday-Friday.
76. Currently, [Child] receives [PediaSure] peptide over a 22-
hour feed and she is gaining weight. As of the fact finding,
[Child] weighed about 20 pounds 7 ounces.
77. Both grandmothers have trained through St. Vincent on
[Child’s] medications and feeding machine, and both report they
will continue to be a support for Parents.
78. [Child] has received a [Bureau of Developmental Disabilities
Services] BDDS waiver and she will get a skilled nurse and
respite care, among other services. Further, Aviana nursing
service is set to be in place and will provide 24-hour nursing
services.
79. Mother has contacted CICOA for therapeutic services as a
possible an additional resource. Medicaid pays for CICOA
therapeutic services.
80. Ms. August Hatter is a DCS Permanency FCM and she was
assigned to [Child’s] case on or near 7/1/2019.
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81. She has conducted 2 CFTMs since this case opened. She
described Father’s demeanor during CFTMs as aggressive and
hostile. He continuously interrupts others when they are talking
and he dominates the conversation. He believes that he knows
more than the doctors and that [Child’s] weight loss was due to
her kidney condition.
82. He said that the State only provides services “when [s***] hits
fan” and that the services offered now should have already been
provided a year ago.
83. DCS recommends that Mother participate in Home Based
Therapy and Home Based Casework to help find her find part-
time employment and parenting education. DCS recommends
that Father participate in home based therapy due to his anger.
84. For [Child], DCS recommends nursing services 24
hours/day, to attend all doctors’ appointments, and to have a
First Steps evaluation.
85. DCS argues that the coercive intervention of the Court is
necessary to ensure that the family follows the doctors’
recommendations.
86. Despite [Child] having been admitted to the hospital for
severe malnutrition and for no other reason, Mother and Father
were insistent about maintaining the home feeding regimen and
did not want it changed to include 24 hour feeds. Parents acted
against medical advice when they turned off [Child’s] feeding
pump.
87. [Child] gained weight as medically expected during her time
at Cincinnati Children’s hospital in January 2019, at St. Vincent
in July 2019 and in placements with her grandmothers.
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88. The inability or unwillingness of Parents to recognize that
[Child] was not thriving causes great concern for the safety and
well-being of [Child] in their care and services are needed in
order to ensure that [Child] will maintain proper nourishment in
the care of Parents.
89. Even when community services were in place, [Child] still
became severely malnourished in her Parents’ care.
90. The coercive intervention of the Court is necessary to ensure
that [Child] will receive the appropriate nutrition in the care of
her Parents.
91. The Court finds that [Child] is a minor child in need of
services because [Child’s] physical or mental condition is
seriously impaired or endangered due to the neglect of parents to
provide her the appropriate medical care, in that she became
severely malnourished while in their care without medical
reason.
Father’s App. pp. 114–121. The trial court placed N.T. in the care of her
paternal grandmother.
[8] The trial court issued its dispositional and parental participation orders on
January 24, 2020. Both parents were ordered to participate in homebased
therapy. Father was also ordered to complete a Father Engagement program
and parenting assessment. Mother and Father now appeal.
Discussion and Decision
[9] Parents argue that DCS failed to prove that N.T. was endangered or that the
coercive intervention of the court was necessary. It is well-settled that
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[i]n all CHINS proceedings, the State must prove by a
preponderance of the evidence that a child is a CHINS as defined
by the juvenile code. When reviewing a CHINS adjudication, we
do not reweigh evidence or judge witness credibility and will
reverse a determination only if the decision was clearly
erroneous. A decision is clearly erroneous if the record facts do
not support the findings or if it applies the wrong legal standard
to properly found facts.
V.B. v. Ind. Dep’t of Child Servs., 124 N.E.3d 1201, 1208 (Ind. 2019) (citations
and quotation marks omitted).
[10] DCS alleged that N.T. was a CHINS pursuant to Indiana Code section 31-34-1-
1, which provides that a child under the age of eighteen is a CHINS under the
following circumstances:
(1) the child’s physical or mental condition is seriously impaired
or seriously endangered as a result of the inability, refusal, or
neglect of the child’s parent, guardian, or custodian to supply
the child with necessary food, clothing, shelter, medical care,
education, or supervision;
(A) when the parent, guardian, or custodian is financially able
to do so; or
(B) due to the failure, refusal, or inability of the parent,
guardian, or custodian to seek financial or other
reasonable means to do so; and
(2) the child needs care, treatment, or rehabilitation that:
(A) the child is not receiving; and
(B) is unlikely to be provided or accepted without the coercive
intervention of the court.
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[11] “That final element guards against unwarranted State interference in family life,
reserving that intrusion for families ‘where parents lack the ability to provide for
their children,’ not merely where they ‘encounter difficulty in meeting a child’s
needs.’” J.B. v. Ind. Dep’t of Child Servs., 2 N.E.3d 1283, 1287 (Ind. 2014)
(quoting Lake Cty. Div. of Fam. & Child. Servs. v. Charlton, 631 N.E.2d 526, 528
(Ind. Ct. App. 1994)). When considering this requirement, “courts should
consider the family’s condition not just when the case was filed, but also when
it is heard.” Gr.J. v. Ind. Dep’t of Child Servs., 68 N.E.3d 574, 580 (Ind. 2017)
(quotations omitted). “Doing so avoids punishing parents for past mistakes
when they have already corrected them.” Id. at 581.
[12] Mother and Father challenge the trial court’s CHINS adjudication by focusing
on the evidence establishing that they provided necessary medical care for N.T.
We agree with the Parents that N.T. did not lack the medical care that she
required. And the facts of this case are complicated because N.T.’s significant
medical conditions impact her ability to gain weight.
[13] However, DCS presented evidence that Parents do not always follow the
recommendations and treatment plans prescribed by N.T.’s medical providers. 2
2
Parents challenge the trial court’s finding that they did not make N.T. available for weigh-ins twice weekly.
James Engelking, the service provider who performed N.T.’s weight checks, testified that he was often only
able to weigh N.T. once per week due to lack of communication from Parents. Tr. Vol. 1, p. 185. Engelking
was required to weigh N.T. on Tuesdays and Thursdays, but the timing of his visits to Parents’ home was not
consistent. He attempted to communicate with Parents to let them know when he would arrive at their home
for the weight check, but Parents did not respond. Id. at 210. The Parents may have had good reasons for not
being present when Engelking arrived at their home, but they failed to communicate with him concerning
their availability for weight checks. This evidence supports the trial court’s finding.
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Most concerning, Parents have not followed N.T.’s prescribed feeding plan. As
a result, when N.T. was admitted to the hospital in June 2019, Dr. Cortney
Demetris, an expert in Child Abuse Pediatrics, concluded that N.T. was
severely malnourished, and the doctor suspected medical neglect.3
[14] DCS proved that while N.T. was in Parents’ care between hospital admissions,
she was unable to maintain weight gain. However, while N.T. was hospitalized
at St. Vincent’s for almost two months, she gained three pounds, seven ounces
and was able to maintain the weight gain. N.T. continued to gain weight,
although at a slower place, after her discharge from the hospital in August 2019
while placed in her grandmothers’ care.
[15] During N.T.’s hospitalization, medical providers observed on more than one
occasion that Parents had turned off N.T.’s feeding tube against doctor’s orders.
Tr. Vol. I, p. 92. Dr. Demetris testified that N.T. gains weight when she is given
proper calories; therefore, N.T.’s “severe malnutrition is secondary to her not
receiving the feedings when” N.T. is not in the hospital setting. Tr. Vol. 1, p.
91. Dr. Demetris opined that N.T. should have been gaining and maintaining
3
Parents argue that the evidence that they waited twenty-four hours to admit N.T. to St. Vincent’s after
medical providers at the hospital in Cincinnati strongly advised Parents admit her immediately does not
support the CHINS adjudication. The Parents do not agree that they were advised to have N.T. admitted
immediately. When the DCS service provider arrived at their home, Parents were making preparations to
take N.T. to the hospital. Because Parents were complying with their medical providers advice, albeit not as
rapidly as those providers or DCS would have liked, we agree with Parents that their delay in taking N.T. to
the hospital would not support the CHINS adjudication absent the other evidence discussed above.
Court of Appeals of Indiana | Memorandum Decision 20A-JC-502 | October 7, 2020 Page 19 of 20
her weight while in parents care if she was given proper feedings.4 Id. at 92.
Father was argumentative with Dr. Demetris which made it difficult for her to
communicate with him about N.T.’s care. Tr. Vol. 1, pp. 94–95.
[16] Parents cite to their own testimony that they do not turn off N.T.’s feeding tube
against doctor’s orders. But it was within the province of the trial court to weigh
their testimony against that of the medical providers, and we will not reweigh
the evidence on appeal.
Conclusion
[17] The evidence of N.T.’s severe malnutrition combined with Parents’ decision to
turn off N.T.’s feeding tube against the medical providers orders establishes that
N.T.’s physical or mental condition is seriously endangered as a result of
Parents’ neglect. This same evidence also supports the trial court finding that
the coercive intervention of the court is necessary to ensure that N.T. receives
the care and treatment she requires.
[18] For all of these reasons, we affirm the trial court’s order adjudicating N.T. a
CHINS.
Bradford, C.J., and Najam, J., concur.
4
The Parents argue that N.T. gained weight while hospitalized at St. Vincent’s because the doctors at that
facility changed her prescription and method of feeding. However, N.T.’s caloric intake stayed the same
throughout her hospital stay. Tr. Vol. 1, pp. 151–52. And the number of calories per kilogram of body weight
decreased during her hospital stay. Id. at 153.
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