Sitting across the table from two Douglas County sheriff’s investigators, a manager at Children’s Hospital Colorado quietly described how an effort to raise the alarm about potential medical child abuse of 7-year-old Olivia Gant was stopped by the hospital’s own child protection team.
“‘We can’t report a feeling,’ was basically their response,” floor manager Brenda Hyle told the investigators in a videotaped interview that was one of several given by doctors and nurses at Children’s Hospital Colorado during the investigation into Olivia’s death.
Those investigators went on to accuse Olivia’s mother, Kelly Turner, of faking Olivia’s illnesses and manipulating providers at Children’s Hospital Colorado into providing unnecessary and even life-threatening care before Olivia died in 2017. Turner pleaded guilty to child abuse negligently resulting in death earlier this year and was sentenced to 16 years in prison.
In the weeks leading up to Olivia’s death, some caregivers at Children’s Hospital Colorado suspected that Turner might be medically abusing Olivia, but the hospital did not alert outside authorities before Olivia died, despite the state’s mandated reporting laws, a Denver Post investigation found last year. Instead, the hospital investigated with its own internal child protection team, which decided there was no need to alert outside authorities.
“They asked a lot of questions, as far as, we need to have some kind of — I don’t know if evidence is the right way to put it — but we have to have something to support why we are reporting, or we can’t report,” Hyle told investigators about her meeting with the child protection team, known as the CAP team. “We couldn’t come up with concrete examples or evidence, other than, ‘This doesn’t feel right, this is not like it normally is for other kids, we’re just not positive we believe Kelly anymore.’ And CAP team was kind of like, ‘Well, we have to have more than that.’”
Hyle’s interview is one of four obtained by The Post this week through an open records request submitted to the Douglas County Sheriff’s Office in February. In the other interviews, three doctors at Children’s Hospital Colorado recounted treating Olivia. Two described experiencing moments of doubt about Olivia’s true condition while she was their patient; another expressed distrust of the state’s child protective system and defended the hospital’s decision to let Olivia’s mother take her into hospice care, where the girl died in August 2017 after she was heavily medicated and fed popsicles and juice for 19 days.
The interviews offer the first candid look at what doctors and hospital staff were thinking toward the end of Olivia’s life in a case that has been largely shielded from public view: the criminal case against Turner initially was suppressed by a judge to keep it secret, and Turner’s guilty plea stopped the case from proceeding to a jury trial, where doctors would have been called to testify and experts would have scrutinized Olivia’s care. Olivia’s surviving family, who pursued a $25 million civil claim against the hospital, have declined to comment since the lawsuit was resolved without going to trial, likely because of a confidentiality agreement.
The hospital’s leadership has refused to answer The Post’s questions about Olivia’s death, even as her ordeal led to a new effort to reform the state’s mandated reporting laws.
But in the lengthy videotaped interviews, the hospital’s doctors, who spoke to sheriff’s investigators without attorneys present, recount Olivia’s case in detail, sometimes with raw emotion.
“I feel absolutely terrible about this,” Dr. Seth Eisdorfer told investigators. “It’s the what if, what could we have done differently, how could we have seen this coming, what could we have done, could we have prevented this, could we have gotten someone involved earlier? Maybe.”
Olivia was a long-term patient at Children’s Hospital Colorado, but it was in the final weeks of her life, in the summer of 2017, that some providers at the hospital began to suspect she was being medically abused by her mother.
One doctor, Thomas Walker, was so concerned by a do-not-resuscitate order that Turner had requested for Olivia that he refused to sign it and called in the hospital’s ethics team.
“That was a scenario where I was really taken aback and saying, well, this girl stood up on the gurney and gave me a hug — if I’m remembering correctly — at the time of admission, and I’m saying, ‘Where does the DNR come from, who says she doesn’t have quality of life?’” he told investigators during an interview in June 2019. “I had frank conversations with mom that went kind of shockingly well. I had to tell her, ‘I’m not comfortable with this, I can’t sign this DNR. I can’t trust you to tell me Olivia has no quality of life.’ I think I probably said, ‘It doesn’t matter who you are, I’m not going to trust you to be the only voice and telling me that Olivia doesn’t deserve what we would offer any other child.’”
RELATED: Children’s Hospital Colorado chose not to report caregivers’ abuse suspicions before Olivia Gant died, records show
After Walker refused to sign the do-not-resuscitate order, Turner moved Olivia from his care to the care of another physician at the hospital who was willing to sign the order.
Walker at the time also expressed concern about the high doses of opioids Olivia was taking and questioned her status as a hospice patient. He told investigators in the 2019 interview that he remained “very, very uncomfortable” with Olivia’s care and had had sleepless nights over her case. He declined to comment when reached by phone Thursday.
During the 2019 interview, Walker said he never pinpointed a time in which Turner was “definitely lying,” and said that the hospital is not well equipped to deal with a parent who purposely misleads doctors about their child’s condition or seeks unnecessary care, a form of child abuse sometimes known as Munchausen syndrome by proxy.
“This is a nightmare for us,” he told detectives. “We are not very good at it, in terms of pressing.”
That sentiment was echoed by Jaime Belkind-Gerson, a doctor at Children’s, who said that doctors do not routinely fact-check parents’ claims. Turner claimed Olivia couldn’t tolerate food, and the girl was eventually diagnosed with pseudo-obstruction of her intestines, a diagnosis that is given to patients who exhibit symptoms of having intestines that are physically blocked, but no such obstruction can be found.
Belkind-Gerson told investigators in July 2019 that was “the perfect diagnosis to lie” about because tests for intestinal problems are “far from perfect.”
“I started getting very very worried,” he said about Turner. “I didn’t believe her, because there were discrepancies that just didn’t quite make sense. And in medicine, the tests are not perfect, we have stuff like this all the time, where you’re like, ‘Wow really? Maybe we should repeat that test because it doesn’t make sense,’ but it was just one after another after another. When you ask for small bowel and the small bowel transit looks amazing. When there’s ‘stool coming out of every orifice’ but nobody sees that.”
RELATED: Policies to review child abuse internally violate spirit of Colorado’s reporting law, ombudsman says
Investigators found Turner repeatedly lied about her daughter’s diagnoses, and some providers at Children’s doubted her descriptions of Olivia’s pain, The Post found after reviewing thousands of pages of Olivia’s full medical record last year.
“We have a medical system that is so divided with so many specialists now, that you will have 30 people involved,” Belkind-Gerson said. “And we’re not having medical meetings all in one room. I don’t know half the doctors who have taken care of Olivia in this hospital, it’s just the size. Of course we’re not able to communicate. The ‘he says, she says’ — it’s so easy. If she says, ‘Oh, the surgeon said this,’ unfortunately, I’m probably not going to take the time to call surgery and say, ‘Did you really say that?’ We just can’t or we don’t, unless we suspect. And I think we didn’t detect it in time, apparently.”
Belkind-Gerson and Hyle did not return requests for comment Thursday.
RELATED: Medical child abuse — like that alleged in Olivia Gant case — is rare and hard to identify, experts say
After the debate about the do-not-resuscitate order, additional ethics meetings were held at the hospital in July and August 2017, when Turner told doctors she wanted to stop Olivia’s nutrition, saying her daughter’s quality of life was poor and she was suffering. The girl was receiving nutrition through a tube in her veins, a process called total parenteral nutrition, or TPN.
Stopping TPN would kill Olivia. At that point, doctors, nurses, ethics consultants and others debated whether to follow Turner’s wishes. Some of Olivia’s caregivers deeply supported Turner, others were staunchly against sending Olivia to hospice, her medical records show.
“We literally said we had two pathways,” Eisdorfer told detectives. “We can say mom has the kid’s best interest in heart, we’ve done what we can medically speaking and we will respect the wishes to transfer to hospice and withdraw care. Or, we call (Colorado Department of Human Services) and pursue a Munchausen’s diagnosis. And that, as you know, is a significant uphill battle without wonderful documentation and no one felt like that was — they’re never cut and dry, but no one felt it fit the right picture for that… I guess in hindsight we maybe made the wrong choice. But at the time, everybody I talked to, including our ethics team… we all felt we didn’t really have, this was the right decision. It was our decision to allow her to pursue this and she had (Olivia’s) best interests at heart and were in line with proper medical care.”
Hyle told investigators that Turner’s willingness to put her daughter into hospice care was different from her experiences with other parents of terminally ill children at the hospital.
“Most parents are really invested in us doing everything possible for their kids,” she said, “sometimes even beyond the point where it’s beneficial, and it’s not going to be helpful… they are so invested in prolonging their child’s life and doing everything possible, to be hopeful and to think if we hang on a little bit longer there might be a new med, a new discovery. And I never got that feeling from Kelly.”
Later on in the conversation, Sgt. Attila Denes pressed Hyle on why the hospital and its child protection team did not report the providers’ suspicions to outside authorities.
“It seems like the consequence of error is, if we go down this path and support the parent, (Olivia will be dead) in about 21 days,” Denes said. “And the consequence of error of making a DHS referral is we upset the parent, she’s going to feel she’s being questioned about her decision-making. In my way of thinking, wouldn’t it be better to investigate and possibly save someone’s life?”
“I can say we definitely had a vigorous discussion on that with some of those meetings with ethics, and with the CAP team and social work,” Hyle said. “There were some people who truly absolutely believed what Kelly said, and that she was making the absolute right decision, but there was also a group of people who absolutely did not align with that decision and were really having a hard time with it.”
Eisdorfer, who declined to comment when reached Thursday, expressed distrust of the state’s child protective system when he spoke with investigators, and said he considered reporting a parent for potential abuse to be an extreme and irrevocable step.
“Not to fault the system, it’s very hit and miss,” he told detectives. “I’ve had families in Stapleton have their kids taken away because they’re playing in the park across the street. I’ve had kids of meth addicts where the report was filed three times and nothing happened. It’s not a perfect system by any means.”
He motioned toward a printed picture of Olivia on the table in front of him.
“If you pull the trigger, the trigger is pulled,” he said. “It’s, ‘You’re an unfit mother you’re doing something wrong.’ Hindsight is 20/20. Clearly, maybe we should have said something or looked into it further. Knowing what I know now, it’s a different story. Knowing what I knew then, we would have done the same thing, 100% of the time.”
A few minutes later, he grabbed Olivia’s picture and turned it over.
“I can’t look at (Olivia’s) face anymore, I’m sorry,” he said.
Statewide reform effort
On Thursday, Children’s Hospital Colorado declined to comment on Olivia’s death and refused to say whether the hospital has made any changes to policies or procedures since she died. Spokeswoman Rachael Fowler called Olivia’s case “incredibly complicated.”
Last year, a different hospital spokeswoman denied that doctors or nurses ever suspected Olivia was being subjected to medical child abuse, despite a note in her medical record on the day she was sent to hospice that said some of her care team had “concerns about the possibility of medical child abuse contributing to Olivia’s condition.”
But some lawmakers and advocates outside the hospital have pushed for change in the wake of Olivia’s death.
Earlier this month, Gov. Jared Polis signed into law a measure that creates a task force to study Colorado’s mandated reporting laws and suggest reforms — an effort that came directly out of Olivia’s death, said Rep. Meg Froelich, D-Englewood, who sponsored the bill.
“We wanted to send a strong message that the reports are not investigative,” she said. “You are reporting what you see, you are not conducting an investigation into what is happening in that house or with that child or with that parent or in that day care center. That is not the job of a mandatory reporter. They shouldn’t have to feel like — it is a gut feeling, it is what you have seen with your own eyes. And you don’t know. And why should you know? You’re a nurse.”
The 34-member, two-year task force will take a deep dive into Colorado’s mandated reporting law, which requires some professionals to immediately report suspected child abuse to law enforcement or the state’s Department of Human Services.
The task force will consider whether the laws are effective, the disproportionate impact of mandatory reporting laws on communities of color, training for mandatory reporters, how quickly reports must be made, how medical child abuse should be reported, and how reporting should work through institutions, like schools and hospitals, among other issues.
“What this task force is doing is pulling together the professionals, the people will lived experience who are impacted by the law, and trying to answer some of these hard questions that we’ve really not done in Colorado,” said Jordan Steffen, deputy ombudsman at the state’s office of Child Protection Ombudsman, which supported the legislation.
The task force will produce an annual report by January 2024 and a final report by January 2025. The two-year time frame is intended to give enough space for the many stakeholders involved to deliberate and investigate, Froelich said, noting that about 40 professions are included as mandated reporters. The original bill she proposed included some immediate changes to the law — like requiring mandated reporters to submit reports within 24 hours instead of “immediately,” a murky time frame not defined in the state’s current mandated reporting law.
But none of the involved stakeholders could agree on even those basic changes, she said, and the issues were instead put to the task force.
“That’s the way it is with legislation,” she said. “You think, ‘Let’s all get on board and stop kids from dying from medical child abuse,’ and then you’re like, ‘OK, how to do it is a little more complicated.’”
Hollynd Hoskins, the attorney for Olivia’s family who pursued a civil claim against the hospital, said she hopes Olivia’s death leads to reform.
“In Olivia’s memory, I hope we all work together as a community to make critical policy, training, education and legal changes to prevent this tragedy from happening to another child,” she said.
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