Taking an injured baby to the hospital is a normal and healthy parental response, but in the case of one Wisconsin family, this led to them losing custody of their baby and the father losing his job as a doctor at a hospital. The parents’ story and that of the hospital’s child abuse team tell two very different tales, raising concerns over how children are removed from homes, how families can proceed, and why due process is so often lacking in family courts.
Dr. John Cox and his wife, Dr. Sadie Dobrozsi, have two older children and a baby they were adopting, L.G., as she is known in the records. Dobrozsi was out of town at a conference with the two other children, leaving Cox and the newborn girl home. He fell asleep, according to his reports, with her in his bed in the early hours of the morning, and accidentally partially rolled onto the baby.
Cox woke up when she cried, quickly picked her up, and was concerned she was injured from his mistake. He talked to his wife over the phone, and she suggested taking the baby to see a doctor to make sure L.G. was okay.
This is where the story becomes a nightmare. Child abuse investigators, including a nurse practitioner, at Children’s Hospital of Wisconsin, identified marks on the baby as bruises. The baby’s collarbone was fractured from where Cox said he had rolled onto her, an injury in an infant that typically heals without intervention.
The case was turned over to Child Protective Services, the baby was removed from their custody, and Cox was arrested. But was this baby abused?
Experts Testify This Wasn’t Child Abuse
According to the 15 specialists who gave statements in defense of Cox, no, she wasn’t. The extensive contusions recorded at Children’s Wisconsin weren’t bruises at all, but birthmarks, according to seven dermatologists. Dr. Yvonne Chiu, who is board-certified and specializes in pediatric dermatology, described the marks on the baby as “pigmentary lines of demarcation which are linear birthmarks, not multiple linear-shaped bruise patterns.”
When lab work was done on L.G., it revealed abnormal hematological results, multiple hematologists testified. Dr. Lynn Malec, the medical director for the Comprehensive Center for Bleeding Disorders at the Medical College of Wisconsin, described L.G.’s hematology results as “abnormal.” L.G.’s results could indicate a bleeding disorder, making bruising or skin discolorations more likely from typical handling, not abuse.
None of these results were included with the criminal complaint by the deputy district attorney when Cox was charged, nor have they been added as the state has proceeded with the case.
The defense’s motion to dismiss also includes testimony from the original doctor who examined L.G., indicating he doesn’t think this baby was abused, that the presentation of the medical testimony has been inaccurate, and that the baby should not have been removed from her family: “I have some concerns in some discrepancies in [L.G.’s] medical records between Ms. Ventura’s (APNP) findings and conclusions and other physician’s findings, including myself. I believe these discrepancies may have led to an incorrect conclusion about suspected child abuse and thereby the removal of [L.G.] from her home.” This information was also excluded from the criminal complaint against Cox.
All the testimony supporting Cox in this defense is by people with specific qualifications in their fields, something Children’s Wisconsin has discounted, both since the Cox family’s problems began and since NBC broke this story:
Kate Judson, a lawyer in Madison and executive director of the Center for Integrity in Forensic Sciences, reviewed the case at NBC News’ request and said it follows a familiar pattern that she’s observed over the years. Child abuse specialists, she said, sometimes overstate their expertise while minimizing the expertise of other subspecialists. ‘What’s striking to me is that you have these leaps in logic that are unsupported,’ Judson said. ‘So you have a nurse practitioner here saying, ‘Well, I can determine with accuracy and certainty that this bruise was intentionally inflicted.’ And then you have a dermatologist, who is unquestionably an expert in the examination of skin lesions, who’s saying, ‘Well, this isn’t even a bruise.’’
Regardless of the extensive expert testimony, the state hasn’t dropped the case against Cox nor returned the baby to her parents.
Lack of Due Process Caused Irreparable Harm
Whatever the final results of the criminal and family court decisions with the Cox family, they will never regain the months they have spent separated from their baby — early, formative months of this child’s life. They will never regain the money they’ve spent defending themselves from this case, not to mention the stress of salvaging their reputations in their community and hospital, where Cox previously worked.
Sensible people want babies and children protected from child abuse. We want children to be safe and loved, with families that treat them well. But that also means the evidence must be clear and well in favor of the state removing children from their families because those removals are traumatic for the children.
This case, with two parents who were well-known and well-regarded in the community, has been the catalyst for conversation, both within Children’s Wisconsin and across the nation. When interviewed by NBC about the situation, about the child abuse team, and about how investigations happen, “Three of the doctors recalled being pressured by child abuse pediatricians to alter medical records, removing passages where they had initially reported having little or no concerns about abuse.”
If this didn’t specifically happen in the Cox family’s case, it’s still a troubling and concerning pattern, one we should evaluate. We expect doctors to report medical facts, findings, and observations, not to build abuse cases against families.
We need families and doctors to work together as teams to help kids grow healthy and strong. Stories such as this erode trust in doctors and hospitals. Parents and their children are vulnerable, and they place an incredible amount of trust in the doctors, nurses, and other medical professionals. They trust that those professionals are clear-headed, unbiased, and there to help.
At Children’s Wisconsin, this case has caused concern for other doctors who watched how this case has unfolded:
Cox’s ordeal has also opened a rift at Children’s Wisconsin, where some treating physicians say they are so alarmed by what’s happened to him that they now hesitate to refer injured children for evaluations by child abuse pediatricians, fearing that an abuse specialist might jump to the wrong conclusion and needlessly report parents to Child Protective Services.
This has altered how doctors there may care for the children in their own families, especially with injuries and other events related to what the Cox family experienced: “Five doctors told a reporter they’re even afraid to bring their own children to their hospital after accidental injuries, fearing that a misdiagnosis or miscommunication might lead Child Protective Services to break their family apart. ‘This is a disease in our hospital,’ one physician said. ‘The way John’s case has been mishandled has opened all of our eyes to how big the problem is.’”
Due Process for Families Is Essential
Child Protective Services faces a difficult task. Far too often overworked, with limited resources and not enough time for all the cases on their schedules, too frequently seeing children hurt in terrible ways, they are in the impossible position of being vilified whether they remove children or leave them. I know good, honest, hard-working people with hearts for helping others through social services, and I know their heartbreak when situations go poorly.
Between these sides should be due process — fair, predictable treatment under the law, with all parties understanding the rules, the timelines, the entire process. Too often, it seems, family courts operate under a different set of rules, despite clear legal guidance that the Constitution and due process do indeed govern family courts. As Mike Hixenbaugh has encountered in Wisconsin, publishing coverage of these issues brings legal challenges even for reporters:
Authorities in Wisconsin did not want you to read this story. First a prosecutor sought a gag order after I reached out seeking comment. Then a state agency sent me a cease and desist order warning of potential criminal charges.
— Mike Hixenbaugh (@Mike_Hixenbaugh) January 27, 2020
There must be a road forward for families, kids, and those who dedicate their lives to protecting children. The mistrust, the doubt, and the fear of doctors and medical institutions shows our system isn’t functioning in a way that best serves anyone. It’s a shame because real lives are at stake. We must do better.