Prosecution of Parent for Death of Obese 13 Year Old

[Jean Norris]

Region I HRSA staff, Regional Nutrition Consultants, and Dep RHA:

In story below, note that IF
the child had Prader Willi syndrome, all of the staff at Kaiser apparently
missed it.  How many HMO staff, private practice staff, CHC staff, et al in New
England might have missed it?  Our MCH training grant at Children's Hospital
(Leadership Education in Neurodevelopmental and Related Disorders) provides
training on Prader Willi and other disorders - do our other three?  And how
many providers who need it do not have access to this training?  What kind of
nutrition screening tool (if any) was Kaiser using which missed this?  What
kind of screenihg tools are being used in New England?  What kind of
specialized training did the Kaiser RD and other staff have?  What kind of
specialized training do New England RD's and other staff have??  In the March
1997 New England SERVE Survey on Managed Care, 73.5% of Primary Care Physicians
(N=253) care for children with "obesity/eating disorder," but 33.5 % of the
Primary Care Physicians were "not satisfied" with their ability to make
referrals for nutrition counseling and 42.9% were only "somewhat satisfied".
(This part of the survey, titled " Provider Satisfaction with Managed CAre
Plans" asked Primary Care Providers to "Rate the degree to which you are
satisfied with your ability to provide quality care for children with special
health care needs who are enrolled in managed care plans.")  (The NE SERVE
project is funded by MCH.)

Massachusetts Health Dept. has done some limited training in the past for HMO
RD's re complex issues of children with special health care needs.  

We (New England) are
planning a nutrition conf in Burlington VT June 1-3, 1998 called The Team
Approach to Services for Children with Special Health Needs: NUTRITION MAKES A
DIFFERENCE / Working within a Managed Care Environment.  We have no funds for
taping at this time, so number of people to benefit from the training will be
limited.

I have applied for P and E money 2 or 3 times in the past to do a needs
assessment of nutrition services in CHC's to assist in identifying
training/staffing needs, but funds were not awarded.  

We have made so much progress, but there is so much more we
could be doing to prevent tragedies, but we do not have staff or funds in this
field office.  It is heartbreaking to know that more could be done but we
cannot do it.

Jean

-----------------








The following letter was sent to the Contra Costa Times in response to the
Times choosing Anneke Hogeland for the Golden Pen Award.  Anneke wrote to
the Times about Marlene Corrigan, who is currently on trial for felony child
abuse because her 680 pound 13 year old daughter was found dead on the floor
of their Richmond, CA apartment.  The Defense Attorney has postulated that
Christina suffered from Prader-Willi syndrome. The Prader Willi foundation
sent a physician to testify in Mrs. Corrigan's defense  Since the coronor
did not perform an "internal autopsy"and only visually examined the body, we
will never know the cause of Christina's death.  This child was taken care
of by an HMO from birth onwards.  She saw an RD for 30 visits when she was 9
years old and weighed about 300 pounds.  I am sharing this letter because we
are all members of the village that failed this child.  Hopefully, we will
do better next time.  

>

>Sent to the paper by fax at noon Sat. by Dr. Eileen Peck,DrMPH,RD

>                                        135 Windsor Avenue

>                                         Kensington, Ca 94708

>                                         December 27, 1997

>                                         (510) 525-4795

>Readers' Forum 

>The Times

>PO Box 100

>Pinole, CA 94564

>

>Dear Editor:

>        Anneke Hogeland may well deserve the Golden Pen Award according to

>your criteria.  However, I strongly disagree with her basic assumption that

>Christina's mother, Marlene Corrigan, is responsible for Christina's

>obesity and death.  I also take exception to her conclusion that in

>covering this tragic case the West County Times was stooping to the level

>of the negative media and reporting trash.  Childhood obesity is a major

>health problem in this state and country that the health care industry and

>society are ill equipped to help.

>        I was the Public Health Nutritionist  with the California

>Department of Health Services Child Health and Disability prevention

>Program from 1981-1990.  Part of my responsibility was to try to find ways

>to combat the problem.  Some progress has been made but much is still to be

>learned.  I know that obesity is the most common nutrition related problem

>found in California  children today.  Many times overeating and under

>activity are the basic causes that education and positive change in eating

>and exercise habits will correct.

>        There are many situations in which childhood obesity is a

>multifaceted problem that does not yield to an easy solution.  Christina's

>problem appeared to be one of these.  To diagnose and treat a problem as

>severe as  this takes a multidisciplinary health care team specializing in

>childhood obesity.  Such teams exist in very few places.  If Mrs. Corrigan

>failed her daughter it was in not demanding that the health care and

>education systems give her and Christina the help they  needed.

>        Many people failed Mrs. Corrigan:  the Doctors at Kaiser in not

>adequately diagnosing the disorder and providing the case management for

>which they are paid; the nutritionist in not realizing this was a problem

>that diet counseling alone could solve;  the school personnel in assuming

>this was not a case warranting home schooling and neglecting their legal

>responsibility to follow up on truancy; the school and public health

>departments in not having public health nurses who could help with case

>management and referral  when Christina did not attend school;  the coroner

>in not performing a complete autopsy; society in being willing to blame 

>fat people for their problems instead of providing the support and services

>families in stress need; and I and my former program for not having more

>aggressively demanded that resources be allocated to this important health

>problem.  

>        The story that really deserves reporting is that childhood obesity

>is a complex problem that the medical care system and society in general

>are not prepared to deal with.

>                                                        Sincerely,

>                                                        Eileen B. Peck,

>DrPH, RD

>                                                        Retired Public

>Health Nutritionist

>

Joanne P. Ikeda,MA,RD
Cooperative Extension Nutrition Education Specialist
Department of Nutritional Sciences
University of California, Berkeley
CA 94720-3104

Phone (510)642-2790
FAX (510)642-0535
E-mail  jikeda at socrates.berkeley.edu