Two decades ago, when Dr. Michael Laposata was the director of clinical laboratories at Massachusetts General Hospital and a Harvard Medical School professor, he noticed a disturbing pattern. The state was taking children from their parents based on mistakes by doctors. Children with bruises or internal bleeding were being misidentified as victims of abuse after doctors missed underlying medical conditions that can cause those same injuries.
In the years since then, Laposata says he’s reviewed hundreds of cases on behalf of accused parents and helped overturn several convictions. Now the chief of pathology at the University of Texas Medical Branch in Galveston, he is part of a growing group of physicians who, along with lawmakers, are advocating for stronger safeguards to prevent child abuse misdiagnoses following a yearlong investigation by NBC News and the Houston Chronicle.
Texas lawmakers launched a series of hearings in response to the reporting, and some have proposed enabling courts or parents to seek a second medical opinion after a doctor reports abuse. Other lawmakers have suggested changing the way Child Protective Services approaches investigations when the only evidence of abuse comes in the form of a doctor’s note. Lawmakers said they plan to take up these proposals in the state’s next legislative session in 2021.
One parent that testified at those hearings was Lorina Troy. Her second son had been born with Benign External Hydrocephalus but was misdiagnosed when only a few months old as being the victim of abuse. Due to this, Lorina’s children were put into foster care and her husband, Jason, was charged with felony child abuse and lost his job. After selling their house and losing $80,000 in legal and medical fees, the family finally got JJ’s correct diagnosis two and a half years later. The legal charges were dropped, but the trauma of the ordeal remains.
But this phenomenon is not limited to Texas. Lorina’s story is just one of the stories shared with NBC News and the Houston Chronicle by more than 300 families from 38 states, following their yearlong investigation. The flood of responses demonstrates the nationwide reach of problems detailed in the series, which showed that child welfare workers in Texas removed children from homes after receiving reports from doctors that were later called into question.
The Texas Pediatric Society has begun discussing ways to improve the system, Camp said, but she stressed that any changes “must be carefully evaluated for potential unintended consequences to the health and safety of these most vulnerable children.”
Before any adjustments are made, Laposata said doctors and government officials must acknowledge what is widely known across all fields of medicine: Even good doctors make mistakes. Such errors are so common, researchers estimate that 12 million Americans receive a misdiagnosis every year, sometimes with devastating consequences.
For that reason, Laposata believes that additional medical experts should be consulted at the start of these cases rather than after an abuse diagnosis has already been made. He is advocating for a model he piloted a few years ago, when he moved to Texas and assembled a multidisciplinary team to provide free case reviews for parents who believe they’ve been wrongly accused.
Each month, the team examines about a half dozen abuse cases from across the country, looking for mistakes or missed medical problems that might explain a child’s injuries. The team then meets to discuss each case and attempts to reach a consensus. Sometimes they agree with the doctors who initially reported abuse, Laposata said, but other times they uncover exonerating evidence.
Similar panels could be set up to review cases on behalf of the state, either funded by the government or independently, Laposata said. Ideally, they would include not just pediatricians, but also pediatric subspecialists and pathologists with experience diagnosing a wider range of conditions that could mimic abusive injuries.
Lorina Troy has expanded on her testimony to the Texas state legislature and become an advocate for a mandatory second opinion law. In addition to Texas, she has talked to lawmakers in California and Washington, D.C. Lorina has also written a book about the family’s experiences with the medical and legal systems, titled “Miracles of Faith,”