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As the number of overseas adoptions increases, so does the demand for specialized health care. A cottage industry of pediatric specialists -- one New York pediatrician, Jane Aronson, even calls herself the Orphan Doctor -- has popped up, offering to treat parasites and other unusual medical conditions not commonly found in American babies, as well as behavior disorders.
In recent years, Chinese baby girls and orphans from the former Soviet Union have become popular choices. But long before those children were in vogue, Americans were adopting babies from South Korea. That continues; South Korea ranked third behind China and the former USSR in foreign adoptions in 1999.
Historically, a Korean baby has been a good choice, particularly if he or she comes from Eastern Social Welfare Services, a well-established, nonprofit Christian orphanage in Seoul, a city with sophisticated medical facilities. Eastern prides itself on the fact that it houses infants who are to be adopted with a foster family until the babies can be sent to their new families in the United States.
And Korean babies have been known to have fewer medical problems than, say, the Eastern European kids who are known for developmental delays from isolation in orphanages, or infants from less-developed countries where illness is common.
That assumes, of course, that the adoption agency shares all pertinent medical information -- a long-standing concern in the adoption community. The U.S. State Department's international adoption regulations are now being reviewed, and one sticking point is what sort of requirements the agencies will have to meet to provide complete medical records on children proposed for adoption.
Here in Arizona, Department of Economic Security guidelines make it clear that adoption agencies are required to provide medical histories of the children.
Concern over a prospective adoptee's health is so great that many people request a videotape of the child, and send that along with medical records provided by the agency to pediatricians trained to make preliminary diagnoses regarding the child's health. Cheryl and Dennis Moore did not do that, but in Jamie's case, it wouldn't have mattered. All the Moores initially received, via Dillon Southwest, was a snapshot of an apparently healthy baby and a birth report showing him to be in excellent health. They were told that the baby had a little diarrhea, but that is so common it was brushed off as insignificant.
The Moores were not told that Jamie's diarrhea was so severe he had been hospitalized at Eastern's clinic for almost two weeks, or that while his height was increasing, he was not gaining weight. No one mentioned that Jamie's head was also growing far more rapidly than the rest of him -- a warning sign of hydrocephalus or another serious malady.
Eastern knew all of this, all along. It did not pass the information on to Dillon Southwest, so the Moores were not told. What is unclear is whether Eastern and Dillon were aware of arguably the most vital piece of information: an ultrasound performed during the mother's final days of pregnancy that showed the possibility of hydrocephalus -- Jamie's ultimate diagnosis.
But what is known -- and it's at the heart of a lawsuit the Moores eventually filed against the adoption agencies -- is that Dillon Southwest did not insist that Eastern release all available medical records. Dillon's employees have repeatedly stated that they trusted Eastern to turn over whatever records were deemed pertinent. Earlier this year, a judge ruled that as the intermediary between Eastern and the Moores, Dillon is responsible for Eastern's actions -- in this case, the failure to produce medical records.
But Dillon's employees have said they've continued to rely on Eastern to decide which records need to be turned over in other adoption cases.
The Joint Council on International Children's Services, an affiliation of international adoption agencies, requires members to: "Seek to provide as complete, accurate and objective information as possible about children who need adoption so that families can make informed decisions about the appropriateness of a particular placement. Divulge all information which is obtained to prospective parents. Provide written information which will include, whenever possible, medical, social, psychological, developmental and legal information."
Dillon Southwest is a member.
Dillon and its employees have declined to comment, through their attorney, Charles Hover, who explained that his clients couldn't talk because of pending litigation. Eastern's attorney, Don Peters, did speak on a limited basis. Hundreds of pages of legal filings, medical records, depositions and paperwork created during Jamie Moore's adoption were reviewed in preparing this story.
If a judge or jury finds that Eastern was negligent in providing medical records, Dillon Southwest could lose its license and Jamie's family could get some much-needed cash to put toward his lifelong care.
But the Moores won't ever get their old life back.
"I pretty much lost my entire life," Cheryl admits. "Honestly, if I'd known what would happen, I would not have taken James. I would not have taken James if I had known half of what was in his medical records before he got here. I wouldn't have. I'm not stupid. I would have taken them to a pediatrician and he would have said no!"