Two years ago, Arizona Child Protective Services took Carol Dunlavy's 2-year-old daughter. It was alleged that Dunlavy was purposely making the child sick because Dunlavy suffered from Munchausen syndrome by proxy.
Like most parents caught up in the system, Dunlavy said she was innocent.
She was right.
Munchausen syndrome by proxy
Now, 16 months after she said goodbye to her daughter, Sarah (not her real name), Dunlavy finally has validation in the form of an investigation from the Arizona Ombudsman-Citizens' Aide that says what Dunlavy has said all along: that she doesn't have Munchausen syndrome by proxy, that CPS failed to follow its own procedures for removing her child, and that she and Sarah would never have been separated if the agency had actually done its job.
The report is bittersweet for Dunlavy. She's lost almost two years to the case — and the report has resulted, so far, in little more than the re-training of a couple of CPS employees.
Dunlavy's story came to New Times' attention in early 2008, when she and her lawyer came forward with her story.
It was clear something wasn't right.
The problems began when Sarah developed feeding issues as an 8-month-old, prompting Dunlavy to have her examined by the Division of Developmental Disabilities (an arm of state government that falls under the Department of Economic Security, also the umbrella agency for CPS). When she was approved for services, Sarah was seen weekly by a string of occupational and speech therapists.
It was hardly the type of Law & Order scene normally associated with Munchausen — the mom sneaking poison into her child's soup to fake cancer or other life-threatening disease.
But, in October 2007, a pediatrician, who was new to Sarah and saw her in his office for less than five minutes, called in the accusation to CPS. At the same time, he arranged for Sarah to be admitted to Phoenix Children's Hospital for observation.
Dunlavy thought she was checking her daughter in to monitor her eating habits and come up with a new therapy plan. She was also glad to be at the hospital because her daughter had recently suffered from unexplained "shaking fits," observed by her therapist, and she was worried there was something else going on.
Turns out the hospital was doing an observation, but not of the child. They were watching Mom.
Throughout Sarah's medical records, which New Times has reviewed, one thing is very clear: Sarah's mother did not want a feeding tube inserted to help with nourishment, despite a recommendation from a doctor. In fact, Dunlavy had taken her daughter to a new doctor to try to avoid it.
But somewhere along the line, that message became twisted, and when CPS came knocking, the complaint was that she was trying to force her daughter to have an unnecessary medical procedure by advocating for the feeding tube.
Though CPS arrived without having done any of its homework — as Dunlavy and, now, the ombudsman report both say — the case still had to wind its way through the system.
The child was placed with her father, hearing dates were set, and the allegations against Dunlavy kept changing.
In February 2008, Dunlavy's dependency hearing — something every parent in the CPS system is entitled to — was thrown out by a juvenile court judge who kicked it down to family court as a custody matter. Dunlavy never got to present her evidence or try to prove that CPS had failed to do its job.
Ever since, Dunlavy and the father, who is not being named by New Times (to protect the identity of the child), have been fighting the case in family court. Reached earlier this month, Dunlavy declined to talk about the progress of the case because final orders will not be issued until June. But court records indicate that she now has overnight unsupervised visitation with the child.
Holly Bartee, the attorney for the father, did not return a call seeking comment.
As the custody case winds its way toward a conclusion in family court, Dunlavy has the ombudsman report to back her up. It's a set of significant accusations against a state-run department usually protected by secrecy.
The report accuses CPS of four key things — all of which were first mentioned in the March 2008 New Times article. CPS failed to:
• Conduct interviews as part of the investigation process.
• Obtain collateral support — Sarah's medical records, from birth through her hospital stay — in a timely manner.
• Provide the mother with services that would have alleviated the circumstances that brought the child into care.
• Obtain a Munchausen expert to collaborate on their investigation.
The final message is clear: "We conclude that the department failed."
The Department of Economic Services declined to comment, referring New Times to its five-page response contained in the report.
The department disagrees with the findings in the report. Tracey Wareing, director of DES, spends five pages defending CPS' conduct.
He's just plain wrong when he tries to discuss Sarah's medical records, raising the question: Has CPS still not reviewed them?
"The mother had informed the medical staff that the child suffered from an extensive history of serious seizures," Wareing writes, justifying the decision to take Sarah in the first place. "Finally, a concern was shared by medical staff that the mother was requesting the insertion of a gastrointestinal feeding tube for the child."
It's clear from the agency's response that the feeding tube was the reason for removing Sarah from her mother's care, yet nowhere in literally hundreds of GI records and notes from nurses does it say Dunlavy wanted a tube. In fact, there are documents that clearly say she did not want one.
If CPS had followed even one of the four policies it violated in this case and read the records, Dunlavy never would have lost her daughter.
But, as the ombudsman's report makes clear, CPS didn't.
Tom Ryan, who represents Dunlavy in the family court case and has worked on a number of Munchausen syndrome by proxy cases in the past, counts the report as a victory, though he acknowledges Dunlavy still must win in family court.
"The taking of this child was entirely unnecessary. Had CPS followed its own internal policies and procedures, this child would have never been taken and they would have determined this wasn't a case of Munchausen syndrome by proxy," he says.
Still, like his client, Ryan sees the report as ultimately unfulfilling, and he balks at the idea that the ombudsman's findings indicate a one-time breakdown in policy.
"I truly appreciate the work the ombudsman put into the report, but it's really just a slap on the wrist," he says.
Change isn't likely.
CPS reform was a big deal to former Governor Janet Napolitano, and in the past two legislative sessions, bills have been introduced to make the agency more open, but with a new governor and a budget crisis, legislators don't expect major policy reform this year.
New laws won't necessarily make things better, says former state Senator Laura Knaperek, who has long been an advocate for CPS reform and says the agency and the Legislature would need to work together to really change the systemic problems highlighted in the Dunlavy report.
"There are many policies the Legislature could pass that would make a positive difference," she says. "However, the reality is: No matter what is passed, CPS is in control of correctly implementing the policy."
Though it's been a long year for Dunlavy, she is happy the report is out, and she looks forward to the ordeal ending in court so she can get back to just being a mom. She spoke on the phone to New Times recently while grocery shopping with Sarah. Toward the end of the conversation, the girl, who turns 4 this summer, got a little fussy. The classic my-child-is-pitching-a-fit-at-the-grocery-store moment wasn't lost on Dunlavy, but she sees things a little differently than most parents now.
"I never thought I'd enjoy temper tantrums," she says. "But there you go."
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