Just before dawn on April 6, a Phoenix woman we'll call Susan Johnson told a nurse about a conversation she'd just overheard at Phoenix Children's Hospital.
According to a sealed Avondale Police Department report--a copy of which New Times obtained--Johnson said she'd heard another woman tell a man, "I think I shook him to[o] hard this time. I may have broken his back."
The 62-page report generated by the west Valley police agency doesn't indicate if the man responded.
The woman overheard allegedly was Elizabeth Shannon Whittle, 23-year-old mother of the "Avondale quads," as they'd become known to Valley residents a few months earlier. Whittle was talking to the quads' 21-year-old father, Tony Perez, according to the police report.
The evening before, April 5, the Avondale couple had driven 3-month-old Anthony Perez to an emergency room after his maternal grandmother noticed his head was badly swollen and he was barely conscious.
Doctors at Phoenix Children's Hospital determined that Anthony had suffered multiple broken bones, including a fractured skull, ribs, collarbone and arm. He was having convulsions, and was bruised over much of his body.
Also, Anthony's retinas were hemorrhaging--often a telltale symptom of "shaken baby syndrome," a medical term describing injuries that result from violent shaking.
Worst of all, Anthony's brain was bleeding badly.
Doctors unanimously concluded that the bleeding was caused by a devastating blunt-force blow, and that his injuries were consistent with child abuse. Examinations of the other quads a few days later revealed similarly serious injuries, though not as immediately dire as Anthony's:
* Baby Damian had suffered 17 rib fractures, two skull fractures, bone-chip fractures of both knees, and permanent brain damage.
* Baby Megan had suffered 13 rib fractures, two skull fractures, fractures of the left arm, right collarbone, and fractures of both thighbones, and permanent brain damage.
* Baby Robert had suffered seven rib fractures, a skull fracture, broken arms and other injuries. It's unclear from the Avondale report if he, too, suffered permanent brain damage.
* Baby Anthony had suffered 11 rib fractures, two skull fractures, a broken right arm, and sustained severe, irreversible brain damage.
It had taken a frightening degree of force to injure the babies so badly.
And doctors say the injuries occurred at different times, over a period of several weeks.
Whittle and Perez denied wrongdoing in untaped police interviews at the hospital early that morning.
"In this writer's opinion," state Child Protective Services (CPS) caseworker Judy Almy wrote April 16, "Anthony and his siblings were the victims of severe physical abuse resulting in life-threatening injuries which most likely will result in multiple, lifelong disabilities. . . ."
Despite that opinion--which echoes those of doctors who have treated Anthony--no one yet has been charged in the assaults. But sources at the Maricopa County Attorney's Office say that a decision on how to proceed is imminent.
The Avondale police report depicts Whittle and Perez as the prime suspects of assaulting their own babies.
A likely motive?
To try to keep the quads from being so much trouble. As pathetic as that sounds, medical literature says that's often the excuse given by people who shake and abuse their babies.
It could be argued that medical personnel could have prevented some of the serious injuries to the quads.
The Avondale report indicates that on March 22, Whittle and Perez took Anthony to Samaritan West Valley Health Center in Goodyear for emergency treatment of what doctors then suspected was meningitis.
There, Anthony was x-rayed. But neither doctors at West Valley nor at Phoenix Children's Hospital--where he was transferred--gave the x-rays a thorough examination, if they looked at them at all.
If they had, they certainly would have seen that Anthony had a freshly broken collarbone, which doctors concluded after his April 5 hospital admission had been caused by a powerful blow.
Pediatric experts contacted by New Times say the broken bone likely would have raised red flags that Anthony had been abused.
Those suspicions, in turn, may have prevented Anthony and his siblings from sustaining more injuries, including--some doctors have told investigators--injuries that rendered Anthony permanently blind and deaf.
On top of that, a doctor at West Valley drew bloody spinal fluid (it's supposed to be clear) from Anthony during a procedure on March 22. Two taps at Phoenix Children's Hospital a few days later also produced bloody spinal fluid.
Medical texts indicate that the presence of blood meant either that the doctor's technique had been faulty, or that the spinal fluid contained blood from Anthony's already battered brain.
Doctors at the two hospitals apparently didn't consider the more sinister possibility until after Anthony was readmitted to the hospital on April 5. By then, he had been damaged beyond repair.
News of the abuse was a big deal, especially in light of the controversy that had enveloped the quads even before their births.
A December story in the Arizona Republic contrasted the Avondale couple's financial struggles with the good fortune--literally--of the Iowa parents of septuplets born in November.
The Avondale quads had been conceived without the use of fertility drugs--a one-in-10,000 shot--but radio talk show callers and newspaper letter writers blasted the unmarried Whittle's failure to use contraception when she already had a child, was unemployed, broke and on welfare.
At the time, the quads' father was working as a $200-a-week security guard, a job he lost in late February.
However, publicity about the couple's money woes also snared thousands of dollars of donations.
Born January 9, the quads were named--in order of birth--Megan, Anthony, Robert and Damian. They were born about a month prematurely, and each weighed little more than three pounds. But Dr. David Hall noted at a January 14 press conference that "the babies are doing extraordinarily well."
Said Whittle at that press conference, "These babies were given to me by God. There's nothing you can say negative about that."
The quads were not in the news again until early April.
"Quads in hospital, abuse suspected," a front-page headline in the April 10 edition of the Arizona Republic said. "Skull fractures, broken bones raise queries in Avondale case."
That day, Whittle told a TV reporter she'd done nothing wrong.
"I would never hurt my babies," she said, whimpering. "God gave me these babies, and not for me to hurt them."
Whittle paused, then added more calmly, "We really can't answer any questions until we get a lawyer."
The couple's co-counsel, Norman Katz, tells New Times, "Our clients have maintained from the start that they didn't abuse their children, and that's a fact. But this isn't the right time to talk. When the time is right, they [Whittle and Perez] or we will probably make a statement."
The Avondale report doesn't say if authorities are convinced which parent--or perhaps both parents--abused the quads. But under Arizona law, if one of them stood by without rendering aid to a battered child, that parent also may be held criminally accountable.
Child abuse can be difficult to prove beyond a "reasonable doubt." Prosecutors must prove a perpetrator had access to a child during the time in which injuries allegedly were inflicted.
That's often a large hurdle, because child abuse usually occurs in isolation, without eyewitnesses. The young victims are unable to testify. If several people had access to a child, chances for a a successful prosecution--or even arrests, for that matter--are slim.
Further, doctors often are unable to determine precisely when a child was injured. That inevitably leads defense attorneys to deflect blame from their client toward anyone who had even scant contact with the victim.
Sometimes, that strategy works.
"The proof of every one of these cases is in the details, details which are often overlooked, misunderstood or ignored by those who have insufficient training in this complex area," says Rob Parrish, chief child abuse counsel for the Utah Attorney General's Office.
Parrish might as well have been talking about the actions of Avondale police in the critical first days after Anthony's April 5 hospital admission.
Probably most important, detectives--in their first and only chance to question Whittle and Perez--failed to pin down the couple on inconsistencies in their accounts of Anthony's health before his emergency admission.
Only after the County Attorney's Office involved itself in the case April 9 did the investigation get on track. But even then, according to its own report, the Avondale department made serious investigative mistakes.
On April 10, for example, Elizabeth Whittle called the police station and left a message for detective Kelly Shore to call her. This afforded Shore a rare opportunity to reinterview a chief suspect--knowing this time that all four babies and not just Anthony had been injured.
But no one apparently told the detective that Whittle had called. Shore didn't get wind of it until three days later, when he read an e-mail message after returning to work after a long weekend.
(Why Shore's supervisors allowed him to take time off during a crucial juncture of one of the highest-profile cases in the city's history is unclear. Shore did not return a call from New Times. Avondale Lieutenant Gordon French declined to comment on any aspect of the case.)
By the time Shore got Whittle's message, the couple had hired an attorney who told them to clam up.
The Avondale police report itself poses another problem in the quads case. It is inexact, incomplete and, at times, incomprehensible--in other words, a defense attorney's dream. An excerpt: "Dr. Vetto stated that the reason why Anthony was brought to the hospital for illness the past few days with a fever and derriere on that day."
If the case weren't so serious, the report would be laughable. Yet the report does manage to describe dangerously stressful conditions at the Whittle/Perez household--conditions that authorities strongly suspect made for a textbook case of child abuse.
Contributing factors cited in the report: a cramped, one-bedroom apartment, financial troubles, ever-demanding babies, Whittle's preexisting mental problems.
If Whittle and/or Perez are charged with crimes, prosecutors will have powerful circumstantial evidence in that the quads all were brutalized in a similar fashion. Doctors say the four repeatedly were shaken and subjected to blunt-force injuries.
The police report says adults with sole access to the quads were Whittle, Perez, Whittle's mother, and Whittle's teenage brother.
About 300 infant deaths were attributed to shaking last year, according to statistics provided by the United States Council on Child Abuse and Neglect. Many other babies--it's impossible to say how many because no central reporting mechanism exists--face permanent intellectual, motor and visual problems from being shaken.
Most often, according to medical journals, an adult will hold an infant by his or her chest and shake violently back and forth. Babies' neck muscles are undeveloped, which exacerbates the damage to the fragile brain tissue. How the perpetrator holds the baby during the shaking sequence often causes broken ribs and other fractures.
The intense shaking causes the baby's head to swing in a whiplash action, which often is sufficient to cause serious intracranial injury or death. But infants often don't exhibit any external signs of the damage inside their heads.
What could possibly possess a parent to brutalize a helpless child? Mental-health experts say more parents think about hurting their kids than would ever admit it.
But it's quite another thing to actually do it.
One mother recalls her then-infant daughters sometimes drove her to the brink.
"You forget they are little people just being themselves," she says, "and you think they try to get under your skin. You're on edge, one shake from becoming an abuser, and you don't know how to cope. You feel so alone. But you just can't go off and take that next step--smash your babies."
Friends and family of Whittle and Perez insist the police have it wrong, that the couple never would have taken that next step.
But the horrors inside that tiny apartment on South Greenleaf Lane in Avondale--population 25,000--happened on the parents' watch. That's why authorities have Whittle and Perez in their sights, and why the couple's arrests seem likely, sooner or later.
Social workers told investigators they knew from the beginning that the Whittle/Perez household was high-risk.
One caseworker said Whittle's mother, Anita Whittle, had worried in mid-February that once she moved into her own place, "Ms. [Elizabeth] Whittle would not be able to handle the pressure of taking care of the quadruplets on her own."
Elizabeth Whittle told the same social worker, according to the police report, "that when [Elizabeth] got to[o] stress[ed], she would lock herself into the bathroom, and hold one of the babies real close to her."
But one theme that emerges in the Avondale police report is the failed good-faith efforts numerous social-service agencies made on behalf of Whittle and Perez.
Those efforts began even before the quads were born.
Mercy Homecare "high risk" case manager Amy Van Ness told Detective Shore and two members of the County Attorney's Office that she'd first visited the home in early December--about a month before the births.
"[Van Ness] stated that Ms. Whittle was diagnosed with clinical depression, and her 6-year-old daughter Ericka had Down syndrome," Shore's report says. ". . . Social worker [Van Ness] also stated that Ms. Whittle wanted to get back on her medicine from ComCare for her depression."
(CPS records say Whittle had been diagnosed as seriously mentally ill, but stopped taking anti-psychotic medication before the quads were born.)
Shore's report says, "Whittle told Van Ness she was feeling tired and depress[ed]. Van Ness said they spoke in great length of getting back on her medicine after the birth. . . .
"Ms. Van Ness stated that, after the birth[s], Ms. Whittle refused any help that was offered to her. Ms. Van Ness said the assistance was offered because of Ms. Whittle's [mental] condition and with the arrival of the quadruplets, her office felt there may be problems of stress once the children were brought home."
Van Ness told Shore that she tried to give Whittle and Perez the names of public and private agencies that could provide them food and baby supplies. But she had difficulty even contacting Whittle after the quads were born:
". . . Other family members would answer the telephone and state that Ms. Whittle was sleeping, during the daytime. . . . All of the help was refused when offered. Ms. Whittle did allow Van Ness to enroll her into a program called 'Nuestra Familia,' but she would not contact the caseworker or return calls."
In a separate interview, Mercy Homecare nurse Wynale Haynes told investigators how difficult Whittle and Perez made it for her even to see the babies.
Haynes said that, during a February 3 home visit, "she spoke to Ms. Whittle about continu[ing] to follow up with health care for herself and her children. Ms. Haynes advised that, during this conversation, Ms. Whittle looked tired. . . . Ms. Haynes advised that, after the first visit with Whittle, she called [a doctor's] office to see if appointments have been kept. She was advised that the appointments had not been."
In February, Whittle's mother, Anita, told Haynes she soon would be moving out of the Whittle/Perez apartment, and she worried that her daughter would be unable to care for the quads:
"Grandmother Whittle advised that she was concern[ed] about leaving her daughter's home and going back to her own residence. Grandmother Whittle explain[ed] her concern that Ms. Whittle would not be able to handle the pressure of taking care of the quadruplets on her own," the Avondale police report says.
Mercy Homecare closed its file on the Whittle/Perez case in early March, Amy Van Ness told the investigators, because "all of the resources had been exhausted. Ms. Van Ness said that she did have concerns about having the case closed, since she felt she had no cooperation from Ms. Whittle or Mr. Perez, and also for the missed doctors' appointments."
Concurrently, Tony Perez lost his security-guard job, and started spending more time with Whittle and the kids in the crowded, noisy apartment. The couple now were financially dependent on Whittle's social-security disability checks.
With minor exceptions, the quads' appointments with doctors until late March were uneventful.
On March 22, however, Whittle and Perez took Anthony to the West Valley emergency room with a 105-degree fever. Radiologists at the hospital took x-rays, and tried to determine what was ailing the infant.
That night, Dr. Thomas Vetto tried to draw spinal fluid from the baby, in an effort to learn if meningitis was present. Vetto later told investigators he'd drawn bloody fluid. Literature on shaken baby syndrome says blood in the spinal fluid often signifies child abuse. That possibility apparently didn't register to Vetto or the other doctors who treated Anthony at the time.
Vetto told investigators he never did see Anthony's x-rays during the infant's hours at West Valley on March 22. That night, a helicopter transported Anthony--and his x-rays--to Phoenix Children's Hospital for emergency treatment.
Doctors at Phoenix Children's attempted their own spinal tap to see if Anthony had contracted meningitis. That tap, too, came up bloody. Apparently, no one at that hospital checked Anthony's x-rays.
Anthony's fever receded with the help of antibiotics, and he was transferred on March 30 to Los Ninos Hospital to complete his treatment. Medical personnel later told investigators they did not notice any signs of child abuse during Anthony's five days there.
Los Ninos discharged Anthony on April 3. A hospital official later told investigators she'd spoken with Elizabeth Whittle before Anthony went home. From Detective Shore's report:
"Ms. [Larisa] Janner talked with Ms. Whittle about any types of needs that the hospital could help the family with, and Ms. Whittle refused, stating that they have everything in place, and that they have a support system."
Less than 48 hours later, Anthony was back in the hospital, in a near-comatose state and in extremely critical condition.
Elizabeth Whittle called Dr. Martin Berger of the Maryvale Pediatric Clinic late on the afternoon of April 5.
Berger later said Whittle informed him Anthony was having a hard time breathing, his head was swollen, and he might be having seizures.
The doctor told her to get Anthony to the West Valley emergency room, and he'd meet her there. Berger got there around 6 p.m., and asked the parents how long Anthony had been ill.
"They told him two conflicting stories," the Avondale police report notes. "The first was that Anthony had been acting this way since 11 a.m. . . . When Dr. Berger questioned the time frame, he demonstrated to investigators that he raised his voice and stated, 'since 11 o'clock.' Dr. Berger advised that they then told him that Anthony had been acting this way only for the past hour."
Anthony was flown by helicopter to Phoenix Children's Hospital, which admitted him at 8:16 p.m.
Detective Shore's report indicates he got to the hospital at 1 a.m. on April 6:
"Anthony's breathing was very labor[ed] and he did not react to touch. I also noticed several bruises across the chest, and arms that were purple in color. . . . [He] had a tube that was inserted into his skull and was draining fluids from his head."
Elizabeth Whittle was lying on a couch in a hallway when Shore arrived. Uniformed officers properly had separated Whittle and Perez--suspected child abusers.
At 2:17 a.m., Shore interviewed Whittle in the presence of CPS caseworker Irma Vega. He relied on his notes and memory in compiling a report of this crucial interrogation.
Whittle told the detective that Anthony had seemed normal after his release from Los Ninos. She said she'd awakened from a nap on the afternoon of April 5 when her mother, Anita, came by the apartment:
"Ms. Whittle advised that Grandmother Whittle went and checked on the four children, and noticed that Anthony did not look normal. Ms. Whittle said that Grandmother Whittle told her that his head looked bigger and he was not very active. . . ."
"Ms. Whittle then expressed her concerns that she was feeling like a criminal, because police and CPS were at the hospital. . . . Ms. Whittle explained that when they brought Anthony home from Los Ninos Hospital, he was acting fine, eating and sleeping regularly. Ms. Whittle advised that the damage to Anthony's head was not cause[d] at home, but must have happened at the hospitals."
Near the end of the 40-minute interview, Whittle allegedly made an unintentionally important admission to Shore.
"Ms. Whittle explained that, since [the] birth of the quadruplets, she and Mr. Perez have been the only caretakers for her children. On occasion, Grandmother Whittle will watch the children for a few hours at their residence, but that has not been done for more than two weeks.
"Ms. Whittle described herself as the aggressor in her relationship with Mr. Perez. Ms. Whittle stated that she will get so stress[ed] at times, that she will almost 'black out.'"
At 3:03 a.m., Detective Shore--again with Vega present--interviewed Tony Perez. Perez also surmised that Anthony had been injured during his 12-day hospital stay that ended April 3:
"Mr. Perez related that he described Anthony as [having] been 'spoiled' at the hospital, because he was double the size before he was admitted. . . . Mr. Perez said that he noticed that Anthony's head was bigger when they brought him home [April 3]. . . . Mr. Perez thought Anthony had been spoiled by hospital staff. . . ."
After the interview ended, police allowed Perez to rejoin Whittle.
"The two appeared to be talking to each other," Shore's report says, "and did not appear to be in a hurry to go see their son."
Shore left the hospital about 4 a.m. to return to the Avondale station. Within a half-hour, he got a call from the hospital. A nurse said Susan Johnson (a pseudonym), whose son was a patient at the hospital, had just overheard a disturbing conversation.
From the Avondale report:
"Ms. [Johnson] said she thought the female was talking on the telephone and she overheard the female saying, 'They're treating me like a bad guy.' Ms. [Johnson] advised she thought the female was talking to her mother or grandmother. . . .
"Ms. [Johnson] advised that she could hear the telephone being hung up and the female talking with an unknown male. The female said, 'I think I shook him to[o] hard this time. I may have broken his back."
Johnson immediately reported this information to the nurse. The only couple in the vicinity, according to the Avondale report, were Whittle and Perez. Johnson later told investigators she'd gotten a brief look at the female, who fit Whittle's description.
Later on the morning of April 6, Shore and CPS caseworker Vega drove to the Whittle/Perez apartment, where they spoke with Anita Whittle. The quads' grandmother agreed to take the remaining three quads to her home until things calmed down.
On April 8, a social worker and a nurse went to Anita Whittle's residence to check on the quads' welfare, and to tell her that Anthony's three siblings had checkups scheduled at St. Joseph's Hospital the following day.
The Avondale police report says Anita Whittle told the women "that she taught Ms. [Elizabeth] Whittle that excepting [sic] help is a sign of weakness, and that she had to be tough."
On April 9, doctors at St. Joe's confirmed that all of the Perez quads had been battered beyond belief.
Since April, news outlets have chronicled how CPS took custody of all four quads and put them in medically equipped foster homes after they were well enough to leave the hospitals.
(Whittle's 6-year-old daughter, Ericka, who has Down syndrome, has been living with her grandmother.)
Whittle and Perez have been allowed supervised, hourlong weekly visits with the quads at CPS offices. A CPS report indicates that, during a May 6 supervised visit, Elizabeth Whittle cooed to baby Megan, "You'll be back with Momma soon."
A week later, CPS officials notified Juvenile Court, "The current case plan is reunification with parents. Because there is an ongoing criminal investigation in this case, a specific target date has not yet been set."
On that legal front, Juvenile Court hearings are scheduled for mid-October to determine if the quads should remain wards of the state or be reunited with their parents.
Talk of reunification appalls pediatric neurosurgeon Hal Rekate, who treated Anthony's fellow quads after they were admitted to St. Joseph's Hospital on April 9.
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"Unless the perpetrator of the injury to these children can be identified and removed from this household," Dr. Rekate wrote in an April 23 to-whom-it-may-concern letter, "I strongly believe that there is no way that any of these children can be safely returned to that environment."
Actually, any likelihood of the quads' reunification with Whittle and Perez seems remote, in light of previously unpublicized information gleaned from the Avondale police report.
And the chance that Whittle might have yet more children is slim. Hospital records indicate she had her tubes tied after the birth of the quads.
Contact Paul Rubin at his online address: email@example.com