Clinic records reveal more injuries
Feb 05, 2010 (The Sacramento Bee - McClatchy-Tribune Information Services via COMTEX) --
Amariana Crenshaw, the Sacramento foster child found dead at 4 1/2 after a fire caused by a Molotov cocktail, had suffered more injuries in foster care than appear to have been known by county and state regulators.
New medical records obtained by The Bee reveal that Amariana was reportedly injured at least 11 times in her foster home before the arson that authorities believe killed her in January 2008.
"How do you explain that? That's horrible," said Dr. Carol Berkowitz, a prominent Los Angeles pediatrician and past president of the American Academy of Pediatrics.
"Somebody should have said, 'This doesn't happen to normal kids.' "
The medical charts, obtained from a Del Paso Boulevard clinic where she was taken by her foster mother, Tracy Dossman, include four injuries not reflected in government files -- including one Amariana suffered after being pushed from a car.
On Thursday, a spokeswoman for the state Department of Social Services said the investigation of the case published in The Bee last week has "raised additional concerns we are reviewing." Sacramento County Child Protective Services issued its own statement, saying the agency also was taking another look at the case.
"Whenever new information comes to light, a child's case is reviewed from top to bottom," the CPS statement says. "Consistent with this practice, we are re-looking at Amariana's case."
The new medical records were obtained by Amariana's biological father, Curtis Crenshaw, 48, whose parental rights were terminated a year before his only daughter's death. Her biological mother, Anisha Hill, had previously secured early childhood records.
The new records peel back another layer on the tumultuous life of Amariana Crenshaw. The girl and her two siblings were placed in the care of Dossman, a 41-year-old foster provider who has been cited for numerous licensing violations -- including two instances of locking the refrigerator while Amariana lived with her, the second time over Christmas 2007.
The girl was dead a month later, burned beyond recognition after a Molotov cocktail, possibly two, landed on or near her as she reportedly slept on the floor of her foster mom's vacant rental property.
Two years after Amariana's death, the case remains unsolved, and Dossman continues to be a foster provider in Sacramento with five children in her care. She has repeatedly declined to be interviewed.
The Bee's investigation raised questions about the official version of events, and whether Amariana was breathing when the fire broke out on Jan. 11, 2008. Some forensic pathologists who reviewed her autopsy for The Bee said the lack of soot in her lungs and carbon monoxide in her blood led them to conclude she was already dead when her small body caught fire.
Sacramento police spokesman Norm Leong said Thursday that, since the newspaper's series ran, investigators have "received some tips that we are looking into."
Record of stunted growth
Besides the chronic injuries, the new records provide additional evidence of Amariana's alarming lack of growth while in foster care.
The records show that from age 20 months, shortly before entering foster care, until her death -- a three-year period -- Amariana grew 3 inches and gained one pound, dropping from the 83rd to the 3rd percentile for weight. When she died, she also had fallen under the 3rd percentile for height.
Berkowitz, along with a renowned Colorado child abuse expert, said Amariana's growth curve is a classic indication of "deprivational dwarfism." The rare syndrome, characterized by stunted growth, is observed in children who experience intense emotional and physical neglect.
Other signs include food hoarding, drinking from the toilet, gorging and vomiting -- all behaviors exhibited by Amariana in foster care, county and state documents show.
"Some children who are severely emotionally neglected don't grow," said Dr. Richard Krugman, a pediatrician and Colorado medical school dean who once headed the U.S. Advisory Board on Child Abuse and Neglect. "When they're put in an environment that's nurturing, they take off."
A more complete picture of life inside Dossman's foster home also is emerging in Amariana's medical records, confidential documents released by the county, and state licensing files and court records.
Together, these documents show that the county was aware of at least seven instances in which Amariana allegedly was injured in foster care between January 2006 and August 2007. Social workers concluded the girl was "accident-prone."
County and state licensing records document five black eyes and/or split and swollen lips, plus an injured leg and a molestation allegation. Only one of the injuries -- a swollen eye and scabbed lip in February 2007 -- prompted any official action. That came from the state, after an evaluator cited Dossman for failing to properly supervise the girl.
But there were other injuries that Amariana's governmental watchdogs may have known nothing about.
Medical records from the Sacramento Community Clinic on Del Paso Boulevard reveal four injuries not noted in county or state records provided to The Bee. These were described as an injured leg in June 2006 after the girl was "push (sic) out of the car;" a "rug burn" on her back in July 2006; a cut scalp in August 2006 following a fall; and an injury to her eye at age 3 following a "fight with sibling."
Crenshaw said he is devastated by the thought of his "angel" being tormented. Crenshaw and Hill had complained frequently to CPS about her injuries but felt rebuffed for making waves.
"I tried to tell everybody, I tried and tried," said Crenshaw, who completed anger management, counseling and parenting classes in an effort to get his daughter back. "But nobody wanted to see it. ... That's the hard, crushing part of it that kills me."
The records Crenshaw obtained this week show that Amariana was taken to the North Sacramento clinic 15 times between October 2005 and September 2007.
In July 2006, a year after Amariana was taken into protective custody, the clinic ordered that the 3-year-old child be tested for sexually transmitted diseases because the caregiver reported the little girl "came from a family (with) multiple problems," and may have been sexually abused.
There is no indication in the records that CPS workers ever suspected Amariana's biological family of physically or sexually abusing her. When she was removed from her mother's care in 2005, the agency cited the mom's "chronic substance abuse" but stated that reunification was possible.
However, four months after Dossman had the toddler tested for gonorrhea and chlamydia (results were negative), a social worker for Doss-man's foster family agency recorded that someone allegedly touched Amariana's genitals in the bathroom of the foster home. The name of the alleged perpetrator was redacted from the record given to The Bee, suggesting that it was a child.
The social worker stated that the accused denied the accusation, but other children said "they observed the incident" through an open door.
Leg injury was serious
The new set of medical records also sheds light on one of Amariana's injuries, which required multiple medical visits and appeared to be serious. The county would determine there was no abuse involved.
On July 27, 2007, an unknown "mandated reporter" notified CPS that Amariana had been hit or kicked in the leg a week or two earlier by someone in the foster home and had not been taken to the doctor. The person said the child was unable to bear weight on her legs.
Dossman told CPS social worker Miri Mee that the clinic "appeared closed" so she took Amariana in six days later, on Aug. 2, 2007, and to a specialist a week after that.
The injury apparently was so painful and debilitating that Amariana was brought three times to the Del Paso Boulevard clinic. There, the provider commented that she was limping and noted that one leg was shorter than the other.
It is unknown whether Amariana ever saw a specialist, as the county and Juvenile Court have not released her full medical records to The Bee -- despite a court decision that her case file be opened.
However, CPS records show that adoptions social worker Mee -- assigned to monitor Amariana -- dismissed the abuse allegation as "unfounded" after Dossman explained the girl had fallen from a swing.
Amariana fell a lot, according to the combined records.
In an 18-month period, Dossman told doctors and social workers that the girl had fallen from a countertop, fallen down stairs, fallen on a toilet bowl, fallen and cut her scalp, and had been pushed from a car.
"Any time there are repeat injuries like that, it's very, very worrisome," said Krugman, the pediatrician and medical school dean from Denver.
Berkowitz, who has served with Krugman on the board of the National Center on Child Fatality Review, said plotting Amariana's size on a growth chart lends credence to suspicions of "deprivational dwarfism," because her height and weight both stalled. In starvation cases, Berkowitz said, the growth chart looks much different, with weight dropping rapidly before height is noticeably affected.
"This kid deserved better," she said. "Some kids seem to have guardian angels. And some kids' guardian angels go away. She didn't have a guardian angel."