Doctors urged social services visit in advance of child's death
Medical records cite “shaken baby syndrome; still no charges filed
Marshall Helmberger
Caroline Medicine-Chavez died of non-accidental head trauma in March of 2012. No charges have been filed to date related to her death.

REGIONAL—Medical staff at the Virginia Regional Medical Center recommended contacting St. Louis County Social Services about injuries to two year-old Caroline Medicine-Chavez nearly three weeks before she died of apparent shaken baby syndrome in 2012. Yet Jennifer Medicine, the mother of the child, said no one from social services ever contacted her or stopped by her Virginia apartment in response to the hospital’s apparent referral.

This latest information comes from medical records obtained by Medicine at the request of the Timberjay. The records paint a picture of a young child who was suffering from repeated head trauma over a period of at least several weeks prior to her death.

Young Caroline died in the early hours of March 22, 2012, after suffering head trauma that treating physicians linked to “shaken baby syndrome,” a condition resulting from the violent shaking of a young child, which can cause severe brain damage or death. The emergency room physicians who treated Caroline upon her arrival at the hospital on the morning of March 21 noted the lack of an apparent external head wound that could have caused the extent of brain damage the child had experienced that morning. While the medical records note a small abrasion on her forehead, and a bruise elsewhere on her head, they indicate both wounds were two-to-three days old.

But physicians did note fresh and extensive internal bleeding on the left side of Caroline’s brain and in her left eye, which is commonly associated with shaken baby syndrome. Indeed, the treating physician wrote “Shaken Baby Syndrome” on the medical report, and stated as much to a Virginia police officer who investigated the injury.

Despite the medical determination, neither the Virginia Police Department nor the St. Louis County Attorney’s office have pursued criminal charges to date against the only likely suspect, Russell Johnson, Jennifer’s former boyfriend, who was alone with the child at the apparent time of her injury. Virginia police closed the case within months, following a brief investigation. The St. Louis County Attorney has since reopened the case following inquiries from the Timberjay.

Not the first time

Caroline’s trip to the emergency room on March 21 was not her first. Just eighteen days earlier, she was rushed by ambulance to the Virginia hospital, after suffering an earlier, unexplained head injury. The arriving ambulance crew found Caroline lying on a mattress and noted she was very lethargic. Her left pupil was dilated and both pupils were slow to respond. They noted “large deformities/contusions to the forehead with a small abrasion which appeared partially healed.”

At the time, both Jennifer and Russell told emergency responders that they were making breakfast in a downstairs kitchen, while Caroline was upstairs crying. “She was being crabby so I asked Russell to go get her,” said Jennifer during an interview with the Timberjay. “He came back down and said she tripped and fell. She wasn’t moving and her eyes were wide open and she was staring at the ceiling.”

The ambulance transported Caroline to VRMC, where she seemed to recover, which is why doctors opted against conducting a CT scan, which might have revealed internal injuries. Instead, doctors diagnosed a concussion and sent her home. But given the circumstances, they opted to refer the case to social services. “From the exam, I suspect accidental injury is most likely, but I recommend social services evaluation anyway,” wrote the treating physician on March 3.

Jennifer said hospital staff told her at the time that she should expect to be contacted by Social Services because of the injury. “But nobody ever did show up,” she said.

While physicians diagnosed a concussion on March 3, Caroline exhibited symptoms following that injury consistent with a more severe injury, such as a milder form of shaken baby syndrome.

While Caroline seemed to have recovered, Jennifer reported that she soon began exhibiting what may have been related symptoms. “Every time she ate, she would get sick,” recalls Jennifer. “She was throwing up a lot. She couldn’t hold anything down, water or food.” Jennifer said she wanted to take Caroline back to the hospital, but Johnson discouraged her, and dismissed her frequent vomiting, irritability, and lethargy as the flu. But those symptoms were consistent, again, with shaken baby syndrome. According to the Mayo Clinic, evidence of shaken baby syndrome includes extreme irritability, difficulty staying awake, poor eating, breathing problems, and vomiting. More severe symptoms include paralysis or coma. “Other injuries that may not be noticeable include bleeding in the brain and eye,” states the clinic on its website.

County officials refuse comment

St. Louis County Social Services officials have refused to comment on the extent of their involvement in the case, and they have taken steps that preclude release of any information pertaining to the case.

Despite a written request, Social Services officials have refused to provide Jennifer Medicine with access to her own case file. Medicine said Social Services supervisor Paula Stocke had initially told her that she would have access to her file, but would have to pay for copies. When Medicine followed up two weeks later, Stocke said she could not release the file, noting that the status of the case had changed. “She said they could not provide it until they closed the case,” said Medicine.

The Timberjay has learned that St. Louis County Social Services has reopened the abuse investigation on young Caroline following the initial newspaper report on the case. That decision has upset some county caseworkers, who question the purpose of reopening a case in which the child victim died a year and a half ago. But reopening the case requires that information in the file remains confidential, since the Minnesota Government Data Practices Act prohibits release of social service case files that remain under active investigation.

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1 comment on this item

So far, from many anecdotal conversations regarding

the new merger with Essentia Health, it has not been an improvement. We are under served with the quality of health care providers in Virginia. So sorry for the loss of the child, ( perhaps avoidable) .

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