Vanderbilt Used "Munchausen's" Once Too Often: Mom/Child Sue for Apology

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National Child Abuse Defense and Resource Center

Roanoke, VA

Tuesday, July 22, 2003

Ranked last in top 17 medical centers by U.S. News & World Report, Vanderbilt University Medical Center did not have such a good day Tuesday when ratings were released. August 7 will be worse if VUMC's and other teaching hospitals' methods of silencing assertive mothers is exposed in federal court.

Too often using British retired pediatrician Roy Meadow's imaginative "Munchausen Syndrome by Proxy" (MSP), and enjoying restrictive Tennessee law to duck accountability for injuries to families from false allegations because of such labeling, VUMC may have met its match.

Young Joseph Harville's name comes first in the alphabet, before parents Steve and Ruth, so his name signs off on their pro se appeal accepted by the U.S. Court of Appeals for the 6th Circuit in Cincinnati and on the docket in two weeks. At 7 1/2 Joseph may be a bit fuzzy on details, but he still recalls being a very sick little fellow and the terror of being taken from his parents.

Referred to VUMC because of slow growth and feeding and various other health problems in their son, the Harvilles took Joseph there in the fall of 1998 with high hopes. Careful review of documentation--both VUMC's and notes Ruth Harville kept--shows a direct connection between her questioning Joseph's treatment and the baseless MSP claim that makes a bad situation worse.

Where's the Science?

Court papers and details in the appeals state the obvious, but too seldom asserted, reality that neither Roy Meadow's nearly 26-year-old untested motivation theory nor its counterpart--known loosely as the "Separation Test"--have been subjected to accepted scientific methodology to validate them, not anywhere at any time by any objective entity.

Following Ruth Harville's annoying one of Joseph's doctors, the frail youngster was whisked into Tennessee foster care. There he lost 21% of his body weight during 3 1/2 months. A kind foster carer's concern, since the doctor withheld truth of Joseph's rapid failing from Tennessee's Department of Children's Services, made a difference.

During an earlier trial one Vanderbilt doctor said MSP is an adult psychiatric diagnosis, admitting the label was placed on a mother and by a pediatrician at that. Another called it a diagnosis but explained there was no clear cut test, only separating the child from a suspected parent to see how the child would survive and assuming Joseph would thrive.

The doctor reporting Ruth Harville, as have many before him, simply sat on information revealing how badly Joseph fared until he was in far worse condition. After all, if the only diagnosis is the equally unsupported "Separation Test," it wouldn't do to have bad results from a necessary cover up move.

Child or "Reputation Protection"?

When the Harvilles began their suit against VUMC in November 1999, at the last minute allowed by Tennessee law, several points including medical malpractice and civil rights were included. They did have an attorney at the time.

Only belatedly did they learn of key issues that attorney failed to share with them as well as other matters the attorney handled without advising them or gaining their consent. That behavior severely compromised their chances for redress toward Joseph's ultimate health and welfare.

Those unfamiliar with the nearly eternal injury of an MSP label may find it hard to believe but from the moment of an allegation on, depending on how a medical record is coded or what kinds of conversations annoyed doctors have with each other off the record, the child and all family members may receive substandard or no diligent medical care because, after all, there an accused Munch Mom once was involved.

Amazing alterations to the Harville family's original claims, at one point reducing them to pursuing medical malpractice only, occurred in proceedings that always involved officials and professionals somehow alumni of, employed by, or minimally emotional loyal to Vanderbilt and the reputations of its many parts in addition to VUMC itself.

By the time Vanderbilt lawyers compromised the few doctors who could have testified with some balance for the defense (inviting them to a CARE meeting that agreed to report Ruth Harville and have Joseph removed) and prevented two major defense witnesses from testifying because they were not pediatricians, the picture looked bleak.

Perhaps it was the outrageous overkill, the apparent fear of letting a modest couple tell their son's story of misunderstanding, misdiagnosis and dangerous mistreatment at a very proud teaching hospital, and the thinly veiled dirty tricks doctors appeared to have been advised to participate in, that inspired the Harvilles to hang in as long as they could to get the simple apology they once would have accepted.

Precedent-setting Potential

When it was clear VUMC would not apologize to the family on letterhead stationery, and that the Harville's own attorney had acted unilaterally and against family interest, Ruth Harville found strength her own health could scarcely provide.

She multiplied her efforts to find and get into judges' hands helpful background information on the multiplying names and claims for MSP by its self-styled experts. At the same time she was determined Tennessee's tricks to spare VUMC's answering for its frequent Munch Mom labeling and separating sick children from families would not persist.

Precedent-setting education can arise from a full reading of the Harville's experience with VUMC as a stand-alone experience that violates trust and civil rights but also as an example of what happens to children and families at medical teaching centers too often.

A serious consideration of Harville papers--the pro se family was thrilled with a request to send them all--and fair decision in 6th Circuit federal Appeals Court could find justices speaking and writing the overdue words that MSP and its cruel companion "Separation Test" have no basis in scientific fact.

If the unholy alliance between doctors as de facto state actors exploiting the child protection system's loose requirement for support behind its "reports of suspicions" is clarified, again, federal judges will have revealed the obvious to a confused public and lower court systems.

Because the Harvilles moved from Tennessee they and their quest for accountability from doctors, still hoping to hide behind a teaching hospital's liability insurance and legal presumed "good faith" immunity, they were able to move their appeal to federal courts.

Unlike others--including famed Johnnie Cochran on behalf of a doctor-mother banished from the VUMC bedside of her ill child, years later now dying of an elsewhere detected disorder--the Harville family decided to sue Vanderbilt, Inc., the whole shebang, and two particular doctors: the annoyed false reporter Dr. Seth Scholer and Dr. Karen Crissenger.

Whose Opinion Counts?

When the Harville's sole professional defense witness Dr. Jay Gordon, pediatrician practicing at UCLA, was disqualified at the first trial in Tennessee because he was not familiar with standards of the county in which VUMC was located, the gentleman was stunned. He knew the Harvilles borrowed money to finance his travels to testify and could not imagine Vanderbilt and area judges permitting such biased treatment of parents seeking redress for costly injuries to a sick child.

Noting that doctors take national exams so standards are not merely local or provincial did not persuade the court or Vanderbilt's lawyers to let Dr. Gordon testify on his professional and personal knowledge of Joseph Harville's condition and Vanderbilt's treatment of the child. Dr. Gordon's righteous indignation did much to encourage the Harvilles to find fairness somewhere, clearly beyond the state line.

Now, thanks to USN&WR's medical center rankings, it appears that local and area esteem in which VUMC is held does not hold across the nation. Dr. Gordon's UCLA ranks third with VUMC in last place. With the lowest number of points and specialties of any institution rated, VUMC was absent among 50 top centers treating digestive disorders, Joseph's major health problem, and is missing from the top 28 centers for pediatrics or 30 in psychiatry.

With its far broader understanding of law, local and national medical standards, and which and how many particular legal disadvantages suffered by the Harville family should earn them a new trial for full, fair, and objective hearing of all pertinent evidence, the federal court offers one family, a nation, and even the world hope that mistakenly and maliciously labeled caretakers have lacked too long.

At this writing the phrase-coiner of MSP himself is under intense scrutiny for sworn testimony that put innocent mothers behind bars or left them childless although original reports and Roy Meadow's speculations were groundless.

MSP on Last Legs in London

On Friday noon on Great Portland Street in London families there affected by exploitation of Roy Meadow's myth and long-term skeptics on the topic will demonstrate in front of the General Medical Council.

The GMC's delay in examining and putting a stop to use of Meadow's motivation theory, while children are traumatized and taken from their homes and innocents are prosecuted and imprisoned, has angered too many for too long and now the press and the nation as well.

Taking a cue from across the pond, where Roy Meadow and Munchausen Syndrome by Proxy have been a mainstay, America's 6th Circuit Appeals Court may provide the first definitive international ruling.

And to think, it may all happen because VUMC doctors and lawyers, once too often, crossed a mother and father who determined to stay the course to clear their son's record and their innocent names.

Barbara Bryan

Contact: reharville@comcast.net

See also: http://web.tiscali.it/humanrights/articles/meadow77.html

http://www.freemarybethdavis.homestead.com

http://www.munchausen-exposed.co.uk

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