Saturday, June 17, 2017

Earlier, a medical examiner said Nevaeh's death was caused either by a single overdose or a build-up of the drug in her system.-------The contents of a prescription issued on Dec. 17, 2013, were deemed to have been properly accounted for. What became of a bottle four times the size that was prescribed on Dec. 27, 2013, is uncertain, bringing questions of dosage and concentration to the forefront of the inquiry.-- ISMP's steadfast recommendation is to administer sedatives only in facilities where trained personnel and resuscitation equipment are available. --Over the years, however, the Institute for Safe Medication Practices (ISMP) has had numerous reports of overdoses and fatalities that have occurred after excessive doses were given in error. Typically, deaths have occurred with chloral hydrate in situations where the prescription was not clear or where untrained individuals, either staff members or parents, were involved. In one case, chloral hydrate syrup was to be given to a 5-year-old boy prior to a CT scan. The prescription was written for the 250 mg/5 mL concentration (used most often in hospitals and available only in unit-dose containers). When the prescription was taken to a community pharmacy, it was correctly labeled with the physician's instructions to give 3 teaspoonfuls prior to the CT, followed by 2 additional teaspoonfuls if needed. The pharmacist, however, mistakenly used the 500 mg/5 mL concentration to prepare the prescription, thereby doubling the intended dose. After the procedure, the mother returned home with her child, only to realize that he had stopped breathing. He was taken back to the hospital but could not be resuscitated. Unfortunately, because the dose was prescribed only by volume (teaspoonfuls) rather than by metric weight (milligrams), detection of the 2-fold overdose was difficult. In another case, a 6-year-old child was to receive chloral hydrate syrup at home prior to a CT scan. The prescription indicated that 12 mL was to be dispensed and that the child was to take the entire quantity before the procedure. The community pharmacy incorrectly dispensed 120 mL instead of 12 mL. Before administering the medication to her child, the mother called the facility where the procedure was being performed to question whether she was really supposed to give the whole amount. Without inquiring as to how much was actually in the bottle, the person at the facility answered "yes." The child then received 120 mL and subsequently died.-------Chloral hydrate is not recommended for children older than 4 years or with neurodevelopment disorders (see cases 1 and 3). Resedation can occur after chloral hydrate administration, as may have occurred in case 1.-------------------------


Since I have not been able to find a repository for the adverse events and fatalities in Alberta I doubt that there will be any changes to group homes due to the discoveries of this fatality inquiry.
Nevertheless the public gets to see the poor performance and oversight in the system where we have a vulnerable child with global developmental delays administered Chloral Hydrate night after night by staff who lack training in either the child's complex care needs or in how to uniformly measure out the dosage. In addition there is the problem of medication reconciliation where a bottle of the medication is missing and can't be accounted for.
How much more pathetic can it get? I'm just waiting to find out as the inquiry goes on and on into the fall.
Comments




The fatality inquiry into the death of a child through the administration of a medication is raising troubling questions in my mind.
Usually medications in the continuing care system are monitored by a pharmacist.
How are medications in group homes where this child was placed--monitored?

http://www.edmontonsun.com/2017/06/16/further-experts-to-be-called-delaying-child-fatality-inquiry-for-months#.WUTFcGhBeY4.twitter

Further experts to be called, delaying child fatality inquiry for months


ROB CSERNYIK
FIRST POSTED: FRIDAY, JUNE 16, 2017 07:44 PM MDT
Nevaeh MichaudJohn and Desiree Knoll pose with a picture of their daughter Nevaeh Michaud who died in an Edmonton group home in 2014 on Monday, June 12, 2017. The parents were at Edmonton's Provincial Courts attending the fatality inquiry into their daughter's death from an overdose of a sleep aid while in care.
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Questions about the sleep aid that caused Nevaeh Michaud's 2014 death mean additional experts are being called to testify, delaying her public fatality inquiry until this fall.
Eight-year-old Nevaeh died from an overdose of chloral hydrate while living in an Edmonton group home.
Her last day before her death was described as typical at the inquiry. Nevaeh had a visit with her mother. She watched the movie Mulan, played and ate macaroni and veggie soup for dinner. Nevaeh was tired, however, and one of her caretakers asked to administer her nightly dose of chloral hydrate early.
Earlier, a medical examiner said Nevaeh's death was caused either by a single overdose or a build-up of the drug in her system.
The contents of a prescription issued on Dec. 17, 2013, were deemed to have been properly accounted for. What became of a bottle four times the size that was prescribed on Dec. 27, 2013, is uncertain, bringing questions of dosage and concentration to the forefront of the inquiry.
Two group home workers testified they used syringes to measure the drug, One of them said in her opinion it would be hard to measure five millilitres in a cup, especially if doing so on an uneven surface. An overnight caregiver described measuring the sleep aid — prescribed for up to 10 ml overnight as needed — in a measuring cap.
Jill Porter investigated group home provider Mariam's Footsteps in a review on behalf of Human Services Department, now the Ministry of Children's Services.
Porter said Friday in her view, as long as measurements are consistent, it's fine, though using different measuring methods could be a cause for concern.
Despite Nevaeh's medical issues, Porter testified group home workers had no special training on how to deal with the girl.
Porter said the measurement, delivery and communications surrounding the drug were factors that needed to be considered in what she referred to as a preventable death.
A toxicologist, pharmacologist and police detective are expected to be the final three witnesses called in the inquiry. They will testify over two days this fall.

**** 

Also why was this drug being used night after night on a child with medical issues?
Was there no consideration of the possibility of problems considering that when it is used for sedation in radiology procedures there have been problems as noted here:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3227310/

Generally considered one of the safest sedative agents, chloral hydrate does have the potential for causing unexpectedly deep levels of sedation as well as upper airway obstruction in some patients. Adverse events have been reported even when chloral hydrate is administered within acceptable dosing limits. Poor outcomes have also been documented when chloral hydrate is administered by non-medically trained personnel. Despite the universal agreement that it violates the standard of care and acceptable safety standards, some practitioners still prescribe chloral hydrate to be administered at home prior to coming to the hospital for a procedure.[] As a result of this practice, adverse events have been reported on the way to a facility for a procedure. Additionally, secondary to chloral hydrate's long half-life, some adverse events have also taken place in automobiles or at home after discharge from medical supervision, further mandating the need for appropriate discharge criteria following procedural sedation. As a result of associated morbidity and mortality from chloral hydrate, the American Academy of Pediatrics (AAP) has issued a position paper on the recommended use of this agent which was published in the May 1993 issue of AAP News.

****
The problems associated with this drug in radiology procedures indicates that perhaps use of this drug should have been monitored more and that the care takers should have been trained in the use of the drug and its side effects.

Inappropriate dosage can result in respiratory arrest as noted here:



Pediatric Preprocedure Sedation Should Not Start at Home

MAY 01, 2004
Kate Kelly, PharmD, and Allen J. Vaida, PharmD, FASHP
Problem
Sedative medications often are used in the ambulatory care setting to prepare pediatric patients for diagnostic procedures, such as computed tomography (CT) scans or magnetic resonance imaging. Over the years, however, the Institute for Safe Medication Practices (ISMP) has had numerous reports of overdoses and fatalities that have occurred after excessive doses were given in error. Typically, deaths have occurred with chloral hydrate in situations where the prescription was not clear or where untrained individuals, either staff members or parents, were involved.
In one case, chloral hydrate syrup was to be given to a 5-year-old boy prior to a CT scan. The prescription was written for the 250 mg/5 mL concentration (used most often in hospitals and available only in unit-dose containers). When the prescription was taken to a community pharmacy, it was correctly labeled with the physician's instructions to give 3 teaspoonfuls prior to the CT, followed by 2 additional teaspoonfuls if needed. The pharmacist, however, mistakenly used the 500 mg/5 mL concentration to prepare the prescription, thereby doubling the intended dose. After the procedure, the mother returned home with her child, only to realize that he had stopped breathing. He was taken back to the hospital but could not be resuscitated. Unfortunately, because the dose was prescribed only by volume (teaspoonfuls) rather than by metric weight (milligrams), detection of the 2-fold overdose was difficult.
In another case, a 6-year-old child was to receive chloral hydrate syrup at home prior to a CT scan. The prescription indicated that 12 mL was to be dispensed and that the child was to take the entire quantity before the procedure. The community pharmacy incorrectly dispensed 120 mL instead of 12 mL. Before administering the medication to her child, the mother called the facility where the procedure was being performed to question whether she was really supposed to give the whole amount. Without inquiring as to how much was actually in the bottle, the person at the facility answered "yes." The child then received 120 mL and subsequently died.
Now tragedy has struck again. A prescription (Figure) was written for a 17-month-old child. The pharmacist interpreted the directions as "30 cc before office visit" and instructed the mother to give her child that amount. The physician, however, wanted the child to receive 500 mg 30 minutes before the office visit. The baby received 30 mL of a 500 mg/5 mL concentration, or a total of 3 g, and became comatose. Fortunately, the baby's mother rushed her to the Emergency Department, where she was successfully resuscitated. Incidentally, the double hash mark symbol ("), which was misread as cc, is sometimes used to indicate seconds; the single hash mark (?) is used for minutes. Neither symbol should be used in medicine, however, because not everyone understands their meaning.
Like the previous incidents, this one should remind readers that a dosing error could prove fatal when parents are asked to administer sedatives to their children at home. ISMP's steadfast recommendation is to administer sedatives only in facilities where trained personnel and resuscitation equipment are available. The American Academy of Pediatrics agrees with ISMP's position. Its current Guidelines for Monitoring and Management of Pediatric Patients During and After Sedation for Diagnostic and Therapeutic Procedures (Pediatrics 2002;110:836-838) recommend that children should not receive sedative or anxiolytic medications without supervision by skilled medical personnel.
Safe Practice Recommendations
In addition, ISMP recommends the following to guide safe pediatric chloral hydrate use:
  • Health care personnel must be aware that chloral hydrate syrup is available in both 250 mg/5 mL and 500 mg/5 mL concentrations. Therefore, prescriptions should be written in terms of total milligrams per dose rather than the volume of drug per dose.
  • Prescriptions should include the total dose and the mg/kg dose. The normal pediatric preprocedure sedation dosage range is 25 to 75 mg/kg/dose. A dose may be repeated 30 minutes after the initial dose, if necessary. Pharmacists should keep in mind, however, that the maximum total cumulative dose, according to United States Pharmacopeia Drug Information, never should exceed 100 mg/kg of body weight, or a total of 2 g.
  • Pharmacists should stock only 1 concentration of chloral hydrate syrup in the pharmacy. Obtain the patient's weight in kilograms, and double-check the dosage. Consider building an alert into the pharmacy computer system that prompts staff members to get the patient's weight and to verify the dosage.
  • Pharmacy label directions should include the dose in both metric weight (milligrams) and volume (milliliters).
  • Pharmacists should advise parents not to administer the medication at home. It should be taken to the health care facility and administered by a properly trained staff member.
  • Pharmacists should share these errors with the staff to heighten awareness of the dangers associated with chloral hydrate use.
Drs. Kelly and Vaida are both with the Institute for Safe Medication Practices (ISMP). Dr. Kelly is the editor of ISMP Medication Safety Alert! Community/Ambulatory Care Edition, and Dr. Vaida is the executive director of ISMP.
If in these cases we have untrained folks providing overdosages why would we expect that untrained group home staff would not also be susceptible to similar errors?

****
This drug also seems problematic in overdose situations because there is no antidote. You can't reverse the overdose.  Also it is not recommended for use for kids with neurodevelopmental disorders:

http://www.thepoisonreview.com/2014/06/23/overdose-and-death-from-pediatric-chloral-hydrate-sedation/

Overdose and death from pediatric chloral hydrate sedation

June 23, 2014, 7:06 pm

Chloral hydrate
Chloral hydrate
★★★★☆
Pediatric Chloral Hydrate Poisonings and Death Following Outpatient Procedural Sedation. Nordt SP et al. J Med Toxicol 2014 Jun;10:219-222.
The medical use of chloral hydrate goes back to the 19thcentury. It is still used occasionally today for pediatric pre-procedural sedation. The risks inherent in this practice are illustrated in this excellent short article. The authors present a series of 3 cases of chloral hydrate overdose, —including 1 fatality — that all occurred within a 4-month period:
  1. A 4-year-old girl was prescribed 900 mg chloral hydrate by her dentist, to be taken at home without food in preparation for having a tooth pulled. One hour after the procedure she was somnolent but arousable and was discharged home. Six hours later her mother found her unresponsive and apneic at home. Return of spontaneous circulation returned in the emergency department, but the child suffered a subsequent cardiopulmonary arrest 12 hours after admission and could not be resuscitated.
  2. In preparation for a dental procedure, a 3-year-old boy inadvertently received 6,000 mg of chloral hydrate (instead of the prescribed 500 mg) because his mother had difficulty reading the dosing instructions. he became unresponsive in the dentist’s office. In the emergency department, cardiac monitoring showed ventricular instability, with bigeminy, trigeminy, and ventricular tachycardia with pulses. Ventricular instability resolved after treatment with esmolol, and the child was discharged from the pediatric intensive care unit neurologically intact.
  3. A 15-month-old girl with multiple medical problems (including hydrocephalus) was given 1,200 mg of chloral hydrate in an ophthalmology clinic prior to an  examination. Approximately 30 minutes later she vomited and became apneic. She received assisted ventilation via bag-valve-mask after which her mental status and respirations improved. She was discharged home after 12 hours of observation.
The authors make a number of important points about chloral hydrate, all of which are illustrated by these cases:
  • Counterintuitively, chloral hydrate is more rapidly absorbed in a non-fasting state.
  • In general chloral hydrate is rapidly absorbed and converted into its principal metabolite trichloroethanol (TCE), which causes sedation.
  • Chloral hydrate is not recommended for children older than 4 years or with neurodevelopment disorders (see cases 1 and 3).
  • Resedation can occur after chloral hydrate administration, as may have occurred in case 1.
  • Chloral hydrate is a gastrointestinal irritant and commonly causes vomiting and aspiration.
  • TCE is a myocardial irritant that can produce ventricular dysrhythmias (especially ventricular tachycardia.
  • The treatment for ventricular irritably following chloral hydrate administration is a beta-blocker such as esmolol.
The authors conclude:
[Chloral hydrate] in our opinion should be no longer used for procedural sedation in patients of any age. Chloral hydrate is associated with significant adverse effects, including death, and safer alternative for pediatric procedural sedation should be sought and utilized.
[ADDENDUM 7/3/14]: Emergencymedicinecase.com has a superb podcast about chloral hydrate toxicity in their “Best Case Ever” series. It’s definitely a must-listen, and can be accessed hereLife in the Fastlane also has a great post about chloral hydrate.



***
Although the article above deals with pediatric sedation for medical or dental procedures we might see how giving a child too much of this medication every day may have resulted in her death.  It also appears that this child had medical issues that would have contraindicated use of this drug.

http://edmontonjournal.com/news/local-news/mothers-sue-government-after-daughters-die-in-care

The lawsuit alleges that group home staff failed to properly store and dispense the sedative to the eight-year-old.
“The defendants were aware that Nevaeh had global development delays,” the suit states. “Her cognitive abilities and functioning were below what is considered normal for a child her age.”
********
Also why is there no medication reconciliation as is required in the continuing care system? In other words why did the group home not have the records to account for a bottle that was prescribed on December 27, 2013 that was unaccounted for?

http://www.edmontonsun.com/2017/06/16/further-experts-to-be-called-delaying-child-fatality-inquiry-for-months#.WUTFcGhBeY4.twitter

The contents of a prescription issued on Dec. 17, 2013, were deemed to have been properly accounted for. What became of a bottle four times the size that was prescribed on Dec. 27, 2013, is uncertain, bringing questions of dosage and concentration to the forefront of the inquiry.


Seems like there were problems in the medication procedures:


http://edmontonjournal.com/news/local-news/mothers-sue-government-after-daughters-die-in-care

Graff said the provincial government needs to ensure all caregivers follow medication policies.
He said an internal government investigation found gaps in the group home’s medication procedures, although changes had been made.


Did the group home understand that there were risks to the use of the medication? Or is this a case of everyone is responsible but no one is actually in charge of the care of this patient?  In the end, this is the responsibility of the group home provider to ensure that the care plan tracks medication use and that the staff are trained. Troubling.

I doubt that the fatality report will provide any changes in the system. The GOA is in disarray in terms of the care of vulnerable folks in Alberta.
We're here to witness the failures in oversight, regulation, and consequences.


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3943656/

Other

Chloral hydrate is still occasionally used for pediatric insomnia. However, safety, side effects, and tolerance concerns should substantially limit its use., Trazodone, an atypical antidepressant, is prescribed for adults, but no studies support its use in children. Doxepin is available for adult use and has mixed effects, including histamine receptor blockade.


***
The end result of GOA incompetence is that we have folks suing the system to ensure that the "learnings" of deaths of kids in care take. I doubt this will happen but perhaps the lawsuits will provide a small bit of justice.

http://edmontonjournal.com/news/local-news/mothers-sue-government-after-daughters-die-in-care

Mothers sue government after daughters die in care

Published on: September 19, 2014 | Last Updated: September 19, 2014 9:14 PM MDT
Kyleigh Crier
Kyleigh Crier
EDMONTON – Two mothers whose daughters died while in government care claim the deaths were due to negligence and have each sued the province for $682,000.
Statements of claim filed by Crystal Crier and Desiree Michaud allege specific negligence at the care homes where their daughters died and systemic provincial issues within the “opaque, secretive and deficient system for investigating the deaths of children in care that fails to collect, track and implement changes to prevent further deaths from occurring.”
In April 2014, Kyleigh Crier, 15, hanged herself from a closet bar rod at Crossroads House, an Edmonton group home licensed under the Child, Youth and Family Enhancement Act. Her body wasn’t discovered by staff for 12 hours.
Before her death, the suit claims, Crossroads staff knew the teenager was in trouble. Kyleigh Crier told her mother she was being bullied at Crossroads and Crystal Crier then approached staff and “requested they intervene to protect” her daughter.
“The defendants were aware that Kyleigh had distinct behavioural and mental health issues that required specialized care,” the suit states. “Kyleigh had a history of engaging in self-harm conduct, including cutting.”
Before she died, she changed the banner on her Facebook page, posting a photo of a coffin with the words: “Now, everyone loves me.”
In 2001, the suit points out, a fatality inquiry into the death of another child in care resulted in a recommendation that provincial group homes use breakaway closet bar rods to prevent such deaths. Crossroads had no such breakaway rods.
Crossroads “did not have the proper procedures and policies to provide for her safety and care,” the claim states.
Crystal Crier is also claiming damages for events after her daughter’s death, including the province’s initial refusal to release the body and a blanket publication ban that ensured she was “prohibited by law from publicly grieving or identifying that Kyleigh had died, compounding the injuries she suffered from the loss of her daughter.”
Eight-year-old Nevaeh Michaud, 8, died in her sleep at the Ayesha’s Light group home on Jan. 5, 2014. The girl was found unresponsive around 8 p.m. and was pronounced dead at the Grey Nuns Community Hospital. Her cause of death, the claim states, was a fatal concentration of sedative prescribed to the girl to help her sleep.
The lawsuit alleges that group home staff failed to properly store and dispense the sedative to the eight-year-old.
“The defendants were aware that Nevaeh had global development delays,” the suit states. “Her cognitive abilities and functioning were below what is considered normal for a child her age.”
Desiree Michaud’s lawsuit states that the treatment of her after the girl’s death was “malicious and oppressive, representing a marked departure from the ordinary standards of decent behaviour.”
In July, the provincial government overturned a publication ban that made it illegal to publish the names and pictures of children and teens who died while receiving child welfare services, even if their families wanted to go public.
The ban was overturned months after a joint Edmonton Journal-Calgary Herald investigation revealed the province dramatically under-reported the number of children who have died in care and failed to monitor implementation of recommendations to prevent similar deaths.
Statements of claim contain allegations not proven in court.
rcormier@edmontonjournal.com
*****
Changes are needed in the operation of group homes and the training of staff. Was this group home an appropriate setting for Nevaeh? Doubtful. Were staff appropriately trained? Unknown. Were there medication reconciliation problems? Probably since the group home cannot account for one bottle of this medication. And what is the GOA going to do about this sort of medication administration and reconciliation problem resulting in an avoidable death? Probably nothing.

Troubling case and I have many questions about the use of Chloral Hydrate by this group home. I doubt that the GOA will use the "learnings" from this child death to prevent future avoidable drug overdoses. I have yet to see the GOA's repository of adverse events and fatalities. Nor have I seen implementation of the "learnings" from these events.

Desiree Knoll hopes an inquiry into the death of her eight-year-old daughter in government care in 2014 will prevent similar tragedies.
GLOBALNEWS.CA

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 http://globalnews.ca/news/3521903/mother-of-8-year-old-who-died-in-alberta-group-home-wants-answers-as-inquiry-begins/
June 12, 2017 3:34 pm
Updated: June 12, 2017 3:37 pm

Mother of 8-year-old who died in Alberta group home wants answers as inquiry begins

By Caley RamsayOnline Journalist Global News
Desiree Knoll (L) holds a picture of her daughter, Nevaeh Michaud, on Day 1 of the fatality inquiry in Edmonton.
Desiree Knoll (L) holds a picture of her daughter, Nevaeh Michaud, on Day 1 of the fatality inquiry in Edmonton.
Courtesy, Velvet Martin
- A A +
Desiree Knoll hopes an inquiry into the death of her eight-year-old daughter in government care in 2014 will prevent similar tragedies.
“We’re definitely hoping that this fatality inquiry will lead us into justice for Nevaeh Michaud,” Knoll said outside court Monday, as the four-day hearing began. “Accountability is definitely my main priority here because that there alone gives my daughter her justice.”
On Jan. 5, 2014, Michaud was found unresponsive in bed by a worker at her group home. She died from an overdose of sleeping medication.
Police investigated but could not determine how the overdose happened.
A report from Alberta’s child advocatefollowing Michaud’s death said the girl had complex needs and was on various medications. Del Graff said her circumstances “raised questions about the need for improved awareness of existing protocols, the handling of children with complex needs, and medication management for children in care.”
Graff said the provincial government needs to ensure all caregivers follow medication policies.
He said an internal government investigation found gaps in the group home’s medication procedures, although changes had been made.
Knoll was in court Monday morning as the medical examiner testified. She believes her daughter’s death could have been avoided.
“It is very slowly starting to appear to a lot of us that this death could have been extremely preventable,” she said. “I want answers based on the whole last year of my daughter’s life because there are so many things that I have never been told, so many things leading up to her death.
“I don’t think it’s just about group homes for me, it’s kind of a little bit of everything. There’s a lot of child services workers out there that take and bend the Child Family Enhancement Act.”
Michaud was in government care for just over a year before she died. Her mother said she was full of life and love.
“My daughter was a very, very special gift from God,” she said. “She was smart, she could’ve done anything she wanted to.”
The fatality inquiry is expected to last four days. Fatality inquiries are meant to look into the circumstances surrounding a person’s death to prevent similar incidents from happening again. They are not meant to assign blame.
With files from The Canadian Press.

Julie Ali · 

This fatality inquiry is very useful in providing information to the public about the medication administration practices at group homes.

It raises several questions that I think the GOA needs to provide to the public.

1) Why was Chloral hydrate being used night after night on a child with global development delays?

2) What happened to the bottle of medication prescribed on Dec. 27, 2013? Why is this medication unaccounted for when a bottle prescribed on December 17, 2013 is properly accounted for? Do group homes have a medication prescription and reconciliation policy/procedure that has oversight by a pharmacist and a physician?

3) Why were staff not trained with reference to this child's complex medical needs and the possible risks of chloral hydrate use in such cases? Why were some staff measuring the medication with a syringe which appears to be more accurate while other staff were using a measuring cup?

4) Who is responsible for this preventable death? Or is this a case of everyone is responsible and no one is responsible? This is the situation in the continuing care system and in the end no one is accountable for system wide failures in service delivery.

5) What will be done by the GOA to prevent further adverse events and fatality resulting from medication errors of this nature? Or are such adverse events merely filed away and we have a repeat of the same avoidable adverse event in another group home? What is the GOA doing about training of staff to ensure that they can meet not only the need for proper medication administration, but also the need for integrated care plans that address the complex care needs of such children? Or is the solution for the system to medicate and control kids with sedatives?
LikeReplyJust now
Leah Thompson
OK,what about the ones that are put into group homes for 3,4 years and these so called caseworkers aren't providing any type of counseling etc that a parent would do on their own! They get abandoned by them because their case load must be that bad..I guess. And still the parents have to pay for lawyers to fight them to get their kid back;but even lawyers let time pass too. Families involved should write letters to the Ministry of Children about what CFS are doing!!!!
Angel Peterson · 

I am just shocked that such young children are placed in group homes, to begin with. I've known of new borns and preschoolers, and children with developmental delays being placed in group homes, where there is a rotating staff of people looking after them. At bedtime, they are locked in their rooms in the dark....If parents treat their children this way, they are at risk of being removed from their homes.
LikeReply2Jun 13, 2017 6:46am
Cynthia Robinson · 

I am following this as a concerned mother. My healthy 30 year old daughter, also with complex needs, entered a specialized group home on May 1, 2017 and died on May 12, 2017. It's too soon to say what happened as we are at the beginning of this investigation but I do wonder, how many other of our kids suffered the same fate? Is a fatality enquiry three years later enough? How many others have died in care while this enquiry simmered quietly in the background waiting to be heard?
LikeReply5Jun 12, 2017 6:34pm
Joni Pearce- Gallagher · 

R.I.P. Nevaeh
I hope your mom get justice for you. As well as having this happen to another child


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