Recent death of child impels DCF chief to propose new guidelines for hospitals

Hartford Hospital Emergency room doctor Alise Frallicciardi Monday gently rolled over the lifelike baby mannequin in the hospital bed and discovered several long bleeding cuts on his back.

She asked Stephen P. Donahue, a hospital trainer playing the part of the baby’s well-dressed but evasive father, what happened.

“I never saw that. I don’t know how he got it,” Donahue said. Later he said he thought his 3-year-old son had done it.

Frallicciardi pressed on, saying she wanted to call in the Department of Children and Families to talk to the father. The father bristled at the suggestion and asked if he could go somewhere else for treatment. Frallicciardi kept calm and said she wasn’t accusing him of anything, but just wanted to help treat the child.

DCF Commissioner Joette Katz (Uma Ramiah/CT Mirror)

The dramatization at the hospital’s Education and Resource Center was a staged for DCF Commissioner Joette Katz and the media to shine a light on the role a hospital can play in detecting signs of child abuse.

The demonstration hosted by Hartford Hospital was held up as a model for Katz’s proposed statewide guidelines to help hospitals assess injuries for signs of abuse or neglect in children aged 6 and younger.

The guidelines come in response to the way Windham Hospital handled the case of a 3-year-old girl who was allegedly beaten to death in November. The girl’s mother and her live-in boyfriend have been arrested in connection with the beating and death.

Katz said she isn’t pointing fingers, but said the incident opened her eyes to what is routine and what should be routine in the emergency room. She said she wants to help hospitals do a better job of detecting abuse and prior injuries.

Under the proposed guidelines, hospitals or medical centers would review all treatment records and DCF records and conduct a full examination when a child arrives with injuries. Katz has been working closely with Dr. Lenworth Jacobs, Hartford Hospital’s chief of trauma, to develop the guidelines.

Every year, 15 to 18 children die in Connecticut from serious abuse or neglect, Jacobs said.

“We really have to have a broad-based plan to raise awareness, to educate, to show people in a very dramatic way how not to miss things,” Jacobs said. He said he’d like to see a poster or index card on the wall of examination rooms to help raise awareness and make this kind of detection routine.

Hartford Hospital has actually been training its emergency room residents — as well as residents from other hospitals, nurses, paramedics, firefighters, police and the military — how to detect such abuse for 12 years.

The hospital has a suite of fake emergency rooms and about a dozen lifelike dummies with a skin-like covering that have pulses, breathe and move. Some even sweat and blink their eyes. The dummies, which cost $70,000 to $80,000 apiece, in some cases have hidden signs of abuse, such as cigarette burns and old skull fractures. It is up to the trainee to discover the problems.

Physicians and others not only have to detect these injuries, but to handle these inquiries carefully so as not to cause undue mental anguish in parents who aren’t in fact abusing their children. Along the same lines, they also have to learn how to not be intimidated, Katz said.

As the commissioner put it: “I’d rather have an irate parent than a dead child. It’s just that simple.”