Munchausen Syndrome by Proxy
Michigan parents accused of Munchausen Syndrome by Proxy are usually under the intense scrutiny of doctors and CPS investigators who suspect that unnecessary medical procedures are being sought. The defense of a Munchausen accusation will require the assistance of a trial attorney who knows how to litigate medical issues and may also require the assistance of medical expert witnesses. If you are being investigated for providing improper medical care for your child, you may contact us online for a free, fully confidential consultation or call us at (800) 576-6035. Either way, we can offer the expertise that comes from decades of successfully defending medical abuse and neglect cases.
Expert Munchausen Defense Attorneys
Although the term “Munchhausen Syndrome” has been with us since the 1950’s, it is not commonly used in courtroom testimony anymore. Nonetheless, it is often lurking in the background as it is still part of the common vernacular with CPS workers and police. Munchausen by Proxy Syndrome, or “MBP” is a description of a particular form of child abuse or neglect in which a parent or caregiver intentionally falsifies, induces, or exaggerates symptoms or illness related to their child. It does not describe a medical condition for a child. Rather, it is a psychological disorder where the caregiver vicariously, or by proxy, assumes the role of the reportedly sick or injured child. The caregiver does this as a way of getting attention and sympathy from others.
Due to controversy in the psychological, psychiatric, and legal communities, Munchausen is now a somewhat disfavored term and is now sometimes known as factitious disorder syndrome. In Michigan courts, MBP is also commonly referred to simply as “medical child abuse.”
The working theory is that perpetrators with Munchausen Syndrome usually cause unnecessary medical procedures to be performed on the child. Those who abuse via Munchausen Syndrome are often put into one of two classifications—“inducers” or “fabricators.” “Inducers” are those who directly cause the child’s illness, while “fabricators” are those who exaggerate their child’s symptoms to get medical attention and treatment. With the focus of Factitious Disorder on the parent, medical care providers (including doctors, pediatricians, and nurses) are keenly aware of certain “red flags” which include things like:
- A mother who seems to the medical staff to have an obsessive interest in medical knowledge and terminology
- A parent who consults a large amount of doctors
- A refusal to accept conservative treatment when recommended by doctors, advocating instead for more aggressive surgical or medical intervention
- Reports of symptoms observed only by the parent (e.g. seizures, digestive disorders, eating disorders, allergies and sleep disorders)
- A parent that seems confrontational with medical staff
While none of these “red flags” is adequate to diagnose a parent with Factitious Disorder, any one of them can change the focus from the child to the parent and bring CPS quickly to the hospital room.
Pediatric Condition Falsification
Because Munchausen's emphasis has changed over time, the approach is now to examine both the parent (almost always the mother) and the child. The examination of the child is focused on what is often called “pediatric condition falsification”. This is where the actual medical conditions that the child is facing are not accurately described. This can be instances where the the medical condition reported is a total fabrication. It can also be instances where the symptoms are exaggerated. Unfortunately, this definition become blurred when a parent forcefully disagrees with the doctors. In that instance doctors quickly begin to practice defensive medicine. Often, the hospital’s risk management attorneys are consulted for guidance. Every medical malpractice defense attorney knows that the best way to avoid a medical malpractice lawsuit is to change the focus away from the child and the doctors, and to place it on the parents.
The Role of the Mandatory Reporter Statute
In Michigan, all medical doctors or medical care providers are mandated reporters. This means that, by law, they must report actual or suspected child abuse or neglect to Children’s Protective Services. Because a mandated reporter who fails to file a report of suspected child abuse or neglect will be subject to both civil and criminal liability, they will always err on the side of caution and file form 3200 with the state. In a civil action, the mandated reporter may be held liable for all damages that any person suffers due to the mandated reporter’s failure to file a report. In a criminal action, the mandated reporter may be found guilty of a misdemeanor punishable by imprisonment for up to 93 days and a fine of $500.
In practice, this means that a belligerent or confrontational parent will almost always be reported and investigated. It also means that parents who demonstrate any “red flags” for Munchausen will be facing an investigation. As a matter of law, CPS must investigate the claim made by the hospital staff.
Legal Consequences of Munchausen by Proxy (MBP)
In Michigan, when a parent or caregiver actively practices MBP, the consequences often involve CPS filing a Petition in court to make your children wards of the court, or to terminate your parental rights entirely. These are civil cases, although they can have devastating consequences for a family. When these petitions are filed, they often result in all of the children being immediately taken into foster care, and supervised parenting time orders being put into place. Many parents who have had difficulty working with medical staff will have an even more difficult time working with CPS parenting time supervisors.
Depending on the severity of the harm alleged, Munchausen accusations may result in criminal charges as well. Under MCL 750.136b, depending on the nature, degree, and method of abuse or inducement of the injury or illness, a person could be charged with first, second, third, or fourth degree child abuse. The penalties for these charges range from one to ten years in jail or prison.
Michigan Munchausen Investigations
The Michigan Department of Human Services has contracts with hospitals who provide access to the Child Abuse Pediatricians for the analysis of suspected medical abuse and neglect cases. As of this writing, those contracts are with Spectrum Health and the University of Michigan. Therefore, it is common for a child abuse evaluation to be done by Dr. Debra Simms or Dr. Bethany Mohr. However, most hospitals today have a Child Protection Team (CPT) and many have board certified Child Abuse Pediatricians on staff as well.
The investigation of a suspected Munchausen case usually involves the evaluation of all available medical records for a child. This can sometimes take months, during which time a family may live with a significant amount of stress and turmoil. In the hospital setting, it is common for the Child Protection Team doctor to show up and want a comprehensive medical history. This is obtained from a parent. Most parents gladly participate in this process and provide the extensive history that will make it possible for the the doctor or CPS to obtain the medical records needed. Few parents understand at this point that they are participating in a child abuse investigation. Therefore, most never contact an attorney until they are facing a hostile CPS or police investigator.
How Do I Defend a Michigan Munchausen Case?
Please don’t take this the wrong way, but the answer is you don’t. Parents facing accusations of Munchausen, Pediatric Condition Falsification, or Factitious Disorder need the services of a knowledgable attorney who understands medical litigation, Child Protective Proceedings (CPS Petitions), and criminal child abuse defense. The defense of these cases is not a job for a garden variety criminal defense attorney and is certainly not something a parent should face without representation.