In part two of our series on the lawsuit against Rady Children’s Hospital in San Diego, Andrea and Dr. Bex continue unpacking the story of Madison Meyer, whose medical journey led to a separation from her parents. After video surveillance at Rady’s starts, a series of escalating concerns, reports to child protective services, and ultimately, a court order removing her from parental custody follows. Andrea and Dr. Bex examine how medical, legal, and child protection teams intersect in cases like this, and the ethics of covert surveillance. *Episode updated with a fact check* *** This podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. *** Follow Dr. Bex on instagram: @secretdoctorbex Order Andrea's new book The Mother Next Door: Medicine, Deception, and Munchausen by Proxy. Click here to view our sponsors. Remember that using our codes helps advertisers know you’re listening and helps us keep making the show! Subscribe on YouTube where we have full episodes and lots of bonus content. Follow Andrea on Instagram: @andreadunlop Buy Andrea's books here. For more information and resources on Munchausen by Proxy, please visit MunchausenSupport.com The American Professional Society on the Abuse of Children’s MBP Practice Guidelines can be downloaded here. Learn more about your ad choices. Visit podcastchoices.com/adchoices
Chapter 1: Who are the hosts and what is the focus of this episode?
True Story Media. Hello, it's Andrea, and today we are sharing part two in our series on the lawsuit against Ratty Children's in San Diego. If you have not listened to part one yet, please go back and start there as you will otherwise be quite lost.
This case is so complex and I am so thankful to Dr. Becks, our resident pediatric hospitalist and frequent co-host, for all of her work researching this. I am currently up to my eyeballs in my reporting for season six, which will be coming to your ears on June 19th.
And just a reminder that if you are a subscriber on Apple or Patreon, you will get all eight episodes in your feed on the day it launches. You also get two bonus episodes a month of our subscriber show, Nobody Should Believe Me After Hours. with me and Dr. Becks. We talk about a lot of pop culture crossover on that show.
Right now, we are covering the Elizabeth Finch case, which was featured in the Peacock documentary, The Anatomy of Lies. You can also join our Patreon as a free member and sample some of our bonus content there before you commit. We are so grateful for your support. There truly is no show without you. And with that, on with the episode. You know I love quince. I talk about it here.
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Chapter 2: What is Madison Meyer's medical background and diagnosis?
And at this point, she's going to be transferred to a hospital in New York where this neurosurgeon, Dr. Paolo Bolognese, practices and where he sees patients.
Got it. And I did want to just flag that we have heard from some listeners who have Ehlers-Danlos syndrome after the airing of our first episode. And so we just wanted to recognize that and say, anybody, feel free to always send us your feedback. But nothing about this conversation is meant to indicate that Ehlers-Danlos syndrome. in and of itself is a questionable condition.
It is very much a real thing and can lead to quite a bit of medical complexity. So we just wanted to recognize that up top.
And I agree. And I think what happened during other cases we've covered is that patients who truly suffer from these conditions and have symptoms
some of the you know long-term consequences and complications of these are actually getting a little bit lost in the shuffle because there are all these places and all these doctors you know that are diagnosing these things kind of in different ways and maybe using different criteria and in a way it's it's kind of what happened with covid with adhd diagnoses right where things are getting diagnosed now even on the internet by other people and the people who are truly suffering from these things at times are now facing drug shortages
inability to get care from providers because of all of this. So I think that's more, I think what Andrea was trying to say is that these conditions exist and they can be debilitating and there's concerns with it. It's just, it's more that how do we kind of find a place where everybody's getting the care they need, but the appropriate care, you know, in the appropriate places. So.
Yeah, and we still have much more to unpack about this particular case, but whenever we are talking about illnesses that happen to come up a lot in Munchausen by proxy cases or in suspected Munchausen by proxy cases, the reason for flagging those is not to say that anybody who has that diagnosis is a red flag.
we are trying to point out what the questionable patterns are that surround those diagnoses. Because we have very much seen that, the example I'm thinking at the top of my head is with like the AHC community that we covered in season five of the show, right?
That we've seen perpetrators take a lot of resources from those communities, mess the data up, especially if it's something that is super rare. And so we see a lot of harm to those communities of people that legitimately have these diseases and or people who are parents of children that have these diseases. We see a lot of harm being caused to those communities by perpetrators.
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Chapter 3: Who is Dr. Paolo Bolognese and what are his specialties?
As I was saying on the first episode, that that did occur even when I practiced in Southern California, where if there are specialists or if there are things that a child needs that are not available at Kaiser Permanente, they will reach out to whatever the local children's hospital is and potentially transfer patients.
So at this point, Madison is transferred back from New York to Rady Children's. And we again meet Dr. Shaylin Niinau, who is a child abuse pediatrician associated with Rady Children's. So we're now in January and Madison is back in San Diego, but now at Rady Children's. And we're going to go into a little bit of what happens now during this stay at Rady.
So we're going to talk a little bit more about Dr. Sheila Nino and exactly how her association with this hospital and the child abuse team works, because this is very different from state to state and hospital to hospital, how these sort of teams interact. So we will break that down a little bit more in a future episode. But for now, what do we know about this admission to Rady Children's?
This is where the question of covert video surveillance comes into play. And I speculate or kind of assume that this is going to be a big part of the court process going forward because it has shown up multiple times in the complaints filed by the parents as to this timeframe during which Madison and her family were under this covert video surveillance within the room.
So when they arrived back to Rady Children's, they were placed in a room that has the capability for video surveillance.
So by the time they get to Rady's, it sounds like we're to assume that there is some suspicion of abuse by the time they get to Rady's.
because there was the report made prior that had been closed for, it sounds like the investigator, it was closed after an evaluation for not having enough evidence at that time to proceed.
So now that she's at Rady and they have the ability to do video surveillance in the rooms, a discussion was had, again, that depending on which side we're hearing kind of different stories, but whatever it's worth, video surveillance began in the patient's room at that time when she was placed at Rady's and carried on for, Over 30 days.
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Chapter 4: What happens when Madison returns to Rady Children’s Hospital?
There's times where it says 36 and times where it says 38, but it was 24 hours a day, seven days a week for at least 30 days or over 30 days. Andrea and I have talked about this a little bit about using video surveillance in these cases. And maybe you can speak a little bit to your experience with video surveillance being used.
Absolutely. And B Yorker, who is a friend of the show and a frequent contributor and a very well-regarded expert in Munchausen by proxy, has actually written about the sort of legal implications of using covert video surveillance. And it can be an extremely helpful tool, especially in cases of, you know, that are serious and life threatening.
Actually, the case that we're covering for season six involves covert video surveillance. There was some covert video surveillance in my sister's case. These can capture anything from instances of suffocation to instances of illness induction via a child's line, improper use of medications, like that kind of thing.
It's really important to understand when you're looking at these cases that you're not looking for a single incident. It is very unlike something like a broken bone or abusive head trauma, where those also might be sort of patterns of abuse over time, but you are looking at a single incident and trying to unpack what happened around a single moment in time or a single period of time.
So for Munchausen by proxy abuse, you know, you're looking for this pattern. And so covert video surveillance can provide a piece of abuse. It is not the only thing. And importantly, I think it's not exculpatory if there's nothing that happens under that. You know, we've seen that.
I'm thinking of the Brittany Phillips case, actually, where she was put under video surveillance that did not capture anything, but she pointed out, like, the video camera and said, you're watching me. It's not a sort of black and white thing, but certainly if something is captured, that is a very strong piece of evidence.
There are other pieces of evidence, you know, in Brittany Phillips' case that I was mentioning earlier, Obviously the medical record review is a huge piece of it, as well as other sort of instances of fabrication that when you cross-reference with social media and in that case, her internet search played a big role. So it is a tool.
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Chapter 5: How is covert video surveillance used in suspected medical child abuse cases?
And I think it's important to say, too, that doing video surveillance is not to falsify evidence of medical child abuse or munchausen by proxy. So just placing the camera in and of itself is not forcing evidence to occur, right? The idea is you have an eye in the room, and you can see behaviors and patterns and things that may stand out. It doesn't mean you're going to find any.
It means it's a tool, like you said, to use, because it's often
varying versions of the same story right there's the medical record there's social media there's what the parents are reporting there's what the child is reporting and you may have two doctors who got two different stories as well so part of it is i think in the world we live in people want to see evidence people want to see clear concise evidence that is going to say this is what is happening and i have no doubt it's 100 and that just doesn't exist in this you know in this world but
The idea of covert video surveillance, if you do capture something, it may mean you're able to save or help the child if you have this piece of evidence. So you're not making something happen. You're doing it as another piece of your, I think, investigation. And what's most important is every state has their own laws as to how covert video surveillance can be used.
Every probably county DCF or Child Protective Services branch has their own kind of methods for using that. And then each hospital has their own set of consents that come into play in these cases. So it really without knowing very specifically this hospital, this county, this state, this HHSA or their child protective services,
that's going to be where all the litigation comes into play i think is kind of how that all does play out but as of now this is the parents do not know that the video is in the room um until much later at which point you know they realized they had been watched for 24 hours a day for seven days a week and so that does come in a lot into the court documents when it comes to
concern for invasion of privacy, violation of constitutional rights to privacy, search and seizure, all of these other things. The covert video surveillance comes up time and again.
Yeah, I just to kind of put a button on that, I think, you know, we sort of talked about in the last episode
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Chapter 6: What are the legal and ethical implications of covert video surveillance?
but while we are trying to be you know yes as open-minded as possible looking at this case i think there are sort of things we will entertain and things that we won't entertain um and the you know the idea again of like child abuse pediatricians being uh looking for cases or you know sort of creating cases that's something that comes up a lot in these lawsuits that came up with sophia
lawsuit, that came up in my sister's lawsuits, that came up obviously in the Maya Kowalski case. You know, their job is to evaluate abuse in a medical context. So this is a tool to evaluate. And I think it's worth saying that they use video surveillance in other capacities in hospitals, right?
To monitor for seizure activity, to monitor for other things, that it is a medical tool and that is how it is used by hospitals and by child abuse pediatricians.
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So I think more to know about the specifics of this case, but you'll just see that this is something that has come up in previous cases and probably will continue to. So we will see how this part plays out. When she does return to Rady Children's, there is another report made to HHSA or called into the abuse hotline. At that time, we do not have access to those reports.
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Chapter 7: What is the role of child abuse pediatricians in these cases?
We know that a report was made. And there is documentation of Dr. Nienau, again, being a part of this because she is the child abuse pediatrician. So she is the one who would be helping with the medical reporting of symptoms that are occurring that are concerning, you know, for medical child abuse or munchausen by proxy or neglect or anything else that is coming up in this case.
By this point, it is stated in the court documents that Dr. Nino or somewhere in these reports that there was a potential risk of death if Madison remains in the care of her parents. We don't have all of those details, but I don't think that's said lightly in my experience or in my opinion. And Andrea, we've seen it in other cases, but there is a path of no return in some of these cases that
there may be warning signs and it may be a review of the record and it may be all of the information you have in front of you but at some point there is a concern for death is there not yes i mean we've seen a lot of cases that were escalating in that direction and unfortunately i'm researching a number of cases right now where the parent followed through on that
And I think certainly like when you see a parent persistently talking about a child's death who has not been diagnosed with a terminal illness, when they are consulting things like palliative care, hospice care, TPN nutrition for a child that doesn't need it, when you're seeing those kinds of escalations.
If you have concerns about induction of illness through contamination of a child's line that could lead to, you know, sepsis. And, you know, those kind of things should be taken really seriously. And I think that that's always where kind of the tension in child protection comes in, right? Like where does a parent's rights matter?
right to make medical decisions for their child and or, you know, where does a parent's right to privacy end if a child's life is in danger? And you are making different decisions with a different sense of urgency if you feel that the child's life is genuinely at risk because you do not know when that will escalate.
You don't know where along the progression you are at any given moment, and particularly if a child has something like a feeding tube or a port that could lead to death instantly, then that certainly is going to elevate that concern.
And the record review that Dr. Nienau or any child abuse pediatrician would do is, I just want to clarify that their specialty is child abuse pediatrics. So Dr. Nienau actually did the fellowship in child abuse pediatrics, is board certified in child abuse pediatrics.
I mean, there's other child abuse pediatricians that have a different backstory, but that is hers and has maintained, you know, continuing medical education in the field, all of that. That being said, the record review is the kind of heart of these cases, at least from that side. There are all the medical records there are.
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Chapter 8: How do reports of suspected abuse affect parental rights and child safety?
Right. And their job is to evaluate the medical piece.
And, you know, something that is not mentioned contextually a lot of times in the media coverage of these cases is that child abuse pediatricians, number one, the data shows us that they find, you know, find have findings of abuse in less than 50 percent of the cases that they evaluate and also that they are less likely to come up with findings of abuse than their less well-trained colleagues.
So, again, I think I said it in the last episode, but I will say if I am a parent who is not abusing my child, I want a child abuse pediatrician making that evaluation. They're less likely to make mistakes.
makes sense right they're more trained and that's i think that's where maybe there's a little bit of dissension in in how people feel about them but again i think when you put it in that context of they are specialists in this field it doesn't mean they're going to find it and like you said it actually data shows that maybe they find it less i think that's an important just an important piece to kind of set this up before we go forward but um as with a lot of the cases we've we've followed
it is going to come into question whether this report, whether the initial call to HHSA was falsified or this idea of a false accusation or false elements of these reports. And that also, it's this word false that I think gets to me personally is, is it false or is it what they saw at that time or their, again, reasonable suspicion of whatever it is that they're calling in or reporting?
which is what we're taught to do, is that you call in when there's a reasonable suspicion. So saying these accusations or these reports are false, I think that word is just is interesting, not to say there couldn't be something that is just blatantly wrong in a report. Of course, there is. But at the same time, that word false accusation or false reporting to me could mean a variety of things.
Yeah, it's it's pretty loaded. And I think, yeah, again, with the standard being reasonable suspicion. So I gather if you are talking about a false allegation,
know if an evaluation said that a parent falsified test documents or lied about you know a test result and they just didn't that's not what the medical record shows then that doesn't match up with the medical record then then yeah i mean that would be but it sort of there's a lot of room for for speculation so this this family is saying then that
The second report, then we're at the second report that was made when when Madison enters radio children's so yeah take us back to the timeline so there's a period of we know there's a period of covert video surveillance and then how long into her stay there is this second report.
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