Monday, May 17, 2004

BALTIMORE — Authorities missed several “red flags” that might have helped prevent the beating deaths of 1-month-old twin girls last week, the city’s top health official said yesterday.

The twins’ parents, 17-year-old Sierra Swann and 24-year-old Nathaniel Broadway, were ordered held without bail by a District Court judge yesterday on two counts each of first-degree murder and child abuse causing death.

The two were arrested Friday after an autopsy report showing that their girls, Emonney and Emunnea Broadway, had fractured skulls and fractured ribs and showed signs of severe malnutrition. The girls were not breathing and their bodies were cold when an emergency crew brought them to Johns Hopkins Hospital last Tuesday, police said.

Police said the couple was living in a vacant home in northeast Baltimore that had no electricity or furniture other than a mattress and a crib. Although the front of the home appeared tidy, the back yard and basement, where the couple lived, was littered with piles of trash and debris. Neighbors said the home had been vacant about six months. They said they didn’t know anyone was living there.

In court yesterday, Miss Swann listed her mother’s home as her address. Mr. Broadway listed his stepfather’s home. Miss Swann was said to be unemployed. Mr. Broadway reportedly worked at a Wendy’s restaurant.

In December, the couple’s 2-year-old girl had been placed in foster care for abuse and neglect.

Baltimore Health Commissioner Dr. Peter Beilenson said the earlier case was just one of several “red flags” that should have alerted officials that they were dealing with a high-risk family.

Dr. Beilenson, chairman of a Child Fatality Review Committee, said his group sees six to 10 fatal cases a year in which a mother has another child and abuses it after the state has removed other children for abuse or neglect.

“This is a systemic problem. It happens far too often. We need a better safety net. Too many kids are dying,” Dr. Beilenson said yesterday.

Although officials said they couldn’t discuss many details of the case because of confidentiality regulations, the following story emerged:

The couple’s first child — then 1 years old — was placed with foster care in December after the state Child Protective Services investigated and confirmed a complaint of neglect and abuse. Case workers apparently did not know the mother was pregnant at the time, officials said. Officials said she did not receive prenatal care through the term of her pregnancy.

The twins were born April 12. The first baby apparently was delivered down the mother’s pants leg, officials said. The mother took a taxi to Johns Hopkins Hospital, where the second baby was born.

Dr. Beilenson said the circumstances surrounding the births and the mother’s history should have alerted medical authorities to contact Child Protective Services.

“They knew she was 17. They knew her first child had been removed. They knew she had received no prenatal care — those were huge warning signs,” Dr. Beilenson said after a review of the case with police and hospital officials yesterday.

Following procedures in such cases, the hospital apparently asked Child Protective Services if it had an open case on the mother. When the agency replied that it didn’t, the hospital referred the case by mail to the health department’s Maternal and Infant Nursing Program, which provides home visitations and counseling to high-risk families. The health department received the referral May 6 and scheduled a visitation for May 12. By then, the twins were dead.

Dr. Beilenson criticized Child Protective Services for closing its file on the mother. He criticized the hospital for not reacting with greater urgency based on the information it possessed.

Hopkins spokeswoman Staci Vernick declined to respond to the health commissioner’s criticism.

Human Resources spokes-man Norris West said the state also was reviewing the circumstances. He said case workers have a mandate to respond to potential child-abuse cases with urgency.

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