October 21, 2005

An Infant Dies Suddenly at a Child Welfare Office

http://www.nytimes.com/2005/10/21/nyregion/21baby.html?adxnnl=1&oref=login&adxnnlx=1130238884-g9y5lYYE+YsDwBVzkpipnw&pagewanted=print (must subscribe to NY Times to view original article)

A month-old baby boy who was in foster care suddenly stopped breathing yesterday at a Newark office of New Jersey's child welfare agency and died a short time later, the authorities and child welfare officials said last night.

What caused the death of the child, Zaire Knott, remained unclear late yesterday. Newark police detectives said that they would treat the case as a homicide, a routine step, until they received autopsy results. The child welfare agency, the Division of Youth and Family Services, also opened an investigation, as did the state's child advocate, Kevin M. Ryan.

Child welfare officials said a preliminary review showed that they had received no allegations that Zaire, who was brought to the office for a visit with his biological mother, had been abused or neglected.

"At this point, we don't think that there is anything improper," said Andy Williams, a spokesman for the State Department of Human Services, which oversees child welfare. Mr. Williams said that child welfare investigators were focusing on whether Zaire had an adverse reaction to two vaccines - for Hepatitis B and polio - that he had received during a regular check-up by a pediatrician hours before he died. Medical experts said yesterday that it is extremely rare for children to die because of bad reactions to vaccines.

Zaire's death comes at a time when New Jersey's child welfare agency is already reeling from a report released by an independent review panel last week that found state officials were not making sufficient progress in putting a court-ordered reform plan in place.

The overhaul of the system, which began two years ago and has already cost the state more than $300 million, was part of the settlement of a class-action lawsuit filed on behalf of the state's foster children by a child welfare reform advocacy group.

After the review panel released its findings, the advocacy group, Children's Rights Inc., asked a federal judge to intervene in the overhaul of the system, a step that could lead to the agency being placed in receivership.

One of the review panel's findings was that just a third of the children who should have received routine medical check-ups had actually done so. In court papers, Children's Rights cited those findings and warned that children in the state's care were suffering "immediate" and "irreparable" harm.

Yesterday, Susan Lambiase, associate director of the group, said that Zaire's death raised questions about the agency's handling of the child's case.

"Was there something obvious about this baby's case that should have caused them to be more careful with and pay attention?" she said. "It could just be one of those things that happens. But when the state takes a child into its custody, it has a responsibility."

Child welfare officials said that records showed Zaire had received all the required medical exams since his birth and was given a clean bill of health. There were no problems found during Zaire's doctor's visit yesterday morning, although an official said that the child was coughing.

However, around noon, while waiting for Zaire's biological mother to arrive at the child welfare agency's third floor office at 153 Halsey Street, workers noticed that he was taking labored breaths and had a bloody nose. Moments later, Zaire stopped breathing and lost consciousness.

"They took him upstairs to the nurse, who performed C.P.R.," Mr. Williams said. Paramedics were called and they took the child to St. Michael's Hospital where he was pronounced dead at 12:46 p.m.

Leticia LaComba, the deputy director of the child welfare agency in northern New Jersey, said that grief counselors were summoned after the incident. "These are strong, resilient people on our staff," she said, "but it was painful for them to see another human being die before their eyes, especially a baby."

Child welfare officials refused to identify Zaire's foster family. They refused to provide details about his biological mother, but acknowledged that her history with the agency had compelled it to take custody of the child at birth.

Medical experts said yesterday that it was "very, very rare" for infants to die after vaccination. "I don't have the literature, but in 20 years of practicing medicine, I've never seen a case of a baby dying as a result of a vaccine," said Dr. Gregory A. Poland, chief of the Mayo Vaccine Research Group at the Mayo Clinic in Rochester, N.Y.

Officials said that preliminary autopsy results could be available today.