LVHN tied to ‘systemic overdiagnosis’ of medical child abuse in Lehigh County report

• By Olivia Marble/LehighValleyNews.com

• A Lehigh County report alleges “systemic overdiagnosis” of medical child abuse, formerly known as Munchausen syndrome by proxy
• About 70 people came to the Lehigh County Commissioners meeting Wednesday. Many said they were affected by false accusations of medical child abuse by LVHN
• LVHN rejected the claims and said physicians who specialize in child abuse often face “emotionally driven and unsubstantiated criticism”

Lehigh Valley Health Network has been accused of repeatedly misdiagnosing medical child abuse.

A crowd of about 70 people who say they have been affected by false accusations of medical child abuse came to the Lehigh County Commissioners meeting Wednesday.

They came with Lehigh County Controller Mark Pinsley, who published a report about what he calls a “systemic overdiagnosis” of medical child abuse in Lehigh and Northampton counties.

Pinsley’s report found an “abnormally high number of medical child abuse diagnoses in the Northeast region of Pennsylvania,” particularly in Lehigh and Northampton counties.

“The reader must understand that our investigation did not reveal a few anomalies attributable to human error,” the report states. “Instead, our analysis showed statistical anomalies suggesting a pattern that requires further investigation.”

Medical child abuse formerly was known as Munchausen syndrome by proxy. It happens when a caregiver deliberately fabricates or induces an illness in someone under his or her care, often to gain attention or sympathy.

About 20 people spoke to the commissioners at the meeting — caregivers who were accused, family of people who were accused and children who had been taken from their parents.

Pinsley’s report doesn’t mention any specific clinician or medical group, but there is only one medical group in the region that handles such cases: LVHN’s John Van Brakle Child Advocacy Center, or CAC.

All the people who spoke at the commissioners’ meeting cited LVHN in their comments. Several specifically mentioned head of the CAC Dr. Debra Esernio-Jenssen.

LVHN sent an emailed statement to LehighValleyNews.com that said the controller’s office has “no jurisdiction over the CAC, nor the clinical credentials to conduct a review of a clinician or the services rendered by a clinician.”

“Due to the sensitive nature of their work, physicians specializing in child protective medicine are often the unfortunate target of emotionally driven and unsubstantiated criticism,” the statement read.

Pinsley argued that he did have the jurisdiction to investigate the issue because the county incurs costs from the potential misdiagnoses – such as foster care and litigation expenses. He said those costs are the focus of the report.

The controller’s office will refer the matter to the state Auditor General’s Office for a more complete investigation, the report reads.

Pinsley said he also will submit a request to local hospitals to participate in the investigation and to consider having an independent third party evaluate medical child abuse diagnoses.

‘We were pawns in a game’

Emmaus resident Steven Steltz said he and his wife, Kim Steltz, took their son to the emergency room of an LVHN hospital.

“Within 30 hours of taking our son to the hospital, and without ever meeting my wife or I, Debora Jenssen and the child protection team labeled both my wife and me having Munchausen by proxy syndrome,” Steven Steltz said.

“This is a one-in-10 million chance for both of us to have it.”

Kim Steltz said it wasn’t just LVHN staff who did not respect her family.

“One day when our son had to leave with the foster parent and not his family, our caseworker pushed open the court doors, walked into the hallway, threw her hands up into the air and celebrated with the foster mother. ‘Congratulations. It’s a boy,’” Steltz said.

“Not one person involved in the process was interested in the truth. Not the caseworkers, supervisors, administrators or solicitors. We were pawns in a game.”

An independent evaluation found neither parents had Munchausen by proxy syndrome. Lehigh County withdrew the case and returned their sons to their custody.

The report’s finding

In the report, Pinsley cited that the Northeast region of Pennsylvania had 40% of the state’s medical child abuse cases from 2017 to 2021, despite having 14% of its population younger than 18.

Lehigh and Northampton counties had eight out of the 10 reported cases in the region.

Pinsley said in the report that Lehigh County’s Child and Youth Services department “heavily relies” on the expertise of Child Protective Units in hospitals when making decisions about whether to remove children from homes.

Pinsley’s report “strongly recommends” that CYS require at least a second medical opinion when child removal is a possible outcome.

“We’re going to remove people from their home,” Pinsley said in an interview. “So it seems like a good idea to get a second opinion, even if it has to be immediately after the fact.”

Pinsley clarified that a second opinion may not be needed or could occur after removal if there is “clear evidence” of abuse. He said the second opinion should come from a different hospital network to make sure collegiality is not influencing the doctor’s conclusion.

LVHN response

LVHN’s emailed statement outlines the process for handing medical child abuse accusations.

Cases of suspected abuse are referred to the CAC through the state reporting system, where Esernio-Jenssen, who is “board-certified in child abuse medicine,” and her team evaluate cases, the statement reads.

The team collaborates with the child’s medical team to look for signs of abuse. A medical examination is only one factor in the final decision about whether protective services are necessary, according to the statement.

“Had the controller followed the typical audit process, we would have provided these details,” the statement read.

Pinsley said that while there is a standardized audit process, a controller can produce a report that does not follow that process. He also said he believes the points raised by LVHN do not contradict his findings.

“I’m not denying what the process [of determining child abuse] is, if that’s what they’re saying,” Pinsley said.

The doctor cited in LVHN’s statement, Esernio-Jenssen, has had several lawsuits brought against her for misdiagnosing medical child abuse, but no charges have been brought against her.

County Human Services response

The Lehigh County Department of Human Services said in a prepared response that “We are currently reviewing the report presented by Mr. Pinsley.”

“At first glance we are concerned that this appears to be rather one-sided in its presentation of facts and conclusions regarding the County of Lehigh’s Office of Children and Youth Services,” the response stated.

“The caseworkers and attorneys of the Office of Children and Youth Services are dedicated professionals who are committed to the protection of children and youth as both a legal and moral imperative.

“Any case in which the agency seeks to remove a child from their parent(s) must first be presented to the Lehigh County Court of Common Pleas before emergency placement, and then a hearing occurs shortly after placement.

“While we are constrained by both state and federal law from fully discussing the situations of the specific Lehigh County cases identified by Mr. Pinsley, we have reviewed the facts and are comfortable with the county’s handling of these matters, and the protection of the children involved.”

EDITOR’S NOTE: Lehigh Valley Health Network is an underwriter of Lehigh Valley Public Media, the nonprofit organization that houses PBS39, 91.3 WLVR and LehighValleyNews.com.