Appeal from the Circuit Court of Kane County. No. 98--JAK--50 Honorable Thomas E. Mueller, Judge, Presiding.
The opinion of the court was delivered by: Justice Galasso
JUSTICE GALASSO delivered the opinion of the court:
Respondents, M.N. and F.N. (hereinafter M.N. and F.N.), appeal from the order of the circuit court of Kane County finding their eight children to be neglected and making their youngest child, I., a ward of the court. On appeal respondents raise three issues, namely, (1) whether the trial court's finding that I. was a neglected minor was against the manifest weight of the evidence and whether its order adjudicating him neglected and making him a ward of the court must be reversed; (2) whether the trial court erred in finding that respondents' seven other children were neglected; and (3) whether the trial court improperly considered a fitness evaluation of M.N. in an unrelated case, where there was no showing that M.N. ever gave his informed written consent to the release of the evaluation.
On April 21, l998, the State filed a three-count petition for adjudication (petition) against respondents, alleging their eight children were neglected minors. The children's names and birth months are as follows: M., Jr., May of l982; J., July of l983; N., February of l985; C., July of l988; Jo., October of l989; M., August of l991; T., October of l993; and I., January of 1998.
The petition alleged in pertinent part:
"3. The minors are neglected minors by reason of the following:
1. That said minors *** are neglected minors under 18 years of age and their parents, who are responsible for their welfare, do not provide the proper or necessary support, education as required by law, or medical or other remedial care recognized under the State law as necessary for the minor's [sic] well- being *** to wit: I. N. was born premature, after suffering inter cranial [sic] bleeding and also [has] an inguinal hernia, and the parents are refusing to follow up with the recommended treatment plan; thereby placing the minor at risk.
3. That [the minor children's] *** environment is injurious to their welfare; to wit: the parents do not provide adequate housing for the minors in that they reside in *** one room [in a motel], which places the minors at risk of harm."
At the end of the Shelter Care hearing held on April 21, l998, the trial court found probable cause to believe that the minors were neglected as alleged in paragraph 3.1 of the petition. However, the trial court found that an immediate and urgent necessity did not exist to remove the minors from their home. Further, the trial court directed that I., who had been taken into protective custody prior to April 21, be returned to respondents. The trial court entered an order of protection regarding all minors, which required respondents, among other things, to follow the medical discharge recommendations for I. and to take I. to all recommended follow-up examinations.
An adjudicatory hearing began on August 24, l998, with respondents appearing pro se. Dr. Diane Nielsen, a pediatrician, testified first for the State. She stated that other physicians in her practice group had treated the N. children and that she had personally treated two of them, I. and M. Sometime in February, 1998, Dr. Kopparthi, a neonatalist who had attended I.'s birth and had treated him in the following weeks at Copley Hospital, asked Dr. Nielsen to see the infant a week after his discharge from the hospital.
Dr. Nielsen's review of I.'s hospital records indicated the following. I. was born prematurely on January 15, l998. A routine ultrasound procedure showed that I. had suffered an intercerebral hemorrhagic infarct, the equivalent of a stroke, prior to his birth. Because of I.'s prematurity, there was also a concern that he could have problems with his eyesight. Dr. Nielsen stated that an evaluation was necessary to determine if I.'s eyes were developing normally.
Dr. Nielsen testified that on February 25, l998, respondents brought I. to Dr. Nielsen's office, stating that their son was there to be circumcised. Dr. Nielsen testified that her examination of the infant revealed that he had the appearance of a normal newborn. His weight gain since discharge from the hospital was appropriate. Dr. Nielsen observed a hernia, which had not been noted before. Despite the hernia, I. appeared to be fine. At the conclusion of this examination, Dr. Nielsen gave respondents the following recommendations: (1) a follow-up eye examination to determine if I.'s eyes were developing properly; (2) a follow-up examination by a neurologist regarding any effects of the intercerebral bleeding; (3) an examination by a developmental pediatrician to determine if there were "early and subtle findings" that could be indicative of developmental delay; and (4) the appropriate vaccinations and physical therapy for I. Dr. Nielsen noted that, at the time of this examination, respondents had already missed an appointment with an opthalmologist, which had been recommended upon I.'s discharge from the hospital.
According to Dr. Nielsen, babies with a history of intercerebral bleeding are at "high risk for many neurological problems." The area of the brain in which the bleeding had occurred "would be susceptible to not developing correctly."
Dr. Nielsen further stated:
"If you initiate therapy early, the brain is very what we call plastic. *** It has the ability to recover from previous injuries at a young age in that if you begin therapy [and] begin working on the developmental skills, motor skills, social skills, *** you can take advantage of an early brain that is going to have a chance to have better development."
Dr. Nielsen also told respondents that they would have to keep close track of I.'s hernia and that, if it became strangulated, i.e., if part of the intestine became stuck in the hernia, then the baby would need immediate treatment. Dr. Nielsen indicated that many hernias in newborns resolve themselves in four to six months.
Dr. Nielsen stated that the follow-up care for I. that she outlined for respondents was necessary for his well-being. However, these directions were met with "extreme resistance," and M.N. indicated to her that he had no desire to follow them.
Regarding the children's immunizations, Dr. Nielsen testified that the children had not received them "according to schedule." I. had been given a DPT, polio, and Hepatitis B vaccination but had not yet received a Hemophilus influenza type B (HIB) vaccination. Dr. Nielsen further stated that she examined another of respondent's children, M., who had come to her for a school physical. During that examination, Dr. Nielsen observed that M. had a "lazy eye." She told M.N. about the need for treatment of this condition. M.N. responded to her that "[h]e didn't believe in eye doctors and [he] could take care of this problem at home." She testified that if a "lazy eye" was not treated, poor vision in the affected eye was a probable result.
On cross-examination, Dr. Nielsen agreed that her concerns regarding I. were primarily based on his being born prematurely and having suffered intercerebral bleeding before his birth rather than on what she observed during the February 25, 1998, examination. She did not recall any religious issues being raised by respondents prior to or during that examination. Further, she stated that respondents did not bring I. to an examination that had been scheduled for April 22, l998. Dr. Nielsen stated that she was unaware that, prior to this second examination, respondents had decided that she was no longer the family's pediatrician. Dr. Nielsen agreed that she had told F.N. during a telephone conversation in the latter part of February l998 that, if respondents did not bring I. in for follow-up examinations, then she would contact the Department of Children and Family Services (DCFS).
The State's next witness, Jerry Waite, was a child protective investigator with DCFS. Waite testified that on February 15, l998, he received a hotline phone call regarding the medical neglect of respondents' children, specifically I. Waite talked on the telephone with M.N. on February 25, l998, to ascertain respondents' intentions regarding I.'s medical treatment. At that time, M.N. was uncertain whether they would continue taking I. to Dr. Nielsen. Waite stated that he told M.N. that it was necessary for respondents to follow Dr. Nielsen's treatment recommendations.
Waite further stated that he talked to M.N. in the middle of April l998. M.N. told him that he was not going to take I. for any type of treatment because I. was not "sick." M.N. further told Waite that I. would not be getting "any shots" until he was five years old. Waite also testified that, at one point in the DCFS investigation, F.N. was informed that she had to meet in person with certain DCFS staff persons but she failed to do so. Additionally, respondents did not provide Waite with their correct address or the ...