MEMORANDUM DECISION
STATEMENT OF THE CASE
[1] Appellants-Respondents, T.M. (Father) and K.J. (Mother) (collectively, Parents), appeal the trial courts Order, adjudicating the minor children, O.M. and E.M. (collectively, Children), to be children in need of services (CHINS).
[2] We affirm.
ISSUES
[3] Parents present this court with four issues, which we consolidate and restate as:
(1) Whether the trial courts Order adjudicating Children as CHINS is clearly erroneous; and
(2) Whether the trial court violated Parents’ right to due process during the CHINS proceedings.
FACTS AND PROCEDURAL HISTORY
[4] Pursuant to our standard of review, the facts most favorable to the trial courts judgment are as follows.
1
Mother and Father are the biological parents of O.M., born on July 24, 2016, and E.M., born on October 12, 2017. Parents lived with O.M. and E.M. in the 1300 block of Archer Avenue in Fort Wayne, Indiana. O.M. was born severely prematurely at twenty-five weeks. During the years prior to 2022, Mother sought treatment for O.M. for what she reported as frequent seizures, cardiac fluctuations, and low oxygen levels. Following Mothers reports, O.M. was diagnosed with a seizure disorder, pulmonary issues including low oxygen levels, cardiac issues, developmental delays, and a genetic disorder, Pilarowski-Bjornsson Syndrome (PBS).
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O.M. was treated by a variety of doctors, primarily at Parkview Regional Medical Center (Parkview) in Fort Wayne, including a neurologist, a pediatric developmental specialist, a pediatric psychologist, a pediatric pulmonologist, a cardiologist, and occupational and physical therapists. O.M. was prescribed the medications Keppra and Sympazan to address her seizures. These medications were to be administered daily. At home, Mother monitored O.M.’s oxygen levels with a pulse oximeter and administered O.M. oxygen. On August 21, 2021, Mother received genetic counseling that PBS is not a fatal disorder. Nevertheless, Mother told O.M. and E.M. that O.M.’s condition was fatal and that O.M. was going to “go to heaven soon[.]” (Transcript Vol. III, p. 71). Mother told health care providers that O.M. was terminal, and she had O.M. and E.M. undergo therapy with Dr. Marla Souder (Dr. Souder) to cope with O.M.’s supposedly impending death.
[5] Despite the fact that O.M. was prescribed seizure medications, Mother continued to report that O.M. was experiencing frequent seizures. As a result, O.M.’s physicians increased the dosages for O.M.’s seizure medications multiple times. On May 2, 2022, Mother brought O.M. to Parkview for seizure activity and heart rate fluctuations. Mother represented to care providers that O.M. never missed any doses of her medication. Mother also brought O.M. to Parkview in July of 2022, reporting that O.M.’s heart rate had varied from sixteen to 250 beats per minute. During both the May and July 2022 Parkview admissions, Mothers reports were shown to be inaccurate, and cardiac issues were ruled out.
[6] The Indiana Department of Child Services (DCS) became involved with this family beginning on August 11, 2022, when it received reports that Mother had been taking O.M. to multiple physicians, had been keeping O.M.’s physicians isolated from each other, and had been providing false or exaggerated reports of O.M.’s symptoms to health care providers. It was reported that Mother suffered from Munchausens by Proxy, also known as Factitious Disorder of Another Person. On August 22, 2022, Mother brought O.M. to the Parkview ER, reporting that O.M. had an elevated heart rate, low oxygen levels, and was experiencing seizures at least one to two times per week despite being administered her medications. That same day, DCS received a report that O.M. was a victim of medical neglect because her seizure medications were not being retrieved from the pharmacy. Investigation revealed that during the seventeen-month period from April 2, 2021, through September 8, 2022, O.M.’s Keppra prescription had been filled for only a three-and-one-half-month supply and that her Sympazan prescription had only been filled for a one-month supply.
[7] On August 23, 2022, O.M. was admitted at Peyton Manning Childrens Hospital (PMCH) in Indianapolis for observation and further assessment. Mother brought O.M.’s seizure medications to PMCH, but those medications were expired. Testing performed at PMCH revealed that O.M. had virtually undetectable levels of Keppra and no traces of Sympazan in her system. PMCH physicians reduced O.M.’s seizure medications to more standard dosages, and O.M. was not observed to have any seizures. While at PMCH, there were no concerns about O.M.’s oxygen levels, and O.M. did not display the symptomology of a child experiencing chronic oxygen desaturation. O.M. was assessed by Dr. Courtney Demetris (Dr. Demetris), a pediatric physician who is a board-certified child abuse pediatrician. Dr. Demetris diagnosed O.M. as being a victim of medical child abuse.
[8] On August 24, 2022, O.M. and E.R. were removed from Parents’ care and were placed in foster care. Since her removal from Parents’ care, O.M. has been weaned off all her seizure medications and has not experienced any seizures, O.M.’s pulmonologist has discontinued at-home monitoring of O.M.’s oxygen levels, and O.M. has not required any emergency care for heart fluctuations. When they arrived in foster care, neither O.M., who was six years old, nor E.M., who was four years old, was toilet trained, dressed herself, or properly used utensils to eat. Both Children quickly learned those skills in foster care.
[9] On August 26, 2022, DCS filed a petition alleging that Children were CHINS. That same day, the trial court held a combined initial/detention hearing at which Parents agreed to proceed by summarizing the testimony of the witnesses they would present. At the conclusion of the hearing, the trial court continued Childrens detention and ordered Parents to have virtual therapeutic parenting time. After the CHINS petition was filed, Dr. Souder diagnosed O.M. with PTSD, being a victim of medical child abuse, psychological abuse, and neglect, language delay, parent-child relational issues, and alopecia. Dr. Souder diagnosed E.M. with PTSD, being the victim of educational and developmental neglect and of psychological abuse, a language disorder, a developmental articulation disorder, and parent-child relational issues. According to Dr. Souder, Childrens educational delays were not due to any lack of capacity to learn but instead were due to lack of exposure and expectations of learning age-appropriate subjects and skills. O.M. and E.M. had experienced significant trauma from being told that O.M. was terminal. E.M. was so focused on O.M.’s illness and potential death that she had issues separating her identity from O.M.’s. After Childrens removal, Mother continued to suggest during virtual parenting time with Children that O.M.’s condition was fatal, causing O.M. severe distress. Prior to one parenting time session, O.M. wanted to wear her nasal oxygen because Mother had told her to do so.
[10] A Dependency Mediation Report filed on September 22, 2022, indicated that, while Parents contested a CHINS finding, they both agreed to submit to psychological assessments and follow all resulting recommendations and to enroll in and successfully complete individual therapy. Parents each subsequently underwent a psychological assessment, but Mother did not report to the assessor that in 2013 she had been convicted of four Counts of theft after pocketing funds she had raised for a sick child who Mother did not know. Mother also failed to disclose to the assessor that she has only supervised parenting time with her two sons from a prior marriage. Mothers psychological assessment included a metric commonly used to assess physical abuse, not medical child abuse.
[11] Fact-finding was scheduled for two days, with DCS and Parents to receive equal time. On January 31, 2023, the trial court held evidentiary hearings on DCS’ petition. On February 3 and February 10, 2023, Parents filed motions seeking an additional trial day to present the testimony of their experts, Julie Foster, Alexandria Burns, Parents, and “several other witnesses” to support their case. (Appellants App. Vol. II, p. 145). Parents’ motion was based in part on the fact that DCS still had witnesses to call after the first day of fact-finding was concluded.
[12] On March 31, 2023, the trial court held the second and final portion of the fact-finding hearing. Although Father testified at the hearing, Mother did not. On April 28, 2023, Parents filed a motion to allow their private counsel to have access to the Allen County Courts’ case management system, Quest. In their unverified motion, Parents allege that the fact that their private counsel did not have access to Quest prejudiced them because they did not have full and timely access to all filings, orders, and court dates for the case.
[13] On June 1, 2023, the trial court issued its Order adjudicating Children as CHINS. The trial court entered findings of fact and conclusions thereon consistent with the aforementioned facts. The trial court determined that, due to Parents’ acts or omissions, O.M. had been the victim of medical child abuse that had caused her physical, emotional, and psychological harm and that E.M. had been emotionally and psychologically harmed as well. The trial court entered the following relevant additional findings of fact and conclusions thereon:
WW. The [c]ourt finds through Dr. Demetris, that “it is important to note that the presence of underlying medical conditions such as a seizure disorder does not rule out medical child abuse. A patient can have both underlying medical conditions and a parent who falsified, exaggerates or induces symptoms that are not caused by the known underlying true medical condition. I do believe-[O.M.] has underlying seizure disorder, though the severity is unclear to me as she is largely not receiving medications and has relatively infrequently reported seizures. I also believe that she has underlying chronic lung disease and some developmental delays as a residual consequence of her extreme prematurity.”
XX. The [c]ourt finds through the testimony of Dr. Souder, Dr. Demetris and [DCS], that significant interventions are required to keep [C]hildren safe and rehabilitate [P]arents, including, but not limited to, ongoing psychotherapy for [C]hildren and psychotherapy for [P]arents.
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C. [ ] The [c]ourt concludes that both [C]hildren are at risk of further harm, including death, if they are returned to the care and supervision of [Parents] without effective intervention.
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G. The [c]ourt concludes that neither child will receive needed care and supervision, treatment, and rehabilitation without the coercive intervention of the [c]ourt. Further, given the “[deep-seated] psychological and emotional pathology” of [Mother] and the failure to protect of [Father], neither parent will receive necessary care and rehabilitation without the coercive intervention of the [c]ourt. These interventions shall include, among other things: individual therapy, parenting education, psychological assessments, and intensive and diligent monitoring of any interactions with [C]hildren until demonstrable benefit from services is shown. Both [P]arents shall be further restrained from discussion of any medical issues or terminal illness with, or in the presence of, either child.
(Appellants’ App. Vol. III, pp. 32-33) (record citations omitted).
[14] On June 28, 2023, the trial court held a disposition hearing. On June 30, 2023, the trial court issued its dispositional order. On August 16, 2023, the trial court issued an amended Order, adjudicating Children as CHINS.
[15] Parents now appeal. Additional facts will be provided as necessary.
DISCUSSION AND DECISION
I. Sufficiency of the Evidence
A. Standard of Review
[16] Parents contend that the evidence does not support the trial courts conclusion that Children are CHINS. Our standard of review of a trial courts CHINS determination is well-settled: we do not reweigh the evidence or judge witness credibility. In re S.D., 2 N.E.3d 1283, 1286 (Ind. 2014). We consider only the evidence which supports the trial courts decision and the reasonable inferences to be drawn from that evidence. Id. at 1287. In addition, where, as here, the trial court has entered findings of fact and conclusions of law, we exercise a two-tiered review. Matter of K.P.G., 99 N.E.3d 677, 681 (Ind. Ct. App. 2018), trans. denied. First, we consider whether the evidence supports the findings, and, second, we determine whether the findings support the judgment. Id. We will reverse a trial courts CHINS determination only if it is clearly erroneous and a review of the record leaves us firmly convinced that a mistake was made. Id. A judgment is clearly erroneous if the record facts do not support the findings or if it applies the wrong legal standard to properly found facts. Yanoff v. Muncy, 688 N.E.2d 1259, 1262 (Ind. 1997). DCS was required to prove that Children are CHINS by a preponderance of the evidence. See Ind. Code § 31-34-12-3.
B. CHINS Determination
[17] The trial court found that Children were CHINS pursuant to Indiana Code section 31-34-1-1, the general neglect statute, and section 31-34-1-2, the injury by act or omission statute. Under both CHINS statutes, DCS must establish that Children are endangered, that Children need care, treatment, or rehabilitation that they are not receiving, and that the care, treatment, or rehabilitation “is unlikely to be provided or accepted without the coercive intervention of the court.” See I.C. §§ 31-34-1-1(2)(B), -2(a)(2)(B). Requiring that DCS show that a childs needs are unlikely to be met without the intervention of the court “guards against unwarranted State interference in family life, reserving that intrusion for families ‘where parents lack the ability to provide for their children,’ not merely where they ‘encounter difficulty in meeting a childs needs.’ ” In re S.D., 2 N.E.3d at 1287 (quoting Lake Cnty. Div. of Family & Children Servs. v. Charlton, 631 N.E.2d 526, 528 (Ind. Ct. App. 1994)). In rendering a CHINS determination, the trial court considers the familys condition not just when the petition was filed, but also when the petition is heard. Id. at 1290.
[18] Parents argue that DCS failed to establish endangerment because when Children were removed “there was no immediate danger to [C]hildren[,]” “O.M. was not scheduled to have any intrusive procedures or surgeries[,]” and there were no medical concerns regarding E.M. (Appellants’ Br. p. 15). However, Mother had been misrepresenting the nature and gravity of O.M.’s symptoms and diagnoses to health care providers and to Children for years. In addition, Mother did not provide O.M. with her seizure medications as prescribed for approximately one and one-half years. Due to Mothers reports that O.M. continued to have seizures despite receiving Keppra and Sympazan, O.M.’s dosages for those medications were unnecessarily increased, exposing O.M. to not only unneeded excess medication but also to potentially increasing side effects of that medication. O.M. was diagnosed with medical child abuse, which Dr. Demetris testified at the fact-finding hearing is “life-threatening and potentially fatal.” (Tr. Vol. III, p. 39). Most shockingly, Mother told Children that O.M. was dying, when she was not. Children were understandably traumatized by and preoccupied with this allegedly impending event. Both Children were diagnosed with PTSD and neglect, and E.M.’s fixation on O.M.’s illness and impending death caused E.M. to have identity issues. Father was living with Children while all of this occurred but failed to protect them from Mothers conduct. Apart from Mothers medical child abuse of O.M. and its effects on both Children, Parents failed to toilet train Children or teach them how to dress themselves or eat with utensils. DCS’ FCM testified at the fact-finding hearing that Children were physically and mentally endangered. We conclude that this evidence supports the trial courts determination that Parents endangered Children, and, thus, that its conclusions on that element were not clearly erroneous. See Yanoff, 688 N.E.2d at 1262.
[19] Parents also argue that the evidence does not support the trial courts conclusion that its coercive intervention is necessary because they completed services without any DCS referrals and because Father was “ready, willing, and able to provide for the needs of O.M. and E.M.” (Appellants’ Br. p. 16). These arguments are unpersuasive, as Parents endangered Children for years before DCS’ intervention. Before DCS intervened, Mother had most recently taken O.M. to the ER for unnecessary medical treatment in May, July, and August of 2022. Although Parents underwent psychological evaluations after DCS filed its CHINS petition, Mother was not entirely truthful with the evaluator, and while both Parents engaged in therapy after Childrens removal, there is no evidence before us that this therapy was the kind of “serious and intensive” “psychological treatment” Dr. Souder recommended that Mother required aimed at preventing further medical child abuse and Mothers “deep-[seated] psychological and emotional pathology.” (Exh. Vol. 45, p. 2).
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Parents face an uphill battle, as according to Dr. Souder, “the prognosis for this type of psychological issue[ ] in a parent is not good in the research and treatment outcomes.” (Exh. Vol. 45, p. 2). Even after removal, Mother continued to reinforce with O.M. during virtual parenting time the idea that she was going to die, causing Children renewed trauma. In the face of pharmacy records establishing that O.M.’s prescriptions had not been filled as prescribed, Father maintained at the fact-finding hearing that they had “always” filled O.M.’s Keppra prescription. (Tr. Vol. IV, p. 78). We conclude that this long-term pattern of abuse and neglect, Mothers continued pathologizing of O.M., and Parents’ lack of forthrightness about their conduct supported the trial courts conclusion that its coercive intervention was necessary to protect Children. Parents’ arguments to the contrary are simply a request that we consider evidence that does not support the trial courts determination and that we reweigh the evidence, which is contrary to our standard of review. See In re S.D., 2 N.E.3d at 1286. Accordingly, we do not disturb the trial courts CHINS determination.
II. Due Process
[20] Parents next contend that their due process rights were violated during the CHINS proceedings. “Due process requires ‘the opportunity to be heard at a meaningful time and in a meaningful manner.’ ” In re K.D., 962 N.E.2d 1249, 1257 (Ind. 2012) (quoting Mathews v. Eldridge, 424 U.S. 319, 333, 96 S.Ct. 893, 47 L.Ed.2d 18 (1976)). The right to due process applies to all stages of a CHINS proceeding. Id. The due process afforded in a CHINS proceeding turns on the balancing of the factors identified in Mathews, namely, “(1) the private interests affected by the proceeding; (2) the risk of error created by the States chosen procedure; and (3) the countervailing governmental interest supporting use of the challenged procedure.” Id. Our supreme court has recognized that
[t]he private interest affected by the proceeding is substantial—a parents interest in the care, custody, and control of his or her child. And the States interest in protecting the welfare of a child is also substantial. Because the State and the parent have substantial interests affected by the proceeding, we focus on the risk of error created by DCSs actions and the trial courts actions.
S.L. v. Ind. Dept of Child Servs., 997 N.E.2d 1114, 1120 (Ind. Ct. App. 2013) (citing In re C.G., 954 N.E.2d 910, 917 (Ind. 2011)). Parents argue that their right to due process was infringed by the manner in which the trial court conducted the CHINS proceedings and when it restricted their private counsels’ access to Quest. Accordingly, we will focus our analysis on whether Parents have established that the trial courts actions created a risk of error in the proceedings or in the courts CHINS determination. See id. Parents’ claims that their due process rights were violated are matters of law which we will review de novo. See Morton v. Ivacic, 898 N.E.2d 1196, 1199 (Ind. 2008).
A. Conduct of the Proceedings
[21] Parents claim that at the August 26, 2022, combined initial/detention hearing, the trial court denied them “the opportunity to call witnesses, or cross examine opposing States witnesses[.]” (Appellants’ Br. p. 17). However, the record reflects that the trial court agreed with Parents that they had a right to present evidence at the hearing; however, due to time constraints, the trial court allowed the parties’ attorneys to summarize their witnesses’ testimony, after which the trial court asked each witness, who had been placed under oath, whether the summary was accurate. Parents’ counsel agreed to this procedure. Parents’ counsel was permitted to cross-examine Dr. Demetris, the only DCS witness Parents’ counsel requested to cross-examine. Parents’ contention that the trial court improperly restricted their right to cross-examination appears to be based on the fact that their counsel asked Dr. Demetris in “how many lawsuits [she had] been named as a [d]efendant?[,]” drawing an objection from the State which the trial court sustained. (Tr. Vol. II, p. 33). On appeal, Parents fail to explain why the trial courts ruling on this objection created a risk of error in the initial/detention proceedings.
[22] Parents’ argument that the trial court violated their due process rights by enforcing what they contend were arbitrary time limits during the fact-finding hearings and at other unspecified hearings meets a similar fate: while Parents contend that this unduly curtailed their presentation of the evidence, including “several” unspecified witnesses, they offer no explanation about how this increased the risk of error in the proceedings or in the trial courts CHINS determination pursuant to the second Mathews factor. (Appellants’ Br. p. 17). We observe that Parents’ February 2 and February 10, 2023, motions requesting an additional day of trial were based in part on the fact that they believed that DCS had additional witnesses to call on the second day of fact-finding. However, DCS called no additional witnesses during the second day of fact-finding, and, after having an additional exhibit admitted at the beginning of the hearing, it rested its case. Parents called two experts on genetics, the psychologist who evaluated Mother, and a medical doctor to whom Mother had reported that O.M. was terminal, as well as the witnesses they had specifically identified in their motions for another day of trial, namely Father, Julie Foster, and Alexandria Burns. Parents rested their case without objecting that they had not been allowed to present additional witnesses, and they made no offer of proof regarding the substance of any additional witness testimony or evidence that they had not been allowed to present. Based on the record before us, we cannot conclude that Parents have established that their due process rights were violated by the manner in which the trial court conducted the proceedings.
B. Access to Quest
[23] As to Parents’ request that their private counsel
4
be allowed access to Quest, we similarly conclude that they have failed to show how their counsels’ lack of access increased the risk of error.
5
See In re K.D., 962 N.E.2d at 1257. Parents contend that their counsels’ lack of access to Quest deprived them of timely notification of filings and orders. However, for most of the proceedings prior to the trial courts entry of its CHINS Order, at least one of Parents’ counsel was also a public defender who had access to Quest. At the June 28, 2023, dispositional hearing while arguing the Quest motion, Parents’ counsel discovered that they had been served with filings and orders in the instant proceedings via email but that those documents had been shunted into their email spam folders. Presumably, this was a factor which Parents’ counsel could rectify without the trial courts intervention. On appeal, Parents do not explain how being served with documents electronically rather than accessing them through Quest increased the risk of error. As such, we find no due process violation. See In re I.L., 177 N.E.3d 864, 871-72 (Ind. Ct. App. 2021) (finding no due process violation where Mother failed to establish that her claimed errors, standing alone or together, increased the risk of error).
CONCLUSION
[24] Based on the foregoing, we hold that the trial courts Order adjudicating Children as CHINS is not clearly erroneous and that Parents have failed to establish any violation to their right to due process.
[25] Affirmed.
FOOTNOTES
1
. We remind counsel for Appellants that, pursuant to Indiana Appellate Rule 46(A)(6)(b) and (c), the Statement of Facts “shall be stated in accordance with the standard of review” and “shall be in narrative form and shall not be a witness by witness summary of the testimony.” Appellants’ Statement of the Facts is in contravention to both of those Rules, as it contains argumentative statements that are not based on the evidence most favorable to the trial courts judgment, and it consists largely of summaries of witnesses’ testimony. We also observe that, in contravention to Appellate Rule 46(A)(7), Appellants’ Brief contains no Summary of the Argument.
2
. PBS is a newly discovered genetic disorder which can present with symptoms such as seizures, developmental delays, and autism-like symptoms. At the time of the fact-finding hearing, only six PBS patients had been the subject of published research.
3
. The record of exhibits in this matter consists of forty-five separate volumes. Appellate Rule 29(A) and Appendix A(14) provide that the court reporter shall prepare an exhibit index which includes “the exhibit volume and page number where the exhibit is located.” We observe that the Court Reporter of the Allen County Superior Court neglected to include this information in the exhibit index.
4
. Parents were jointly represented by two private attorneys.
5
. It appears that the trial court may have never ruled on this request, although it indicated at least twice during the lower court proceedings that it was awaiting input from an unspecified source regarding Parents’ motion. We assume for the sake of resolving Parents’ appellate claims on this issue that the trial court denied Parents’ motion.
Riley, Judge.
Brown, J. and Foley, J. concur