DSS sought early end to life support

The state Department of Social Services sought a legal order to withdraw life support from a brain-damaged girl, who is now showing some signs of improvement, within three weeks after she was hospitalized following a brutal beating, court records show.

Agency officials, already under fire for missing signs that 11-year-old Haleigh Poutre was chronically abused, defended their decision to act so quickly, saying they followed doctors' diagnosis that her condition was hopeless.

''We're not doctors," DSS Commissioner Harry Spence said last night. ''We have relied on the medical community for advice."

Though neurologists say that some patients with severe brain injuries show major improvement months later, DSS officials say they were told by doctors last fall that Haleigh was ''virtually brain dead" and in a ''persistent vegetative state" from which she would never recover.

But lawyers for Haleigh's stepfather, who could face murder charges if she dies, questioned why DSS was willing to give up so quickly in a case that is so medically complex.

''They were writing this kid off," said Jack Egan, a Springfield lawyer representing Jason Strickland. ''What was the rush?"

Court records show that DSS asked for the order allowing the agency to take Haleigh off life support by Sept. 30, less than three weeks after the Westfield girl was brought Sept. 11 to a local hospital unconscious from a beating, allegedly administered by her adoptive mother and stepfather.

Strickland's attorneys say DSS, which took custody of Haleigh on Sept. 13, sought the order on Sept. 19. DSS officials declined to confirm the date they went to court for the order. A juvenile court judge granted it on Oct. 5, and the Supreme Judicial Court backed that ruling Tuesday.

DSS said Wednesday it had suspended plans to take Haleigh off life support. DSS lawyers are scheduled to appear before a judge today to provide new test results that show, among other things, that she is breathing on her own and responding more to stimulation.

DSS officials would not say yesterday if the agency plans to ask Juvenile Court Judge James G. Collins of Holyoke to rescind or indefinitely stay his order allowing breathing and feeding tubes to be removed from Haleigh.

''We will make sure he knows everything we know," said DSS spokeswoman Denise Monteiro.

After the court hearing, Spence plans to discuss Haleigh's case at a press conference this afternoon. He said he will focus on how DSS missed signs of abuse.

''This was a classic case of conscientious error," he said. ''We did what we were supposed to do. Everyone misread the data before us."

He said social workers visited the home every week and were convinced that the girl's injuries were self-inflicted. Then when the girl's unconscious body arrived at the hospital, they realized the adoptive mother had lied to them.

''It was a huge shock to all of the professionals," he said. ''One day -- bang -- they suddenly realized they misread or were duped by the mother."

The House chairwoman of the legislature's Committee on Children and Families said yesterday she thinks lawmakers should investigate how DSS handled Haleigh's case, from its acknowledgment that it missed signs of abuse to its actions in regard to her life support.

Representative Shirley Owens-Hicks, a Mattapan Democrat, said the agency clearly failed to keep Haleigh safe, though she also acknowledges that the agency, with nearly 40,000 children in its caseload and nearly 10,000 in its custody, faces tremendous challenges in caring for so many vulnerable children.

Most importantly, she said, Haleigh is now showing some medical progress.

''She's improving -- and that's a blessing," Owens-Hicks said.

Haleigh's biological mother, Allison Avrett, said yesterday that she has received no update that the girl's condition has changed significantly since Wednesday morning, when she saw Haleigh at Baystate Medical Center in Springfield with opened eyes and seemingly responding to some commands.

Monteiro said that Haleigh is not breathing through her mouth, but through a small pipe that has been attached to her trachea. She said medical staff has to clean the mucus from the tube hourly because she cannot swallow.

Avrett said she is eager to know if the new tests indicate hope for a full recovery or if Haleigh is likely to remain in a vegetative state with perhaps only fleeting signs of improvement.

''We need to investigate and see what the tests reveal," she said.

DSS disclosed Wednesday that Haleigh was breathing without a ventilator. Yesterday, the agency said that Haleigh had been weaned off her breathing tube last week, before the Supreme Judicial Court ruling, and that DSS did not inform the court of that development.

Court spokeswoman Joan Kenney said she does not know of a requirement for parties in a case to provide the justices with updated medical facts in end-of-life cases.

Spence said he does not believe that DSS withheld any significant information from the court. ''There was no one in the medical community saying there was a change in the condition" to alter the view that life support should be removed, he said.

But a lawyer for Haleigh's stepfather said yesterday that he believes DSS should have disclosed the information to the court. ''I'd think the court would have liked to know that," said John Thompson, one of two Springfield attorneys representing Strickland.

Strickland had fought to keep the girl on life support and to be designated a ''de facto" parent who should have a say in her care.

But the high court, in its ruling on Tuesday, said it would be ''unthinkable" to give such power to a man who has been charged in the girl's beating.

Strickland's wife, Holli Strickland, was found dead on Sept. 22, two days after the couple's arrest on child abuse charges. Her body was found alongside her grandmother's in what police believe was a murder-suicide.

Much remains unclear about Haleigh's medical condition. Her medical records are impounded because she is a juvenile. The Globe has joined a legal effort by another newspaper, the Republican of Springfield, to unseal the DSS brief, filed with the Supreme Judicial Court, which contains medical information.

But even if all the medical reports were publicly available, neurologists say there are no clear-cut answers about which brain-injured patients who are in a vegetative state have the potential to recover and to what degree.

Haleigh has two major factors on her side, however. Neurologists say that children with brain injuries generally fare better than adults and that those whose injuries come from trauma, such as Haleigh, fare better than those whose brains were starved of oxygen. Doctors caution, however, that many patients may have limited recoveries and cannot communicate or feed themselves.

Tuesday's court ruling cited doctors who said that Haleigh was in ''an irreversible vegetative state" and that she had suffered a stroke on both sides of her brain. It said the girl's brain operated on such a primitive level that ''the child could not see, hear, feel, or respond."

Patricia Wen can be reached at wen@globe.com.