On December 19, 2022, approximately 10-month-old Natalina Hellums (N.H.) was placed in a bathtub by her mother and grandfather due to a soiled diaper at their home in Burien, Washington. It was unclear who was supposed to be watching the child. The mother returned to the bathroom to find N.H. floating in the water with her legs and arms extended. Emergency medical services responded and administered CPR for approximately one hour, but N.H. could not be revived and was pronounced dead at the scene. The medical examiner determined the cause of death was asphyxia due to drowning and acute fentanyl intoxication, and the manner of death was ruled homicide. The mother had a known fentanyl abuse problem, and burnt foil and clear baggies of powder were found in the home. The family had previously been involved with Child Protective Services following N.H.'s birth when the mother tested positive for methadone and marijuana, but the CPS case had been closed approximately eight months before the child's death.
Contexts/Conditions
Is there any mention of child drug ingestion or overdose?
The fatality report states: "The medical examiner reported to DCYF that N.H. passed away from asphyxia (drowning) and acute fentanyl intoxication." This directly indicates fentanyl was present in the child's body at a lethal level, constituting drug ingestion/intoxication.
Is there any mention of a drowning incident (either intentional or accidental)?
The fatality report states: "N.H. passed away from asphyxia (drowning) and acute fentanyl intoxication." The ME report (WA_22_1635.pdf) confirms: "Cause of Death: Asphyxia due to drowning." N.H. was found floating in a bathtub.
Is there any mention of a firearm incident?
Is there any mention of inappropriate supervision (e.g., child wandered off and drowned)?
The fatality report states: "N.H. had been put in the bathtub by the mother and grandfather due to a soiled diaper. The referrer said they were unclear about who was supposed to be watching N.H. The mother returned to find N.H. floating in the water with legs and arms extended." The ME report further corroborates: "was left unattended in the bathtub." An infant left unattended in a bathtub constitutes inappropriate supervision.
Is there any mention of inflicted injury? (e.g. slapped, punched, kicked, choked)
Is there any mention of malnutrition, starvation, or dehydration?
Is there any mention of medical neglect?
Is there any mention of a motor vehicle crash or incident?
Is there any mention of a murder-suicide incident?
Is there any mention of outdoor elements (including hot car deaths)?
Is there any mention of prenatal substance exposure (including fetal alcohol syndrome or neonatal abstinence syndrome)?
The fatality report states: "In February 2022, DCYF received a report that at the time of N.H.'s birth, mother tested positive for methadone and marijuana. The referrer said the mother reported substance use, including fentanyl, opiates, and methamphetamines, and most recently used approximately 10 days prior." Additionally, N.H. was monitored for 96 hours after birth before discharge, which is consistent with neonatal drug exposure monitoring protocols.
Is there any mention of sexual abuse?
Is there any specific mention of shaken baby or abusive head trauma?
Is there any mention of prolonged abuse or torture (including restraints, captivity)?
Is there any mention of an unsafe sleeping environment?
Individuals Involved
Was an adoptive parent or guardian involved in the death?
Was a biological father involved in the death?
Was a biological mother involved in the death?
The fatality report states: "N.H. had been put in the bathtub by the mother and grandfather due to a soiled diaper." The mother was one of the individuals who placed N.H. in the bathtub, and the referrer noted it was "unclear about who was supposed to be watching N.H." The mother returned to find N.H. floating. The manner of death was ruled homicide. Additionally, the mother had a fentanyl abuse problem and fentanyl-related items were found in the home, while N.H.'s cause of death included acute fentanyl intoxication.
Was a day care worker, babysitter, or nanny involved in the death?
Was a female paramour or friend involved in the death (e.g., girlfriend, stepmother)?
Was a foster parent involved in the death?
Was a male paramour or friend involved in the death (e.g., boyfriend, stepfather)?
Was another adult relative involved in the death? (e.g., grandfather, aunt)
The fatality report states: "N.H. had been put in the bathtub by the mother and grandfather due to a soiled diaper. The referrer said they were unclear about who was supposed to be watching N.H." The grandfather was directly involved in placing N.H. in the bathtub, and there was confusion about supervisory responsibility between the mother and grandfather.
Was a sibling involved in the death?
Child Characteristics
Was the child adopted?
Was the child homeschooled (including "cyberschooling") or taken out of school?
Was the child in foster care at the time of the incident?
Was the child living with relatives at the time of the incident (but not parents)?
Is there any mention of a neurological developmental child disability? (e.g., autism, intellectual disability, nonverbal)
Is there any mention of a physical child disability? (e.g., feeding tube)
Is there any mention of prematurity or low birthweight?
Is there a history of child protection reports prior to death (for this child or siblings)?
The fatality report documents that a CPS risk-only case was assigned in February 2022 following N.H.'s birth due to the mother's positive drug tests: "In February 2022, DCYF received a report that at the time of N.H.'s birth, mother tested positive for methadone and marijuana... A CPS risk-only case was assigned." This case was closed by April 2022, and the fatality report confirms: "N.H. and family were involved with Child Protective Services (CPS), but did not have an open case at the time of N.H.'s death."
Does the child have a history of foster care (but not in care at time of incident)?
Is there a history of a sibling death (separate incident from this death)?
Parent/Caregiver Factors
Was an adult charged or arrested for the child's death?
Is domestic violence by the parent/caregiver referenced?
Is there any mention that the death occurred in a temporary shelter or while homeless?
Is an intellectual disability of the parent/caregiver referenced?
Is the mental health of the parent/caregiver referenced?
Is a history of arrests or criminal charges for the parent/caregiver referenced?
Is substance use by the parent/caregiver referenced?
The fatality report extensively documents the mother's substance use. At birth: "mother tested positive for methadone and marijuana. The referrer said the mother reported substance use, including fentanyl, opiates, and methamphetamines." At the time of death: "The referrer said the mother had a fentanyl abuse problem and there was burnt foil and clear baggies of powder located in the home." The mother was also participating in SUD treatment and medication-assisted treatment throughout the case.
Notable Details
The fatality report describes significant systemic workforce issues at the DCYF office handling this case. The caseworker was approximately six months into their career when the case was assigned, had only shadowed another caseworker once, and had their supervisor accompany them in the field only one time after completing Regional Core Training. At the time of the review (approximately 18 months into their career), the caseworker reported carrying 55 cases. The Committee discussed that "when caseloads are this high, child safety is the focus and that other tasks may fall by the wayside" and noted "the workforce crisis has been a common theme across DCYF offices statewide." Additionally, the Committee noted the mother "may have benefited from additional discussion and planning related to keeping N.H. safe should she relapse," highlighting a gap in relapse prevention planning related to child safety. Despite these identified systemic concerns, "The Committee did not develop any recommendations."
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