On March 20, 2023, B.B.'s mother called 911 at 7:40 a.m. to report that B.B. was unresponsive, cold to the touch, with blue lips in the crib. Law enforcement found drug paraphernalia in the mother's room, which she shared with B.B. A toxicology screen completed during B.B.'s autopsy came back positive for fentanyl, and the cause of death was determined to be fentanyl poisoning. At the time of death, the family had an open CPS investigation with DCYF, and the FVS caseworker had texted the mother just four days prior that the FVS case would be closing. The family had an extensive history with DCYF, with 30 prior reports, and the mother had a documented history of heroin use and substance use disorder. Both parents subsequently received founded findings for neglect, though neither was charged with a crime in connection with the fatality.
Contexts/Conditions
Is there any mention of child drug ingestion or overdose?
The fatality report states: "The toxicology report came back positive for fentanyl. B.B.'s cause of death was determined to be fentanyl poisoning." This clearly describes a child drug ingestion/overdose.
Is there any mention of a drowning incident (either intentional or accidental)?
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 notes a July 2021 report alleging "lack of supervision of the children." Additionally, B.B. died of fentanyl poisoning while in the care of parents who had drug paraphernalia in the room shared with the child, implying a failure to adequately protect the infant from dangerous substances. Both parents received founded findings for neglect in connection with B.B.'s death.
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)?
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?
The fatality report states that "Law enforcement found paraphernalia in the mother's room that she shared with B.B." and that B.B. died of fentanyl poisoning while in the crib in that room. The presence of drug paraphernalia in a room shared with an infant, combined with the resulting fentanyl poisoning, implies an unsafe sleeping environment. Additionally, for an older sibling in 2016, "the caseworker provided the mother with a pack and play sleep space as there were concerns that she was co-sleeping," demonstrating a history of sleep environment concerns.
Individuals Involved
Was an adoptive parent or guardian involved in the death?
Was a biological father involved in the death?
The fatality report states: "B.B.'s father had returned to the home at this time as well" and "a new report was made to DCYF with allegations of neglect by both of B.B.'s parents. This report met criteria for a CPS investigation and both parents received founded findings in that investigation." The biological father received a founded finding for neglect in connection with B.B.'s fentanyl poisoning death.
Was a biological mother involved in the death?
The fatality report states that "B.B.'s mother had called 911 to report B.B. was in crib unresponsive," that "Law enforcement found paraphernalia in the mother's room that she shared with B.B.," and that both parents received "founded findings" for neglect. The mother was the primary caregiver and had drug paraphernalia in the room she shared with B.B., who died of fentanyl poisoning.
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)
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 explicitly states: "Prior to the critical incident, DCYF received 30 reports on B.B.'s family. Of those 30 reports, 14 met criteria for CPS investigation or Family Assessment Response (FAR)." The report details extensive CPS history dating back to 2014 involving the mother and older siblings, including founded findings for neglect.
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?
The fatality report explicitly references domestic violence multiple times. The mother received a "founded finding for neglect for exposing [child] to marijuana and domestic violence." An ex-girlfriend of the maternal uncle alleged "she had been a victim of domestic violence in her relationship with the maternal uncle and the mother had assaulted her as well." The mother was "referred for... domestic violence resources" and "participated in a domestic violence support group." The Committee Discussion also identifies "complex issues of domestic violence" in the case.
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?
The fatality report states that "The school was concerned the mother was having a mental health, medication, or substance use issue." While this references mental health as a possible concern, it is not confirmed as a diagnosis or established condition - it is one of several possibilities the school raised.
Is a history of arrests or criminal charges for the parent/caregiver referenced?
The fatality report states regarding a 2016 involvement: "the father had recently gotten out of jail but was not living in the home." This reference to the father having been in jail predates and is separate from B.B.'s fatal incident in 2023.
Is substance use by the parent/caregiver referenced?
The fatality report contains extensive references to parental substance use. The mother was on a "Subutex program" and "reported she had stopped using heroin." "There were also reports that the father was using heroin." There were reports of the "mother and maternal uncle using alcohol and heroin." The school reported "the mother often appeared high or not fully alert" and was concerned she "was having a mental health, medication, or substance use issue." The mother was asked to complete urinalysis testing. Drug paraphernalia was found in the mother's room.
Notable Details
The fatality report describes significant systemic issues. The Committee learned the field office "had been functioning at a reported 50 percent vacancy rate at the front end programs (CPS, FAR and FVS) for several years." This led to "high turnover of caseworkers, caseworkers with little experience, caseworkers with high case loads and supervisors forced to carry cases." The Committee noted caseworkers were "focusing on important aspects of the case but perhaps not always the most important aspects," categorizing it as being about the children's behaviors rather than recognizing signs of substance use. Additionally, the FVS caseworker texted the mother to close the FVS case just four days before B.B.'s death. The Committee also noted that in September 2022, "the local office utilized secondary screening authority to override" a report that had met CPS investigation criteria, choosing not to investigate a report describing the mother as "out of it" and "non-responsive." Finally, the Committee criticized over-reliance on urinalysis testing rather than comprehensive SUD behavioral assessment.
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