GIG HARBOR — Winona Thigpen was sick in early October.
The girl, born five weeks earlier as the first child to Annie and Abram Thigpen of Gig Harbor, had been congested and coughing. A blood vessel popped in one eye, and she had red dots on her face known as petechiae.
There were two other issues: a bruise above her right eyebrow and linear contusions from under her armpit down the back of her left arm. The Thigpens believed those marks could be immediately explained. Winona had accidentally bonked heads with her grandma during burping the day before and the seam of a swaddle she wore matched up exactly with the line on her arm, they said.
The Thigpens, who had also been sick, took their newborn daughter to her pediatrician. The doctor noticed the arm bruising and expressed concern that Winona’s platelets could be low, likely from an underlying viral infection. The family was referred to Mary Bridge Children’s Hospital in Tacoma for more testing, where the infant’s platelets were determined to be fine.
At the hospital, where they spent three days, the tone shifted. Annie Thigpen, 25, said she initially thought little of it when the hospital flagged Child Protective Services, considering it to be part of a standard procedure to ensure all children were safe in the hands of their caregivers.
“I think maybe I was in denial because I just knew there’s no way we would ever do anything to Winona,” she said in an interview. “It was just so obvious to me. It didn’t even cross my mind that no one would believe us.”
But the state and hospital, concerned by the combination of injuries, ultimately did cast suspicion on the Thigpens, who battled accusations of child abuse for months until a dependency case filed against them was dismissed in early April.
Interviews and an examination of court hearing footage, medical reports and state and police records that Annie Thigpen shared with The News Tribune offer a glimpse inside Washington State’s confidential child welfare system, including one instance when a family contends that the system got it wrong.
“As the process went on, I felt like not only did the medical professionals fail us but (the) state, too,” Abram Thigpen said. “I feel like the state has let us down.”
Concern for a child
Dr. Susan Lamb, a child-abuse pediatrician at Mary Bridge Children’s Hospital, believed there were reasons to be concerned for Winona’s well-being. Lamb would later testify in a child welfare court hearing regarding the Thigpens that she diagnosed abuse in roughly 40% of screened cases referred to her. In the others, there was an alternative explanation: an accident, a medical condition or something other than child abuse.
To Lamb, Winona’s case fell into the 40% category. Her combination of injuries without a plausible accidental history were “highly suspicious for physical abuse,” Lamb wrote in an Oct. 5 evaluation report. Bruising and petechiae were caused either by direct blunt force trauma or compression of the tissues that impairs blood flow, she wrote.
“Winona is at risk of re-victimization if she is in the same environment where her physical abuse occurred,” the report said.
In an interview, Lamb said she was barred by confidentiality rules from speaking about specific cases.
“We want to do what’s best for the child,” she said. “We want to figure out the truth.”
Lamb’s assessment is at the crux of criticisms shared by the Thigpens and their legal counsel. Specifically, they said she only examined Winona briefly, didn’t document differential diagnoses and had been unwilling to consider reasonable alternatives to the infant’s injuries that they said other doctors supported, including Winona’s recent fits of coughing, sneezing and crying, and her positive test for rhinovirus, the most frequent cause of the common cold.
Dr. Niran Al-Agba, a physician hired by the Thigpens’ counsel to review the case, noted alternative explanations in a consultation report in January. The marks on Winona’s arm were not consistent with typical abuse, she wrote, and the forehead bruise aligned with the accidental injury reported by the family.
“Based on my medical education, training, clinical experience, and review of the records, there is absolutely no evidence to support an accusation of non-accidental trauma or child abuse,” her report said.
Annie and Abram Thigpen, 26, however, found themselves under the watch of the state’s Department of Children, Youth and Families, which oversees CPS. In December, the agency filed in juvenile court a dependency petition, which seeks temporary legal custody of a child for their protection. Those types of proceedings could lead to a child being placed outside their home or staying at home with services.
More than 1,900 dependency cases were filed last year in Washington state, according to DCYF spokesperson Nancy Gutierrez.
There were signs that the state’s case involving the Thigpens was less than certain.
Evidence was insufficient for law enforcement to prove abuse, Pierce County Sheriff’s Department spokesperson Sgt. Darren Moss said, confirming that prosecutors this month declined to file charges. A neutral, court-appointed representative for Winona declared during a court hearing in February that she didn’t think the state’s intervention was necessary.
“I don’t know what happened, your honor, but having the state involved and watching this child and this family is not in (Winona’s) best interest,” Pierce County guardian ad litem Kelly Downey-Chamberlin said.
Last month, DCYF’s active scrutiny evaporated after the Thigpens agreed to a private parenting assessment and their case was dropped. The dismissal order, presented April 11 by an assistant attorney general representing the state, noted only that dependency had not been established.
The state Attorney General’s Office declined to comment on an inquiry seeking explanation for the dismissal, citing the confidentiality of child-welfare matters.
“DCYF is the agency that handles dependencies. Our office’s role in that process is as legal counsel to DCYF,” spokesperson Brionna Aho said in an email. “Our office provides options-based advice to clients, and decisions are ultimately up to the client.”
The News Tribune was unable to discuss the case with DCYF, which said they couldn’t comment on specific cases. Speaking generally, Gutierrez, the DCYF spokesperson, said a case dismissal could signify that the agency was satisfied that safety concerns had been addressed and there was no longer an imminent threat of physical harm to a child.
In a statement, MultiCare, the Tacoma-based health system that owns Mary Bridge Children’s Hospital, said the hospital was required by law to report any suspected child abuse or neglect to authorities.
“Mary Bridge Children’s, with our multidisciplinary clinical teams and community partners, does everything we can do to help children in our community stay safe and healthy,” MultiCare said.
A misdiagnosis
The most alarming diagnosis given to Winona when she arrived at the hospital was one that she didn’t have after all. Winona had petechiae, or a common but concerning type of rash, on her face; a subconjunctival hemorrhage (broken blood vessel) in her left eye; a bruise on her right forehead; and linear bruises on her left forearm and upper arm, a medical report showed.
It had also been suspected that she sustained a more serious, hairline skull fracture under her forehead bruise. The day after it was documented, a radiologist’s suspicion was proven to be wrong. A hospital neurosurgeon who reviewed Winona’s CT scan said he didn’t believe she had a fracture, according to court records, which noted that repeat X-rays also confirmed the misdiagnosis.
If the skull fracture hadn’t been reported, law enforcement wouldn’t have been summoned to the hospital because that injury had been the most concerning issue, according to Moss, the Sheriff’s Department spokesperson.
“What is the child abuse that occurred now?” he said in an interview. “We don’t have child abuse.”
In an incident report, a detective called to investigate the alleged abuse noted that the forehead bruise was clearly not caused by a hand, but by a straight object, and the petechiae around Winona’s eyes was barely visible. Photographs also showed Winona’s arm contusions were “more red and thin, almost stringy looking.” The detective’s list of witnesses included Lamb, who was documented as “resolute in her opinion” that the arm marks were bruises and wouldn’t entertain any possible alternative and innocuous causes for the injury, the report said.
If the contusions did line up with clothing seams, Lamb told the detective, then it meant that someone had been carrying the infant by the arm, according to the report.
Lamb also remained certain about her child-abuse diagnosis despite the no-fracture finding, according to her testimony during a dependency hearing in late January. In response to a grievance filed against Mary Bridge by the family over the child abuse allegations, the hospital said that the injuries absent the fracture were concerning, records show.
Lamb testified that the family’s explanations for Winona’s constellation of injuries were not consistent with their documented pattern. For instance, pressure marks from clothing wouldn’t last longer than 36 hours and infants didn’t have the head control to bonk their grandma under their own power, she said.
Winona had sensitive skin, the family said. Annie Thigpen told The News Tribune that she, herself, has all the necessary requirements for Ehlers Danlos Syndrome, a condition where fragile skin is a common symptom, and was in the process of finalizing testing to learn the type. Some forms of the syndrome are inherited and passed on from parent to child, according to the Mayo Clinic.
For Lamb, Winona’s injuries were representative of sentinel ones, which she explained were relatively minor and easily healed; at risk for being overlooked by medical providers; and without a plausible explanation for how they occurred.
“So, the concern is that there is something going on where this child is experiencing more minor physical abuse,” she testified, “and if things continue, they may go on to experience more major, life-limiting or life-ending physical abuse.”
In closing arguments for one hearing on Feb. 14, assistant attorney general Mike Jewitt pointed out that Lamb was qualified and had spoken with other treating doctors. He questioned the credibility of Winona’s grandmother’s account of bumping heads with the infant, alleging that it wasn’t geometrically possible in the way she had explained it.
“As it regards to the services, I think the biggest thing is keeping eyes on this child,” Jewitt said.
‘A broken system’
A Pierce County Superior Court judge sided with the state after closing arguments, finding Winona was at imminent risk for harm. The ruling was the culmination of multiple court dates for the Thigpens’ “shelter care hearing” — the first in a series of hearings expected in the dependency case. It maintained the lowest standard of proof in judicial proceedings: Reasonable cause.
Lamb’s testimony was key. The judge noted that while the credentials were impressive for both Lamb and Al-Agba, Lamb’s opinion was more credible in this case because she had reviewed more records, directly spoken with family members and worked with other medical providers.
Downey-Chamberlin, the guardian ad litem, disagreed with the ruling. In her closing statements, she rejected the notion of there being an active safety threat, expressed fear that the state’s continued involvement had sowed a distrust in the system and noted the Thigpens’ strong support structure.
“You have all these family members who are already watching this child … because this is their grandchild and they were so excited to have this baby,” she said.
The Thigpens’ family members and friends have recently protested outside Mary Bridge Children’s Hospital a few days a week, according to Annie Thigpen. Their signs include those that read, “No More Skull Fracture Misdiagnosis Cover-ups!!!”, and “Mary Bridge — Stop the Harm To Our Children!”, according to photographs she shared with The News Tribune.
Lamb said that she has ridden with security between her office and the hospital in order to prevent any unnecessary confrontation with the protesters.
In her role for nine years — the last two at Mary Bridge — Lamb said that she understood the implications of her findings, or when parents were upset by her diagnosis. But she added that there were quality controls in her work, such as peer reviews, and families should feel secure that she was doing everything to keep up with science and evidence-based medicine.
“These are weighty matters,” she said, “and I just have to put my head down and say, ‘Hey, let’s just focus on my piece, the medical piece, and what I can do.’”
After the judge’s ruling, Winona was allowed to remain in her home, but regular health and safety visits were ordered for the family. Prosecutors said it wasn’t their intention to try to remove the baby. The next scheduled court proceeding — the fact-finding hearing — would have required a tougher, preponderance of evidence standard, but the case never made it that far.
By the time the Thigpens’ case was dismissed, the parents had been engaged in three voluntary DCYF safety plans, each one finding no new reasons for concern and subsequently de-escalating in their severity of conditions, state records show. When the investigation opened in early October, Winona was moved to be with her grandparents, and the Thigpens weren’t allowed unsupervised visits. Once the skull fracture was deemed misdiagnosed, a new plan returned Winona home and prescribed weekly unannounced visits from a social worker.
The Thigpens claimed that the state kept moving the goalposts. The parents had taken Winona in for a wellness check and skeletal survey and followed safety plans. When those actions proved insufficient, CPS requested they take five-month parenting classes. At that point, the parents hired a lawyer. Health-and-safety visits began at attorney Chris Torrone’s office.
In an interview, Torrone said he believed that the Attorney General’s Office realized it had a bad case that was ultimately hurting a family more than it was helping them. He questioned why the state waited two months to file a dependency petition, given Lamb’s child-abuse opinion, suggesting that the state had decided to lay liability at the feet of the court.
“It’s a sign of a system that is broken,” he said.
Torrone added that it was rare for guardians ad litem to be out of lockstep with the state, and he said it was “unusual” for a case to be dismissed as this one had.
“I believe that this was a type of case that, had it really been analyzed thoroughly, could have protected other families who are going to unfortunately catch themselves in the exact same circumstances,” he said. “So, I personally believe this is a case we should have won.”
Moving on
Annie Thigpen was born and raised in Gig Harbor. Abram Thigpen moved away but returned in middle school. He was discharged from the Coast Guard in December, a plan underway prior to the child-abuse investigation, and now is working alongside his wife’s father in a family real estate business.
For five years, the couple tried to have a baby, going as far as fertility treatments that caused medical complications, according to Annie Thigpen, revealing she also had two miscarriages. Winona was their “miracle,” she said.
While the case’s dismissal provided a sense of relief to the family, they were less optimistic when discussing the ramifications of having fallen under the suspicions of the child-welfare system.
“We had a hard time going public with it because there’s always going to be people who think you did abuse your kid,” Annie Thigpen said. “But I’m hoping that if we can share what happened, than other people, who are being affected the way we are, will be able to get more help because there’s not the stigma of ‘you’re guilty.’”
A CPS investigation had cleared each parent of two claims of physical abuse in January, but two allegations of negligent treatment or maltreatment against each were founded, records show. Those findings, based on a “more likely than not” standard, will remain on their records unless they can successfully argue to remove them administratively.
Annie Thigpen said she was fearful that it could mean the state could try to take Winona anytime she gets sick. She also wondered whether the findings would prevent her from being able to volunteer at Winona’s schools or accompany her on field trips.
