IN THE INTEREST OF G.A.A.-G. AND J.S.A.-S., CHILDREN
Appeal from the 309th District Court Harris County, Texas
Trial Court Cause Nos. 2007-20638 & 2008-39339.
consists of Justices Christopher, Spain, and Poissant.
Charles A. Spain Justice.
issues in these cases involve whether the jury's findings
to terminate a mother's parental rights are supported by
legally- and factually-sufficient evidence. This accelerated
appeal arises from final orders in which, after a final
hearing before a jury, the trial court terminated the
parental rights of appellant A.A. (Mother) with respect to
her children, G.A.A.-G. (George), J.S.A.-S. (John),
appointed the appellee Department of Family and Protective
Services to be the children's sole managing conservator.
See Tex. Fam. Code Ann. § 109.002(a-1);
Tex.R.App.P. 28.4 (accelerated appeals in
parental-termination cases). John's father relinquished
his parental rights, and George's father's rights
were terminated in an earlier proceeding. Neither father has
appealed the termination of his parental rights. Concluding
that sufficient evidence to support the jury's findings,
we affirm the final orders of termination.
cases began in 2007 with a petition to establish the
parent-child relationship between George and his father,
F.B.G. The trial court found that F.B.G. was George's
biological father. The court appointed Mother and F.B.G. as
George's joint managing conservators and ordered F.B.G.
to pay monthly child support to Mother. In 2008, the trial
court entered an agreed child support order for John in which
the court determined that B.S.S. was John's father, named
the parents as joint managing conservators, and ordered
B.S.S. to pay monthly child support to Mother.
2011, in each case, the Department filed a motion to modify
conservatorship and petition for protection of a child for
conservatorship and termination in a suit affecting the
parent-child relationship. The removal affidavits attached to
the motions to modify and petitions for termination reflect
that the Department received a referral on October 2, 2011 in
which physical abuse of John was reported. John, born May 28,
2008, was found unresponsive in his crib. The referral noted
that Mother was the perpetrator of the physical abuse. The
Houston Fire Department was called to Mother's residence
on October 2, 2011 because John was in cardiac arrest and was
experiencing breathing problems. Bruising was observed around
John's neck and arms and was inconsistent with
Mother's explanation of how the bruises occurred.
Department's investigation revealed that John had special
needs since birth. John had an oxygen machine in the
one-bedroom apartment, which was placed adjacent to a litter
box "full of cat feces." Mother had been John's
sole caregiver and had no explanation for many of the bruises
on John's body. Medical staff at Texas Children's
Hospital diagnosed John as malnourished and failing to
thrive. Scratches, lacerations, and bruises covered
John's entire body.
(Grandmother) arrived at the home earlier on the day of the
referral to pick up George. Grandmother left with George
shortly before Mother called telling her that John was
non-responsive. Grandmother told the investigator that Mother
needed a psychiatric evaluation. The referral noted that
George was at substantial risk of harm due to Mother's
inadequate supervision. Mother voluntarily placed George with
a family friend.
time of the referral John was diagnosed with respiratory
failure, seizures, failure to thrive, multiple bruises, cuts,
lacerations, and excoriations over the abdomen, back, and
extremities. At that time treating physicians were not
certain whether John would survive his injuries.
filed a petition in intervention seeking sole managing
Family Service Plan
received a family service plan, which required her to:
• attend, actively participate in, and successfully
complete a seven-week "Exceptional Parenting" class
offered by Escape Family Resources that is designed for
parenting children with special needs;
• provide the caseworker with a list of at least three
appropriate individuals who will be used for a support
• obtain and maintain legal and verifiable employment;
• contact her caseworker at least one time per week;
• attend all court hearings, family visits, and
• obtain, pay for, and maintain appropriate housing for
herself and her children;
• participate in an anger management course that is at
least six to eight weeks in length;
• participate in a psychosocial evaluation; and
• attend and actively participate in individual therapy.
Holmes, a Department investigator, was the child-fatality
investigator when the case was first received in October
2011. The child-fatality unit of the Department investigates
child deaths that have occurred as well as children that are
believed to be abused and may die as a result of the abuse.
Holmes was called because John's injuries were such that
his treating physicians thought he might die within 24 hours.
Holmes received a report that John, three-years old at the
time, was found in cardiac arrest and was covered with
bruises, especially around his neck and wrists. The nature of
John's bruises reflected that John may have been bound.
Photographs of John's appearance on the day of the
referral were admitted into evidence without objection.
spoke with Grandmother at the hospital. Grandmother expressed
concern about Mother's mental health and stated that
Mother needed a psychiatric evaluation. Grandmother reported
that Mother had denied her access to John and that
Mother's apartment smelled of cat urine. Grandmother
speculated that medication Mother was taking may have caused
her to injure John. Mother was taking an antidepressant and a
spoke with Mother, who gave inconsistent stories about the
potential causes of John's bruises. Mother found John
unresponsive in his crib at 4:00 in the afternoon. When
Holmes first asked Mother how John got the bruises, Mother
responded, "I don't know what to tell you."
Then Mother reported that John had fallen down a couple of
steps two weeks earlier and injured his ankle. Mother said
she did not notice the injury to John's ankle until
medical personnel pointed it out to her. Mother reported that
therapists came into the home four days a week to help John
with his physical development.
time of the investigation George had been living with Mother.
Holmes also interviewed George who told Holmes that John had
been locked in the closet by Mother and that she would hit
John while he lay in his crib. In addition to making the
referral to the Department, Holmes contacted law enforcement
to follow up on potential criminal charges.
pediatrician, Dr. Jennifer Macia, testified that John had
been born prematurely and had chronic lung disease. At
six-months old when Macia first treated John, he had some
brain damage and problems with irritability and feeding. John
was fed through a tube known as a G-tube because he had
difficulty swallowing. John was a medically fragile child who
was prone to lung problems such as pneumonia or asthma. Macia
recommended that Mother take John to several specialists for
issues involving his heart, eyesight, and hearing. The
hospital had no record of John being seen by any of the
specialists. John had progressed while in Macia's care
but seemed to plateau from approximately 19 months old to 28
visited John in the hospital a few days after the referral.
Macia was very concerned about the symmetric marks around
John's wrists and ankles because it appeared that John
had been restrained. One of the photographs admitted into
evidence, and shown to Macia during her testimony, reflected
that the skin was gone around one of John's ankles.
Another photograph showed a bruise and cut on one of
John's eyes. Macia testified that the photographs also
showed bruises of varying ages on John indicating that the
injuries had been incurred at different times. When Macia saw
John in the hospital she was not sure he would survive.
explained that the bruises on John's abdomen were a
result of her attempt to replace the G-tube and secure the
tube with household tape. Mother reported that the balloon
that holds the G-tube in place had deflated three days
earlier. Macia testified that the deflated balloon was an
indication that Mother should have taken John to the
emergency room to have a new G-tube inserted immediately.
Mother also explained that John fell as he was getting out of
the bath. According to Macia, Mother's explanations were
not consistent with the bruising on John's body.
testified that if John had been properly cared for and eating
properly, he would not have been in the condition he was in
at the time he was hospitalized. If Macia had seen bruises on
a child like those suffered by John she would have reported
potential abuse to the Department. A prudent parent who had
been trained on the use of a G-tube, as Mother had, would
have immediately sought medical attention when the tube fell
out and the balloon deflated.
Graf was the attending physician the night John was admitted
into the intensive care unit at Texas Children's
Hospital. Graf is an associate professor at Baylor College of
Medicine and intensive care liaison for the child protection
committee at Texas Children's Hospital. John came to the
intensive care unit through the emergency room where he
received immediate life-support treatment. When Graf first
saw John she noted that he was "a frail, poorly
nourished looking child who was on a breathing machine, who
had multiple marks all over his body." The marks on
John's body were not consistent with an average child or
a special-needs child falling or playing, and were in unusual
places. Graf testified that the marks did not fit the stories
Mother reported. Shortly after John arrived in the ICU he
suffered a seizure. Because John's injuries appeared to
have been caused by abuse or neglect Graf reported his
condition to the Department.
documenting John's injuries Graf observed a bruise on
John's head on the left side of his temple, a bruise on
the area in front of his left ear, and an abrasion between
the left side of his nose and eye. Graf could not see
John's neck because he was wearing a collar to protect
against potential injury to his neck. Graf further observed a
small laceration at the side of John's clavicle, and
scrapes, scratches, and bruises on the right side of his
body. The area around John's G-tube looked like an open
wound that was seeping. John had two bruises on his left
interior hip and fingerprint-like bruises on both thighs.
John had marks encircling both ankles and a bruise on the top
of his foot. On John's back he had multiple, small
superficial lacerations between his armpit and hip. He had
bruises on the middle of his back and his hip, and ligature
marks around both wrists.
testified that when John came to the hospital he was in organ
failure, which is caused by lack of delivery of blood to
appropriate places or lack of the ability to breathe.
John's breathing was failing and his blood pressure was
falling, which indicated his heart and lungs were failing.
John was also severely dehydrated. Blood tests revealed that
John had not been receiving regular nutrition. If John had
not come into the hospital when he did he most likely would
have died within 24 hours.
Graf asked Mother about John's injuries Mother responded
that John had been ill for four days with gagging and
coughing after feeding. Mother called 911 when she found John
limp and pale. When asked about John's bruises Mother
reported that she had fallen while holding John as she got
out of the bathtub. Mother reported that John fell on his
back. Mother's explanation would only explain the bruises
on John's back; it did not explain all the other bruises,
lacerations, and ligature marks.
Graf's opinion John's injuries were caused by child
abuse and could not have been caused by anything else. Graf
explained that John's skin had manifestations that were
inconsistent with Mother's explanations.
father, (Father) who executed a voluntary affidavit of
relinquishment, testified that shortly after John was born
Father's parentage was adjudicated and he began paying
child support. A Department caseworker contacted Father to
tell him that John had been placed in the Department's
care. The Department developed a service plan for Father with
which Father complied. Father continued to have contact with
John and noticed improvement in John's condition since he
came into the Department's care. Father described the
change as, "It went from a bag of bones to a full
healthy, loveable child who can actually enjoy his life
now." Father observed John with John's foster father
and was impressed by their relationship and the improvements
John made progress with the foster father, including toilet
training and eating solid food.
testified that it was in both children's best interest to
live with the foster family rather than with Grandmother.
Father described two occasions in which he had to pick up
Grandmother because she was too drunk to drive. Father also
noted that if the children were placed with Grandmother ...