Outcry Grows Over Pennsylvania Child Abuse Pediatrics Program

Dozens of parents in the Lehigh Valley of Pennsylvania watched with interest as a jury recently awarded Maya Kowalski and her family a multimillion-dollar judgment against Johns Hopkins All Children’s Hospital in Florida.

Like Maya’s family, these parents also had been separated from their children due to allegations of “factitious disorder imposed on another” — more commonly known as Munchausen syndrome by proxy (MSBP) — made by staff at Lehigh Valley Health Network (LVHN) over the past several years.

In 2014, LVHN hired child abuse pediatrician Debra Esernio-Jenssen, MD. Jenssen had been the medical director of the child protection team at the University of Florida from 2010 to 2014, after serving in a similar role at Schneider Children’s Hospital in New York.

At LVHN, Jenssen promoted a protocol for screening pediatric patients for abuse, called “Every child, every time.” She was also instrumental in setting up LVHN’s John Van Brakle Child Advocacy Center (CAC) in 2015, in coordination with then-Lehigh County Executive Thomas Muller. Since the CAC’s establishment, LVHN has received hundreds of thousands of dollars in grant money from the Pennsylvania Department of Human Services, including $231,954 to improve its CAC, which has still not received full accreditation by the National Children’s Alliance.

In 2021, the district attorney of neighboring Northampton County, Pennsylvania, signed an agreement with the Lehigh County district attorney to use the CAC. Since then, virtually every child abuse report in these two counties has been medically evaluated by Jenssen’s team — including reports originating within LVHN hospitals and affiliated pediatric practices.

In June 2022, one of two sisters temporarily taken from their parents by Northampton County during CAC evaluations of MSBP allegations contacted the editor of a local paper, which published an investigative series on the accusations. This family was not alone. Other families accused of MSBP had begun to find each other, and had started an advocacy group called Parents’ Medical Rights Group (PMRG).

Unbeknownst to most Lehigh Valley families, Jenssen’s professional record was checkered. She was removed from her role leading the University of Florida child protection team in 2014. Multiple family court judges in New York described her as a combative and unreliable witness. One Queens County judge noted that Jenssen “rigidly rejected any alternative to her favored scenario, despite advice from her own child abuse team.”

PMRG co-founder Kim Steltz contacted Lehigh County Controller Mark Pinsley about what seemed to her like an overzealous doctor unfairly accusing parents of medically complex children. The controller inquired into Jenssen’s past and the MSBP numbers in Lehigh Valley.

Concerned that there was a pattern in the area served by the CAC, he performed a non-audit service, which gave him a general view of expenditures using publicly available data. (The controller does not have access to confidential case data, although some families voluntarily shared their records with him.)

The non-audit service uncovered a higher rate of MSBP diagnoses in the Northeast region (which includes the Lehigh Valley) than other regions of Pennsylvania. In the Northeast, there were 2.6 cases per 100,000 children; in the Southeast, by contrast, there were 0.7 cases per 100,000 kids.

Pinsley saw costs: Harm to innocent families, and the diversion of caseworker resources from investigating situations of immediate danger.

“This isn’t just about one problematic doctor. It’s a process issue,” he told MedPage Today, adding, “We can make other decisions [such as medical guardians] to ensure children’s safety. We don’t always need to remove children ‘when in doubt.'”

On August 23, at the Lehigh County board of commissioners meeting, the dam broke. Thirty people from affected families offered public comment about the unjust family separations they alleged they had endured based on CAC evaluations and resulting actions taken by the Office of Children and Youth Services (OCYS).

Some who spoke were members of PMRG. Others had been accused of physical abuse, rather than MSBP, but felt that their explanations had fallen on deaf ears — explanations including children’s underlying medical issues, such as osteogenesis imperfecta and oral phase dysphagia.

Virtually everyone who spoke named Jenssen as instrumental in their family separations. Steltz testified that “Expert physicians, teachers, and school staff tried to get a hold of OCYS, but none of it mattered.”

Controller Pinsley spoke, announcing his findings and recommending changes. He believes OCYS should seek a second opinion from a medical specialist (outside LVHN) regarding a child’s previously diagnosed illness before removing a child from the home. He also wants the county to bring in a third party to assess OCYS processes.

After initially supporting Jenssen in public statements, LVHN moved her out of the CAC and replaced her with Sarah Kleinle, DO. Jenssen continues to work in pediatrics at LVHN.

When reached for comment, LVHN provided a statement to MedPage Today from October that noted less than 0.5% of children who visited the children’s hospital last year “were referred for suspicion of child abuse” and that its top priority is “always to protect the health and safety of our patients.”

Lehigh County Department of Human Services committee meetings to discuss current OCYS policies and potential changes began October 18 with a meeting dominated by committee chairman Bob Elbich. He revealed that the county outsources all its statutorily mandated investigative responsibilities to the CAC, over which — according to Elbich — the county has no influence or control. Elbich reiterated that the CAC is independent of the county.

The next Human Services committee meeting was scheduled for mid-November, but after PMRG publicly endorsed law firm Francis Alexander for parents seeking help, commissioner Elbich canceled the meeting. Elbich told MedPage Today, “With the announcement that probable lawsuit(s) may be filed against LVHN and possibly Lehigh County, the atmosphere is no longer conducive to open dialogue. Therefore, at least until the end of my term in December, there will be no separate committee meetings held.”

PMRG leader Steltz asserted, “You can’t really stop or delay something that was never meaningfully started in the first place. It has been almost three months and nothing has changed. Continuing to delay corrective actions only causes more families to be harmed by false allegations of child abuse.”