>"...the blood test she received in February did not look for
pregnancy...
>"That is ordered if there is an indication that the person has missed
her period or if the caregiver indicates there is a need to do pregnancy
tests," Serina >said. "(Among) the developmentally disabled, that is the
last thing you think of. There was no probable cause to be suspicious."
I would think scrutiny for likely abuse and more than likely pregnancy
would be high priority. The discriminatory assumptions here appall,
given how they distort cognition and preempt preventive and remedial
action.
Of course, we discriminate, draw barriers, amongst our own...why would
TABs differ?
This was worth my time to read, ponder, and post. Thanks, Toobs.
ISM (<----- Heading back to dubious 3D.)
Region & State Monday, May 14, 2001
Innocence lost
Bruce McAvinew has more questions than answers. Key among them: How did
his disabled daughter's pregnancy go unnoticed?
May 13, 2001
By TONY SAAVEDRA
and TRACY WOOD
The Orange County Register
Christa McAvinew, once trusting and affectionate, is withdrawn and
hasn't walked since she left the hospital, her father, Bruce, says.
Photo: Cindy Yamanaka / The Orange County Register
She bled in the dark, on pink floral sheets destined for the police
evidence locker. There was no one to hold Christa McAvinew's hand. No
one to explain to the 30-year-old woman with the mind of a 2-year-old
that her body was rejecting a baby allegedly conceived in rape.
Her pregnancy went undiscovered at her Santa Ana group home - by doctors
who examined her once a month, by caregivers who changed her diapers and
charted her health, and by the local regulators responsible for
monitoring her care, records and interviews show. Christa's father said
he constantly complained to caregivers about his daughter's sudden
20-pound weight gain, swollen legs and moody demeanor.
But the alleged rape stayed secret within Christa's swollen belly for an
estimated seven months, until the contractions began in the middle of
the night April 19. Christa, severely disabled, didn't have the mental
capacity to seek help. If she screamed in pain, no one came.
It wasn't until 6:05 a.m. that housemother Dia Ramos noticed the blood
and opened Christa's diaper.
She found a stillborn fetus. A boy - whose DNA later would be linked by
police to Christa's other caregiver, Robert Rogelio Rios. Police are
investigating whether the two other disabled women at the home were
molested. Rios, 45, remains in custody on a rape charge. An attorney has
not yet been assigned to him.
Confidential charts kept by Christa's caregivers, court documents and
state and local inspection reports obtained by The Orange County
Register tell a story of neglect and abuse by the two businesses that
alternately operated the state-licensed home on Camden Place.
The operator, Anaheim- based Westview Services Inc., has closed
Christa's home and is under investigation by the state Department of
Social Services. Westview and the two doctors who gave her routine
checkups also are being sued by Christa's father, Bruce McAvinew.
"The message is going to be sent to (regulators) and to the caregivers
that they can't treat human beings as if they are less than that," said
Mc Avinew's attorney, Timothy J. Ryan.
In his first public interview, Bruce McAvinew said he is haunted by
Christa's miscarriage and the thought of her bleeding. Hurting.
"I'm devastated because of the pain Christa went through," McAvinew
said. "Christa hasn't recovered yet. It's going to leave its mark on her
for a long time. She has enough brainpower to understand some things."
That much was evident when she refused to hug her father at Fountain
Valley Regional Hospital and Medical Center, where she was taken after
her miscarriage.
"I sure can't blame her," said McAvinew, 62, a former ambulance company
executive. "She probably felt, 'How come you weren't there?' "
His daughter's miscarriage haunts Bruce McAvinew. He says she refused to
hug him at the hospital afterward. "I sure can't blame her. She probably
felt, 'How come you weren't there?'."
Photo by Michael Goulding / The Orange County Register
TRUSTING, AFFECTIONATE
Christa was an easy mark, overly trusting of strangers, with a habit of
hugging and kissing anyone in reach, her confidential care records show.
Caregivers noted in personal growth charts that they were trying to curb
her excessive affection.
Now she is withdrawn, her father said, and hasn't walked on her own
since she left the hospital. She is living in a new home in Orange with
a higher level of medical care.
Christa's case has prompted social-services officials to take a hard
look at Westview and its seven residential homes and 11 adult day-care
programs in Southern California. The 15-year- old nonprofit company has
been cited by state regulators for physical abuse, safety hazards and
other state violations. Regulators said Westview's history is unusually
troublesome.
Mary James Radecki, head of Westview, disagreed with regulators that her
services were poor, and her attorney has maintained that Westview did
nothing wrong in Christa's case. Radecki said Christa's caregivers were
thoroughly screened.
"We believe we go well beyond our legal obligations." Radecki said. "I
think our staff is really great. It's like a mission to us. It's like a
mission to me."
State and local regulators in the past year had stepped up inspections
at Westview facilities, records show. But it wasn't enough to protect
Christa.
She lived for 11 years in the tan house with red trim. For much of that
time, the home was one of three operated by Wilfredo and Teresita
Hidalgo.
State records show the Hidalgos sold their business to Westview last May
after a state audit accused them of overcharging their developmentally
disabled clients $3,519 for trips to Disneyland and Knott's Berry Farm
and other outings. They were ordered to repay the money.
During Christa's stay under the Hidalgos' ownership, state auditors also
criticized the couple for mishandling the spending money provided by the
federal government for the disabled clients. And the Hidalgos were
accused of forging state-required first- aid certificates and other
documents for caregivers. The Hidalgos did not respond to numerous
messages left by the Register.
Inspection records obtained from the state's Community Care Licensing
Division show that, under the Hidalgos, Christa lived in a home where
medication, poisonous cleaning solutions and knives were kept within
reach of the severely disabled. The bathroom sometimes lacked toilet
paper and a shower curtain. The refrigerator sometimes didn't have
enough food to last two days.
Bruce McAvinew said he knew there were problems but thought they were
minor. Most importantly, Christa seemed happy there. A little
disheveled. But happy, he said.
"I did a lot of surprise visits," McAvinew said. "When I came by,
Christa was always in good shape, (though) sometimes not in the best of
clothes."
Caregivers painted Christa McAvinew's fingernails and put her hair up in
pigtails for Christmas last year.
A CLOSE-KNIT TEAM
As a baby, Christa showed no outward signs of mental retardation until
eight months, when, her father said, he noticed she wasn't progressing
as quickly as other kids.
The divorced father raised Christa alone since she was 4. They were a
team: McAvinew and the girl with blonde hair and blue eyes. They went
camping, sailing and fishing. McAvinew taught Christa to swim in a
neighbor's pool. They raised chickens, rabbits and three dogs.
Christa had trouble speaking, but her personality shone. She broke the
tape regularly in the 50-yard dash at the annual Special Olympics, and
once took second place at a Huntington Beach fishing hole for the
biggest catch. She sported gold earrings and flashy costume jewelry from
Saks Fifth Avenue.
Christa's grandmother moved in and helped care for her.
The girl was a handful, but her father said he refrained from putting
her in a group facility until he collapsed after a heart attack 13 years
ago. Christa was 17. McAvinew placed her for a short time in one home.
He later found the Camden Place facility with help from the Regional
Center of Orange County. The agency oversees local programs for the
developmentally disabled. McAvinew took Christa home or visited every
weekend. Because she is so severely disabled, her care is paid for with
state and federal funds.
McAvinew's attention to his daughter never waned despite the distraction
of his trial and acquittal last year on allegations of Medicare fraud
stemming from the ambulance service he helped run.
A SHIFT IN CARE
Christa seemed to thrive, even as cerebral palsy curved her spine and
gave her seiz ures, her father said. Then the Hidalgos sold the business
in May 2000 under pressure from the state. Westview took over despite
concerns from the regional center and state social services about
problems at other Westview facilities. McAvinew said he was never
notified of the regulators' concerns or Westview's record.
Westview brought in Ramos and Rios. The new caregivers started in May
2000, after passing criminal back ground and reference checks, according
to Westview officials. Rios also passed separate state and federal
fingerprint checks, the regional center said.
Things were supposed to get better under Westview's operation. And they
did. Christa's appearance, at first, improved dramatically. Caregivers
painted her nails red for Christmas and did her hair in dainty pigtails.
McAvinew came regularly to the home, once bringing a VCR, another time
setting up cable television for the residents, he said.
"Robert seemed very polite. He looked like a nice guy. I had my trust in
him because Christa seemed OK," McAvinew said.
Until last November.
McAvinew noticed that Christa was gaining a lot of weight. He wrote his
observations in a journal. She had gone from 119 pounds to 140 pounds,
her father said.
"Christa seems to be twice the size she was in January," said a November
2000 entry in McAvinew's journal.
On Dec. 10, McAvinew observed: "After seeing Christa's decline over the
last three weeks, I have made observations that concern me. Extreme
water/weight gain, increase in drooling and blinking of eyes. Christa is
now down to crawling to the bathroom and kitchen."
Around the same time, care givers noted in a confidential report that
Christa was screaming, biting, hitting and pinching herself.
Days before her miscarriage, McAvinew said, he again asked Rios about
Christa's condition.
"I patted her on the belly and said to Robert, 'How come her belly looks
so big?' " McAvinew recalled. "He said, 'I don't know.' Dia and Robert
were virtually my only contacts." The Register has been unable to reach
Dia Ramos, who was identified by police as Rios' wife.
A MISCARRIAGE
On the morning of the miscarriage, police records say, Ramos asked Rios
what to do after she found the stillborn fetus. He allegedly told her to
put it in a plastic bag and place it somewhere, according to a Santa Ana
search warrant. Ramos put the fetus in a box in the garage but later
retrieved it, taking it and Christa to the Fountain Valley hospital.
Ramos and supervisor Fe Bravo Santos left the fetus in the car when they
arrived at the hospital, according to the affidavit.
Confidential records show that Christa was checked monthly since October
2000 by a medical doctor, a neurologist and a psychiatrist. She also was
given two medical checkups, including at least one blood test, in the
two months before her miscarriage.
Dr. Eliseo Serina, who has practiced in California for 17 years, was her
primary physician.
But, he said, his monthly visits consisted of little more than taking
Christa's blood pressure, recording her weight and asking caregivers if
there were any problems. Serina said Christa had a history of edema,
swelling caused by water retention. He attributed her weight gain to
edema and prescribed diuretics.
Christa already was taking strong medications to control her seizures.
He said the blood test she received in February did not look for
pregnancy.
"That is ordered if there is an indication that the person has missed
her period or if the caregiver indicates there is a need to do pregnancy
tests," Serina said. "(Among) the developmentally disabled, that is the
last thing you think of. There was no probable cause to be suspicious."
Serina attempted to give Christa a pelvic exam during her yearly
physical but could only muster a Pap smear because she was resistant.
An attorney for Westview said at least one other doctor checked Christa
a month before her miscarriage and diagnosed her as constipated.
Dr. David Diaz, a fertility specialist who did not examine Christa, said
there was no excuse for missing her pregnancy.
"You have a woman of reproductive age, who has been (mentally)
incapacitated, with a (large) weight gain - the first thing you do is
rule out pregnancy and abuse," Diaz said.
Christa's attack has left her father wondering whom he can trust with
his daughter. How well are the caregivers checked? How well are they
trained? How closely are regulators watching? How good are the doctors
retained by care programs?
"It's awful for me because now I'm looking at everybody (with
suspicion)," McAvinew said. "It reflects on every body."
Register staff writer John MacDonald contributed to this report.
Rape case unfolds
April 19: Police investigate the death of a baby delivered at a care
home by a disabled woman.
April 21: Care home relinquishes its license and all of its clients are
relocated.
May 8: Robert Rogelio Rios, 45, a caregiver at the home, is arrested on
suspicion of rape.
------------------------------------------------------------------------
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Copyright 2001
The Orange County Register
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ISM
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