Expert testimony sheds light on condition of Trebilcocks' adopted son

Date: 2012-07-21
Source: tdn

Expert testimony sheds light on condition of Trebilcocks' adopted son


The condition of Jeffrey and Rebecca Trebilcock's 13-year-old adopted son shocked medical professionals last year when he was brought to a doctor and later admitted to Longview and Portland hospitals, medical experts testified last week in the couple's child abuse and neglect trial.

Throughout last week, Deputy Prosecutor James Smith called on an array of medical experts in an effort to prove that the boy and his four adopted sisters were starved by the Longview couple before the children were seized and placed in foster homes in March of 2011.

The bench trial continues this week in Cowlitz County Superior Court, with Jeffrey and Rebecca Trebilcock expected to testify Thursday. Their defense attorneys are trying to convince Judge Michael Evans that the boy's thin frame, shortness and poor condition were caused by a number of medical conditions, not starvation.

Doctors, nurses and specialists testified last week that the alleged abuse was discovered after Rebecca Trebilcock brought her sick adopted son to the Pediatric Clinic, 748 14th Ave. in Longview March 1. The boy was emaciated, cold and covered in eczema sores, they said. Doctors would later learn he had four broken ribs.

"He was very small, kind of hunched over, shivering, teeth chattering," recalled Amanda Vaillencourt, a nurse at the Pediatric Clinic. "I could see his cheek bones very defined, very skinny. He didn't look well at all."

The boy's body temperature was too low to register on her electronic thermometer, she said.

Meanwhile, she said, Rebecca Trebilcock lingered in the background, looking concerned, but keeping her distance and not comforting her son. Vaillencourt said the mother's detachment seemed "very" unusual.

"Usually when we have any kind of child in the room, parents are right there with us, comforting the child, holding the child, just right there making sure that child feels safe and comfortable," Vaillencourt testified.

Another Pediatric Clinic nurse, Kimberly Hash, testified that the boy was "probably one of the worst cases I've ever seen."
"I mistook him for a very much younger child," Hash said. "He seemed very frail to me. He had sores on his arms and legs. ... My impression was that he hadn't been cared for well."

Hash said she wrapped the boy in a blanket and placed a space heater in the exam room to warm the boy up.

Rebecca Trebilcock "complained to me about it because she said I was making the room too warm," Hash testified. "I told her that I apologize if she was uncomfortable, but it was more important to get (the boy) warm."

Dr. Danielle Parrott, also of the Pediatric Clinic, said the nurses "were upset" and demanded that she see the boy immediately. Parrott testified that the boy's heart rate was so low he should have been unconscious. So little blood was flowing to the boy's extremities, she said, she thought he was close to having a heart attack.

"He was extremely quiet," Parrott said. "He only answered in one- or two-letter words and he didn't say very much."

Parrott said she didn't understand how the boy could be "awake or talking."

She said she listened with a stethoscope for the normal "bowel sounds" the body makes when it digests food. There were none, which indicated "that he hadn't eaten in a long time."

He weighed 49 pounds, she said. (Authorities have said that's about half what a 13-year-old should weigh.)

Parrott said she asked Rebecca Trebilcock what the boy had eaten in the last few days. Most parents describe meals and foods when they're asked this question. Rebecca Trebilcock provided "a specific calorie amount," Parrott said, adding that the response seemed odd.

When Parrott told Rebecca Trebilcock that the boy's condition was life-threatening and that he needed to go to PeaceHealth St. John Medical Center immediately, the mother protested, Parrott testified.

"She seemed pretty angry," Parrott said. "She said that she couldn't go, that she was in pain and had surgery and got on the phone and started making calls."

"He was critical and he needed serious attention," Parrott told the court. "We called 911 and had an ambulance come."

Doctors in the Emergency Department at PeaceHealth St. John Medical Center wrapped the boy in what's known as a "Bair Hugger," a specialized blanket that circulates warm air, testified Emergency Department physician Trevor Tredennick. The boy's "core temperature" rose and his blood pressure improved, Tredennick said, but the boy was still very ill and "needed a higher level of care." It was decided the boy should be sent to Doernbecher Children's Hospital in Portland, he said.

Yet, again Rebecca Trebilcock protested, Tredennick said. "She didn't want him to be transferred initially," he said, adding that Rebecca Trebilcock explained that "she was sick herself and, because of some other obligations with her family, she couldn't visit him in Portland."

The Trebilcocks "eventually consented" to sending the boy to Portland after the hospital's "house supervisor" — an official in charge of the facility during a given shift — was called in to speak to them, he said.

Tredennick said he was surprised by the exchange. "Most of the time when you have a sick child, the parents want everything done possible," he said.

Later, Dr. Gretchen Potschka, a PeaceHealth primary care doctor, said she was approached by one of the pastors at Kelso-Longview Seventh-Day Adventist Church, where she attends services. He knew the Trebilcocks "and asked for my help," Potschka testified.

Potschka said she spoke with Rebecca Trebilcock, who also attends the church, in the back of the sanctuary. The mother wanted her to "provide second opinion," said Potschka.

Potschka said she examined the boy at her clinic on March 10, just after he was discharged from the Portland hospital.

"He was quite small for his age, very thin, pleasant, cooperative — a very nice kid," she said. " He mostly told me about everything he had been eating since he got out of the hospital."

Yet the boy was "cachectic," meaning he was emaciated and wasting — like a terminal cancer patient, Potschka said.

His body, she said, was covered with a "significant amount of very fine peach fuzz," which is a sign of malnutrition. Potschka said the fuzz, which blanketed the boy's trunk and face, is the body's way of trying to insulate and warm in itself in the absence of fat beneath the skin.

Potschka said she determined the boy's wasting was from "lack of food." She also said she concluded that the boy's small stature — he was 4-feet, 4-inches, which is surprisingly short for a 13-year-old -- was "due to malnutrition."


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