ALEXANDER PERKINS - 6 yo (2010) - Colorado Springs CO

The stench of diarrhea and vomit clotted the air.
Three used diapers on the bathroom floor. Feces covered his toilet
and bathtub. Dirty dishes. More leaking diapers in the living room and hallway.
That’s where Alexander Perkins stopped breathing.



He died four days shy of his sixth birthday. His 7-year-old brother
was rushed to a hospital a week later with an impacted bowel that
stretched nearly the width of his waist.
Six months later, government agencies remain at odds over whether
parental neglect is to blame. Charges against Alexander’s parents over
the death were filed and then dropped six weeks later.
Teller County social workers and a sheriff’s investigator suspect
Alexander died of a curable and nonfatal condition. The El Paso County
and Teller County coroner’s offices ruled differently — Alexander, they
say, died of natural causes. It was a condition for which his parents
sought medical help, they said.
Complicating matters have been the following missteps documented in a
report by the Colorado Department of Human Services released in December:
• The Teller County Department of Social Services failed to properly
investigate a report of child abuse and neglect five months before Alexander died
• Teller County social workers waited more than 24 hours to check on Alexander’s sibling following his brother’s death
• Former Teller County Coroner Earl Byrne interfered with Teller
County social workers twice as they tried to check on the 7-year-old’s condition.
• Physicians treating the children never made a child abuse and
neglect report despite concerns about the children’s health and that
their parents weren’t following through with their advice
The case has spawned two criminal investigations and a custody battle.
The latter case reached a milestone in early February: Chad and
Krista Perkins agreed to seek parental counseling in order to regain
custody of Alexander’s brother — the first such agreement since social
services intervened in August.
As part of that agreement, Krista Perkins admitted neglecting Alexander’s brother. His father did not.
But the status of criminal investigations remains murky. Child abuse
charges were dropped in November, though prosecutors and detectives
insist the case remains “open and active.”

*****
“I have to basically say in this autopsy report if I’m going to call
this neglect or abuse, I have to give you the scientific evidence that
proves that. Right on this front page, I have nothing.” -Leon Kelly,
forensic pathologist for the El Paso County Coroner’s Office

Leon Kelly first saw Alexander’s body on August 9.
The young coroner, two years into his job at the El Paso County Coroner’s Office,
immediately suspected abuse or neglect.
“There was always concern from the very beginning about neglect or
abuse,” Kelly said. “So you go through and say OK, we’re concerned.
Let’s see if we can prove if it’s there or not.”
Kelly grabbed a scalpel as Byrne and Teller County sheriff’s Sgt. Nick Olmsted looked on.
A Y-shaped incision into Alexander’s chest revealed a healthy heart
and strong lungs. Fluid in his eye showed he was well-hydrated. His
height and weight were relatively normal, meaning the boy ate well, Kelly said.
Only one thing stood out: Alexander’s rectum had been plugged by a
“rock hard” ball of feces bigger than a baseball. The rectum being
naturally unable to stretch, the ball pushed against surrounding tissue,
killing it and flooding his blood stream with bacteria. Sepsis and
bowel failure ensued.
Kelly also noticed diaper rash. But there were no bruises, no scrapes
nor broken bones on his small, pale body.
The blocked rectum killed Alexander, Kelly said.
“I can’t see his emotional well-being, I can’t see his psychological
well being,” Kelly said. “I can’t see anything else other than the
physical attributes of his body at the time and that’s what I’m limited to.”

*****
“It is one of those cases that will never go away.” –Sgt. Nick Olmsted, detective for the Teller County Sheriff’s Office

Olmsted refuses to let the sights and smells of that house fade from his memory.
“This case is going to remain open well into my retirement years if
it takes that long to get it done,” Olmsted said. “I’m not going to let go.”
The 27-year Teller County Sheriff’s Office veteran thought he
finished his investigation in September, when the detective filed arrest
warrants for Chad and Krista Perkins on suspicion of felony child abuse
resulting in death and serious bodily injury.
According to the warrants, a child’s night time jumper lay next to
dirty diapers in a hallway, adding to more used diapers strewn “all
over” the “filthy” house. Feces covered a nearby toilet and bathtub.
A few feet away, the handle to the boys’ bedroom had been
turned backward, allowing it to lock from the outside.
Inside the room, Olmsted saw a single bed on the floor, covered in
plastic and topped with a blanket and two pillows. The room was
otherwise empty — no clothes in the closet, no toys in sight.
Two days later, Olmsted spoke to the parents.
Chad and Krista Perkins said Alexander and his older brother suffered
from encopresis — a condition associated with painful constipation that
leads to uncontrollable bowel movements, the warrant said.
The condition was treatable; doctors told them to use a mix of enemas
and Miralax, along with scheduled sitting times after meals to cure the condition.
Olmsted was told by another detective that the parents had given
their youngest son Kaopectate the day he died — a drug often used to
treat diarrhea, exacerbating constipation.
Standing in the house, he asked the couple when they quit the
doctor’s original treatment plan, according to the warrant.
Looking at her husband, Krista Perkins answered: four months ago.

*****

“I’m down to one grandchild and he’s it.” –Leon Perkins

Leon Perkins remembers happier times.
Three weeks before Alexander died, Leon Perkins left his house in St.
Joseph, Mo., for a trip to his grandson’s house in Cripple Creek. His
first order of business: fishing.
Hoping to keep his grandchildren from spending too much time in front
of a computer, they hiked half a mile down the road to a nearby pond
and dipped their lines in the water. The activity didn’t last long — the
trio quickly decided to throw stones in the pond.
“We were laughing and having the time of our life,” Leon Perkins said.
Back home, the house was “a little bit cluttered,” though he didn’t
see soiled diapers lying around. Instead, he saw dirty dishes and kitty
litter on the floor.
Alexander, 5, and his 7-year-old brother wore pull-ups, Leon Perkins
said. Whenever he’d ask his son about potty training the children, Leon
Perkins said he was told the same answer: the children needed diapers to
deal with colon problems that had affected them for several years.
“Anytime I’m around, I ask questions. I’m a concerned grandparent,”
Leon Perkins said, adding the answers seemed to make sense. Wearing a
diaper that night, Alexander’s brother read to his grandfather.

*****

“They chose to do the ‘do nothing’ route,” -Brian Perkins

Chad’s brother, Brian Perkins, picked up his phone March 10
and dialed the Teller County Department of Social Services.
His nephews, Alexander and his older brother, didn’t get out of the
house very often, he said. They were “supposedly” home-schooled; both
were small for their ages, suffered from impacted colons and were never potty trained.
“Enough things had come together,” Brian Perkins said. “Thinking
about if something did end up happening, I would feel responsible that I
hadn’t attempted to do something.”
The next time Teller County social services got a call about
Alexander, it was from the Teller County Sheriff’s Office. The
5-year-old boy, they said, was dead.
In the nearly five months between Brian Perkins’ call and Alexander’s
death on Aug. 7, social workers apparently did little to check on the
family, according to a December report by the Colorado Department of Human Services.
According the report, Teller County social workers never opened a
full-fledged investigation into Brian Perkins’ concerns, opting instead
to make one call to Cresson Elementary School in Cripple Creek. The
conversation confirmed the children were registered to be home-schooled.
A Teller County social worker later told state investigators that
there was “no information available from reporter of abuse and neglect as defined by law.”
In December, state investigators ruled otherwise.
State investigators also found that a Teller County social worker
waited more than 24 hours to check on the welfare of the older child
after his brother’s death. They should have responded much quicker,
according to department policies.
The department has since implemented new policies, said Kim Mauthe,
executive director of Teller County social services. A two-person team
reviews calls to the department and a supervisor must be notified of all after-hours calls.
“We’ve acknowledged what we needed to improve,” Mauthe said. “We’re
moving forward and making sure that we follow what we’re supposed to be doing.”

******

“It’s simply a matter of right and wrong. When you see something that
you know is wrong, you’ve got to do something about it.” –Brian Boal,
former deputy district attorney for the 4th Judicial District Attorney’s Office

Brian Boal learned about his first homicide case from Olmsted in the middle of September.
“I could tell by the way he was acting that he was seriously disturbed by what he had seen,” Boal said.
Three years out of law school, Boal said he was the first person in
the 4th Judicial District Attorney’s Office to review the case. Only one
deputy district attorney — in this case, Boal — oversaw criminal cases
in Teller County, he said.
He said he looked over an early copy of the arrest affidavit and gave Olmsted his OK to arrest the couple.
“The colon was impacted,” Boal said. “It was something that wouldn’t
get there overnight. It would have taken months and the child would have
been in tremendous pain.”
Boal mentioned the case to his supervisor, Amy Fitch,
on the day the couple was arraigned on felony child abuse charges.
“Nobody downtown had any involvement with it up to this point,” Boal
said. “She told me that that was something that needed to be referred to
a senior deputy district attorney.”

*****

“At first I thought he was going to die.” –Brian Perkins

Alexander’s older brother didn’t stay in the house very long.
The 7-year-old was placed into the care of his aunt and uncle three
days after Alexander’s death. Less than a week later, however, he was
rushed to a hospital, where he spent the next two and a half weeks.
One day, he confided in his uncle.
“He said ‘mommy and daddy are going to spend more time with me now
that Xander’s gone,’” Brian Perkins said. “He said ‘They’re going to
take better care of me so I don’t die like Xander did.’”
The boy also confided in a hospital social worker.
“The one good thing about (Xander) dying,” he told a hospital worker, “was that he was now safe.”
Their accounts were detailed in interviews with family members and
court documents obtained by The Gazette that revealed myriad concerns by
doctors and relatives that Alexander’s 7-year-old brother was in danger
of permanent bowel damage.
The boy’s name has been withheld due to his age.
He was very thin and small for his age — his height and weight in the
third percentile. Doctors at the hospital also said he suffered from
encopresis — a condition associated with constipation that stretched his
bowel to within 80 percent the size of his waist, according to a report
by a court-appointed advocate.
Dr. Laura Boschert told the advocate she suspected the condition was
caused by dietary habits or psychological issues — there were no
physiological causes for his condition, the report said.
She said she also looked at the brothers’ medical records.
“She stated that she strongly believed that Alexander’s was not a natural death,” the report stated.
A handful of doctors also raised concerns after Alexander’s death,
including worries about the Perkins’ dirty household, malnutrition and a
general lack of bowel regimens and toilet training, according to the
arrest warrants for the parents.
“Evidently the social situation was extremely neglectful,” said one doctor in the warrants.

*****

“It was my feeling that there was no child neglect.” –Earl Byrne, former Teller County Coroner

Byrne drove up to the ambulance parked at the Teller County
fire station and saw paramedics standing over Alexander’s body.
Alexander, they said, suffered from a chronic bowel condition.
Byrne then talked to Alexander’s parents. He watched Kelly perform
the autopsy and retrieved the brothers’ medical records. He talked to the parents again.
Other doctors told Chad and Krista Perkins about this bowel condition
before, Byrne noted. Medical records showed the couple visited doctors
about the encopresis, he said.
“Program of treatment and management had been outlined to them,”
Byrne said. “It was my opinion that the parents had diligently been
attempting to follow that treatment program.
“The medical examiner concluded this was a natural death and the
cause was related to chronic constipation,” Byrne continued. “I
concurred completely with that. That’s as far as my statutory
responsibilities extend.”
But Byrne went beyond those responsibilities in the days after
Alexander’s death, court records and state reports show.
In a letter to District Judge Edward Colt, Byrne said he was “at a
stage in life that when I witness what I perceive to be an injustice
that I should not simply turn a blind eye nor an indifferent shoulder.”
Alexander’s mother, he wrote, suffered from depression and Addison’s
disease — a condition leaving people lethargic — leading him to suspect
this led to the condition of the Perkins’ household and their ability to care for their children.
Convinced Colt was unaware of this, Byrne said he was left in
“profound dismay” when Alexander’s brother was sent to live with relatives on Aug. 10.
“The rush to remove (the boy) from his parents was appalling,” Byrne wrote.
The letter followed other unusual behavior.
In a report by the Colorado Department of Human Services, state
investigator Ruby Richards said Byrne first asked social workers to hold
off assessing the condition of Alexander’s brother for 24 hours.
When caseworkers ignored Byrne’s request and visited Alexander’s
house, they met another roadblock: Chad Perkins refused to let social
workers into his house, claiming to be acting on Byrne’s advice.
Chad Perkins eventually allowed workers to examine Alexander’s brother outside the house.
Byrne said the Teller County Department of Social Services interfered
with his investigation, talking to Alexander’s brother before he finished the autopsy.
“I was absolutely irate,” Byrne said.

*****
“Did they contribute to this? Did they help cause this? I don’t have it.” -Leon Kelly

Kelly waited six weeks to finish toxicology tests before signing off on his autopsy.
Normally, he keeps busy during this wait. Kelly is known for
undergoing an exhaustive process of interviewing parents, doctors,
siblings and social workers — anyone that could tell him if a child died of abuse or neglect.
But Kelly said he only does this for children who die in El Paso
County. When a child dies in Teller County, he only performs the physical and chemical autopsy.
The rest was left to Byrne.
At the end of that Aug. 9 autopsy, Kelly spoke with Olmsted and his fellow coroner.
“I remember that they hadn’t had a chance at that point to
effectively question parents,” Kelly said. “But they never brought any
additional information to me that was all that different.
“It wasn’t like there was a smoking gun that the next week they found and were like, ‘Oh, by the way.’”
Test results linking Alexander’s death to other diseases besides
encopresis came back negative. He made up his mind: The child was
well-nourished and hydrated and his parents sought medical help — both
in late 2009 and on the night Alexander died.
Byrne said Krista Perkins called Langstaff-Brown Urgent Care Center
in Woodland Park the night Alexander died, complaining her son had
suffered from diarrhea for two days. The urgent care worker recommended
she keep Alexander well-hydrated and then come by in the morning.
On Sept. 29 — a day after the couple was arrested — he issued his
final report: “Autopsy reveals no indication of neglect, abuse or maltreatment.”
Alexander, he wrote, died a “natural” death.
“That’s why the last statement is ‘Autopsy reveals no indication of
neglect, abuse or maltreatment,’” he said. “The autopsy didn’t. It is what it is.”

****
“We’re all unanimous that there is insufficient evidence at this time.” -Dan May, 4th Judicial District Attorney

The list of prosecutors on this case is long.
Donna Billeck and Donna Pearson, the respective current and former
head of the 4th Judicial District Attorney’s Office child abuse unit,
each put in time. Amy Fitch, a senior deputy district attorney also
helped. Diana May, the chief deputy district attorney; Dan Zook,
assistant district attorney; and Dan May, 4th Judicial District
attorney, all sat in on meetings regarding Chad and Krista Perkins.
All agreed charges against the couple should be dropped.
“Every district atrorney I’ve worked under has not filed a case
unless they felt there was a reasonable likelihood of success at trial,”
Dan May said. “I adhere to that same standard.”
But the case remains “open and active.”
He can’t comment on open cases — only noting that the arrest warrant
was carried out a day before the autopsy was finalized.
But the office has been playing catch-up, he said, because its
on-call child abuse homicide unit was never called to help investigate —
meaning no one from the DA’s office interviewed parents, Alexander’s
brother, doctors or attended the autopsy.
Brian Boal, who sat in on many of those meetings, said prosecutors
could never prove Chad and Krista Perkins caused the condition.
He admits there is a higher standard that prosecutors are held to:
the district attorney’s office must prove a case beyond a reasonable
doubt; social services must only prove neglect based on a preponderance
of evidence.
Boal, however, stands by filing the charges.
He resigned from the office in early November to take another job. He
said, however, that May dismissed him a week before he was supposed to
leave after complaining of the decision to drop charges.
“This was not the type of case where the coroner cannot tell you the
cause of death, based on the facts and circumstances,” Boal said. “The
fact is the condition was treatable, the fact is when the autopsy was
performed, the kids colon was severely impacted.
“There’s just so many different things that in my mind just should
have been looked at a little differently and given a little more weight
in making a filing decision.”

*****

“We are all pleased with the progress.” –Peggy Fulks, Alexander’s brother’s guardian ad litem

Alexander’s brother continues to grow.
Having turned 8 in December, he has grown two inches and gained
several pounds while living with a foster family in Colorado Springs. He
has started to learn to use the toilet, ditching his diapers in favor
of catching up to his peers. He attends first grade.
“The child is thriving — very happy,” said Peggy Fulks, guardian ad litem, during a recent court proceeding.
Alexander’s brother is also on track to re-join his parents. The
parents must first complete a treatment plan. Should they complete it
successfully, they will be given custody.
They have never mentioned anything in court about Alexander’s death.
Chad and Krista Perkins declined to comment for this story.
Read more: http://www.gazette.com/articles/diapers-113489-bathroom-living.html#ixzz1FAxt06YY