A young boy seized from his Johns Island home during a 2017 abuse investigation is back with his parents after a medical expert convinced a Charleston County judge the child's multiple broken bones resulted from a case of rickets, according to attorneys for the family.
Rickets results from an extreme deficiency of vitamin D, which helps the body absorb calcium. It causes children to have soft, weak or deformed bones. And that's what led to more than a dozen fractures throughout the boy's infant body that sparked authorities' suspicions and tore the family apart for nearly two years, their attorneys said.
Family Court Judge Michele Forsythe found the argument compelling, ordering Wednesday that the 22-month-old boy be immediately returned to his parents because the state Department of Social Services failed to prove abuse had occurred.
Forsythe blasted DSS's handling of the case and ordered the agency to provide counseling and therapy to the family for a year, said Abigail Duffy, an attorney for the boy's mother.
Ryan Schwartz, attorney for the boy's father, said the case was a travesty of justice that amounted to "state-sponsored medical kidnapping.”
Not everyone was quick to condemn authorities. Two Republican state lawmakers, Rep. Nancy Mace of Daniel Island and Sen. Katrina Shealy of Lexington, said they have grave concerns about the judge's decision to return the boy to his parents so quickly while a criminal case against them is still awaiting trial.
Shealy called the decision “a potentially egregious misstep of justice.”
“And if an ounce of harm comes to this child in the future, then we need to hold the Family Court and DSS accountable,” said Mace, who noted she had been contacted about the ruling by multiple constituents, including previous foster parents of the boy.
The parents, Joshua Michael Coker, 29, and Ashley Carolina Joyner, 27, face charges of unlawful conduct toward a child.
Ninth Circuit Solicitor Scarlett Wilson said she and her staff will review a transcript of the closed-door Family Court hearing and evidence in the case before making a determination on how to proceed.
Signs of abuse?
Foxx Coker was just 2 months old in May 2017 when doctors at Medical University Hospital found 16 fractures throughout his body in various stages of healing. Authorities later arrested his parents on suspicion of child abuse after testing failed to pinpoint a medical condition that could have caused the injuries and doctors pointed to signs of possible trauma, according to arrest affidavits.
DSS took Foxx into protective custody and he cycled through a succession of foster homes as the state moved to terminate Coker and Joyner's parental rights, Duffy said. The couple was allowed to see their son for just two hours each month in a supervised visit at a DSS facility. Meanwhile, DSS was taking steps to help the boy's foster mother adopt him, she said.
Foxx's parents had limited means at their disposal to hire an expert to contest the state's allegations, Duffy said. A medical expert in bone disorders ultimately came to their aid after reviewing Foxx's x-rays and finding a different explanation for the boy's injuries, she said.
Douglas Benson, a California orthopedic surgeon with extensive experience in rickets, testified Foxx had a vitamin D deficiency as an infant that led to the brittle bone disease, Duffy said. Joyner was trying to exclusively breastfeed her son at the time, and she apparently did not have enough vitamin D in her system to pass on, Duffy said.
Nutritional rickets, according to the Centers for Disease Control and Prevention, has been considered rare in the US since the introduction of vitamin D-fortified milk and infant formula. But the disease has seen a rise in occurrences in the last several decades according to recent research by the Mayo Clinic.
"Dr. Benson said he was 100 percent positive it was rickets," she said. "He was qualified as a medical expert in bone disorders, so his opinion carried a lot of weight with the judge."
Forsythe did not return a call seeking comment Thursday. Reached by phone, a staff member in Forsythe's chambers said the case was sealed and the judge would not be publicly discussing on her ruling.
DSS officials also declined to comment on specifics of the case, saying only that they would comply with Forsythe's order.
“Where a court makes a ruling, we are mandated to follow that court order,” DSS spokeswoman Pam Bryant said.
Testing for rickets
MUSC professor Bruce Hollis was not involved in the boy's care but he is an expert on diseases like rickets. Hollis said he gets calls about once a month from desperate parents who’ve had their children taken by social services. The average person would be surprised by how often cases of rickets pop up, he said.
If a mother breastfeeds her child and does not give formula or supplement the milk with vitamin D, rickets can develop in the first month or two of life, Hollis said. If an infant is taken to a hospital with broken bones, staff should immediately draw blood samples from the baby and the mother, and send the samples off to be tested for vitamin D levels, he said.
Duffy said the Medical University of South Carolina did not perform the vitamin test until 39 hours after Foxx's mother brought him to the hospital. At that point, the hospital had been pumping the boy with vitamin D supplements to help with healing, so they could not establish what his base level was when he arrived for care, Duffy said.
MUSC officials said privacy laws prevented them from discussing any aspect of the boy's stay or treatment.
Schwartz said the child’s parents continued to cooperate with authorities at every turn despite the threat of not seeing their child again.
“They missed his first birthday, first words, his first steps, all the milestones,” Schwartz said. “They got death threats.”
Duffy said the state agency's case to terminate their parental rights at trial this week hinged mainly on a MUSC physician who is a court-qualified expert in child abuse, but not in bone disorders. He told the court doctors had ruled out a number of causes but couldn't say for sure that abuse was behind the boy's fractures, she said.
DSS did not request to review Foxx's x-rays from the hospital prior to the trial and the agency's attorney objected to them being presented as evidence because she had not seen them, Duffy said. The judge, however, allowed them in, she said.
DSS did not call a witness to challenge Benson's findings, relying instead on two agency caseworkers who raised questions about the boy's ability to bond with his parents. The family's attorneys noted the small window of time Foxx was allowed to spend with his parents each month while in protective custody.
DSS presented no evidence of abuse other than their suspicions, Duffy said.
"They said it was abuse and ran with that explanation," she said. "And as a result, these parents have missed out on two years of critical bonding with their son."
Gregory Yee and Caitlin Byrd contributed to this report.