J-S27031-15

NON-PRECEDENTIAL DECISION - SEE SUPERIOR COURT I.O.P. 65.37

IN THE INTEREST OF: A.C., A MINOR IN THE SUPERIOR COURT OF

PENNSYLVANIA

APPEAL OF: A.C., FATHER No. 2723 EDA 2014

Appeal from the Order entered August 19, 2014, 

in the Court of Common Pleas of Philadelphia County, Family Court,

at No(s): CP-51-DP-0001680-2013, FID No. 51-FN-003321-2013

BEFORE: FORD ELLIOTT, P.J.E., STABILE, and FITZGERALD*, JJ.

MEMORANDUM BY FITZGERALD, J.: FILED AUGUST 13, 2015

A.C. (“Father”) appeals from the order entered in the Philadelphia 

County Court of Common Pleas adjudicating dependent his daughter, A.C. 

(“Child”), born in April of 2013, and finding he perpetrated child abuse 

against her.1 Father argues the court erred in finding he physically abused 

Child, alleging Child “did not suffer severe pain” and “the injuries to [her] 

were accidental.” Father’s Brief at 8, 9. We affirm.

The trial court set forth the factual and procedural history as follows.

On August 3, 2013, [the Philadelphia Department of 

 

* Former Justice specially assigned to the Superior Court.

1 At the time of the hospital visit precipitating this matter, Child was four 

months old. At the time of the adjudication hearing, she was one year and 

four months old. By separate order, the trial court also adjudicated 

dependent L.C., Father’s three-year-old daughter. Father did not appeal 

from that order.

G.R. (“Mother), the mother of Child and L.C., took an appeal from both 

children’s adjudication orders. This Court affirmed at Interest of L.C., 2689 

EDA 2014 (unpublished memorandum) (Pa. Super. Aug. 10, 2015).
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Human Services (“DHS”)] received a Child Protective 

Services . . . report, which alleged that Mother took 

Child,[2]a 4 month old, to St. Christopher’s Hospital for 

Children (“Hospital”) because Child was bleeding from her 

mouth. While at Hospital, Child received an evaluation, 

which revealed that Child sustained rib fractures on her left 

and right side, which were in the healing stage, 

hemorrhage of her left eye, a laceration across the entire 

floor of her mouth, and an abrasion on her cheek. [N.T., 

8/19/14, at 11.] Subsequently, doctors admitted Child to 

Hospital.

[The following day, o]n August 4, 2013, DHS spoke to 

parents at Hospital and parents were unable to provide an 

explanation for Child’s injuries. On August 5, 2013, 

Mother told DHS that Father frequently squeezed Child in 

an attempt to relieve her body of gas. Mother also 

explained to DHS that the rib fracture might have 

happened when Child fell off the bed about a month ago or 

from [her sister, L.C.,] sitting on Child’s back while 

playing. [Id. at 14.] Mother stated, to DHS and to Dr. 

[Maria] McColgan (“Doctor”), [the Medical Director of the 

Child Protection Program at Hospital,3] that Father 

scratched Child’s mouth with his fingernail while 

attempting to insert a pacifier in her mouth. Initially, 

Mother explained that Father called Mother while she was 

away from the home and told her that Child needed to go 

to the hospital because Father was unable to stop her 

mouth from bleeding. [Id. at 12-13.] However, Doctor 

testified that when [he] spoke to Mother, [she] told [him] 

she was at home when . . . Father reached behind him to 

put Child’s pacifier in her mouth and that is how the 

laceration happened. [Id. at 13.] Father corroborated 

Mother’s explanation regarding how the incidents occurred. 

Doctor testified that [he] explained to Mother that the type 

of injury Child sustained, posterior rib fractures, were 

unlikely from someone squeezing Child and not a result of 

a direct blow or . . . a fall. After Doctor gave this 

 

2

In its opinion, the trial court referred to Child as “Child #1” and her sister 

as “Child #2.” For ease of discussion, henceforth we refer to A.C. as “Child” 

and refer to L.C by her initials.

3 N.T. at 9.
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explanation, Mother immediately responded, “I knew it 

was him.” [Id. at 15.] Mother then stated . . . Father 

would sometimes try to help Child’s stool when she was 

having trouble by squeezing on her abdomen. [Id. at 15, 

32-33, 45.] Doctor diagnosed the inflicted injury as . . . a 

result of physical abuse because the injuries . . . would not 

have been from just pressing on the abdomen, someone 

would have to be squeezing the ribcage in order to create 

the fractures Child sustained. [Id. at 15, 19.] Doctor also 

testified that some of the injuries occurred at separate 

times. [Id. at 19.] On August 7, 2013, DHS learned that 

Hospital determined that Child’s injuries were nonaccidental.

On August 8, 2013, DHS obtained an Order of Protective 

Custody (“OPC”) and the Hospital discharged Child and 

[L.C.] into the care of their aunt and uncle. On this day, a 

Safety Plan was implemented in the home of the children’s 

aunt and uncle. The Safety Plan stated that the children’s 

parents were not to have visitation with the children for 21 

days and that the aunt and uncle would ensure that the 

children’s basic needs, including medical appointments, 

were met. On August 9, 2013, a shelter care hearing was 

held, the OPC was lifted, and the temporary commitment 

to DHS was ordered to stand. 

Trial Ct Op., 11/4/14, at 2-3 (citations to record omitted).

On August 13, 2013, DHS filed separate petitions, for Child and L.C., 

for an adjudication of dependency. One year later, on August 19, 2014, the 

court held a hearing, at which the following witnesses testified: Dr. 

McColgan, whom Father stipulated was an expert in child abuse, the DHS 

caseworker, Father, and Mother.

At the hearing, the court found both Child and L.C. dependent,4and 

 

4 The Juvenile Act defines a “dependent child” as, inter alia, a child who “is 

without proper parental care or control, subsistence, education as required 

by law, or other care or control necessary for his physical, mental, or 
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found Father perpetrated child abuse against Child. N.T. at 66. The trial 

court found “both parents were the children’s primary caregivers” but “found 

child abuse as to Father only.” The DHS caseworker informed the court the 

parents have, on alternating Saturdays, supervised visits and unsupervised 

visits. N.T. at 67. She confirmed to the court there were “no issues” with 

the unsupervised visits and the court permitted them to continue. Id. at 68, 

74. She further advised the court that a family service plan was already 

“scheduled,” both parents completed several training programs,5and DHS 

was awaiting “the results of the parenting capacity evaluation that both 

parents have completed.” Id. at 70-71. The parents were also referred to a 

housing program which “assist[s] parents in locating housing,” because “the 

house is not appropriate.”6 Id. at 73.

On September 15, 2014, Father timely filed a notice of appeal and a 

concise statement of errors complained of on appeal pursuant to Pa.R.A.P. 

1925(a)(2)(i) and (b).

 

emotional health, or morals.” 42 Pa.C.S. § 6302(1). Father does not 

challenge the adjudication of dependency.

5 Specifically, Father “completed anger management, parenting and healthy 

relationships.” N.T. at 74. Mother “completed parenting, employment 

services, empowerment group[,] anger management,” and “healthy 

relationships.” Id. at 73.

6 DHS caseworker Lissa Varghese testified the home was “not safe” because 

six adults and one child were living in the home in June of 2014, there was 

“high traffic” and the “children sustain [unexplained] injuries in the home.” 

Id. at 35-36.
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On appeal, Father does not challenge the underlying adjudication of 

dependency. Instead, he raises one question for our review: whether the 

trial court abused its discretion in finding he physically abused Child.7 In 

support, he first asserts Child did not suffer severe pain. While Father 

concedes “Dr. McColgan testified [Child’s] rib fracture would cause 

significant pain,” Father avers the doctor also “indicate[d] it’s subjective to . 

. . determine how much pain someone else,” especially a child, 

“experiences,” and thus Dr. McColgan “could not establish the level of pain

suffered by” Child. Father’s Brief at 8. Father maintains there is no history 

of child abuse or “even the slightest hint [he] intended to harm his child.” 

Id. He further reasons that “doctors must report child abuse in any case 

where . . . abuse is even suspected,” and thus “many ‘suspected’ cases are 

erroneous.” Id. Father’s second argument is that Child’s injuries “were 

accidental.” Id. at 9. He points out “[M]other took [Child] to the hospital 

after noticing injury” and he “also went to the hospital to help his child.” Id. 

 

7 We note the argument section of Father’s brief, at one and a half pages in 

length, fails to cite legal authority beyond a one-sentence definition, from 

Interest of K.M., 53 A.3d 781 (Pa. Super. 2012), of “clear and convincing 

evidence.” See Father’s Brief at 8-9. Furthermore, the relevant statement 

in Interest of K.M. pertained to termination of parental rights, an issue not 

present in this case. See Interest of K.M., 53 A.3d at 786 (“The burden is 

upon the petitioner to prove by clear and convincing evidence that its 

asserted grounds for seeking the termination of parental rights are valid.”).

We remind Attorney Rosenbaum that the failure to develop an argument 

with citation to and analysis of relevant authority may waive an issue on 

appeal. See Harris v. Toys “R” Us-Penn, Inc., 880 A.2d 1270, 1279 (Pa. 

Super. 2005).
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Father insists he “had no way of knowing about these injuries.” Id. We find 

no relief is due.

Our Supreme Court has stated:

“[T]he standard of review in dependency cases requires an 

appellate court to accept the findings of fact and credibility 

determinations of the trial court if they are supported by 

the record, but does not require the appellate court to 

accept the lower court’s inferences or conclusions of law.” 

We review for abuse of discretion.

Interest of L.Z., 111 A.3d 1164, 1174 (Pa. 2015) (citation omitted).

To adjudicate a child dependent, a trial court must 

determine, by clear and convincing evidence, that the 

child:

is without proper parental care or control, 

subsistence, education as required by law, or other

care or control necessary for his physical, mental, or 

emotional health, or morals. A determination that 

there is a lack of proper parental care or control may 

be based upon evidence of conduct by the parent, 

guardian or other custodian that places the health, 

safety or welfare of the child at risk.

42 Pa.C.S.A. § 6302. “Clear and convincing” evidence has 

been defined as testimony that is “so clear, direct, 

weighty, and convincing as to enable the trier of facts to 

come to a clear conviction, without hesitancy, of the truth 

of the precise facts in issue.”

In re A.B., 63 A.3d 345, 349 (Pa. Super. 2013) (some citations omitted).

Section 6303(b)(1) of the Child Protective Services Law8 defines “child 

abuse” in pertinent part as follows:

 

8 The version of Section 6303 cited was effective at the time of the 

underlying adjudication order. See 23 Pa.C.S. § 6303 (valid through 

December 31, 2014).
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(i) Any recent act or failure to act by a perpetrator 

which causes nonaccidental serious physical injury to a 

child under 18 years of age. 

* * *

(iii) Any recent act, failure to act or series of such acts 

or failures to act by a perpetrator which creates an 

imminent risk of serious physical injury to or sexual abuse 

or sexual exploitation of a child under 18 years of age.

23 Pa.C.S. § 6303(b)(1)(i), (iii). “Nonaccidental” is defined as “[a]n injury 

that is the result of an intentional act that is committed with disregard of a 

substantial and unjustifiable risk.” 23 Pa.C.S. § 6303(a). In addition, 

“serious physical injury” is defined as “an injury that (1) causes a child 

severe pain; or (2) significantly impairs a child’s physical functioning, either 

temporarily or permanently.” Id.

On March 25, 2014, subsequent to the trial court’s underlying 

dependency order, our Supreme Court decided Interest of L.Z., in which it 

held:

While a petitioning party must demonstrate the existence 

of child abuse by the clear and convincing evidence

standard applicable to most dependency determinations, 

42 Pa.C.S. § 6341(c) . . . the identity of the abuser 

need only be established through prima facie

evidence in certain situations[ pursuant to 23 Pa.C.S. § 

6381(d).]

Interest of L.Z., 111 A.3d at 1174 (emphases added). 

We note the following discussion by the Court:

[C]hild abuse cases often involve a child presenting to a 

hospital with significant injuries that are entirely consistent 

with common types of child abuse and entirely inconsistent 
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with the implausible explanations concocted by the parents 

and responsible persons to avoid allegations of child 

abuse. . . . As the children may be too young or fearful to 

describe the abuse, CYS agencies are left to prove their 

case with only the physical evidence of injuries that would 

not ordinarily be sustained but for the action of the parents 

or responsible persons and the implausible statements of 

the parents and responsible persons. . . . 

Id. at 1171.

The Court further held the presumption was rebuttable by the parent:

The parent or responsible person may present evidence 

demonstrating that they did not inflict the abuse, 

potentially by testifying that they gave responsibility for 

the child to another person about whom they had no 

reason to fear or perhaps that the injuries were accidental 

rather than abusive. The evaluation of the validity of the 

presumption would then rest with the trial court evaluating 

the credibility of the prima facie evidence presented by the 

CYS agency and the rebuttal of the parent or responsible 

person.

Id. at 1185.

In the instant case, the trial court specifically found “[a]ll of DHS’ 

witnesses credible.” Trial Ct. Op. at 5. In finding Child’s rib injuries were a 

result of abuse and not accident, the trial court stated the following.

[T]he Doctor’s testimony established that the injuries Child 

sustained would not occur by someone just pressing on 

her abdomen, someone would have to be squeezing the 

ribcage in order to create the fracture. [N.T., 8/19/14, at 

15.] The explanations the parents gave, that the fractures 

were caused either by Child falling from a bed or by L.C. 

sitting on Child’s back, are not consistent with the injuries 

Child sustained. The Doctor testified that Child would have 

cried when the event occurred that fractured her ribs. . . . 

Parents were never able to explain Child’s injuries in a way 

consistent with the type of injuries [she] sustained. 

Furthermore, the Doctor testified that the type of rib 
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fractures Child had are a type . . . that do not occur from 

an accidental injury. [Id. at 26.] Child had multiple rib 

injuries[:] lateral rib fractures and fractures on the left 

side still . . . healing. [Id. at 13-14.] The rib fractures 

[were] a serious injury causing significant on-going pain to 

Child. [Id. at 14, 17-18, 27.] Father also testified that in 

order to relieve Child of gas pains, he would push on her 

abdomen. [Id. at 45.] Mother had said that Child 

sometimes cried when . . . Father squeezed on her 

abdomen. Father testified that no doctor ever instructed 

him to push on Child’s abdomen to relieve gas pains. [Id.]

Trial Ct. Op. at 4-5 (some record citations omitted).

With respect to Child’s eye and mouth injuries, the court opined:

The Doctor testified that the hemorrhaging in the right eye 

was also from trauma and that an infant, such as Child, 

would not be able to self-inflict this type of injury to her 

own eye. [N.T. at 16, 18.] The Doctor also testified that 

the laceration to Child’s mouth would not occur from an 

ordinary fingernail scratch, the laceration was across the 

entire floor of the mouth and deep under her tongue. 

Significant amount of force would be required to cause 

such an injury. [Id. at 24.] There were six other adults 

and three other children who live with parents[,] Child and 

[L.C.] Father testified that no other adult[ ] who lives in 

the house witnessed the injury to the mouth.

Trial Ct. Op. at 5. 

The court further noted:

The injuries Child sustained while under the care of her 

parents could not be explained by her parents, the injuries 

were serious, and caused Child severe pain. The Doctor 

spoke with Mother, and Mother said that Father was the 

perpetrator of Child’s rib fracture by exclaiming “I knew it 

was him” to the Doctor. [N.T. at 15.]

Trial Ct. Op. at 5. The court’s findings are supported by the record.
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We reject Father’s assertion that Dr. McColgan “could not establish the 

level of pain suffered by the child.” See Father’s Brief at 8. Dr. McColgan 

testified Child “had bilateral fractures of the 11th ribs” which were 

approximately one to three weeks old at the time she was examined. N.T., 

at 11, 14. She testified that a rib fracture “is a serious injury. It would have 

caused pain to the child.” Id. at 14. Moreover, Dr. McColgan testified:

[DHS’ counsel: I]n your opinion, how much pain would 

have Child occurred [sic] when she sustained the rib 

fracture?

[A.] This would be significant pain. [I]t’s subjective to 

be able to determine how much pain someone else 

experienced. A rib fracture is a fracture of the bone, which 

is typically severe pain.

[Q.] Would Child cry? Would it be likely that she would 

cry?

A. It would be likely that she would cry.

Id. at 17-18. Based on Dr. McColgan’s testimony, we discern no abuse of 

discretion by the court in finding Child’s bilateral rib fractures were a 

“serious physical injury” pursuant to section 6303. See 23 Pa.C.S. § 

6303(a).

With respect to whether A.C.’s rib fractures were nonaccidental in 

cause, Dr. McColgan testified as follows:

[DHS’ counsel: I]n your professional opinion, would a 

four month-old incur these injuries on her own?

[A.] No, these are not self-inflicted injuries. At four 

months of age, typically, you’re just learning how to roll 
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over, maybe lifting your head, but you would not have 

enough movement to cause these injuries yourself.

[Q. I]n your professional opinion, is it likely that a 

four[-]month-old would sustain these injuries without 

some sort of non-accidental trauma?

[A.] You could have accidental injury, but the accidental 

injuries that were reported would not have accounted for 

all of these injuries, nor were they likely to have caused 

these injuries.

[Q.] Can you say, to a reasonable degree of medical 

certainty, that [Child’s] injuries were caused by child 

abuse?

[A.] Yes, my diagnosis was physical abuse.

N.T. at 18-19; see also id. at 24-25. Based on Dr. McColgan’s testimony, 

we likewise discern no abuse of discretion by the court in finding that A.C.’s 

rib fractures were nonaccidental in cause pursuant to section 6303.

In addition, Dr. McColgan testified about Child’s mouth injury as 

follows. Child had a laceration “across the floor of the mouth, just behind 

the gum line,” as well as “hematoma, which is a collection of blood 

underneath her tongue.” Id. at 11. This injury was “relatively recent.” Id.

at 12. Mother’s explanation, that Father caused it by putting a pacifier in 

her mouth, “should not” have caused the mouth injury. Id. at 13. 

Furthermore, Dr. McColgan replied “Yes,” to the specific question of whether 

Child would have “been in pain when she received that injury.” Id.

Dr. McColgan further testified Child’s left eye had a “subconjunctival 

hemorrhage . . . which is a collection of blood in the white portion of the 
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eye. . . .” Id. at 11. Dr. McColgan opined the eye hemorrhage was from 

trauma, explaining:

The white part of the eye—you can sometimes see 

hemorrhages there, usually from trauma. You can also get 

them from very severe coughing or very severe vomiting, 

but that’s pretty unlikely in a three month—whatever she 

was—an infant, and there was no report of severe vomiting 

or coughing for [Child].

Id. at 16. In addition, Dr. McColgan testified there was no biological or 

medical reason for Child’s eye hemorrhage. Id. at 16-17. 

Dr. McColgan further testified Child “had abrasions on her face,” 

including “a diagonal line across the cheek,” approximately “a half to a 

centimeter wide by several centimeters long.” Id. at 11. Dr. McColgan did 

not recall if an explanation for these cuts was provided. Id. at 16. 

Significantly, Dr. McColgan testified Child’s injuries were incurred on 

“at least two separate episodes:”

Some of the injuries had to have occurred at separate 

times. The rib fracture was, again, a week to [three] 

weeks old. The scratches on the face and the laceration 

on the tongue and the eye injury were likely relatively 

more recent. . . . 

So, we know there was at least two separate episodes, 

but I can’t tell you that the face injury, the mouth injury or 

the eye injury did or didn’t happen at the same time.

[Child Advocate: ] But they happened separate from the 

ribs?

[A.] Yes.

Id. at 19-20.
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Based on the foregoing testimony of Dr. McColgan, as well as Father’s 

and Mother’s explanations for Child’s injuries, we discern no abuse of 

discretion by the court in finding Child was the victim of “child abuse” 

perpetrated by Father. See Interest of L.Z., 111 A.3d at 1174. We 

conclude the testimonial evidence demonstrates that Child’s bilateral rib 

injuries satisfied the definition of “child abuse” under section 6303(b)(1)(i). 

See 23 Pa.C.S. § 6303(b)(1)(i). With respect to Child’s injuries to her 

mouth, left eye, and face, we conclude that the testimonial evidence 

demonstrates that she suffered “child abuse” under section 6303(b)(1)(iii), 

as they created “an imminent risk of serious physical injury.” Accordingly, 

we affirm the adjudication order. See 23 Pa.C.S. § 6303(b)(1)(iii).

Order affirmed.

Judgment Entered.

Joseph D. Seletyn, Esq.

Prothonotary

Date: 8/13/2015