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IN RE INTEREST OF PRINCE R.

Cite as 308 Neb. 415

In re Interest of Prince R., a child 

under 18 years of age.

State of Nebraska, appellee, v. Mohamed K., 

appellant, and Abak R., appellee 

and cross-appellant.

___ N.W.2d ___

Filed February 12, 2021. No. S-20-342.

1. Juvenile Courts: Evidence: Appeal and Error. Juvenile cases are 

reviewed de novo on the record, and an appellate court is required to 

reach a conclusion independent of the juvenile court’s findings; however, when the evidence is in conflict, an appellate court may consider 

and give weight to the fact that the trial court observed the witnesses 

and accepted one version of the facts over the other.

2. Parental Rights. The purpose of the adjudication phase is to protect the 

interests of the child.

3. Juvenile Courts: Jurisdiction. To obtain jurisdiction over a juvenile at 

the adjudication stage, the court’s only concern is whether the conditions 

in which the juvenile presently finds himself or herself fit within the 

asserted subsection of Neb. Rev. Stat. § 43-247 (Reissue 2016).

4. Juvenile Courts: Jurisdiction: Proof. At the adjudication stage, in 

order for a juvenile court to assume jurisdiction of minor children under 

Neb. Rev. Stat. § 43-247(3)(a) (Reissue 2016), the State must prove the 

allegations of the petition by a preponderance of the evidence.

Appeal from the Separate Juvenile Court of Lancaster 

County: Linda S. Porter, Judge. Affirmed.

Robert Wm. Chapin, Jr., of Chapin Law Office, for appellant.

Patrick F. Condon, Lancaster County Attorney, and Maureen 

E. Lamski for appellee State of Nebraska.

Nebraska Supreme Court Online Library

www.nebraska.gov/apps-courts-epub/

03/12/2021 01:09 AM CST
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IN RE INTEREST OF PRINCE R.

Cite as 308 Neb. 415

Mona L. Burton, of Anderson, Creager & Wittstruck, P.C., 

L.L.O., for appellee Abak R.

Heavican, C.J., Miller-Lerman, Cassel, Stacy, Funke, 

Papik, and Freudenberg, JJ.

Papik, J.

The separate juvenile court of Lancaster County adjudicated 

Prince R. as a child who lacked proper parental care by reason 

of the fault or habits of his parents, Mohamed K. and Abak R. 

The juvenile court concluded that the parents failed to ensure 

that Prince received necessary medical care after he was diagnosed with a rare form of cancer. Mohamed appealed and Abak 

cross-appealed this determination, but, for reasons we will 

explain, we affirm.

BACKGROUND

Adjudication Petition and 

Preliminary Motions.

The State commenced this action on October 21, 2019. In 

its adjudication petition, the State alleged that Prince, who was 

born in August 2015, lacked proper parental care by reason 

of the fault or habits of both Mohamed and Abak. The State 

asserted that Prince had been diagnosed with alveolar rhabdomyosarcoma of the right forearm with local metastases to 

the axillary lymph nodes; that the condition was curable with 

regular chemotherapy and radiation; that without treatment, 

the condition would be fatal; that Mohamed and Abak, having 

been informed of Prince’s diagnosis and prognosis, intentionally kept him from receiving treatment; and that the actions of 

Mohamed and Abak placed Prince at a risk of harm.

On the same day the State filed its petition, it filed an 

ex parte motion for immediate custody of Prince. The juvenile court granted the State’s motion. The court later granted 

motions by the State for Prince to remain in the temporary 

legal and physical custody of the Nebraska Department of 

Health and Human Services (DHHS).
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Cite as 308 Neb. 415

Adjudication Hearing.

The juvenile court held a trial on the State’s adjudication 

petition over the course of 4 days in January and February 

2020. A summary of the evidence presented follows.

Melissa Acquazzino, a board-certified physician who specializes in treating children with cancer at Children’s Hospital 

and Medical Center (Children’s) in Omaha, Nebraska, first 

saw Prince when he came to Children’s in July 2019 with a 

tumor on his right forearm. Following a biopsy, Acquazzino 

and others on a pediatric pathology team diagnosed Prince 

with alveolar rhabdomyosarcoma, a form of cancer. It was later 

determined that the cancer had spread to the lymph nodes of 

Prince’s armpit. Acquazzino testified that there are only about 

350 patients diagnosed with this form of cancer in the United 

States per year.

Acquazzino informed Mohamed and Abak of Prince’s diagnosis. She also informed Mohamed and Abak that Prince 

would need to receive chemotherapy. Acquazzino recalled 

that Mohamed and Abak were “distraught.” She testified that 

Mohamed expressed anger at the length of time it took to make 

the diagnosis as well as a belief that if Prince had received 

antibiotics earlier, cancer would not have developed.

After additional testing on the tumor tissue, Prince was 

determined to have what Acquazzino referred to as “intermediate risk” rhabdomyosarcoma. Acquazzino testified that 

this meant that Prince had about a 60-percent chance of 

relapse-free, long-term survival if the best available treatment 

were provided. According to Acquazzino, the best available 

treatment in Prince’s case would include an initial round of 

chemotherapy followed by either surgery or radiation and then 

continued chemotherapy for a total treatment duration of about 

66 weeks. She testified that an international consortium of 

children’s hospitals to which Children’s belonged recognized 

this course of treatment as the best available and that any other 

hospital within that consortium would have recommended 

the same treatment. If Prince did not receive this treatment, 
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Acquazzino said that he would die in 6 months to a year. 

Acquazzino testified that when patients have a very poor prognosis even if the standard treatment is provided, Children’s will 

offer the option of palliative “comfort care,” which is expected 

to end in the patient’s death. Acquazzino testified that was not 

an option explored in this case given Prince’s prognosis.

On July 23, 2019, Acquazzino and Christina Chesters, a 

social worker at Children’s, met with Mohamed and Abak 

regarding Prince’s prognosis and next steps. Acquazzino testified that she outlined the recommended treatment and informed 

Mohamed and Abak that most patients with Prince’s condition 

will respond to the treatment and achieve long-term survival. 

Acquazzino also testified that she told Mohamed and Abak 

that the treatment could involve side effects, which could be 

managed with medication. Mohamed and Abak also received 

various printed materials explaining the treatment and possible 

side effects.

According to Acquazzino, Mohamed and Abak expressed 

concern at the July 23, 2019, meeting, about the need for 

chemotherapy. Acquazzino perceived Mohamed and Abak as 

resistant to the recommended treatment. After Acquazzino 

told them that this was the best available treatment and that, 

without treatment, Prince would die, Mohamed and Abak 

agreed to proceed. Prince began the recommended treatment 

that night.

Acquazzino testified that Prince’s treatment went well initially. His tumor visibly shrank, his side effects were minimal, 

and he made it to all his appointments. Chesters worked with 

Mohamed to identify and eliminate any barriers to regular 

attendance at treatment. As part of that effort, she made financial resources available to pay for car repairs and other bills 

Mohamed and Abak reported having trouble paying.

After several weeks of treatment, Prince began to experience 

expected side effects such as nausea, vomiting, and fatigue. 

Then, in September 2019, Prince started missing some of 

his scheduled chemotherapy appointments. Chesters testified 
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Cite as 308 Neb. 415

that she contacted Mohamed after Prince missed one appointment and that Mohamed told her he believed the doctors 

were giving Prince too much medicine too quickly. According 

to Chesters, she emphasized to Mohamed that it was very 

important Prince receive the treatments as scheduled and that 

the appointments were not optional. The missed appointments 

were concerning to Acquazzino, because they could lead to the 

cancer building resistance to the treatment regimen.

The treatment plan called for Prince to begin radiation 

treatments while continuing chemotherapy in early October 

2019. Concerned about the prior missed chemotherapy appointments and whether Mohamed and Abak would bring Prince 

to the radiation appointments, Acquazzino asked to meet with 

Mohamed and Abak on October 1, 2019.

Both Mohamed and Abak attended the October 1, 2019, meeting with Acquazzino and Chesters. The meeting lasted about 

an hour. Acquazzino recalled that, at the meeting, Mohamed 

and Abak said Prince was being given too much medicine and 

that Mohamed said the cancer would not kill Prince, but the 

chemotherapy would. Mohamed and Abak asked that Prince 

be given less medicine. Acquazzino explained to them that 

reducing the medication would expose Prince to the same side 

effects, but would not be as effective at treating the cancer. She 

also told them that skipping scheduled treatments could lead 

to the cancer building resistance and becoming more difficult 

to treat.

Acquazzino testified that during the meeting on October 1, 

2019, Mohamed and Abak said that they wanted to get a second opinion. While Acquazzino and Chesters offered to help 

facilitate a second opinion by making a referral or sending 

records to another provider, they also emphasized that the situation was time sensitive, so any second opinion would need to 

be obtained quickly. Acquazzino testified that while any delay 

in treatment was not ideal, she would have “tolerated maybe 

a one to two week delay” to get a second opinion because 

the benefits of improving the relationship with Mohamed and 
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Cite as 308 Neb. 415

Abak would counter the risk of delaying treatment. According 

to Acquazzino, Mohamed and Abak did not ask for a referral 

and said they had to think and talk about whether they were 

interested in one.

Acquazzino testified that for much of the meeting on 

October 1, 2019, Mohamed and Abak expressed opposition 

to beginning radiation treatment. By the end of the meeting, 

however, Mohamed and Abak committed to bringing Prince 

to his radiation appointment the next day. After the meeting, 

Acquazzino and Chesters decided to make a Child Protective 

Services referral. Acquazzino felt that a referral was appropriate because, based on the discussion at the meeting, she was 

concerned that Mohamed and Abak would not ensure that 

Prince continued to receive treatment.

Prince did attend his radiation appointment on October 2, 

2019. After that, however, neither parent brought Prince to any 

further radiation or chemotherapy appointments.

On October 2, 2019, Vildana Parmer, a caseworker at 

DHHS, was assigned to investigate the concerns expressed in 

the Child Protective Services referral. Parmer had access to 

several possible addresses in Lincoln, Nebraska, for Mohamed 

and Abak and initially tried to make contact with them at 

those locations. These efforts were unsuccessful, but Parmer 

did reach Mohamed by telephone on October 4. She testified 

that she asked Mohamed where Prince and Abak were and 

that Mohamed told her they were at one of the addresses she 

already visited. After Parmer informed Mohamed that she had 

recently visited that address and no one was there, Mohamed 

told her that Abak and Prince were residing at the People’s 

City Mission (PCM). Parmer then visited PCM and asked an 

employee there to provide her business card to Abak.

Deanna Borg, an employee of PCM, testified that PCM 

records showed that Abak and Prince began residing at PCM 

on August 1, 2019. Borg testified that in early October, someone from DHHS asked her to provide Abak with the DHHS 

employee’s business card. Borg provided Abak with the 
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Cite as 308 Neb. 415

card and told her that the DHHS employee said that it was 

important that Abak contact her. After providing the business 

card, Borg did not see Abak and Prince again. Borg testified 

that those people staying at PCM are required to sign a paper 

on their door if they intend to spend that night there. Abak last 

signed the paper on her door on October 1.

Parmer later found Mohamed outside his residence in 

Lincoln. She testified that she asked Mohamed where Prince 

was and that Mohamed initially said that Abak and Prince went 

to Utah, but later stated they were in Arizona. He said that 

they went there to seek a second opinion for Prince’s medical 

treatment. Parmer testified that she asked Mohamed to have 

Abak call her, but Abak never did. Parmer also testified she 

emphasized to Mohamed that it was important Prince receive 

his medical treatment and that if he did not receive it, he would 

likely die. According to Parmer, Mohamed expressed disagreement with that statement.

Patrick Wingfield, an officer with the Lincoln Police 

Department, attempted to locate Abak, beginning on October 

8, 2019. Wingfield found Mohamed outside his residence in 

Lincoln and requested that Mohamed ask Abak to contact 

him. Mohamed told Wingfield that Abak had taken Prince to 

Arizona to get a second opinion for his medical treatment. 

Wingfield testified that Mohamed told him that this was none 

of his concern and that Prince was safe.

Luis Herrera, an investigator with the Lincoln Police 

Department, began attempting to locate Abak and Prince on 

October 9, 2019. Herrera first attempted to contact Abak via 

text message and by contacting other police departments. On 

October 12, he reached Mohamed by telephone. Mohamed told 

Herrera that Abak and Prince were in Arizona to get a second 

opinion for Prince’s medical treatment. Herrera testified that 

Mohamed told him, based on his research, Prince was being 

given too much medication and that Mohamed said, if he disagreed with the medication being given, “he would step in and 

correct the doctor.”
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Cite as 308 Neb. 415

After other attempts to locate Abak and Prince were unsuccessful, Herrera initiated an emergency “ping” on a cell phone 

number belonging to Abak on October 18, 2019. The ping 

indicated that the cell phone was in Murfreesboro, Tennessee.

Herrera then called Mohamed again. Mohamed indicated he 

had been in contact with Abak. Herrera asked that Mohamed 

facilitate contact between Herrera and Abak. Herrera testified 

that during this conversation, Mohamed complained about the 

treatment Prince was receiving through Children’s and stated 

that Children’s had a “clandestine agenda.”

A few hours after his conversation with Mohamed, Herrera 

spoke to Abak on the telephone. During the call, Herrera asked 

Abak whether Prince was receiving medical treatment, but 

Abak said she did not want to discuss that. When Herrera asked 

whether Abak and Prince were still in Nebraska, Abak said she 

was not and would not be coming back. She also said that “if I 

even get another doctor, it’s not going to be in Nebraska.”

Herrera acquired a warrant to obtain an ongoing ping on 

Abak’s cell phone. Those pings indicated that the cell phone 

was at an apartment complex in Murfreesboro. After Herrera 

provided law enforcement in Tennessee with information 

regarding the case, Tennessee law enforcement found Abak at 

the apartment complex on October 26, 2019. Herrera worked 

with child welfare services in Tennessee to ensure that Prince 

was taken to a hospital as soon as he was found.

No evidence was presented that Prince received any treatment or was seen by any medical professionals between October 

2 and 26, 2019. No evidence was presented that Mohamed or 

Abak had arranged for another medical professional to provide 

a second opinion. Chesters testified that although she compiled 

Prince’s medical records in response to Mohamed’s request in 

an October 8 email, she also told Mohamed that he would need 

to pick up a disc containing the records and that he failed to 

do so.

Prince, in the temporary custody of DHHS, resumed 

treatment through Children’s once he returned to Nebraska. 
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Cite as 308 Neb. 415

Although Acquazzino could not say with certainty to what 

extent the delay in treatment affected Prince’s prognosis, she 

testified that, in general, delays increase the risk of relapse and 

decrease the overall efficacy of the treatment. Acquazzino also 

testified that because chemotherapy can cause blood counts to 

drop severely, Prince was placed at risk by not having blood 

tests run on a weekly basis. In addition, she testified that 

because Prince was receiving chemotherapy and had a central 

line inserted in his body, Prince was at risk for infection.

Mohamed testified at trial. He agreed that after beginning 

chemotherapy, Prince’s tumor noticeably shrank. He testified 

that when Prince began experiencing side effects, it was difficult to get him to take the oral medications that would help 

manage them. He testified that he asked the doctors if Prince 

could take the medications used to manage side effects in some 

other way. At one point in his testimony, Mohamed said that he 

only wanted a second opinion regarding Prince’s wrist, which 

had limited functionality after the biopsy, and that he never 

wanted a second opinion about the treatment protocol. Later in 

his testimony, however, he testified that he also wanted to get 

a second opinion for Prince’s cancer diagnosis.

Mohamed testified that he and Abak were not and had never 

been married. He testified that while Prince resided with Abak 

at the time of the events at issue, Prince had lived with him at 

earlier points in his life. Mohamed testified that it was Abak’s 

decision to leave Nebraska. He testified that he did not ask 

Abak to return because he believed she was seeking a second opinion.

Mohamed disagreed with Chesters’ testimony that he did 

not obtain the medical records, claiming that she emailed the 

records to him. He conceded that he never gave the records to 

another medical provider.

Mohamed denied ever telling anyone that the treatment 

would kill Prince, but the cancer would not. He also denied ever 

saying that he intentionally did not bring Prince to treatments 

because he believed Prince was receiving too much medicine 
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through chemotherapy. He acknowledged that Acquazzino had 

informed him that it was harmful to Prince to miss scheduled 

treatments, and he testified that he believed that was true. He 

testified that he wanted Prince to receive all of the treatment 

recommended by Children’s.

Abak did not testify at trial.

Juvenile Court’s Adjudication Order.

The juvenile court found that Prince lacked proper parental 

care by reason of the fault or habits of both Mohamed and 

Abak. In reaching this conclusion, the juvenile court emphasized various points. It observed that there was no medical 

evidence presented disputing Acquazzino’s opinions concerning Prince’s diagnosis or that there was a standard treatment 

provided for patients with such a diagnosis. It also credited 

Acquazzino’s opinion that Prince had a 60-percent chance of 

survival with the standard treatment, but would die without 

it, and that if Prince’s treatment was interrupted or delayed, it 

would increase the risk of relapse and decrease the treatment’s 

efficacy. It noted that neither parent raised a religious or cultural objection to the treatment Prince was receiving.

The juvenile court also considered and rejected both parents’ 

argument that they withdrew Prince from treatment only to 

obtain a second opinion. It found that the parents’ “more likely 

motivation in removing Prince from the state was to stop his 

treatment altogether for an undetermined period of time.” The 

juvenile court specifically noted that it found unconvincing 

Mohamed’s testimony that he deferred to Abak in removing 

Prince from the state and that he lacked knowledge of Abak’s 

“efforts or lack thereof in seeking a second opinion.”

Mohamed appealed, and Abak cross-appealed.

ASSIGNMENTS OF ERROR

Mohamed assigns that the juvenile court erred by finding (1) that Prince lacked proper parental care by reason of 

his faults or habits and (2) that his actions placed Prince at a 
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definite risk of harm. On cross-appeal, Abak assigns that the 

juvenile court erred by making the same determinations with 

respect to her.

STANDARD OF REVIEW

[1] Juvenile cases are reviewed de novo on the record, and 

an appellate court is required to reach a conclusion independent 

of the juvenile court’s findings; however, when the evidence is 

in conflict, an appellate court may consider and give weight to 

the fact that the trial court observed the witnesses and accepted 

one version of the facts over the other. In re Interest of A.A. et 

al., 307 Neb. 817, 951 N.W.2d 144 (2020).

ANALYSIS

Background Regarding Adjudication 

Proceedings in Juvenile Court.

[2,3] Before addressing Mohamed’s and Abak’s arguments, 

we briefly review the standards governing the adjudication 

phase of a juvenile court proceeding. The purpose of the adjudication phase is to protect the interests of the child. In re 

Interest of Justine J., 286 Neb. 250, 835 N.W.2d 674 (2013). 

To obtain jurisdiction over a juvenile at the adjudication stage, 

the court’s only concern is whether the conditions in which 

the juvenile presently finds himself or herself fit within the 

asserted subsection of Neb. Rev. Stat. § 43-247 (Reissue 2016). 

In re Interest of Justine J., supra.

Section 43-247(3)(a) sets forth numerous grounds by which 

the juvenile court could take jurisdiction over a juvenile. 

See In re Interest of Jeremy U. et al., 304 Neb. 734, 936 

N.W.2d 733 (2020). The ground relevant to this case is that 

the juvenile “lacks proper parental care by reason of the fault 

or habits of his or her parent, guardian, or custodian.” See 

§ 43-247(3)(a). As we have previously explained, “proper 

parental care” includes

providing a home, support, subsistence, education, and 

other care necessary for the health, morals, and wellbeing of the child. . . . It commands that the child not 
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be placed in situations dangerous to life or limb, and not 

be permitted to engage in activities injurious to his health 

or morals.

State v. Metteer, 203 Neb. 515, 520, 279 N.W.2d 374, 377 

(1979). See, also, In re Interest of Jeremy U. et al., supra.

In considering whether a juvenile lacks proper parental care, 

our case law has incorporated a risk of harm component. In 

re Interest of Jeremy U. et al., supra. To show that a juvenile 

lacks proper parental care, the State is not required to prove 

that the child has actually suffered physical harm, but the State 

must establish that, without intervention, there is a definite risk 

of future harm. See In re Interest of Kane L. & Carter L., 299 

Neb. 834, 910 N.W.2d 789 (2018).

We recently explained in In re Interest of Jeremy U. et al.

that a claim under § 43-247(3)(a) that a juvenile “lacks proper 

parental care by reason of the fault or habits of his or her parent, guardian, or custodian” should be analyzed through a twostep inquiry:

The first step is to determine if the juvenile is lacking 

proper parental care, whether such care is being provided 

by a parent, a guardian, or a custodian. If a juvenile is 

not lacking that type of care (and . . . there is no definite risk of harm), adjudication under this provision of 

§ 43-247(3)(a) is improper. If, on the other hand, the 

juvenile is lacking such care, the court should proceed to 

the second step: Does that condition result from the fault 

or habits of the juvenile’s parent, guardian, or custodian? 

If the answer to that question is also yes, then the juvenile 

court should take jurisdiction of the juvenile and proceed 

to a proper disposition.

304 Neb. at 748, 936 N.W.2d at 744-45.

[4] At the adjudication stage, in order for a juvenile court 

to assume jurisdiction of minor children under § 43-247(3)(a), 

the State must prove the allegations of the petition by a preponderance of the evidence. In re Interest of Heather R. et al., 

269 Neb. 653, 694 N.W.2d 659 (2005). A preponderance of 
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the evidence is the equivalent of the greater weight of the evidence, which means evidence sufficient to make a claim more 

likely true than not true. See In re Interest of Vladimir G., 306 

Neb. 127, 944 N.W.2d 309 (2020). Both Mohamed and Abak 

argue on appeal and cross-appeal that the State failed to carry 

its burden to show that Prince lacked proper parental care by 

reason of their faults or habits and that, without intervention, 

Prince faced a definite risk of future harm. We turn to their 

arguments now, beginning with Abak’s.

Abak’s Cross-Appeal.

Abak contends that Prince did not lack proper parental care 

by reason of her fault or habits and that Prince did not face a 

definite risk of future harm. In support of her argument that 

Prince received adequate parental care, Abak primarily emphasizes evidence of her care for Prince prior to the meeting at 

Children’s on October 1, 2019. She mentions, for example, 

that she noticed the swelling in Prince’s forearm and arranged 

for him to be seen by doctors. She points out that she agreed 

to the treatment plan recommended by Children’s and that 

Prince initially received treatment as recommended. She also 

directs us to a note recorded by Chesters in July 2019 stating 

that she and Mohamed “love Prince very much.” But even if 

this evidence tends to show that Abak was ensuring that Prince 

received adequate medical care for a period of time, it fails 

to address the crux of the State’s case: that in early October, 

Abak took Prince out of Nebraska and, for more than 3 weeks 

until the State was able to locate them, kept Prince from 

receiving the treatment Acquazzino testified was essential to 

his survival.

The closest Abak comes to providing an explanation for 

her actions after the October 1, 2019, meeting are suggestions that she was not refusing to allow treatment, but merely 

seeking a second opinion. This claim might have more force 

if there were evidence in the record that Abak had actually made arrangements to obtain a second opinion or taken 
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significant, concrete steps toward doing so. But even though 

Acquazzino had recently informed Mohamed and Abak that 

Prince’s condition was serious, that delays in treatment subjected Prince to risk of lethal harm, and that thus, any second 

opinion must be obtained quickly, there is no evidence that 

even after Prince had already missed approximately 3 weeks 

of scheduled treatment, Abak had so much as begun to identify where she might obtain a second opinion. Further, Abak’s 

comment to Herrera that “if I even get another doctor, it’s not 

going to be in Nebraska,” suggests that Abak had no immediate intentions of arranging for a second opinion. (Emphasis 

supplied.) Based on this evidence, we agree with the juvenile 

court that it is more likely than not that Abak did not leave 

Nebraska with Prince to obtain a second opinion, but to stop 

his treatment altogether for an indefinite period of time. We 

also agree with the juvenile court that the decision to indefinitely stop treatment, which Acquazzino testified was essential 

to Prince’s survival, deprived Prince of proper parental care by 

reason of the faults or habits of Abak.

Abak also argues that the juvenile court erred by finding that, without intervention, Prince faced a definite risk of 

future harm. Here, Abak argues that because the State could 

not definitively show that Prince was harmed by not receiving 

treatment during the time in which she and Prince were not in 

Nebraska, it did not prove the risk of harm element. Abak’s 

argument, however, is an attempt to transform the risk of harm 

requirement into a requirement that the juvenile suffer actual 

harm before the juvenile court obtains jurisdiction. As we 

have emphasized on many occasions, however, the Nebraska 

Juvenile Code does not require a juvenile court to wait until 

disaster has befallen a minor child before the court may acquire 

jurisdiction. See, e.g., In re Interest of Justine J., 286 Neb. 250, 

835 N.W.2d 674 (2013).

The State introduced evidence showing that Prince was 

placed at risk of harm by a delay in treatment. As we have 

noted, Acquazzino testified that treatment delays increase 
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the risk of relapse and decrease the overall efficacy of the 

treatment and that if the treatment was stopped altogether, 

Prince would die. Her testimony also established that due to 

his treatment and the central line in his body, Prince needed to 

be regularly seen by medical professionals. We find the State 

established that, without intervention, there was a definite risk 

of future harm to Prince as a result of Abak’s actions.

Under the two-step analysis set forth in In re Interest of

Jeremy U. et al., 304 Neb. 734, 936 N.W.2d 733 (2020), the 

State established that Prince lacked proper parental care and 

faced a definite risk of future harm and that this resulted 

from the fault or habits of Abak. We thus find no merit to 

Abak’s cross-appeal.

Mohamed’s Appeal.

In his appeal, Mohamed makes many of the arguments 

made by Abak. Like Abak, he contends that he ensured Prince 

received the treatment recommended by Children’s up until 

early October 2019 and that the treatment stopped at that point 

only because a decision was made to obtain a second opinion. 

He also makes the argument that because the State did not 

prove that Prince actually suffered harm because of the treatment delay, it did not establish the risk of harm element. As we 

have already explained, however, we are unpersuaded by these 

arguments. We have already determined under the first step of 

the two-step In re Interest of Jeremy U. analysis that, after his 

treatment was stopped in early October 2019, Prince lacked 

proper parental care and, as a result, faced a definite risk of 

future harm.

Mohamed does make one argument, however, that remains 

unaddressed even after our analysis of Abak’s cross-appeal: 

Mohamed attempts to place any blame for a lack of parental care exclusively on Abak. Mohamed argues that while he 

agreed that a second opinion should be sought, he believed 

Abak was, in fact, seeking such an opinion when she left 

the state with Prince in October 2019. Although he does not 
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frame the argument in these exact terms, Mohamed appears 

to argue that even if the State proved at step one of the In re 

Interest of Jeremy U. analysis that Prince lacked proper parental care and faced a definite risk of future harm because of the 

treatment delay in October 2019, it did not prove at step two 

that this was a result of the fault or habits of Mohamed.

As noted above, the juvenile court rejected this argument, 

finding that both parents made the decision to withdraw Prince 

from treatment and to remove him from Nebraska—not to 

obtain a second opinion but to stop his treatment altogether for 

an undetermined period of time. We agree that, based on the 

evidence in the record, it is more likely than not that Mohamed 

supported and bears responsibility for the decision to remove 

Prince from treatment indefinitely regardless of whether a second opinion was sought. Several pieces of evidence inform this 

conclusion, which we outline below.

Initially, we note that the record contains evidence of multiple statements by Mohamed that the recommended treatment 

was not only unnecessary to Prince’s survival, but harmful to 

him. Acquazzino, Chesters, Parmer, and Herrera all testified 

that Mohamed made such statements. Although the fact that 

Mohamed made these statements alone would not demonstrate 

that Prince lacked proper parental care by reason of the fault or 

habits of Mohamed, they do suggest that Mohamed disagreed 

with and wanted to discontinue the recommended treatment 

and was not merely an unwitting victim of Abak.

There are also pieces of evidence that, when considered 

together, undermine Mohamed’s claims that he wanted to 

obtain a second opinion, that he deferred to Abak to arrange 

for such an opinion, and that he believed that such an opinion was being sought. First, Mohamed offered testimony 

regarding his devotion and attachment to Prince. The juvenile 

court found this testimony credible, observing that Mohamed 

“undoubtedly loves his son.” But while there is no dispute that 

Mohamed cared deeply for Prince, there is evidence suggesting that he would not have trusted Abak to ensure that Prince 
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received needed medical care. Mohamed and Abak reported to 

Chesters that “they don’t always get along.” In addition, in a 

meeting with Chesters, Mohamed shared that he was concerned 

about Abak’s arrest record and drug and alcohol use and that 

he believed her drug usage might explain why Prince missed 

several speech therapy appointments. During that meeting, 

Mohamed requested that all appointments be made on days on 

which he did not have to work. Given Mohamed’s attachment 

to Prince and his prior concerns regarding Abak’s reliability, it 

is difficult to believe that Mohamed entrusted Abak with the 

task of obtaining a second opinion.

Mohamed emphasizes that he sent an email to Chesters on 

October 8, 2019, asking that Prince’s medical records be compiled so that a second opinion could be sought. This evidence 

does not persuade us that Mohamed bears no responsibility 

for the lack of proper parental care. Chesters testified that 

while she compiled the records, she also informed Mohamed 

he would need to arrange to come pick up a disc containing 

the records, and he never did so. Mohamed disagreed with this 

testimony, claiming that Chesters emailed the records to him. 

But even assuming the truth of Mohamed’s testimony on this 

point, Mohamed also testified that he never sent the records to 

another medical provider. The assertion that Mohamed believed 

a second opinion was being obtained is difficult to square with 

the fact that he knew the records necessary to obtain such an 

opinion had not been given to another provider.

We acknowledge that Mohamed testified that he believed 

Abak was arranging for a second opinion and that Abak told 

him she had made an appointment with another provider. The 

juvenile court, however, found Mohamed’s “claimed ignorance 

of [Prince’s and Abak’s] whereabouts, or [Abak’s] efforts or 

lack thereof in seeking a second opinion, unconvincing.” The 

juvenile court had the opportunity to observe Mohamed’s 

testimony firsthand, and given the evidence in the record we 

have discussed, we believe deference to its assessment of 

the credibility of Mohamed’s claims is warranted. See In re 
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Interest of Leyton C. & Landyn C., 307 Neb. 529, 949 N.W.2d 

773 (2020).

Based on the foregoing, we agree with the juvenile court that 

it is more likely than not that Mohamed supported Abak’s taking Prince from the state because he too wanted the treatment 

stopped indefinitely and did not want Prince to be found. We 

thus reject Mohamed’s argument that the State failed to prove 

at step two of the analysis under In re Interest of Jeremy U. et 

al., 304 Neb. 734, 936 N.W.2d 733 (2020), that Prince lacked 

proper parental care because of Mohamed’s fault or habits.

CONCLUSION

We find that the juvenile court did not err by adjudicating 

Prince as a child that lacked proper parental care by reason of 

the fault or habits of both Mohamed and Abak. Accordingly, 

we affirm.

Affirmed.