Court Opinion

ID: 9369939
Source: CourtListenerOpinion
Date Created: 2023-02-10 11:09:52.152382+00
Date Added: 2024-06-11T17:16:18.174841
License: Public Domain

IN THE
                                  TENTH COURT OF APPEALS

                                           No. 10-22-00278-CV

                IN THE INTEREST OF J.A.S. AND J.A.S., CHILDREN

                                   From the 335th District Court
                                      Burleson County, Texas
                                       Trial Court No. 30,583

                                  MEMORANDUM OPINION1

           Mary and Dan appeal from a judgment that terminated their parental rights to

their children, J.A.S. (hereinafter referred to as "Bob") and J.A.S. (hereinafter referred to

as "Gail"). According to the judgment, Mary's parental rights were terminated pursuant

to Section 161.001(b)(1)(D), (E), (N), and (O) and a finding that termination was in the

best interest of the children. Dan's parental rights were terminated pursuant to Section

161.001(b)(1)(D), (E), and (O) and a finding that termination was in the best interest of the

children. Mary and Dan complain that the evidence was legally and factually insufficient

1   In this proceeding we will use aliases for the parents and the children. TEX. R. APP. P. 9.8(b)(2).
to support the jury's findings as to Section 161.001(b)(1)(D), (E), and (O) and best interest

as to each of them. Because we find that the evidence was legally and factually sufficient

as to Section (b)(1)(E) and best interest, we affirm the judgment of the trial court.2

STANDARD OF REVIEW

        The standards of review for legal and factual sufficiency in cases involving the

termination of parental rights are well established and will not be repeated here. See In

re J.F.C., 96 S.W.3d 256, 264-68 (Tex. 2002) (legal sufficiency); In re C.H., 89 S.W.3d 17, 25

(Tex. 2002) (factual sufficiency); see also In re J.O.A., 283 S.W.3d 336, 344-45 Tex. 2009). If

the evidence is sufficient as to one ground, it is not necessary to address other predicate

grounds because sufficient evidence as to only one ground in addition to the best interest

finding is necessary to affirm a termination judgment. In re N.G., 577 S.W.3d 230, 232-33

(Tex. 2019).

SECTION 161.001(b)(1)(E)

        In Mary's second and Dan's first issue, Mary and Dan complain that the evidence

was legally and factually insufficient to support the jury's findings pursuant to Section

161.001(b)(1)(E). Section 161.001(b)(1)(E) allows termination of parental rights if the

factfinder finds by clear and convincing evidence that the parent "engaged in conduct or

2Because we have found that the evidence was sufficient as to Section 161.001(b)(1)(E), a ground we would
be required to address regardless of Mary's failure to preserve the appellate complaint regarding Section
161.001(b)(1)N), we do not need to otherwise address subsection (N) in this opinion. See In the Interest of
N.G., 577 S.W.3d 230, 237 (Tex. 2019).

In the Interest of J.A.S. and J.A.S., Children                                                      Page 2
knowingly placed the child with persons who engaged in conduct which endangers the

physical or emotional well-being of the child." TEX. FAM. CODE ANN. § 161.001(b)(1)(E).

"Endanger" means "to expose a child to loss or injury, or to jeopardize a child's emotional

or mental health."         In re M.C., 917 S.W.2d 268, 269 (Tex. 1996) (per curiam).    An

endangerment finding often involves physical endangerment, but it is not necessary to

show that the parent's conduct was directed at the child or that the child suffered actual

injury. Tex. Dep't of Human Servs. v. Boyd, 727 S.W.2d 531, 533 (Tex. 1987). "Rather, the

specific danger to the child's well-being may be inferred from a parent's misconduct

alone." Id. In our endangerment analysis pursuant to Section 161.001(b)(1)(E), we may

consider conduct both before and after the Department removed the children from a

parent. In re S.R., 452 S.W.3d 351, 360 (Tex. App.—Houston [14th Dist.] 2014, pet. denied).

Although significant, evidence of improved conduct, especially of short duration, does

not conclusively negate the probative value of a parent's history of drug use and

irresponsible choices. See In re J.F.-G., 627 S.W.3d 304, 316-17 (Tex. 2021).

        Evidence of drug use may constitute evidence of endangerment. In re J.O.A., 283

S.W.3d 336, 345 (Tex. 2009). The failure to provide appropriate medical care for or to

appropriately feed a child may also be considered conduct that endangers a child. In re

D.E., 761 S.W.2d 596, 600 (Tex. App.—Fort Worth 1988, no writ). This is true even if the

parent did not cause the condition that requires medical treatment. In re S.H.A., 728

S.W.2d 73, 88 (Tex. App.—Dallas 1987, writ ref'd n.r.e.). Further, the failure to administer

In the Interest of J.A.S. and J.A.S., Children                                        Page 3
medically necessary medication to a child can also qualify as endangerment. See In re

J.I.G., No. 01-18-00023-CV, 2018 Tex. App. LEXIS 4960, 2018 WL 3233874, at *8 (Tex.

App.—Houston [1st Dist.] July 3, 2018, no pet.) (mem. op.).

        The first time Bob was removed from Mary and Dan by the Department was

shortly after his birth. Bob tested positive for methamphetamines at birth and had

medical issues due to Mary's drug use and possibly alcohol abuse while she was pregnant

with him.       Bob suffered primarily from a seizure disorder which required regular

medication and continued medical care, but he also had other physical, mental, and

emotional issues caused by Mary's drug use while she was pregnant with him that would

also require long-term specialized care. Bob was returned to Mary and Dan after they

completed their service plans and the Department was dismissed as conservators of Bob.

Gail was born around the time that the first case was dismissed.

        The events leading to the second removal of Bob began when Bob was taken to the

emergency room by Dan for an elbow injury he had sustained the prior day. Dan and

Mary contend that Bob, who was two years old at that time, fell off a trampoline which

caused the elbow injury. Bob was discharged with instructions to consult an orthopedic

specialist. Mary testified that no appointments were available for approximately two

weeks after Bob's discharge, but that she took him to that doctor. The orthopedic doctor

she saw told her that she needed to see a different pediatric orthopedic specialist. Mary

testified that she was unable to get an appointment with this doctor for several weeks.

In the Interest of J.A.S. and J.A.S., Children                                     Page 4
        Bob was taken to his pediatrician for a COVID test prior to having an MRI on his

elbow. Due to insurance requirements, the pediatrician was also required to conduct a

well-child examination that was past-due. Bob had on a mask when he was brought into

the pediatrician's office, which, according to the doctor, Mary did not want removed.

When the mask was removed, the doctor observed that a significant part of Bob's septum

(the area between the nostrils connecting the middle of the nose to the face) was missing

and the injury was bleeding and looked possibly infected. There was no injury to the tip

of Bob's nose. When asked about the injury, the pediatrician testified that Mary told the

doctor that it resulted from a dog bite. The pediatrician did not believe this explanation

because of the lack of further injury on the tip of the nose.

        The pediatrician's exam also showed that Bob was suffering from "cauliflower ear"

on both ears but primarily to his right ear, which appeared to not be a recent injury but

had been untreated. 3 The pediatrician opined that the injury would have caused severe

swelling, extreme pain, and would have turned the ear purple. If treated within a few

hours of the injury, an ENT (Ear, Nose, and Throat) doctor could drain the injured area

and it would not be as severe.

        The examination by the pediatrician also showed that Bob had unexplained

scratches and scarring on his stomach and bruising on his back. Blood tests were also

3"Cauliflower ear" is a term used to explain an impact injury to the ear which results in swelling that if left
untreated, causes permanent damage to the outer ear. The injury is commonly found in professional
boxers.
In the Interest of J.A.S. and J.A.S., Children                                                          Page 5
conducted, which showed that the anti-seizure medicine prescribed to Bob that was

necessary to prevent seizures was not present in Bob's blood at all. The blood tests also

showed that Bob had such a high level of Vitamin D that it did not register on the tests,

which had led to high levels of calcium, phosphorus, and magnesium. High levels of

calcium, phosphorus, and magnesium could cause severe consequences, including

seizures, if left untreated. Additionally, Bob had low albumin and iron levels, which was

likely the result of poor protein intake and a bad diet. Bob had been prescribed a vitamin

D supplement because his levels were low at a previous visit; however, the amount

prescribed would not lead to the extreme level present in Bob's blood.

        The pediatrician was so horrified by the state of Bob's injured nose that she

immediately called a colleague who was a pediatric ENT doctor to get Bob an immediate

appointment to be seen. However, Mary told the pediatrician that she could not take Bob

right away because she had to take lunch to Dan. The specialist agreed to see Bob

whenever Mary could arrive that day. Photographs of Bob's nose, ear, and his torso

showing the doctor's concerns were taken at the pediatrician's office and were admitted

into evidence.

        Mary later stated that the nose injury was caused by a fever blister and that she

had been treating it for approximately two weeks with Neosporin per the instructions of

the nurse at the pediatrician's office. The pediatrician testified that there was no record

of Mary contacting her office. The pediatrician also testified that Mary told her that she

In the Interest of J.A.S. and J.A.S., Children                                       Page 6
had not sought medical treatment when the injury first became apparent because she

knew that she would be seeing the doctor in a couple of weeks, but the injury was not

mentioned by Mary at the visit until the doctor removed Bob's mask and was shocked

when she saw the severity of the injury. The pediatrician opined that it was not possible

for fever blisters to cause the degree of tissue decay that was present.

        Bob was taken and admitted to a children's hospital for treatment to his nose. The

team of specialists that evaluated him determined that surgery was not appropriate at

that time.

        Based on the injuries to Bob, all four of Mary and Dan's children were removed

from the home. 4 Mary, Dan, Bob, and Gail all tested positive for methamphetamines at

that time. Mary and Dan admitted to the recent use of methamphetamines. Mary

testified that the children's positive drug tests were because of skin contact where she

held the children. Mary and Dan did not test positive for drugs again after the removal

of the children but did test positive for alcohol.

        One of the older two children also made an outcry that at some point after Bob

was returned to the home that the child saw Dan strike Bob on the head with a belt edged

with rhinestones because he was not acting properly, which left a noticeable scar on Bob's

head. Mary was not at home at the time.

4When this proceeding began, all four children were included. During the proceedings, the older two
children were severed out and a final order was entered that placed the children with another person and
named Mary and Dan as possessory conservators.
In the Interest of J.A.S. and J.A.S., Children                                                   Page 7
         Less than a month after the removal, Bob was seen by a pediatric plastic surgeon

who testified as to the severity of the injuries and that the nose injury could cause nasal

collapse and other issues with breathing. The plastic surgeon was unable to determine

how the injury occurred but believed that it had happened more than three weeks prior

to the visit. The plastic surgeon testified that it was possible that the injury was caused

by a fever blister although he had never seen that occur. Rather, the surgeon testified

that similar injuries usually occur from something like a dog bite or a pressure injury in

an infant. The plastic surgeon deferred reconstructive surgery to allow the injury to heal,

and when he saw Bob approximately six months later determined that although the area

would not completely grow back, reconstructive surgery was not needed at that time.

         The plastic surgeon also evaluated Bob's cauliflower ear, which he testified is

generally caused by blunt trauma, likely repeatedly, to the side of the head. The injury

causes blood to collect between the cartilage and skin of the ear, which if left untreated,

results in a permanent deformity of the ear. The plastic surgeon testified that the blood

would need to be drained within six hours or so of the injury. The plastic surgeon further

testified that the injury would be immediately noticeable when it occurred, was still very

noticeable, and had likely occurred a long time ago because there was no blood in the

area to drain. A surgery would be possible in a few years after Bob's ear had grown close

to adult size but would be very difficult and would never restore the ear to its original

shape.

In the Interest of J.A.S. and J.A.S., Children                                       Page 8
        Mary did not know what had caused the ear injury. Dan testified that the ear

injury was caused by the trampoline fall but that the ER doctor that treated Bob's elbow

did not see the injury. Dan also testified that he spoke to a doctor on the phone about the

fever blister on Bob's nose and followed his recommendations but never took him to see

the doctor in person.

        Mary and Dan had been together for over 16 years at the time of the jury trial and

there was no allegation that either was unaware of the injuries to Bob or that either of

them was more at fault than the other for the reasons for which the children had been

removed.

ARGUMENT AND ANALYSIS

        Mary argues that there was inadequate evidence as to the extent of her drug use

or evidence as to how her drug use harmed either child. Mary further argues that the

evidence was legally and factually insufficient for the jury to have found that she caused

any of the injuries or failed to seek medical care for Bob because there was no dispute

that Bob fell off of the trampoline and there was no agreement among the experts as to

what caused the septum injury. Mary also argues that the evidence that she called the

nurse further shows that she did not fail to seek medical treatment.

        Dan argues that even if the evidence presented by the Department as to Bob's

injuries was true, "a two-month period of alleged medical neglect should not satisfy the

endangering conduct standard on these facts."

In the Interest of J.A.S. and J.A.S., Children                                       Page 9
        The standards for legal and factual sufficiency require us to defer to the factfinder

as to the credibility of the witnesses and the weight to be given to their testimony and do

not allow this Court to supplant those findings with our own. In re H.R.M., 209 S.W.3d

105, 108 (Tex. 2006). The jury could reasonably have determined that Mary and Dan's

failure to properly seek medical treatment for Bob's permanently-disfiguring injuries,

taken with their failure to give him his necessary medications for his seizure disorder,

overdosing him on vitamin D, failing to ensure adequate nutrition, striking Bob on the

head with a belt for misbehavior resulting in a scar, using methamphetamines in such a

way that both Bob and Gail tested positive for those drugs after Bob had already been

removed due to the parents' methamphetamine use and returned to them only seven

months before the removal in this proceeding constituted endangering conduct and that

the explanations given by Mary and Dan were not credible. When we view the evidence

under the proper standards for legal sufficiency and factual sufficiency, we find that the

evidence was legally and factually sufficient for the jury to have found by clear and

convincing evidence that Mary and Dan "engaged in conduct … which endangered the

physical or emotional well-being of the child[ren]."            TEX. FAM. CODE ANN. §

161.001(b)(1)(E).

        Further, because we have found that the evidence was legally and factually

sufficient as to one predicate act necessary for the termination of their parental rights, we

do not address Mary's first and third issues or the rest of Dan's first issue as to the other

In the Interest of J.A.S. and J.A.S., Children                                        Page 10
predicate acts. We overrule Mary's first, second, and third issues and Dan's first issue.

BEST INTEREST

        In Mary's fourth issue and Dan's second issue, Mary and Dan complain that the

evidence was legally and factually insufficient to support the jury's finding that

termination was in the best interest of the children. In determining the best interest of a

child, a number of factors have been consistently considered which were set out in the

Texas Supreme Court's opinion, Holley v. Adams, 544 S.W.2d 367, 371-72 (Tex. 1976). This

list is not exhaustive, but simply lists factors that have been or could be pertinent in the

best interest determination. Id. There is no requirement that all of these factors must be

proved as a condition precedent to parental termination, and the absence of evidence

about some factors does not preclude a factfinder from reasonably forming a strong

conviction that termination is in the children's best interest. See In re C.H., 89 S.W.3d 17,

27 (Tex. 2002). Evidence establishing the predicate grounds under section 161.001(b)(1)

also may be relevant to determining the best interest of the children. See C.H., 89 S.W.3d

at 27-28.

        While the children were too young to express their desires, Bob's visitation with

Mary and Dan had been terminated months before the jury trial at Bob's therapist's

recommendation because the visits were so distressing to him and caused substantial

behavioral disruptions. Neither parent ever asked the trial court for visitation with Bob

to be reinstated. Conversely, both Bob and Gail were in foster homes where they were

In the Interest of J.A.S. and J.A.S., Children                                        Page 11
bonded with their foster families. Bob and Gail visited with each other regularly and it

was believed that the foster parents would ensure that their relationship would continue

after the trial. The foster parents also ensured that Bob and Gail were able to visit with

their two older siblings, although it was unclear as to whether this would continue if the

older children were ever returned to Mary and Dan.

        Bob was under the care of a substantial number of specialists and would require

medical care and therapy for his seizures, behavioral challenges, and other issues due to

the drug exposure while in utero. Although Mary testified that she would ensure that

Bob's medical care continued, she was unaware as to all of his providers and did not

know what special education services the school district offered at the school Bob would

attend if returned to their home. Mary and Dan did have health insurance available for

the children. The foster home in which Bob was placed had been able to get him

medically stable during his placement with them and would continue to do so. Gail did

not have any known medical issues.

        Mary and Dan completed the majority of their service plan and had tested negative

for all substances except for alcohol after the first positive test taken after the children's

removal. They had completed the initial drug treatment, but did not complete the

recommended after-care and did not attend AA/NA meetings as required in their service

plan. Mary and Dan had completed individual counseling and parenting classes, but the

Department and the CASA worker who was the children's guardian ad litem testified

In the Interest of J.A.S. and J.A.S., Children                                         Page 12
that they did not observe that Mary and Dan demonstrated any improved parenting skills

during the supervised visits with the children. There was testimony that Dan tried to get

Bob to put his eye near a faucet at a water park before it came on and that he intentionally

kicked a ball into tall weeds where Bob had to go get it. At one visit, Mary and Dan were

observed walking ahead of 3-year-old Bob, leaving him behind to catch up, which was

upsetting to Bob.

        Mary and Dan were both employed and resided in a home with no mortgage that

was owned by Dan. There were no concerns about the condition of the home. Mary had

five different jobs during the proceedings but testified that she had left each job for

another job that paid more. Mary was attempting to advance to a better position at her

current employer, but also testified that she would work part-time or become a stay-at-

home mom if needed to care for Bob.

        There were no concerns about either foster home in which the children were

placed, and both placements wanted to adopt the child placed in their home. Both had

encouraged and enabled ongoing contact between Bob and Gail.

ANALYSIS

        Although it is laudable that Mary and Dan have worked to complete their service

plan and remained drug-free during the pendency of this proceeding, we find that the

jury's finding that termination was in the best interest of the children was supported by

legally and factually sufficient evidence. As stated above, evidence of improved conduct

In the Interest of J.A.S. and J.A.S., Children                                       Page 13
by a parent, especially of short duration, does not conclusively negate the probative value

of a parent's history of drug use and irresponsible choices. See In re J.F.-G., 627 S.W.3d

304, 316-17 (Tex. 2021). This is especially true when the parents have not explained their

failures or presented evidence as to what changes they would make in the future if the

children were returned. Mary and Dan had regained custody of Bob after his first

removal for drug use only seven months prior to this removal. During this time, Bob was

deprived of necessary medications, overdosed on vitamin D, improperly fed, exposed

once again to methamphetamines his parents were both using that resulted in him and

Gail testing positive, and neither Mary nor Dan explained nor provided any excuses for

any of it, nor have they shown that these same issues would not occur again if the children

were returned to them. We overrule Mary's fourth issue and Dan's second issue.

CONCLUSION

        Having found no reversible error, we affirm the judgment of the trial court.

                                                 TOM GRAY
                                                 Chief Justice

Before Chief Justice Gray,
       Justice Johnson, and
       Justice Smith
Affirmed
Opinion delivered and filed February 8, 2023
[CV06]

In the Interest of J.A.S. and J.A.S., Children                                      Page 14