‘Red flags’ ignored? Expert says doctors could have done more to protect abused baby who died

Baby girl Makenzie Nevarez died on Oct. 28, 2016 — just four days after an attack by her mother’s coworker and roommate left her with a cracked skull and brain injuries.

That man, Juan Santos, of Pompano Beach, has already pleaded no contest to aggravated manslaughter and aggravated child abuse in the death of the six-month-old child with soulful brown eyes and a smile that lit up the room. He is now in prison, where he is expected to remain until his sentence ends in March 2031.

But is he the only one to blame?

That is the question at the center of a wrongful death lawsuit that went to trial last week and continued on Monday.

Justin Grosz, attorney for the baby’s father and grandmother, told the jury last week that the Broward Sheriff’s Office is ultimately to blame for the child’s death. He represents Makenzie’s father and grandmother, who filed a lawsuit in 2018 accusing the Sheriff’s Office of negligence leading to the baby’s death.

A six-person jury will decide whether to award damages to the family.

Toniele Henry, at the time a child protection investigator working for the Sheriff’s Office, failed to review medical records or speak to any of the doctors tending to Makenzie’s injuries, jurors learned last week. On the stand, she acknowledged not contacting the baby’s father either, saying she did not have his number.

Michael Piper, an attorney for the Sheriff’s Office, told jurors last week that the investigator could have handled things better — but so could the baby’s father and pediatricians.

On Monday, the defense called its first witness to the stand: Makenzie’s mother, Keshia Walsh.

Walsh testified that she and Makenzie’s father lived together from 2010 to 2015 and had two children.

Evidence photos of Makenzie Nevarez. are shown on Aug. 8 at the Broward County Courthouse in Fort Lauderdale. Six-month-old Makenzie died on Oct. 28, 2016, four days after being taken to the hospital with a cracked skull and brain-related injuries. Her caretaker pleaded guilty to aggravated manslaughter and aggravated child abuse and is expected to remain in prison until his sentence ends in March 2031. (Joe Cavaretta/South Florida Sun Sentinel)
Evidence photos of Makenzie Nevarez, are shown on Aug. 8 at the Broward County Courthouse in Fort Lauderdale. Six-month-old Makenzie died on Oct. 28, 2016, four days after being taken to the hospital with a cracked skull and brain-related injuries. Her caretaker pleaded guilty to aggravated manslaughter and aggravated child abuse and is expected to remain in prison until his sentence ends in March 2031. (Joe Cavaretta/South Florida Sun Sentinel)

Her son was born in February 2012 and Makenzie came along four years later, on April 20, 2016. The couple broke up in 2015, while Walsh was expecting.

She went back to work when Makenzie was six weeks old and relied on three friends to help watch her baby when she was not home.

In June 2016, Walsh took Makenzie to the West Boca Medical Center Satellite Emergency Center in Coconut Creek after she displayed signs of choking.

“They just said she was having a temper tantrum,” Walsh said from the stand.

In August of that year, Walsh took Makenzie to North Broward Medical Center and told medical staff the child had fallen off the couch. The child had bruises and a black eye.

“The doctors said this happens all the time and she was fine,” Walsh testified.

Makenzie was back in the hospital just two months later, on Oct. 13, 2016. This time, her mother took her to Northwest Medical Center for a fever and leg pain.

“She was acting weird when I was changing her diaper,” Walsh testified. “I took her to the hospital to have her checked out because something was wrong. The doctors told me she had a fracture in her leg.”

After X-rays showed three fractures, the doctor reported the case as possible abuse to a state abuse hotline. The case was assigned to a Child Protective Investigation division run by the Sheriff’s Office.

Less than two weeks later, on Oct. 24, 2016, Makenzie was again back in the hospital. This time, she had severe injuries and was no longer breathing. Her mother had left her in the care of Santos at their Pompano Beach apartment while she went to work.

Makenzie died four days later. The cause of death: Blunt force trauma that caused severe injury to the brain and optic nerve.

Ann McClain, the grandmother of Makenzie Nevarez, talks to her attorney Monday during a wrongful death trial in Fort Lauderdale. McClain and her son filed a lawsuit against the Broward Sheriff's Office in 2018, two years after Makenzie died of blunt force trauma. (Carline Jean/South Florida Sun Sentinel)
Ann McClain, the grandmother of Makenzie Nevarez, talks to her attorney Monday during a wrongful death trial in Fort Lauderdale. McClain and her son filed a lawsuit against the Broward Sheriff’s Office in 2018, two years after Makenzie died of blunt force trauma. (Carline Jean/South Florida Sun Sentinel)

To bolster their argument that there was blame was to be shared, the defense shared details from a deposition given by Dr. Eli Newberger, an expert witness for the other side who spent 30 years working as a pediatrician at Boston Children’s Hospital.

In his deposition, Newberger was highly critical of hospital medical staff, Makenzie’s pediatricians — and also the child protection investigator who worked for the Sheriff’s Office — for not doing more to make sure Makenzie was not being abused.

One emergency room physician who treated Makenzie on Oct. 13 assumed she would remain in the hospital. But another doctor who took over the shift ended up letting Makenzie go home with her mother after Henry failed to talk to the doctors, Newberger said in his depo.

The fact that the child was not kept in the hospital showed a “grave lapse” in the standard of care, he said.

“There was plenty of information with red flags waving in the wind, which were ignored,” he said.

He also criticized doctors for believing the claim that Makenzie fell off the couch.

“Someone or some people assaulted this child and that’s what caused these injuries,” he said. “I seriously doubt these injuries were caused by a fall from a couch. … We’re dealing with a system — and pediatricians are part of that system — designed to protect children. In my opinion, the child should have been immediately separated from the home where these injuries occurred.”

Henry testified last week that she was still in training when she inherited the Makenzie case.

On the stand, she acknowledged she had the authority to remove the child from the home but did not.

Henry is still an investigator, but now works for the Department of Children and Families. The agency has since taken over child protection investigations statewide.

Closing arguments are expected Tuesday, with the trial resuming at 9:30 a.m. in the courtroom of Broward Circuit Judge Carol-Lisa Phillips.

Susannah Bryan can be reached at sbryan@sunsentinel.com or on Twitter @Susannah_Bryan

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