Rodger Mallison rmallison@star-telegram.com
Rodger Mallison rmallison@star-telegram.com

Special Reports

Could the death of one abused child have saved the life of another?

May 31, 2017 12:36 PM

They died more than two years apart and were not related, but the 1-year-old girl and the 3-year-old boy shared disturbing similarities in death.

Both had old and new rib fractures. Both had lacerated livers.

And both, the girl named Phaneese and the boy named King, had been under the care of their mothers and their mothers’ boyfriend — the same man — when they drew their last breaths.

Police investigations in Fort Worth and Arlington and autopsies would reveal troubling injuries, but the Tarrant County medical examiner’s office would rule both children’s manners of death as “undetermined.”

In both cases, the medical examiner’s office opined that some of the injuries were caused by CPR.

No arrests were made. The boyfriend and the mothers of the two children are not being identified because they have not been charged with crimes.

But three forensic pathologists who reviewed the children’s autopsy reports, at the Star-Telegram’s request, expressed concerns with Tarrant County’s findings.

“These injuries are not consistent with CPR,” said Dr. Joye Carter, a Houston-based forensic pathology consultant, lecturer and author. “These rib fractures are consistent with forceful squeezing of the rib cage. I have seen these type injuries associated with numerous fatal child abuse injuries.”

Two of the forensic pathologists consulted went as far as to say that the injuries suffered by King, the 3-year-old boy, point to his death being a homicide.

“I strongly disagree with this,” Dr. Cyril Wecht, a renowned forensic pathologist from Pittsburgh who has consulted in many high-profile cases, said of the undetermined ruling handed down in the boy’s case. “The injuries speak for themselves.”

Though experts acknowledge there are times when an undetermined ruling is unavoidable, they say failing to make a call when the evidence is there thwarts justice and can put additional children in danger.

“If you have the ability to make a call and you don’t — you call it undetermined — the next death is on you,” said Dr. J.C. Upshaw Downs, a Georgia-based forensic pathologist, consultant and author.

When contacted about the Star-Telegram’s findings, Tarrant County Medical Examiner Dr. Nizam Peerwani agreed to reopen both cases, and in May, brought most of the involved agencies — Fort Worth police, Child Protective Services, and the district attorney’s office — together to review and discuss their findings.

Peerwani said Arlington police were invited but did not attend the meeting.

At the review’s conclusion, Peerwani did agree to change the rulings in one of the children’s deaths — but not to homicide. More than six years after she died, Phaneese’s death will now be deemed “natural” after Peerwani said his office discovered she had “sickle cell trait” during their recent review.

He said King’s death will remain undetermined.

“This is an unnatural death, but we’re not sure if it’s a homicide or not,” Peerwani said.

“We don’t have any vested interest in this case,” Peerwani said. “We’re going to call it based on the best possible evidence we have at hand. If there is a doubt, how are we going to convince a jury?”

Confronting child abuse in Tarrant County

Tarrant County is No. 2 in Texas in the total number of confirmed cases, behind Harris County, but that only tells part of the story.

‘No, Lord! No! No! No!’

Instinct told Shirley Williams something was wrong with her granddaughter.

A paternal grandmother to Phaneese, she’d noticed that the girl seemed reluctant to return home with her mother at the end of visits. She had spotted knots on the front and back of Phaneese’s head in December 2010. And, that same month at the girl’s first birthday party, she’d seen how Phaneese appeared fearful of her mother’s new boyfriend.

“When he came to her at the birthday party, she cringed and clinged to my chest,” Williams recalled.

Williams had helped her son raise Phaneese — her only grandchild — for the first six months of her life so that the girl’s mother could finish college. But after Phaneese’s mother and her son broke up, her relationship with the mother began to deteriorate.

On Christmas Eve 2010, when the mother came to pick up Phaneese with her boyfriend in tow, Williams became even more distressed with the situation.

“I had asked her not to bring him by my house, as him and my son were arguing each time they came by,” Williams said. “That particular evening, when I went to the car and I saw him, I said, ‘I told you not to bring that boy back over here.’ He started cussing, acting like he wanted to fight, jumping up and down. The baby just froze.”

Seeing her granddaughter’s reaction, Williams said she quit arguing with the mother’s boyfriend and walked away.

“That was the last time I saw her,” she said.

Nikki Robinson and her aunt Shirley Williams talk March 8 about the death of 13-month-old Phaneese Alexander in 2011. Phaneese was Williams’ granddaughter. .
Rodger Mallison rmallison@star-telegram.com

Shortly after 7 p.m. on Jan. 2, 2011, Williams’ son received a text from his daughter’s mother.

“Pray for my baby gets better ... she had a seizure due to instant high fever,” it read.

The mother would later tell authorities that she and her boyfriend had left a relative’s house and were driving home with Phaneese when they noticed she appeared to be having a seizure. They drove the girl to Baylor All Saints Cityview Hospital in Fort Worth.

There, Phaneese was loaded into an ambulance to be transferred to Cook Children’s Medical Center, but she stopped breathing before leaving the parking lot.

When Williams and her son arrived at the hospital, medical staff were still performing CPR on Phaneese. When the chaplain arrived, Williams knew.

“There Phaneese was — dark, lifeless, with a diaper on and they were doing compressions,” said Williams, crying. “...So I start praying. I’m like, No, Lord! No! No! No! And I got the baby and I tried to rub the baby and I knew she was gone. I just knew she was gone. And they was letting me hold her for the last time.”

When she left the hospital that night, a heartbroken Williams drove around, ending up at an east Fort Worth police station off East Lancaster Avenue.

“I was just like, I need to tell somebody this. It’s not right,” Williams said.

“They had me sit in a room by myself and write down why I thought it was suspicious,” she said. “It just crippled me. I knew it was something I needed to do.”

Confronting child abuse in Tarrant County

Tarrant County is No. 2 in Texas in the total number of confirmed cases, behind Harris County, but that only tells part of the story.

‘There are signs of abuse’

The case would be investigated by Fort Worth Detective P.G. Henz, then with the Crimes Against Children Unit.

Henz said he remembers being called to the medical examiner’s office as they were midway through Phaneese’s autopsy.

“There are signs of abuse. You need to come down here,” he recalled being told.

A CPS report states that the medical examiner initially indicated he believed the death was caused by a blow to the back, which lacerated the liver.

Phaneese’s mother told authorities that the girl had been sick earlier in the month, running a fever and throwing up twice, but had seemed fine the day she died.

She denied ever abusing her daughter, or seeing her boyfriend hurt the girl, and seemed very troubled when told by police about her daughter’s older rib fractures.

When questioned by police, the boyfriend also denied abusing the girl.

Phaneese Alexander died at 13 months of age.
Family Photo Family photo

Police and CPS conducted multiple interviews in their investigation, but the case was closed the next month after the investigators and an assistant district attorney met with Dr. Shiping Bao — who had conducted the autopsy — and were informed that the manner of death would be listed as undetermined.

Bao, who initially flagged signs of abuse, told investigators that he now believed Phaneese’s liver was damaged by her spinal cord during CPR, but could not determine what caused her fractured ribs.

He said he had confirmed the victim had pneumonia and that he did not believe her injuries alone caused her death.

As such, he ruled the cause of death as “sudden death with seizures, acute hemorrhage in adrenals, broncho-pneumonia and rib fractures” and but left the manner of death as “undetermined.”

A year later, Bao would make headlines after leaving Tarrant County to work in Volusia County, Fla., where he conducted the autopsy on Trayvon Martin, a black teen whose shooting death in 2012 sparked outrage. Bao was ultimately fired from his job in Florida, not long after giving conflicting testimony during the trial of George Zimmerman, who was ultimately acquitted of murdering Martin.

‘They don’t care’

Henz closed the investigation after consulting with the district attorney’s office after the meeting.

“In these type of cases, we have to depend on medical experts. Short of a confession, I have to go by what is told to me by medical personnel as to what would have caused this,” Henz said.

Still, Henz said the uncertainty behind the girl’s death bothered him enough that he kept the little girl’s photograph taped to his file cabinet for the remainder of his years working in the CACU.

“She was a beautiful girl and had her whole life in front of her. She did nothing to deserve to die at such a young age,” Henz said. “Looking at her picture would help give me the energy to keep working these cases.”

CPS determined that someone had physically abused the girl prior to her death, but could not say if it had been the girl’s mother or her boyfriend.

“The child’s autopsy revealed that the child had sustained injuries consistent with abuse prior to her death, however the investigation was unable to identify who inflicted the non-lethal injuries,” the CPS report states. “Both the mother and the mother’s paramour served as caretaker for the child.”

The mother denied in a recent Facebook exchange that Phaneese was abused.

“They can say the rib fractures were old but that had to be done when CPR was done for more than an hour,” the mother insisted.

They don’t care. She’s just another number rolling across the steel bed.

Shirley Williams, grandmother of Phaneese

Williams said she met with police and even later the medical examiner’s office, pushing for justice in her granddaughter’s case, but received only excuses, with each agency blaming the other.

“They don’t care. She’s just another number rolling across the steel bed,” Williams said.

She said she was told that the different agencies, including the district attorney’s office, had discussed the case and decided there was not enough evidence to arrest anybody or take the case any further.

“I never thought anything like that would happen. I know things fall through the cracks, but not on a baby.”

Phaneese’s mother and her boyfriend broke up after the girl’s death.

Two years later, he was living with a new girlfriend in Arlington, when history seemed to repeat itself.

‘Your son is dead’

Timothy Nevil had only been involved with his girlfriend for two weeks when he was sentenced to eight months in jail.

While he was away, the girlfriend learned she was pregnant with his child.

But any hopes of their relationship continuing ended when Nevil was released and chose to return to his hometown of New Orleans.

Nevil still wanted to be a part of his son’s life, though, and when King Felder turned 3 months old, he returned to North Texas, ready to be a father.

He said his son had a glow about him.

“He used to walk up to me, grab my face and put his finger on my lips every time when I fussed at him,” Nevil said, laughing. “He was so friendly. He always used to smile. He had this sense of humor like no other. It used to light up my world.”

But their frequent visits stopped after Nevil married another woman, which did not set well with King’s mother.

“She tried to hold King from me,” he said.

Timothy Nevil, father of King Felder, said he has long held suspicions regarding his son’s death.
Timothy Nevil Courtesy

The father and son’s last visit would be in August 2013, after Nevil’s new wife reached out to King’s mother through Facebook, pleading with her to let Nevil spend his birthday with his son.

“Everyone was asking me, ‘What do you want for your birthday?’ I told everyone, ‘I want to see my son on my birthday,’” Nevil said.

King’s mother agreed, letting Nevil keep the boy for two days. It was a visit that Nevil now thanks God he got to have.

“I know God works in mysterious ways,” Nevil said. “It was heavy on my heart to see my son on my birthday.”

Less than a month later, on Sept. 2, 2013, Nevil and his wife noticed people sending prayers to King’s mother on Facebook. King’s mother called soon after.

“She didn’t have no sorrow. She wasn’t crying or anything. She said, ‘Hey, Tim. I just want you to know your son is dead,’” Nevil said. “Those words will haunt me until the day I die.”

‘I need to know the truth’

Nevil said he was told his son had fallen from his highchair while at day care on Aug. 30, the Friday before. The mother told him that on Saturday, King had been running in the kitchen when he slipped and hit his head again.

The mother told Nevil that she put ice on their son’s head and kept him up for a while, as he was lethargic after the fall.

She said that early the next morning, her boyfriend found the child unresponsive. He performed CPR on King, then drove the child to Medical City Arlington Hospital, where the boy was pronounced dead.

According to the CPS report, King’s mother told investigators her son had two prior accidental injuries, both at the day care, that resulted in King hurting his head. Day care records confirmed the incidents but reported that the child sustained no injury, the report states.

Nevil said a detective would later confirm to him that police suspected foul play in his son’s death. The father said his own suspicions grew after he learned that the cause of his son’s death was ultimately ruled as blunt force injury to the abdomen.

“The whole time she’s got me thinking it was a head injury,” Nevil said. “I wound up calling her. I said, ‘Whatever you’re hiding, I need to know the truth. What actually happened to my son? I said, ‘You’re lying. The autopsy don’t say nothing about no head injury.’”

King Felder “had this sense of humor like no other,” said his father, Timothy Nevil. “It used to light up my world.”
Courtesy of Timothy Nevil

Nevil said King’s mother got hysterical and hung up on him. They have never spoken again, he said.

Nevil, who returned to New Orleans after his son’s death, said he tried to get in touch with detectives but was told only that the case was still under investigation.

“It really hurts,” Nevil said. “I always said once I get the funds, I’m going to Texas and to try to get this case reopened. Get a lawyer. Just someone to do more investigation than I felt they did.

“I just never had any closure,” he added. “Everybody tells me, leave it in God’s hands. God is going to work it out for me.”

King’s autopsy report showed the boy had bruises and abrasions on his head, torso and extremities but no significant head trauma. Abdominal injuries, however, including old and new fractures of the ribs, internal hemorrhaging and lacerated organs, were noted in the autopsy.

“There is significant and likely serious to lethal blunt force trauma of the abdomen that has occurred what appears to be several days prior to death,” Deputy Chief Medical Examiner Marc Krouse noted on King’s autopsy.

In ruling the manner of death as undetermined, Krouse noted that the acute liver and intra-abdominal injuries are consistent with the description of “untrained bystander CPR” given by the mother’s boyfriend in his statement to Arlington police.

He also noted that the day care facility used by the mother noted multiple conflicts between King and other children, as well as occasional hyperactivity with the potential for self-injury.

Nevil said that until he was told by the Star-Telegram, he did not know his son’s manner of death had been classified as undetermined or that the boyfriend of King’s mother had previously had another child die in his care.

CPS: Couple abused King

CPS investigators would conclude in their own investigation that the couple physically abused the boy, leading to his death.

“While neither adult assumed responsibility for abusing the child, it is reasonable to determine that either one or both of the adults caused the injuries, and that one or both have covered for the other, and/or deceived CPS resulting in failure to protect the child from harm,” the CPS report states.

CPS also stated that the mother committed medical neglect by not getting medical attention for her son until after he was found lifeless, despite acknowledging she was concerned about her son’s injury.

Because there were no other children in the house, CPS closed its case.

Within days of King’s death, the boyfriend was arrested for violating his probation in a 2009 possession of a controlled substance (cocaine) with intent to deliver case out of Dallas. The boyfriend pleaded true to violating conditions of his bond and was sentenced on Oct. 10, 2013, to nine years in prison.

He was released on parole in February 2016 and, that same month, married King’s mother.

In a phone interview May 9, the couple denied abusing King. The boy’s mother said CPS simply got it wrong.

“Just because CPS says reason to believe, that’s just a reason to believe,” King’s mother said. “Doesn’t mean it happened or it didn’t.”

The boyfriend said he suspects King fractured his ribs in a fall from the highchair at day care. He also denied hurting Phaneese, but declined to talk further about the children’s deaths.

The couple say they now have a 3-year-old son together, who was placed under CPS’ watch the first six months of his life. If they had abused or caused King’s death, King’s mother questioned, why would CPS allow their son to remain with them.

“He’s well taken care of. They did an investigation on our son when he was born, too. They say he’s fine,” the boyfriend said.

Arlington police said in an email that homicide investigators were aware of the previous death involving a child in the boyfriend’s care “but we had to work with the current incident and could not use previous history against him.”

“The TCME Office ruled the cause of death as undetermined. No charges were pursued after consultation with the DA’s Office,” Arlington police officials stated. “We do not make decisions whether to charge an individual. The DA’s Office determines whether to accept or reject a case and whether to present a case to the Grand Jury.”

The DA’s office declined to comment on the case, calling it an “ongoing investigation.”

‘These cases give me grave concern’

The forensic pathologists asked by the Star-Telegram to review King’s and Phaneese’s autopsies had serious concerns about their deaths.

All of them preceded their shared opinions with the caveat that they would want to review other documents before giving a formal ruling, including pediatrician, hospital, police and CPS records.

Perhaps if someone had pursued this death from 2011, the death of 2013 may not have occurred.

Dr. Joyce Carter, forensic pathologist

Carter said she believes the autopsies show that both children suffered from non-accidental blunt force traumatic injuries that are consistent with physical abuse, both acute and chronic.

“The fact that the same male is involved in both should have caused someone to take a second look,” Carter said.

That neither of the mothers — nor the common boyfriend — could offer explanations for some of the injuries only raises more red flags, she said

“Perhaps if someone had pursued this death from 2011, the death of 2013 may not have occurred,” Carter said. “...These cases give me grave concern that these children’s deaths did not receive the benefit of justice.”

Wecht and Downs said they could not disagree with the initial undetermined ruling in Phaneese’s death due to other noted medical issues, but also believed more investigation was needed into what caused Phaneese’s older rib fractures on the left and right posterior sides.

“Where the hell did they come from?” Wecht asked. “That makes it a very, very suspicious case. ...That’s not the kind of thing someone gets just from falling.”

Wecht said he has seen cases where CPR has led to rib fractures, and even a lacerated liver, but he said King’s injuries went far beyond that.

“You do not get transection of the colon and hemorrhage into the pancreas from resuscitative trauma and you don’t get it from a fall, front or back,” Wecht said.

Downs also echoed that the child’s bowel injuries could not have come from CPR and expressed disbelief that Krouse would describe the boy’s abdominal injuries in the autopsy as “significant and likely serious to lethal.”

“Are you blanking kidding me?” Downs asked. “Significant and likely serious to lethal? No! These are devastating and not only potentially lethal, in this case, absolutely lethal injuries.”

Downs said that while he would want to review the entire case, from what he sees from the autopsy report alone, “I would be incredibly surprised if that were not a homicide based on what I see.

“My provisional diagnosis would be homicide,” Downs said.

‘A very significant finding’

Peerwani called the opinions shared by the outside pathologists “disturbing because they are made without full knowledge of the case.”

“It is easy to call a case a ‘homicide’ than to deliberate with care,” Peerwani said.

He said all child deaths are peer-reviewed by the office’s seven pathologists, as well as the senior forensic department staff. In addition, he said, once a month, he invites involved agencies like police and CPS to a meeting to discuss and share information on children’s cases in which the deaths do not appear to be from natural causes, often before rulings are handed down.

Downs said that while reviews can be beneficial, those done by peers also run the risk of colleagues merely placating one another and “rubber stamping” findings.

“You’re going to go against the deputy chief’s opinion?” Downs asked. “Do you really value your job?

“And just because I have a consensus — I have a lot of people agree with me — doesn’t make me right,” Downs said. “I don’t know why these people agreed. Guess what, there was a consensus the world was flat.”

Though both Phaneese’s and King’s deaths have been the subject of prior peer reviews, Peerwani agreed to reopen and review the cases after being contacted by the Star-Telegram.

During that review, Peerwani said forensic pathologists discovered something previously missed by Bao in his autopsy of Phaneese in 2011 — the girl had sickle cell trait.

Dr. Nizam Peerwani said all child deaths are peer-reviewed by the Tarrant County medical examiner’s office’s seven pathologists, as well as the senior forensic department staff.
Ron T. Ennis Star-Telegram archives

He says this was confirmed by a newborn screening conducted by the state, the results of which, he said, had not been included in the medical records previously provided by the girl’s pediatrician after her death.

Williams said, to her knowledge, no one in the family had ever been told that Phaneese had sickle cell trait.

Peerwani said evidence of sickle cells were found in the girl’s organs, including throughout her brain, leading them now to believe that the girl had sepsis, which brought on a sickle cell crisis.

“Sickle crisis is a very significant finding,” said Dr. Susan Roe, a Tarrant County deputy medical examiner.

With the new discovery, Peerwani said he plans to amend her death to “natural.”

“Was this child abused? The answer is yes,” Peerwani said, pointing to the girls’ old posterior rib fractures as evidence. But he said the rib fractures didn’t cause her death.

He said he believes the acute rib fractures, as well as the liver laceration, did occur from CPR.

Peerwani said medical and forensic literature have described several injuries that can occur from resuscitation, among them perforations of the stomach and colon, liver, spleen and pancreatic lacerations, rupture of the heart and rib fractures.

‘The children suffer’

Peerwani said he also believes that King was abused and calls the boy’s death concerning, but said he will keep the boy’s ruling as undetermined as “we have no evidence to show it as a homicide yet.

“Being concerned and then having enough information to leap to homicide are two different things,” Roe said. “We are very concerned about the case.”

Peerwani said King’s mesa colon, the mesentery that supplies blood to the colon, was cut likely a week before his death. That injury, Peerwani said, led to necrosis of King’s colon, leaving the boy susceptible to spontaneous rupture or rupture with even minor trauma.

“We have no idea how this injury occurred,” Peerwani said, adding it could have occurred through abuse, fighting at day care, or falling down.

He said day care notes indicate the boy was occasionally hyperactive and prone to altercations with the potential for self-injury.

“We aren’t calling it an accidental death. We’re putting it back on the shoulders of the DA and police department, saying we are concerned about this case. This is an unnatural death,” Peerwani said.

Downs countered that an internal visceral injury is extremely painful and, if accidental, would have likely prompted the child to mention the event that caused it and/or the pain.

“Bowel ruptures take significant force — otherwise, all those football players who get blocked and tackled all over Texas on Friday nights and in pee-wee games would be dying in droves,” Downs said.

Downs said he’d need to look at photos and microscopic samples to make better sense of the case.

“Sadly, it appears that sometimes ego — and fear of looking ‘wrong’ — stand in the way of our shared values of truth and justice ... so the children suffer,” he said. “In fact, twice — once at the hands of their killers and again at the caprices of the ME [medical examiner].”

Williams, Phaneese’s grandmother, said she is suspicious of why the medical examiner’s office has just now — six years after her granddaughter’s death — come up with a new explanation for the cause.

“I don’t believe them,” she said. “I really don’t.”

She continues to believe her granddaughter’s death was from abuse and that, if the case had been handled properly, King’s death may have been prevented, too.

“I feel so sorry for Phaneese and poor King,” she said. “But I know one thing. I know there’s a God and I know there is angels working and I know the truth will be revealed. I may be dead and gone but the truth will be revealed.”

Deanna Boyd: 817-390-7655, @deannaboyd

About this project

In examining the broad topic of child abuse and neglect in Tarrant County, Star-Telegram reporters spent five months poring over court documents and autopsy, police and Child Protective Services reports, as well as conducting interviews with child abuse victims, family members and perpetrators, child advocacy experts, forensic scientists, law enforcement investigators, social service and mental health workers, faith leaders, doctors and educators.

The project is underwritten by Cook Children’s Medical Center through the support of Bank of America, but the Star-Telegram retained complete control of editorial content.

Project team

Reporters: Deanna Boyd, Jeff Caplan, Mitch Mitchell and Diane Smith

Photos, videos: Jared Christopher, Max Faulkner, Joyce Marshall, Rodger Mallison and Paul Moseley

Editor: Lee Williams

Contributing editors: Kathy Harris, Rick Press, Tim Sager and Patrick Walker

Design: Michael Currie and Mark Hoffer

Photo, video editor: David Kent

Social media editor: Maricar Estrella

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