Advocates confront childhood drowning and parental responsibility.

By Dan Schechner | 11.25.2011

PHOTO BY DENISE BAKER It was a summer evening in 2010, and Jovita Ibeagwa was getting ready for her night shift as a nursing assistant in Jacksonville, Fla.

Before leaving the house, she called her husband, at work, who said he would come home and watch the kids, Jovita later told police.

However, Markanthony Ibeagwa decided instead to remain at his job to “get more hours [of pay],” according to police reports, and the couple’s children — Gerrard, 6, and Blessing, 3 — were left alone.

By 10 p.m., both had drowned in a neighbor’s pool.

The Ibeagwas admitted to authorities that they had failed to properly watch their children, who subsequently died due to a lack of supervision.

In July 2010, the State Attorney’s Office charged the Ibeagwas with aggravated manslaughter and child neglect.

In discussing the decision to press charges, a state prosecutor said, “When parents and caregivers fail in [their] obligation, it is the duty of law enforcement to investigate and charge those responsible. We are mindful of the great loss these parents have suffered, but the facts and circumstances of this case demand the filing of criminal charges. Parental responsibility for the safety and supervision of their children has been, and will remain, a bedrock principle of the State Attorney’s Office.”

This philosophy represents a gradual, yet definitive, sea change in the American mindset on childhood drowning. In the past, the concept that beleaguered parents had “suffered enough” often dictated how these cases were handled. But new data has emerged connecting fatal submersions to child abuse and neglect, a link that is helping to transform the way drownings are approached and investigated.

Across the country, advocates are lobbying for more comprehensive probes into childhood drownings, which they believe could help prevent future tragedies by identifying those groups that are most vulnerable.

Yet despite tangible results, these efforts continue to meet roadblocks along the path to widespread acceptance.

At Risk
The following chart illustrates the death rates among U.S. children, from 2000-2005, based on age groups and selected causes. Note the spike in drownings for 1- to 4-year-olds.

SOURCE: CDC / NCHS, NATIONAL VITAL STATISTICS SYSTEMScope of the problem
Every year, nearly 500 American children under age 5 drown in a body of water, with approximately 70 percent of those incidents occurring in a swimming pool or spa, according to the Centers for Disease Control and Prevention and the National Drowning Prevention Alliance. Another estimated 4,000 are treated in emergency rooms for non-fatal submersions.

Although drowning occurs at all ages, young children are the most vulnerable demographic, particularly in pools and spas. This is due to a number of factors: Toddlers are extremely curious, have no ability to comprehend danger, and generally, upon falling into water, do not splash or call for help.

Sadly, most child drownings occur when a parent or caretaker is distracted. In a 2004 review of drowning deaths sponsored by the National Safe Kids Campaign, nearly 90 percent of incidents took place while the child was allegedly being supervised. Yet in nearly 35 percent of cases, the victim was last seen in a location other than the pool.

Another study, this one released in the journal Pediatrics in June, spotlights the same problem. In examining portable pool drownings and near-drownings from 2001-2009, the study’s authors cited numerous instances of parents distracted by activities ranging from phone calls to household chores.

CONCLUSION
“Persistent references to ‘tragic,’ ‘freak’ and ‘horrible’ accidents made by study respondents indicate there is still important work needed at a fundamental level to frame unintentional injuries as preventable.”
— from Assessment of caregiver responsibility in unintentional child injury deaths: challenges for injury prevention, a study published in the February 2011 edition of the journal Injury Prevention.“It’s this prevailing attitude that it’s not going to happen to me,” says El Paso County (Texas) Assistant District Attorney Penny Hamilton, who heads up the office’s Rape & Child Abuse unit.

“People fool themselves into thinking their children are safe,” she continues. “Even if it’s just a 2-year-old, there’s too much responsibility placed on toddlers.”

While drowning-prevention advocates continue to call for stricter barrier requirements, it can be argued that pools and spas have never been safer. In fact, the industry has seen an exponential increase in regulation over the past decade, from isolation fencing to covers to pool alarms. Yet, according to the NSKC study, 63 percent of drowning victims entered through an open or unlocked gate. Moreover, “in cases where it was known whether the child was unattended at the time he or she gained access to the pool area through a gate, 39 percent of victims were known to have been alone upon entry,” the findings revealed.

Indeed, there is a single variable that transcends all other safety requirements. It is consistently identified as a primary factor in child drownings, yet is all too often understated when doling out blame. That factor is adult supervision.

“Supervisors should maintain continuous visual and auditory contact with children in or near water … and should not engage in distracting behaviors such as talking on the phone, preparing a meal or reading,” the NSKC study authors conclude.

A painful connection
In 2010, the Broward County (Fla.) Health Department conducted a comprehensive study into childhood drowning, and reached a groundbreaking conclusion.

The researchers reviewed all investigated child drownings county-wide from January 2006 to March 2009, using data from the Broward Sheriff’s Office’s Child Protective Investigation Section.

On the Lookout
A 2004 study by the National Safe Kids Campaign revealed that parents were the primary supervisor in nearly half of all investigated drownings among children ages 0-14 in 2000-2001.

Parent Other relative Other Not supervised, but should have been Childcare provider No supervision needed
The study also asked parentsto report what activities they were engaged in while supervising their children swimming.

Talk to someone Supervise another child Read Eat Talk on phone Close eyes and relax Drink alcohol Released early this year, the report found that nearly 70 percent of families with children that had drowned also had a prior criminal, domestic violence, drug or abuse/neglect charge with CPIS. It also revealed that in 90 percent of cases, the child had exited the home through a door without anyone noticing. Investigators further concluded that every single case included some level of neglect, and each one was preventable.

“These unintentional child deaths have to be investigated from an abuse and neglect standpoint,” says Kimberly Burgess, executive director of the Fort Lauderdale, Fla.-based NDPA and drowning prevention coordinator for the Broward Health Department, who also co-authored the report.

“We investigate when parents leave their babies in a hot car, or when they leave a loaded handgun lying around and it goes off,” she adds. “So what’s the difference? Why don’t we do the same with drownings?”

A central question for investigators — and those who must decide whether charges could be warranted — is whether a lapse in supervision rises to the level of criminality. Does it merit the same level of investigation as other acts of neglect or abuse? Law enforcement in Florida, where drowning is the leading cause of death for children under age 5, are increasingly answering in the affirmative, says James Walker, assistant program administrator in Broward’s CPIS.

Citing state statutes, Walker notes that child neglect could involve a singular occurrence, or “a one-time omission that a prudent person would consider essential for the safety and well-being of a child.”

In Broward and a handful of other Florida counties, law enforcement and Child Protective Services (CPS) launch dual investigations whenever a child drowns. However, that regulation is far from the case statewide, and such triggers are spotty at best across the nation, officials say.

This failure to investigate child drownings for possible abuse or neglect can be traced to multiple factors. For one, different jurisdictions employ vastly different methods of incident-reporting. So whereas paramedics in one county may be directed to notify CPS in the event of a child drowning, that duty may fall strictly to law enforcement in a neighboring county.

Discretion is another key: A first-responder may independently conclude that an incident doesn’t warrant a call to the state’s CPS hotline. Or the decision could be left to an operator.

“In some states, when a call comes in, the CPS dispatcher determines if they should send out an investigator,” Burgess says. “Most drownings are considered an accident, and they don’t send them out. They tend to use statutes as the be-all end-all, and if it doesn’t rise to that level, they won’t send out investigators.”

However, bureaucratic nuances, while certainly an issue, are not the primary reason why so many child drownings go uninvestigated. The key factor, experts say, lies in human emotion.

‘They’ve suffered enough’
When 20-month-old Aubriana Aguilar slipped out of her Fontana, Calif., home and into the family’s backyard hot tub in July, her father, Alex, said she was out of sight just 15 minutes. Choking back tears, the young man described the horror he felt after discovering his daughter face-down in the spa.

CONCLUSION
“Severe state budget cuts will impact agencies’ ability to identify and investigate certain child abuse cases, in addition to impacting the amount of completed training necessary for investigators.”
— from Report on Multidisciplinary Protocol for the investigation of Child Abuse issued in September 2010 by the Maricopa County (Ariz.) Attorney’s Office.“As I looked out that window, I saw her,” he recalled during a poolside vigil a week later. “So I laid her down, and my dad just started pushing on her. He started doing CPR.”

Police and emergency crews responded to the scene almost immediately. But despite their efforts, the little girl did not survive. Speaking of the incident, San Bernardino County Fire Capt. Darrel Crane told reporters, “These are tragic events. The depth of sorrow of this family cannot be measured.”

When a drowning occurs, law enforcement is frequently first on the scene. Officers have the nearly unthinkable task of trying to resuscitate a stricken child in the midst of hysterical onlookers, many of them parents and relatives. Under those circumstances, it can be virtually impossible, even for trained professionals, to set personal feelings aside.

“Law enforcement, oftentimes, views it as the family has been traumatized, that they’re already going through tough times,” Walker says. “So they may be thinking, ‘Why would we traumatize the family further by having other individuals respond to the home and look at situations and circumstances that relate to [the incident]?’”

In many states, including Florida and Texas, those same officers are often the parties responsible for notifying CPS when a child has drowned or is hospitalized. And disparity in training and local protocols means that what looks like a clear-cut case of neglect to one officer may not even raise a red flag for another. Too often statements are taken, incidents are classified as accidents, and cases are quickly closed, officials contend.

“Without a doubt it is a training issue,” says Maj. Connie Shingledecker, commander of the Criminal Investigation Division of the Manatee County (Fla.) Sheriff’s Office. “We know the numbers are huge, but the amount [of neglect cases] we actually get are much smaller.”

Lack of prosecution
Local prosecutors face similar challenges. In El Paso, Assistant DA Hamilton says she has presented child drowning cases to grand juries over the years, but not one has ever resulted in the filing of formal charges.

“They’ve always declined to indict,” Hamilton says. “I can only speculate, but maybe that is just the prevailing view within the community — that this is so sad, we don’t want to cause any more pain.”

Prosecutable childhood drowning cases are equally rare in Maricopa County (Ariz.), according to a spokesman for the County Attorney’s office. If police don’t believe a crime was committed, there’s typically little point in pursuing charges, says Jerry Cobb, a public information officer.

In their decision to abandon a case, authorities consider what he calls a “standard of reasonable likelihood of conviction,” or whether a jury is apt to find a parent guilty of wrongdoing. Usually those cases occupy a gray area, where investigators must rely on the evidence they’re able to gather, he says.

Often there are no eyewitnesses, stories change, and the exact circumstances can be difficult to ascertain.

CONCLUSION
“Nearly one-third (32 percent) of the children’s families had a history of prior referrals to Child Protective Services; 25 had had at least one CPS investigation … Although this study could not calculate drowning risk among families with CPS involvement, this group appeared over-represented.”
— from Analysis of pediatric drowning deaths in Washington State using the child death review for surveillance: what CDR does and does not tell us about lethal drowning injury, a study included in the February 2011 edition of the journal Injury Prevention.“When talking about child drownings and prosecution, you’re ultimately going to have to present that to a jury comprised of other parents,” Cobb says. “Children get away from you. No parent is perfect. Even the most dedicated ones will readily admit that they aren’t able to monitor their child’s activities constantly. So now you have to convince a jury. It’s not easy.”

Another roadblock facing prosecutors may actually lie in the charges themselves. Terms such as “aggravated manslaughter” or “negligent homicide” don’t readily align with images of grieving parents, many of them inconsolable.

One possible solution comes from Australia, where officials in New South Wales want to enact a new criminal negligence offense that relates solely to swimming pool deaths.

“Where a drowning results from the negligence of a parent, there is reason for a community response even if that negligence [does not] justify a charge of manslaughter,” Deputy State Coroner Paul MacMahon told The Sydney Morning Herald recently.

Instead, he recommended the Attorney General create “a criminal offense, analogous to that of negligent driving causing death, to apply in circumstances where a person dies as a result of the negligence of a third party with respect to … the use of a private swimming pool.”

Stretched resources
Among the most valuable tools in the fight against childhood drownings are Child Death Review programs. This system of multidisciplinary teams examines child fatalities, gaining a clearer picture of why they occur and providing solutions to help prevent further loss of life.

Established on a widespread scale in the 1980s and ’90s, CDR teams exist today in every state and a number of local jurisdictions, and typically include representatives from the law enforcement, legal, public health, medical and child-welfare communities. Their findings are generally compiled into annual reports that are distributed to state and local legislators, policymakers and advocacy groups.

Over the years, data from CDR teams — which are widely considered the gold standard in fatality investigation — have helped guide public policy and legislation in a number of areas, including seatbelt use and child-proof medicine containers.

However, a report released last summer on the status of CDR in the United States showed that at least 10 states had no funds allocated for these programs in 2009.

States of Alert
For summer 2011, the National Drowning Prevention Alliance highlighted those areas with the most pool drownings among children under 11.
42
41
34
26
20

Texas Fla. Calif. Ariz. Pa. California, which regularly ranks among the top states for drownings, has been unable to fund a child death review team since 2008. It’s also been several years since California has produced an annual state report on child fatalities.

Officials with Florida’s Child Abuse Death Review Team are concerned as well that the scope of their work could fall victim to state finances.

“We are an unfunded mandate,” says Michelle Akins, the team’s quality assurance coordinator, who is based in Ft. Pierce. “We have no actual funding source. And with budget cuts we could always be suspended, or downsized on how we look at and review cases.”

State budget cuts throughout the nation will continue to handicap CDR teams — and the findings they produce — in the coming years, officials predict. And the result, they fear, is a decline in the investigation of child abuse and neglect cases.

Looking ahead
In Broward, child-protective investigators gather a wide swath of information from the scene of a drowning. They are trained to assess for drug and alcohol impairment, and conduct subsequent screenings; they check barriers and points of entry to the swimming pool or spa; and they collect data on the family that accounts for cultural and socioeconomic factors, among others.

“How do we prevent this if we truly don’t know what we’re dealing with?” says Shingledecker, who is also chairwoman of Florida’s Child Death Review Committee. “You have to recognize what it is. And to me, the bigger picture really is prevention. There may be a few cases that end up going through the criminal court system, but the biggest thing is to recognize the issues. Because you can’t fix what you don’t know.”

Shingledecker and others believe that every child drowning should be reported immediately to the state CPS hotline, regardless of the circumstances. That contact, she says, launches a dual investigation that can help the two agencies better coordinate and determine the nature of an incident.

CONCLUSION
“On the basis of analyses of the Texas Child Fatality Review (CFR) data, a large proportion of deaths were among children with a history of maltreatment victimization and whose caregivers had a history of maltreatment perpetration.”
— from History of maltreatment among unintentional injury deaths: analyses of Texas child fatality review data, 2005-2007, a report included in the February 2011 edition of the journal Injury Prevention.Under Burgess’ direction and in coordination with Broward Sheriff’s, a local program was created last year that has already dramatically reduced the rate of child drownings. It relies on data-sharing between public health officials, CPS and the fire marshal’s office.

A single allegation of child abuse prompts fire rescue personnel to conduct a home evaluation that includes a water-safety survey for each family with children under age 9. That, in turn, triggers a home-safety plan, which incorporates measures such as placement of door alarms near water hazards.

By early August, Broward County, which regularly leads the state in childhood drownings, had logged just two fatalities all year.

“It’s because we investigated — we found out who was drowning and then targeted that group,” Burgess says. “So if we target that at-risk family, and give them education tools, and let them know we’re watching them, they’re a little more careful, and their children aren’t drowning.

“Look, it may not be neglect to the point that the parents need to be prosecuted,” she adds, “but at least we can raise awareness that there are patterns that emerge from all this data, like it has in Broward. It may be far-reaching to expect zero child deaths, but that’s what we can at least shoot for.”