Dr. Bruno Chumpitazi's three-year-old patient had been to the hospital 26 times in 19 months, and still he couldn't figure out what was wrong.
The gastrointestinal specialist had been seeing the young girl since she was a year and a half. Another pediatrician had referred her to him because she, too, couldn't figure out why the baby had trouble feeding. Her mother, Katie Ripstra, brought her to see an occupational therapist in October 2009 when the baby kept having excessive spit-up after feeding. Chumpitazi knew that, when she was four months old, doctors found in a feeding test that the girl did in fact suffer from severe reflux — meaning the contents of her stomach came up readily after feeding.
But it was something doctors expected they could easily fix; instead, the girl inexplicably got worse. And now, six years later, Chumpitazi is testifying in court against Ripstra, who is facing two counts of intentionally causing bodily injury to a child. She's accused of poisoning her daughter with salt through a catheter and of chronic medical abuse. And because she was a pediatric nurse at Texas Children's Hospital, prosecutors argue that would make her capable of committing such a crime. As for the motive, prosecutors contend Ripstra kept her daughter ill for attention and affirmation from fellow moms in a Facebook group called Moms with Toddler Angst.
Because Ripstra consistently reported that her daughter couldn't eat without throwing up, the child had been relying on feeding tubes or IVs to get her nutrients since she was one and a half. Doctors thought if they delivered the liquids directly into her intestines, she would stop vomiting because the stomach would be bypassed. That didn't work. They had tried many different medications, had given a host of medical tests. Yet every time Ripstra brought her daughter to doctors, it was the same report: vomiting, diarrhea, fever. And there was hardly ever any progress.
That is, until August of 2013, shortly after Ripstra was separated from her daughter because of suspected medical child abuse.
Ripstra's daughter, now six, no longer relies on tubes or IVs, and no longer throws up or has excessive diarrhea. She eats like a normal child, according to witnesses who testified in court this week.
Chumpitazi testified that he last saw Ripstra's daughter in February 2013, shortly after her 26th hospital stay. At the time, the girl had been suffering a brand-new problem: unexplained plummeting blood levels. After a handful of stays in the ICU, not even a blood specialist could figure out what had gone wrong with her. Chumpitazi told Ripstra that they would need to change treatment. Ripstra objected, Chumpitazi said, and that's when he decided to drop her daughter as a patient. “I could not in good conscience continue treating her in that way,” Chumpitazi testified.
When Chumpitazi learned several months later, in August 2013, that Ripstra's daughter was taken off the feeding tubes and was eating like a regular kid, he said he began to question all those hospital trips. Because Ripstra was a nurse, Chumpitazi said her concerns were always taken seriously and considered credible when she turned up at the hospital, reporting her daughter's high fever.
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Chumpitazi testified that, after plummeting blood levels or a bacterial infection in her tubes were discovered, her fever would not return for the remainder of these hospital stays. Nor, save for one report, Chumpitazi noted, would nurses see vomiting or diarrhea from the girl once she got to the hospital. In addition, Ripstra would claim the feeding tube had been displaced or was leaking and would need to be replaced — even though Chumpitazi said G-J feeding tubes generally last for six months with no issue.
All scenarios, Chumpitazi said, were “extremely unusual.” Prosecutors questioned whether it was possible that somebody — specifically a nurse — would be able to manually remove the tube or manually cause an infection. “It's possible to physically remove a G-J tube,” Chumpitazi testified, “and in light of what I saw — the complete 180-degree change after separating from her mother — the most likely explanation is that it was manually removed.”
During opening arguments earlier this week, Ripstra's defense attorneys said that there would be no physical evidence to prove that any of this was true. And so far, that has been correct.
The defense team did not yet have a chance to cross-examine Chumpitazi; it will do so on Wednesday.