The last time Katie Alice Ripstra saw her four-year-old daughter was August 6, 2013, when she brought her to the emergency room at Texas Children's Hospital. Ripstra, who is facing two counts of intentionally causing serious bodily injury to a child, was separated from the girl once doctors began to question whether Ripstra may have poisoned her daughter with salt. Authorities eventually began to question whether the girl's 26 hospitalizations over the past two years had been intentional medical child abuse all along.
Ripstra, whose criminal trial began Monday, has pleaded not guilty to both counts.
Ripstra had her daughter through in vitrio fertilization in 2009 and continued to raise her as a single mom. By the time the girl was supposed to begin eating solid foods, Ripstra began to take her daughter to a pediatrician, saying she could not keep the food down. After visiting a host of other doctors, including gastrointestinal specialists and occupational therapists, the daughter apparently was still not able to eat and would have chronic diarrhea if she did try any regular food.
Ripstra's daughter instead got the nutrients she needed to survive through several types of tubes or IVs over the course of two years. Those IVs and tubes often led to infections for her daughter or, in one case, a severe blood clot. During the girl's last hospitalization, she suffered such plummeting blood levels and skyrocketing sodium levels that she suffered brain damage that affected her motor skills.
Prosecutors pointed to Ripstra's former job as a pediatric nurse with Texas Children's Hospital as indication she'd be capable of medical child abuse.
But before recounting all this, the state opened its argument with the scene of a birthday party at a gym for tykes. Here, the state said, mothers who had known Ripstra and her daughter since she was born watched astounded as the girl ate cupcakes, cheese, crackers and fruit. This was not long after the daughter had been separated from Ripstra and released from the ICU. “They couldn't believe what they were seeing,” Harris County prosecutor Tiffany Dupree told the jury.
It appears the prosecution's case will lean heavily on what these women, who knew Ripstra through Facebook support groups for mothers, say they noticed about the daughter both before and after she was in Ripstra's care. Prosecutors argue that Ripstra essentially continued to keep her daughter ill and poison her with salt so that she'd continue receiving the attention of concerned mothers in these Facebook groups — called Birth, Baby & Beyond, and Mothers with Toddler Angst. “They encouraged her,” Dupree said. “They gave her the affirmation she so desired.”
But Ripstra's defense attorney, Casey Garrett, says there's no physical evidence that proves Ripstra intentionally did anything to make her daughter sick. During her opening arguments Monday, Garrett argued that the girl received excessive, overzealous medical treatment from “well-meaning doctors who just kept trying one more thing.” Garrett told the jury that Ripstra's daughter suffered two of her four episodes of hypernatremia, a condition of dehydration where sodium levels spike dramatically, in front of doctors at Texas Children's Hospital — "not in the secrecy of somebody's home," Garrett said.
Garrett noted that the defense would be bringing in outside doctors to explain how Ripstra's daughter was able to recover following her last hospital stay. Notably, she said, those doctors would include Dr. Steven Alexander, the chief of pediatric nephrology (a kidney specialist) at Stanford, and Dr. Richard Boles, a medical geneticist and clinician who would explain that the girl suffered from mitochondrial disease — a disease that is cured by weaning the child off medical treatment, Garrett said. “There are other explanations than salt poisoning," she said.
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But on the case's first day in court, the only two witnesses brought to the stand were two Facebook group moms whose kids often played with Ripstra's daughter. The first mother, Sarah Ball, had actually fostered the girl for 15 months when Child Protective Services ordered the separation. Ball said the daughter had eaten just like any normal child and had thrown up only three times during that stretch.
In her cross-examination, Garrett focused more on Ripstra's efforts to give her daughter a normal life despite her digestive issues. Although Ripstra's daughter had to carry around her feeding tubes everywhere in a backpack, both witnesses confirmed that the girl ran around and played just like any other kid, and that Ripstra brought her daughter to all of the field trips and outings just like any other parent. And, Garrett noted, Ripstra posted on Facebook about the medical issues her child faced just as the other moms did, too.
Attorneys sifted through 12,000 pages of those Facebook posts — from both Ripstra and other moms. Prosecutors plan to use a portion of the posts to prove Ripstra's attention-seeking habits. But because not all those moms were present to confirm they had actually made those Facebook comments and posts, state District Judge Jeannine Barr was hesitant to admit all of the Facebook content as evidence.
Judge Barr is expected to determine how many of those Facebook posts the jury will ultimately see before trial resumes Tuesday in the 182nd District Court.