McCAWLEY, individually, and
Suing By Her Next of Friends
and Parents, HAROLD N. McCAWLEY






Comes now the Affiant, HAROLD N. McCAWLEY, who, after being duly sworn, makes oath that the following statements are true:

1. My name is Harold M. McCawley. I am the father of Ashley N. McCawley, who was born on July 15, 1986. My wife, Tina L. McCawley, is the mother of Ashley.

2. On October 26, 1990, my wife and I took Ashley to our pediatrician, Dr. Marian Day, in Hixson, Tennessee. Ashley had complained of tender spots on the inside of her thighs which had made her reluctant to engage in her normal playtime activities. Ashley became very uncomfortable and returned from attempting a short bike ride with complaints of pain in her legs. Upon close examination, we found that Ashley had formed a small knot on the inside of her left leg below her underwear line. We immediately took her to Dr. May for examination. Dr. May thought it was probably traumatic fat necrosis and asked us to remeasure the knot in about a week. By October 30, 1990, the knot had turned pink and was tender. Dr. May then diagnosed it as inflammation of a lymph node and prescribed an antibiotic. The knot continued to grow.

3. Ashley was then referred to a pediatric surgeon who performed an incision, drainage, and biopsy of the lesion. Ashley returned home and experienced no health problems (fevers, joint soreness, weight loss, etc.) over the next few months.

4. In March 1991, Ashley had formed more small knots in both her legs and BB size lesions on her stomach. A reddish rash had also begun to form on her extremities and face. We took her back to Dr. May who suggested that the pediatric surgeon take a biopsy of her new lesions. Upon return of the biopsy information which revealed calcific fat necrosis, Dr. May ran some blood tests on Ashley and told us that she thought Ashley had alpha - 1 antitrypsin deficiency. She wanted to refer us to another pediatrician at Vanderbilt University, a Dr. Gerald B. Hickson, who would better verify that Ashley had alpha - 1 - antitrypsin deficiency.

5. On May 22, 1991, my wife and I took Ashley to the General Pediatric Referral Clinic at Vanderbilt University Medical Center in Nashville, Tennessee, for an appointment with Dr. Gerald B. Hickson. Dr. May told us that Dr. Hickson would extensively examine Ashley for alpha-l-antitrypsin deficiency.

6. We arrived at Dr. Hickson's office and waited to be led to an examining room. The attending office personnel/nurse did not ask us any questions pertaining to our family history, personal history, or Ashley's current condition during this time. We were then led to an examining room. The attending nurse did not ask us any questions about our family history, personal history, or Ashley's current condition. Dr. Hickson finally came into the room to examine Ashley. He asked my wife about her pregnancy with Ashley. Other than that question, Dr. Hickson did not inquire about our family history, personal history, or Ashley's current condition. He did not ask Ashley any questions during the visit.

7. Dr. Hickson conducted a limited physical examination of Ashley. Dr. Hickson did not inquire about Ashley's ability to keep up with her classmates at school, her ability to play with family and friends, or her daily activity level. On our own initiative, we. told Dr. Hickson that Ashley was weak, falling down and stumbling constantly, and could not run. We told him that Ashley didn't even like to walk for more than a short distance. Despite our information, Dr. Hickson did not examine Ashley's gait while walking. In fact, Ashley did not ever get off the examining table during the entire visit. Furthermore, Dr. Hickson did not comment on Ashley's reddish skin rash on her face, elbows, knees, and knuckles. He said very little during the visit. Dr. Hickson took photographs of Ashley's lesions.

8. During Ashley's examination, I asked Dr. Hickson, "What exactly is "alpha - 1 - antitrypsin deficiency?" Dr. Hickson just responded that Ashley did not have alpha - 1 - antitrypsin deficiency. Since we had been referred to Dr. Hickson for that very reason, I asked him, "If Ashley didn't have alpha - 1 - antitrypsin deficiency, when would they know what was wrong with her?" Dr. Hickson told me that he did not know if he could ever tell us what was wrong with our daughter.

9. Dr. Hickson then left the room and brought in some physicians to look at Ashley. They briefly examined the lesions on her stomach and legs and then left the examining room. We were not introduced to any of these physicians. They did not speak to us at all during their brief examination of Ashley. Again, Ashley was never moved from the examining table.

10. After the physicians left, Dr. Hickson returned to the examining room and ordered that a sample of blood be taken from Ashley for testing. He did not order or perform any other tests that day on Ashley. He told us to bring Ashley back in about two weeks. After we left the office, Dr. Hickson returned to the examining room and ordered that a sample of blood be taken from Ashley for testing. He did not order or perform any other tests that day on Ashley. He told us to bring Ashley back in about two weeks. After we left the office, we did not hear from Dr. Hickson again. Dr. Hickson never contacted us regarding Ashley's condition after our afternoon office visit on May 22, 1991.

11. On the morning of June 6, 1991, we were awakened at home by a knock on the door. A representative of The Department of Human Services and a representative from the Sheriff’s Department had been sent to our house to take our child, Ashley, from our home, away from us, and turn her over to DHS. The representative of DHS read the Court's Order to us which stated: "The minor child has been a victim of ongoing physical abuse, at the hands of one or both of the natural parents. One or both of the natural parents suffer from a mental illness, Munchausen by Proxy Syndrome. The child continues to be at high risk of harm from the activity of parents."

12. My wife and I were stunned. Completely astounded by these accusations, I asked the DHS representative what specifically my wife and I were being accused of doing to Ashley. The DHS representative told me that DHS had been told that we had been injecting something into Ashley. I asked if we were being accused of injecting drugs into our daughter. The DHS representative said, no, DHS had been told that we had been injecting human fecal matter into our daughter. The DHS representatives then left our home, taking Ashley with them. My wife and I were devastated. Our mental anguish was so great, it is hard to describe.

13. Ashley was taken to the Department of Human Services. While at the Department of Human Services a member of DHS did a taped interview of her. She was asked on numerous occasions if she had been given shots by her parents (us). At no time did Ashley ever indicate that we had injected her with anything. If Dr. Hickson suspected us of injecting feces into our child, why didn't he ever ask Ashley if we were abusing her in any manner?

14. After Ashley was taken away, I immediately phoned Dr. Hickson and asked him why he had reported us to DHS and had our daughter removed from our home. I asked Dr. Hickson why he had never contacted us after the May 22, 1991 visit. Dr. Hickson would not directly answer my questions. Dr. Hickson just told me that every possible test had been run and that he could arrive at no other conclusion except Munchausen Syndrome by Proxy.

15. Days and weeks slowly passed. We were allowed to see our daughter for only one hour visits twice weekly and only under DHS supervision. Ashley's lesions continued to multiply and worsen. We were very concerned about her illness and fearful for her health. We wanted her to be properly diagnosed as soon as possible so appropriate treatment could begin and Ashley could finally be allowed to return home.

16. We tried to persuade the juvenile court to have Ashley re -examined by another physician. We offered to pay for her to be examined even in distant places, if necessary. Finally, after diligent efforts on our part, the Juvenile Court of Rhea County agreed to allow an independent medical examination of Ashley. Ashley was to be taken to LeBonheur Children's Medical Center in Memphis, Tennessee on July 2, 1991 to be re-examined for Munchausen Syndrome by Proxy.

17. Dr. Noel K. Frizzell was the first physician to examine Ashley at LeBonheur Children's Medical Center. He examined Ashley's lesions, noted her red rashes on her face, legs, and arms, and observed her stumbling gait. He asked us questions about Ashley's ability to keep up with friends at school. He noted that Ashley could not walk well or run at all. Within 10 minutes, Dr. Frizzell announced that he was sure Ashley had dermatomyositis, a form of muscular dystrophy. He quickly rounded up a team of specialists to examine Ashley, run appropriate testing, and confirm his initial diagnosis of dermatomyositis.

18. Blood tests and an electromyography test were run. A muscle biopsy was obtained from Ashley's arm and was analyzed. Within hours, all of the physicians consulted agreed that Ashley had exhibited ",classic" signs of dermatomyositis and that the testing conclusively confirmed that Ashley was indeed suffering from this illness. Once properly diagnosed, Ashley was quickly administered the proper treatment for her condition. Dr. Frizzell contacted the Rhea County Juvenile Court and informed them that Ashley had finally been diagnosed correctly and that we had never abused our child. After thirty - three days, the Rhea County Juvenile Court allowed us to take Ashley back home with us.

19. More disturbing, however, was the fact that Dr. Frizzell told us that he had contacted Dr. Hickson after correctly diagnosing Ashley's condition, but that Dr. Hickson had still refused to alter his original diagnosis of Munchausen Syndrome by Proxy. We were told that dermatomyositis was included in the list of possible diseases compiled by the pathologist who analyzed a biopsy from Ashley's lesions in March 1991. The pathologist's report was given to Dr. Hickson by Dr. May prior to our May 22, 1991 office visit. Munchausen Syndrome by Proxy was not even included in the list of possible diagnoses. In fact, we were later told that it was suggested by the pathologist in a telephone conversation with Dr. May that Munchausen Syndrome by Proxy be considered only if all of the other diseases listed in the differential had been conclusively ruled out. Dr. Hickson did not rule out the other diseases in the differential before coming to his diagnosis of Munchausen Syndrome by Proxy.

20. Dr. Hickson should have noticed Ashley's "classic" signs of dermatomyositis. If Dr. Hickson had only obtained a muscle biopsy and had run an EMG test, Ashley's dermatomyositis would have been quickly diagnosed, and this terrible nightmare for my family would have been avoided. My wife and I will always carry the stigma of "suspected child abusers. Ashley fears every day that she will be taken away from us. on a daily basis, Ashley has nightmares and cries that strangers will come take her away from us. Our family has suffered and is continuing to suffer great mental anguish and humiliation due to the carelessness of Dr. Hickson in unreasonably assessing our daughter's condition.

Further Affiant saith not.

Harold M. McCawley

M.A.M.A. Note: This case never made it before a jury because of "Good Faith Immunity."
See resulting article in Southern Medical Journal, 1996, Vol.89, No.4, "False Positive" Facticious Disorder by Proxy.

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