GUILTY DE - Stephanie McMullen for child endangerment, Bear, 2005

A mother and former nurse on trial for injecting fecal matter into her toddler son's bloodstream took the stand yesterday.
In response to her lawyer's questioning, Stephanie McMullen said she never did anything to make her son sick....

McMullen has been charged with felony assault by abuse or neglect causing physical injury to a child and first-degree reckless endangering.

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WILMINGTON -- A 30-year-old mother on trial for allegedly injecting feces into her son's blood was questioned Wednesday about a meticulous log she kept on her son's health as well as related Internet searches.

The log kept by Stephanie A. McMullen, a former Alfred I. duPont Hospital for Children nurse, contained details including the first time her son vomited, his blood pressure, when the boy had smelly urine and how often he had diarrhea or constipation.

"Was Reilly your son or your patient?" Deputy Attorney General Christina M. Showalter asked McMullen.

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The trial of a former pediatric nurse accused of poisoning her son by injecting him with feces ended in a mistrial after jurors could not reach a unanimous verdict...
Jurors voted 9-3 to convict McMullen of assault by abuse or neglect and 7-5 to acquit her of first-degree reckless endangering, according to forewoman Amy Jerman...

Jerman said it was difficult to reach a unanimous verdict because the accusations against McMullen were based on "about 85 percent circumstantial evidence."...

McMullen's defense attorney, Edmund Lyons Jr., told the jury there was no physical evidence to show that his client had injected the boy with feces. He suggested that a number of other people could have poisoned the boy, including staff at Alfred I. du Pont Hospital for Children.

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Dr. Zitelli concedes that it is extraordinarily difficult to make a diagnosis of PCF. No single definitive medical test reveals the condition.   No definable series of symptoms will be associated with each case.   No clinical algorithms have been developed to aid doctors in the diagnosis.   And much, if not all, of the patient's medical history is false because the caretaker providing the history is often the perpetrator of the abuse.  

Nevertheless, Dr. Zitelli still maintains that physicians employ both a scientific methodology and objective diagnostic criteria to diagnose PCF.24
The methodology, according to Dr. Zitelli, first involves a meticulous review of the child's medical records.   If the records identify a series of events or symptoms that do not follow physiological parameters-that is, through evidence based medicine 25 a doctor detects a biological or physiological inconsistency and concludes that the symptoms can only be explained by looking beyond the body's normal function-then the physician justifiably should place PCF in the differential diagnosis.   The next step is to narrow the differential diagnosis by systematically testing for known medical causes of the symptoms while at the same time removing the child from potential sources of induced illness (e.g. his caretakers).   If the child has a true underlying illness, then separation from the alleged perpetrator should not, itself, improve the condition-the illness will proceed whether a caretaker is present or not.   If, however, the illness subsides after separation has occurred, then this factor supports a PCF diagnosis.   Finally, the physician/investigator should look for toxins in a child's system and, if found, determine whether they would be present in the body but for the intentional introduction of the toxin(s) by a perpetrator.   In summary, the objective criteria outlined by Dr. Zitelli that could lead to a diagnosis of PCF are:  (1) physiological or biological inconsistency in the presentation of the child that cannot be linked to known medical conditions;  and/or (2) separation of the child from a suspected perpetrator and subsequent recovery;  and/or (3) presence of unexplained toxic agents in the child's body.

Zitelli was consulted by the State to review Reilly's case.   After reviewing Reilly's extensive medical record, Dr. Zitelli made a diagnosis of PCF.

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A former pediatric nurse, who claimed she suffered from Munchausen disorder and was charged with injecting human feces into her then 22-month-old son's bloodstream, pleaded guilty Friday to the second-degree assault of her son.

Stephanie A. McMullen also admitted in a Superior Court hearing to giving her son laxatives that led to severe diarrhea while he was being treated at Alfred I. duPont Hospital for Children in 2005.

"I gave him laxatives to cause him diarrhea so that the doctors would continue to test him," McMullen said, wiping tears from her face.

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A former pediatric nurse who admitted giving her then-22-month-old son laxatives so he would have diarrhea and doctors would continue testing him was sentenced to three months in prison Friday.

Other than unresolved issues concerning her father's death, a teary Stephanie A. McMullen said she could not explain what drove her to do this to her son, Reilly, who is now 3.

"I have no idea what I will say when Reilly asks 'Why?' " she told Superior Court Judge Joseph R. Slights III before her sentence. McMullen added she is being treated for her problem and looked forward being reunited...

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