Munchausen by Proxy

[BBelle]

Hello all. I was wanting to know what you all thought about Munchausen by Proxy (MBP)?

Have any of you ever came across a case of it and if so how did you proceed?

And how can one really tell if it is MBP?

There was a case in Missouri where a mother was accused of MBP. Her child had died of ethylene glycol poisioning.The mother was charged with the child's death. This mother had another child and the doctor's found that the infant had a rare disease, methylmalonic acidemia, which had caused the death of her first child. Needless to say she initiated legal action against the hospital and the State.

I would just like to know your views on this. Belle

[jschut, BSN, RN]

Oh my goodness....what a horrid thing to do to a poor defensless child! So many children out there are being hurt by ones who are supposed to love them and care for them.....

Life is sad....

[dawngloves, BSN, RN]

Wow! Not as bad as LR, but I've seen a couple of moms really groove on the hole NICU thing. They come with their friends and neighbors to show off the baby and then they sit and socialize at bedside. They know every nurse, every pt and their diagnosis despite having never met their parents. They watch every thing even when you tell them they can't leave their child's bedside.

Had this one mom who was always messing with her baby's ET tube, I think she was trying to get it out. We'd tell her not to mess with it and we'd catch her! Or we'd tell her not to touch the baby because she's having a bad day and the next thing you know the baby's bradying becaue moms in the isolette.

Bizarre!

[JailRN]

Sad situation--You need a license to be a nurse, drive a car, but none to be a parent.

[Mattigan, RN]

I work Peds and this and surrounding counties our hosp. services has higher than the national average.We see it alot. Sometimes it can't be proved and we have to have Social Services use the freg. admissions/accidents as endangerment or neglect as it doesn;t get termed MBP but it is. Our Dept. of Children's Services aren't very aggressive and some docs don't want to get too involved(as not to have to spend time in court) and it is a real problem for us.

[colleen10]

Hi BBelle,

I recall seeing on the news the story you mentioned about the mother and child with methylmalonic acidemia.

I am still a student but I do believe in MBP. Not exactly MBP but a similar story......My mother's uncle was married to a woman who was a nurse and she used to fake being sick and ill. Since she was a nurse she knew exactly what to tell the doctors and would self diagnose herself and convince the doctors that she needed this test or that operation. She had her appendix and gall bladder removed and countless other operations and drugs administrated to her. This was not a case of a hyperchondriac.

She eventually OD'd on drugs and died. This was back in the late '60's and early '70's so I guess back then it was not well heard of or understood.

After hearing stories like those above, I leave nothing to the imagination anymore.

[nurs4kids]

I've seen it twice, actually made the call myself the second time. Had a mom that just continued to bring her child in, request the same unit for admission and would not accept the fact that her child was well. Mom constantly hung over the nurse's station enjoying the attention. Finally, after 3 admissions for unrelated complaints that turned out to be nothing, I mentioned my concern to the doc who blew me off..agreed that the mom was crazy, but not a case of munchausen's. A week later, the child was readmited to our unit, this time, at my begging the unit manager, we placed her in one of our seizure monitoring rooms that has video monitoring. Unfortunately, I was proven correct when the child coded. The child was safely resuscitated, thank God. When mom was questioned about the events leading to the child's coding, mom stated the child (2yr old) was sitting in the bed eating pizza and mom had gone to the restroom. When mom came out, the child was blue. Upon replay of the video, mom had suffocated the child with a pillow. Sad...real sad. These women are sick, period.

[BBFRN, BSN, PhD]

Originally posted by BBelle

This may sound awful to say, but I think that those who are found guilty, beyond a showdow of doubt, should be given a dose of there own medicene. They should be the ones who are injected with bleach, orificenic, saliva or feces. This way they will get all the da** attention they want, negative attention that is.

They should be grateful that they are in prison because if I were to ever see them on the streets I would be the one hauled off in shackles and the coroner would be scrapping them off of the

I was an institutional nurse in a women's prison for about a year, and we had several MBP inmates. They were all in the seg. cellblock so the other inmates wouldn't harm them. This meant that they were in isolation cells mixed in with the deathrow inmates. The weird thing about MBP'ers when they spend the majority of their time alone is this: they tend to do very strange things to harm THEMSELVES for the attention. I had one that ate her own breast- i kid you not. And yours truly was the one that had to assess her and clean her up after they restrained her. Then I had one that cut her arm with a staple she found on the floor, and then proceeded to stuff things in the wound such as cornbread,styrofoam,toilet paper, and feces so that it would get worse and worse. She refused her abt's, and ended up with compartment syndrome. She almost lost her hand, but just loved the fact that the surgeon had to be consulted to see her once a week. Very weird people to say the least.

[stevierae]

Originally posted by Dplear

I work a Pedi Neuro floor and we have seen MANY cases of Munchausens by Proxy. We have had 2 in just the last month. You usually can spot it pretty quick if you see enough of it.

Dave

Dave, just curious--what kinds of things do they do to the child that gets them admitted to a neuro floor? And, how do the docs handle it? Does social services or Child Protective Services come in? Do they videotape (secretly) the goings on in the chil's room, to catch the parent in the act?

I saw a true detective show special on MBP. They showed a lot of those parents, usually moms, being videotaped in hospital rooms with their "sick" children. The nursing staff would be watching the video at the desk, while the mom tried to smother their children just enough to make them stop breathing and set the alarms off.

One mom was obese; she would lay on the child and attempt to asphyxiate him with the weight of her body. The child would stop breathing and go limp; the alarms would go off; the staff would come running, and then you'd see the mom sitting back and enjoying all the attention. They did not hide the faces for these TV shows.

I don't know if I agree with the staff's tactic of letting it go on until the very last possible second--seems a bit unnecessary, and abusive in its own right, to allow a child to come that close to asphyxiation. Seems like they should have intervened as soon as they saw the mom lay on the child, or (another mom) picking up a pillow.

There was another one where the mom insisted her child was constantly vomiting. While with the child, she would unscrew his bottle of formula, pull off the nipple and dump the entire bottle over the chilld's pajamas. Then, she would ring for the nurse and tell her he had just had projectile vomiting.

There is a book about a woman in upstate New York, Mary Beth somebody, who killed all 9 of her children--a couple of them adopted--before she was finally arrested and convicted. She, too, held court at their open coffins, reveling in all the attention she was getting as the poor, undeserving victim of yet another tragedy.

[stevierae]

Originally posted by [email protected]

I was an institutional nurse in a women's prison for about a year, and we had several MBP inmates. They were all in the seg. cellblock so the other inmates wouldn't harm them.

Were these women in prison in the FIRST place for being MBPers (that is, those who harm others, like their own children, for self-attention, and were finally caught and convicted?)

Or were they imprisoned for other crimes, and started harming THEMSELVES for attention (Munchausen's syndrome?) Curious to know if those with Munchausens' by proxy develop Munchausens syndrome when they no longer have an innocent victim, and must inflict damage on themselves.

[Teshiee]

That disorder is a trip if you ask me as for Susan Smith she should have been drowned like being tried as a witch. But these women manage to breed left and right all over the place. It is a very psychotic disorder and I can't for the life of me understand it. I just pray for the victims involved. just my 0.02cents worth.

[Dplear]

Stevie

They end up on a neuro floor quite often because of what they do to the kids causes all sorts of developmental delays and seziures. Many of these kids are neurologically damaged for life even if the mothers are found out. Also the unit I am on is one of the smaller units in the hospital so we usually have real good staffing for closer watching. In Texas the courts take a dim view of secret monitering by video camera so it is hard to do.

Dave

[Q.]

Tracy,

What a horrible story. Damn smart to place them in the seizure room for monitoring.

Good job.