Decision looming in HIV case

Published 10:43 am Thursday, April 4, 2013

AUSTIN — A Brownsdale couple on trial because of their child’s medical conditions and their views toward his HIV treatment may know within several weeks if they retain full custody.

Mower County District Judge Fred Wellman can extend the 15-day deadline for the decision in the case by an extra 15 days while both the prosecution and defense review transcripts and submit their final arguments in writing.

Initially, a court order allowed Mower County Human Services to remove Rico Martinez Nagel from his parents’ home on Jan. 18. However, Rico was allowed to return home to his parents, Lindsey Nagel and John Martinez, on March 8. The case has revolved around the parents’ and grandparents’ view about use of an antiretroviral drug and suspicion about their willingness to administer it. Lindsey and John testified again Tuesday that they never skipped medications nor will.

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The two-day trial adjourned Tuesday afternoon after Alice Snater, guardian ad litem for now 3-month-old Rico Martinez Nagel, recommended the parents retain custody with some exceptions. She recommends the parents continue to be monitored every other day to ensure they are still administering HIV treatment, and that monitoring could be reduced to three times per week if things are going well. From there, she further recommended a review hearing within 45 days. Lindsey and John have currently been administering HIV medications on the Internet via Skype to show health and county officials they are complying with legal medical requirements for an HIV positive child.

The original petition for a CHIPS also case mentioned the parents missed two doctor’s nutritional appointments in January. John and Lindsey testified that they thought those appointments were optional, that they sought a second opinion and tried to reschedule those appointments.

Much of the controversy surrounds an antiretroviral drug called AZT. Lindsey was on the drug until age 2, as she tested positive for HIV when her parents, Steve and Cheryl Nagel, adopted her 22 years ago. Steve and Cheryl stopped using the drug because they say it was slowly killing Lindsey, causing severe cramps and pain. Court documents mentioned repercussions for taking Rico off of the drug, of which county officials feared the parents would do. However, doctors have since switched Rico from AZT to a similar antiretroviral, of which Lindsey and John say they are administering to their son.

On Monday Annette Ekoue, a county social worker, testified that the couple have not missed a daily treatment, and in fact have been so diligent about delivering medication that at one point, she suggested scaling back on the number of times the county checks in. Nagel and Martinez declined, she said, saying that they didn’t want to take the chance that officials might think they missed a treatment or were not being careful.

Yet earlier Monday, Mower County Assistant Attorney Aaron Jones questioned Dr. W. Charles Huskins, a Mayo Clinic expert in pediatric infectious disease who was on call when Rico was born, about concerns the clinic staff had at the time of the birth. Huskins testified Lindsey Nagel failed to provide written documentation in her initial medical history that she was infected. He said she also apparently refused recommendations that she undergo treatment while pregnant that could reduce the risk of transmission of the HIV infection to the fetus to “less than 2 percent.”

Lindsey testified Mayo medical professionals already knew she was HIV positive from past records, confirmed it with her while she was pregnant but never received any advice about HIV risk-reducing drugs for her unborn child.

The Mower County Attorney’s Office and the Department of Health and Human Services are legally barred from commenting in the pending case. Lindsey and John’s attorney, Scott Cody, also refrained from commenting on behalf of his office’s policies.