About two weeks after the boy's Jan. 30 death, state toxicologists reported finding lethal amounts of salicylates in the boy's blood. Salicylates are common in aspirin and other over-the-counter drugs. By the time police received those results, the boy's body had been cremated.
"It means there are a lot of unanswered questions that we may never have the answers to," Monroe police detective Spencer Robinson said Monday.
Police are investigating the death as a potential manslaughter. Among other things, they are trying to reconcile evidence suggesting the boy had been dead for hours, and already was in rigor mortis, when his father brought him to a hospital emergency room. There's also documented history of neglect in the home.
An autopsy could have helped determine if the boy accidentally ingested the drug, or if there was another explanation for the lethal amounts in his blood, according to Thomas Cox, an Everett criminal defense attorney who handles homicide cases.
"It leaves you guessing in a lot of areas where you should never have to guess," Cox said. "Without an autopsy, I don't see how you can prove that it was intentional or even accidental."
Before the toxicology tests were completed, the medical examiner's office labeled the child's death "low suspicion" due to the boy's history of seizures, according to a search warrant filed last month. The medical examiner told the detective the case was being closed without an autopsy because they didn't have any suspicion or evidence of neglect or abuse.
Monroe police made at least four calls to the medical examiner's office regarding the case, spokeswoman Debbie Willis said. At least one was unreturned. Detectives made it clear there was troubling history, she said.
The child's father pleaded guilty in 2010 to reckless endangerment after police discovered his children living in deplorable conditions, including human feces and urine on the floor. The children, then 10 and 5, were removed from the home for three months. Before then, state social workers investigated numerous allegations of mistreatment involving the couple's two sons, including a report that the older boy had been given a double dose of anti-seizure medication on at least two occasions.
The man did not respond to phone calls Monday from The Herald.
The boy is not named in court papers, instead police refer to him by the initials "A.J."
The man told investigators that he woke up about 3:30 a.m. and felt like he needed to check on his son, the search warrant said.
He told the detective that this son was ash white. He said he thought the boy may have had a seizure so he decided to take him to the Valley General Hospital emergency room in Monroe, court papers said.
The father allegedly reported that the boy was breathing and alive when they left their home, about two miles from the hospital. He said he buckled the boy into his car seat. His wife stayed home.
The emergency room doctor said the boy was not breathing and was in early stages of rigor mortis.
"It was all convoluted when they came in as to whether he was alive or dead," he told detectives. "There was no breathing, no electrical activity … he was pretty stiff."
In an average person, rigor mortis usually becomes apparent two to four hours after death, the detective reported. It would be difficult to put a child into a car seat once rigor mortis starts, Robinson wrote in the search warrant.
The family lived a five-minute drive from the hospital, Robinson said. According to their own statements, the boy reached the hospital 40 minutes after his father reported finding him having medical trouble.
It is unknown how the boy ingested a lethal amount of salicylates, Robinson said. The boy's doctor told police that his motor skills likely would have prevented him from opening a child-lock bottle by himself.
In a given year, the Washington Poison Center might see a couple of cases with salicylate concentrations as high as found in the child, Dr. Thomas Martin, a Seattle toxicologist said.
"It would be very unlikely a normal child would take that much," Martin said.
Salicylate ingestion continues to be a common cause of poisoning in children but the incidence of poisoning has declined because of use of other medicines and more child-resistant containers.
Once detectives learned the toxicology test results, they moved to obtain a search warrant to secure the boy's body for further examination. It was too late. The boy already had been cremated. The medical examiner's office now is saying additional investigation is needed to determine if the death was accidental or something else, court papers said.
Management concerns have dogged the Snohomish County Medical Examiner's Office. In 2010, a consultant, hired at the insistence of the County Council, found problems with employee morale and workplace behavior.
Deputy Executive Gary Haakenson has made a priority of addressing those problems. He said Monday he was unaware of questions about the Monroe boy's death prior to being contacted by a reporter. He declined detailed comment, citing the active police investigation.
Monroe police tried to talk to the boy's parents since learning the toxicology findings. The father told police he'd just laid his son to rest and he wasn't in the mood to talk, court papers said.
"I don't like where this is going," the man reportedly told the detective.
State social workers earlier had advised the couple that no autopsy would be required without their consent because the medical examiner initially wasn't treating the death as suspicious, said Sherry Hill, a spokeswoman for the state Department of Social and Health Services.
The parents have since retained attorneys and stopped cooperating with investigators.
The older boy, now 12, has been removed from the home and placed with relatives, pending the outcome of investigations by police and social workers, Hill said.
The next step for detectives is going through hundreds of pages of medical records, Robinson said. It's still not clear why the younger boy had seizures. Both boys were severely developmentally delayed, but doctors haven't found genetic or neurological reasons.
Robinson investigated the family in 2010 after a neighbor heard a child crying and became concerned.
Investigating officers found the house contaminated with human and rat feces, mold and rotting food, court papers said.
"The smells of body odor, body excrement were so overwhelming" that the detective had to wear a respirator to breathe, according to the 2010 case file. The house was unlivable, police reported. The two children were home with their father.
Police photographs included in the search warrant show floors littered with rotting food and clutter. Police found rat droppings in the cupboards. Detectives also reported finding black mold throughout the home.
Social workers in 2010 removed the children and placed them with relatives.
Police learned that the father stayed home with the children and his wife worked full-time. The man told investigators that he tried to provide a safe environment for his children, but "he couldn't watch his kids and clean too," court papers said.
He denied that his children were neglected.
His wife told investigators that work was her priority. She is a teacher in the Lake Washington School District.
Police reported that neither parent realized how "disgusting, unclean and unsafe the house was for their children. Their attitudes suggested the house had been this way for so long they had become accustomed to the environment," court papers said.
During their 2010 investigation, detectives learned that numerous reports had been made to Child Protective Services about the boys dating back to 2005.
Paramedics were called to the older boy's school in 2006 after the child was stumbling. Social workers later learned he had been given a double dose of an anti-seizure medication. A similar incident had been reported six months earlier.
The father pleaded guilty to two counts of reckless endangerment, a gross misdemeanor. He was placed on electronic home monitoring for a month.
The children were returned to their parents in June 2010. Social workers kept the case open until February 2011 to monitor the family's progress, Hill said. The parents were cooperative and completed all court-ordered services, she said. Social workers reported the home had been cleaned.
The state received no other reports prior to the boy's death in January, Hill said. Officials with the Children's Administration plan to conduct a fatality review, she added. That's required by law when a child's death is suspected to be the result of abuse or neglect, and the child has received services from the state in the last year.
Noah Haglund contributed to this report.
Diana Hefley: 425-339-3463; firstname.lastname@example.org.
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