Tara Shaskey, Open Justice
A mother who repeatedly and deliberately infected her child with disease and kept the youngster sick for more than a year, while appearing to relish the "drama", broke down in tears as she was sent to prison.
The woman, who cannot be named, continues to deny the offending, while family members have described her as "caring and attentive" and a "model mother".
But their assessment stood in stark contrast to the findings of doctors, police and a jury, who all concluded the mother had caused the child grave harm.
On Monday, the woman appeared in the High Court at Nelson for sentencing on four charges of ill-treatment of a child and three of infecting with disease after a jury found her guilty earlier this year.
While the woman declined to undergo a psychiatric assessment, as ordered by the judge, a pre-sentence report revealed the offending "may be consistent with" factitious disorder imposed on another (FDIA), formerly known as Munchausen syndrome by proxy.
Justice Lisa Preston detailed how the child, whose details are suppressed, including their gender, underwent 28 hospital admissions, 13 operations including exploratory procedures, 44 imaging scans and 1038 lab tests across 2019 and 2020, from infancy to toddlerhood.
The child was being treated for what was considered to be a gastrointestinal disorder after presenting with symptoms of failing to thrive and the mother's claims that the child was unable to eat by usual means.
Doctors, specialists and nurses at multiple hospitals oversaw the child's care, but none could identify the cause of their poor health.
The problem was later revealed to be the mother repeatedly exaggerating and fabricating symptoms, causing an infection in the child's peripherally inserted central catheter, and tampering with the child's medical equipment.
As alarm bells rang for medical staff, and the child was admitted to a paediatric intensive care unit in a life-threatening condition, the mother was ordered to keep her hands visible at all times.
"Yet on one occasion, you were seen with your hands under [their] blanket, gripping [their] upper leg and shoulder, leaving red marks," Justice Preston said.
"You were also noted gripping [a connector] on [their] central line. And during this period, that piece of equipment was noted to be disconnected."
On another occasion, the mother was again seen with her hands under the child's blanket, near where they had a device in their arm, before throwing a syringe into a bag near her feet.
A nurse later looked in the bag and saw the syringe.
"Every medical mother has a syringe," the mother wrote in a message after the nurse's discovery.
A report of concern was made to Oranga Tamariki and the child was immediately removed from the mother's care.
The child then made a "remarkable swift recovery" to full health.
"A little [child] who on your report was not able to tolerate any food or liquid whatsoever through [their] digestive tract resumed eating within a matter of weeks," Justice Preston said.
"Thereafter, happily [they] consistently gained weight and was eating different types of food. [They] suffered no more mishaps of [their] medical equipment.
"Remarkably, also, given that [they] had been requiring multiple blood transfusions due to anemia, [their] anemia resolved and [they] required no further transfusion."
However, the judge said it had not been proven that the mother was drawing blood from the child.
In early 2021, the child was discharged with a diagnosis of medical child abuse.
At sentencing, Justice Preston said that during the child's hospitalisation, the mother was reported as seeming "unconcerned" and "fascinated" by other patients.
Medical staff also described her behaviour as "odd" and "seemingly enjoying or seeking the drama of being a medical mother of a very unwell child".
"As to your wish or desire whether conscious or unconscious to be so regarded, the communications in the case supported this," Justice Preston said.
She said the mother showed an interest in tube feeding long before the child was born, having joined an online forum.
Justice Preston said the Crown sought a starting point of eight years' imprisonment.
The defence, which argued at trial that the woman was a hyper-vigilant mother of a medically vulnerable child, argued for seven years and six months.
In addition to the harm caused to the child, Justice Preston said the mother had also caused harm to the medical professionals involved in their care, and there had been an "extremely high" cost to the public health system.
Other aggravating factors included the child's vulnerability, the prolonged offending, premeditation and the "appalling" breach of trust.
In mitigation, Justice Preston accepted the woman had previous good character and, despite there being no diagnosis, that FDIA may have been at play, allowing 5 percent credit.
She allowed a further 15 percent discount for the impact the mother's incarceration will have on her other child, but not for the impact it would have on the child she offended against.
Justice Preston sentenced the woman to six years' imprisonment, from a starting point of seven years and six months.
The woman, who had been sobbing throughout the hearing, broke down into tears as she was led away by Corrections staff to begin her sentence.
