CLEARWATER--Two weeks ago, child protection investigators removed 5-year-old Elizabeth Holder from her home after she was found running around a Clearwater mobile home park while her mother was under the influence of methadone, Percocet, marijuana and the anti-depressants Wellbutrin and Celexa, according to authorities and court records.
Eight days later, Elizabeth, by now in foster care, was sitting on a couch in Dunedin watching television with her two-year-old sister and some other children when she clutched her head in pain, crying out, "It hurts. It hurts. It hurts." Then she fell limp and died.
No one knows yet what killed the little girl. There's no doubt she was a victim of a bureaucratic oversight.
Within 72 hours after she and her sister Kayla were taken from Unit 419 in the Gulf to Bay Mobile Home Park, each was supposed to undergo a medical screening, in accordance with state law. But, while appointments had been set up for each child, the screenings themselves did not take place within the three-day period, as required.
The person whose responsibility it was to set up the screenings was a family support worker employed by the Pinellas County Sheriff's Office. Since 1999, the sheriff has contracted with the Florida Department of Children and Families to handle all child protection cases in Pinellas.
On Thursday, Sheriff Bob Gualtieri held a press conference on Holder's death in what is arguably his first scandal since he was elected in November. He gave a chronology of the events leading up to Holder's death, and took full responsibility.
"This falls squarely on me," Gualtieri said. "This falls squarely on us at the Pinellas County Sheriff's Office.".
"It's inexcusable and it's not going to happen again.".
The family support worker, who was not identified, contacted St. Petersburg Pediatrics and arranged for a screening for Elizabeth for Jan. 22 and one for Kayla on Jan. 24, way past the three-day threshold, Gualtieri said. The worker also called the Pinellas County Health Department, and listed to a phone message as to when appointments were available, but never followed up.
Gualtieri was careful not to lay all of the blame on the family support worker. He said she didn't receive a form directing her to set up the appointment until Jan. 14, by which time the 72 hours had elapsed or were about to. It was unclear whether the child protection investigator in charge of the case, or a supervisory sergeant, was aware of the appointment made for Elizabeth.
At the same time, there may have been some institutional confusion over the 72-hour deadline, the sheriff said.
When the sheriff's office, which removes children from troubled homes, contracted with Eckerd Community Alternatives, which places them in foster care, it was agreed that the sheriff's office would handle the medical screenings before the children were placed.
The language in the contract is different from the law, Gualtieri said. The contract stipulates the sheriff's office has to "initiate" the medical screening within 72 hours, as opposed to getting it completed, which is what the law stipulates.
At the mobile home park, Elizabeth Holder lived with her sister, her mother, Stephanie Judah, 34, who doesn't work, and her father, Corey Holder, 29, a tree trimmer, according to authorities and neighbors.
Matthew Galvan, who lives next door to the family, said Elizabeth was running around the neighborhood while her mother went to a drug store with Kayla. Galvan said he kept on trying to put Elizabeth back in her trailer, but she kept escaping. Several people in the mobile home park called police.
The neighbors brought Elizabeth back to her mobile home, and confronted Judah, Galvan said. Judah complained, "How am I supposed to watch both of my children when I have to look after the baby," Galvan said.
When sheriff's deputies arrived, Judah admitted to having purchased illegal narcotics on the street three days previously-- methadone, Percocet, and marijuana-- and that she had taken all three the day Elizabeth was running around. Judah also admitted to taking the anti-depressants Wellbutrin and Celexa.
She claimed she had prescriptions for the anti-depressants, but couldn't provide the bottles, according to police records. She was arrested on a charge of child neglect, and was released from the Pinellas County Jail a few days later after posting $ 5,000 bail.
The children's father, Corey Holder, then arrived home, but authorities didn't believe they could leave the children in his care because he, too, was under the influence of non-prescribed prescription drugs, and he was also drunk, Gualtieri said. A decision was made to put the two children in foster care, and they ended up in a foster home in Clearwater.
On Jan. 18, the foster parent had an obligation, and brought Elizabeth and her sister to a babysitter in Dunedin, Gualtieri said, and the sisters spent the night. The next day, Elizabeth played and ate as all children would, but then clutched her head at roughly 4 p.m. while watching television.
The sheriff said the girl had developmental issues-- she still wasn't toilet trained. And Galvan, the neighbor, said Elizabeth sometimes frothed at the mouth. He said both Elizabeth and her sister were born with methadone in their system.
An autopsy was conducted, but the sheriff doesn't expect the results to be available for 60 to 90 days because of toxicology tests. There was no sign of trauma on the girl's body, no sign of physical injury.
Gualtieri said he may never know whether a medical screening would have detected something, and Elizabeth's life could have been saved.
"This is our failure," the sheriff said. "I can only hope that failure did not contribute to her death.".