## Facts

- Virginia Lynnette Fabritz, the mother of three-and-a-half-year-old Windy, left the child on October 1, 1973, in the care of Thomas and Ann Crockett, with whom Fabritz lived.
- Fabritz saw Windy again around 1:00 p.m. on October 3 and found her “very listless”; Crockett attributed the child’s condition to sickness after a “bumpy” motorcycle ride.
- By about 2:30 p.m., Windy complained of cramps and had a slight fever; Fabritz attributed the symptoms to the flu.
- While bathing Windy that afternoon, Fabritz observed the child’s extensively bruised body but did not seek medical care and instead put Windy to bed.
- Around 5:00 p.m., Windy appeared semiconscious; Fabritz still did not take her to a hospital, later stating she was “too ashamed” of the bruises.
- Windy was brought to a hospital late that evening (about 9:45–10:35 p.m.) by Ann Crockett and was pronounced dead on arrival.
- The child had numerous bruises and died from peritonitis due to a perforated/ruptured duodenum caused by blunt trauma; medical evidence placed the infliction of injuries within 18–24 hours of death.
- Medical testimony indicated Windy would have survived if operated on approximately 12 hours before death and might have survived if operated on about one hour before death.
- It was undisputed that Fabritz did not inflict the beating and did not know in advance the Crocketts would abuse Windy.
- Fabritz was convicted by a jury of child abuse under Md. Code, Art. 27, § 35A, on the theory that her failure to obtain prompt medical care caused additional injury and death.

## Issues

1. Whether a parent who did not inflict the initial beating can “cause abuse” under Md. Code, Art. 27, § 35A by knowingly failing to obtain medical care for a severely injured child, resulting in additional physical injury and death.
2. Whether the evidence permitted a rational jury to find that the parent’s omission constituted “cruel or inhumane treatment” and was a substantial factor in producing additional injury.

## Decision

- The Court of Appeals of Maryland reversed the intermediate appellate court and reinstated the conviction and five-year sentence.
- The court held that “causes abuse” under § 35A is not limited to causing the original injury; it includes subsequent conduct or omission that results in additional physical injury.
- The court concluded a jury could find that Fabritz’s knowing failure to seek medical help for many hours after observing the child’s condition was “cruel or inhumane treatment.”
- The court found the medical and timing evidence sufficient for a jury to determine the omission was a substantial factor in causing additional injury and death.

## Legal Principles

- A parent may “cause” child abuse under Md. Code, Art. 27, § 35A through an omission when the omission constitutes “cruel or inhumane treatment” and results in additional physical injury to the child.
- “Cruel or inhumane treatment” is given its common meaning and can include serious neglect of a child’s urgent medical needs.
- Parents have an affirmative legal duty to provide reasonable medical care; breach of that duty can support criminal liability when it leads to further bodily harm.
- Causation under § 35A may be established where the failure to seek medical care is a substantial factor in producing additional injury, including death, even if the defendant did not inflict the initial trauma.
- A jury may infer the required culpability from evidence that the parent knew or should have known of the child’s urgent condition yet consciously failed to obtain medical assistance.

## Conclusion

The court held that felony child abuse may be proved where a parent, though not the initial assailant, knowingly withholds necessary medical care in circumstances showing cruel or inhumane treatment, and that omission causes additional physical injury and death.


State v. Fabritz, 276 Md. 416, 348 A.2d 275 (1975)