Mother, interrupted: CPS accused her of everything from neglect to excessive care, never proved anything, and took her daughter anyway

They reported what they called "shuddering spells" to Dunlavy, who wasn't in the room during the session, and suggested she have her daughter checked by a neurologist.

Dunlavy called Berger's office and left a message for him. Later that day she was told to bring Sarah to Phoenix Children's Hospital, where she would be evaluated for both the shuddering spells and also her feeding issues, as Shub had suggested at their consultation.

She followed their instructions, but she had no idea what was going on behind the scenes. Between her first phone call and Sarah's arrival at the hospital, Berger called Phoenix Children's and made a very serious allegation.

He wanted the hospital to evaluate Dunlavy for Munchausen Syndrome by Proxy, though the note made in Sarah's medical records does not say why.

(Interestingly, the two therapists who first noticed the shudders — and who had been treating Sarah for more than six months, at that point — were never consulted when the MSBP diagnosis was made. Not by the doctors at Phoenix Children's Hospital, and not by CPS.)

Twelve days later, Dunlavy lost her daughter.

She never suspected a thing, but Carol Dunlavy and Sarah were under constant surveillance at Phoenix Children's Hospital.

The hospital would not comment on her case, nor would it answer questions about Munchausen Syndrome by Proxy. Debra Stevens, a spokeswoman for the hospital, did say the hospital has a zero tolerance policy when it comes to child abuse.

In Dunlavy's situation, it's difficult to determine from the records exactly what she was doing wrong.

The accusations made against her by CPS claim she wanted to expose her daughter to unnecessary medical procedures, like the feeding tube.

But Dunlavy made it clear she didn't want the surgery for her daughter from the moment it was brought up, a fact documented in reports from both GI surgeons she visited and the admitting physician at PCH who wrote, "Mom says she would rather not see her child get a PEG tube."

Yet on October 26, forensic pediatrician Jennifer Geyer wrote a report recommending the child's removal and accusing Dunlavy of pushing for the tube.

"I am concerned that [the child] may have progressed to surgery if there had been no intervention," she wrote, despite a report written only one month earlier from a GI doctor at the same hospital stating otherwise.

The doctors at PCH also accused Dunlavy of lying about seizures in her child. While Sarah was admitted to find out what caused the shudders observed by her therapists, the admitting documents show Dunlavy never said the word seizure. She still just calls them "shudders."

The hospital found no evidence of epileptic activity, though it did record two shuddering episodes, which have never been explained.

Because Sarah was hooked up to an EEG, to monitor her brain activity and detect seizures, the room was under video surveillance — though notes show this was used more to watch Dunlavy than to monitor the child.

During the hospital stay, controversy constantly swirled around Sarah's eating habits. She was put on a strict feeding plan — too strict, in Dunlavy's opinion. She worried her daughter wouldn't eat anything, and notes do show behavior typical of Sarah's fussy eating habits. Sometimes she would eat a few bites, but she was just as likely to throw her pancakes or use her fruit slices as building blocks. She did this whether or not her mother was in the room.

Dunlavy decided she didn't want to follow the strict plan and made it known that if her daughter asked for something to eat, she was going to give it to her, even if it wasn't on the menu.

"My view was, why don't you feed her what she normally eats? And then you can see what her normal intake is," she says. "When she didn't eat, I wanted to be allowed to give her other things like ice cream to fatten her up."

She was caught on camera doing so. A nurse's note from October 20, 2007, says, "RN got call from video monitor today said mom is feeding patient bagel and milk via sippy cup."

A note from the attending pediatrician that same day indicates there was no medical reason why Sarah's diet couldn't be expanded.

Another note accuses Dunlavy of throwing a diaper away. Under the feeding plan, Dunlavy was supposed to weigh and save all diapers. She acknowledges she put it in the trash but says she wasn't trying to hide it from doctors; she'd just forgotten. By this point, there was so much controversy over the plan, in general, that the diaper incident was regarded with great suspicion.

Boston-based psychologist Eric Mart, a national expert on Munchausen Syndrome by Proxy, says this is common in cases where MSBP is alleged.

"One thing you see frequently is that these allegations often come up after there's an altercation between the parent and doctor," he says. "Next thing you know, it's Munchausen."

On October 22, the doctors decided they had enough evidence to remove the child from her mother's care. Up until this day, her father had not been very active in Sarah's life. He'd come by the house to see her on occasion, but medical records show he admitted in an interview with a PCH speech therapist his lack of involvement.

Records also show he became very concerned about Sarah after the allegations CPS made against her mother.

The thing is, nothing about the child's feeding behavior changed after Dunlavy was out of the picture.

Notes indicate Sarah was just as disinterested in eating with her dad as she was with her mom: "Secondary to dad's surprise arrival, patient lost all interest in food . . . as soon as patient saw cafeteria she started crying and said, 'No, no!' Sat on dad's lap and took one bite of grilled cheese. Patient was not interested in food.

But the final nail in Dunlavy's coffin was her big lie. For most of the time Sarah was in the hospital, the staff thought her mother was a child psychologist. To them, this meant she had the medical knowledge to fake an illness — a classic MSBP sign. Later, after the father was involved, he told them the child psychologist line was a lie. Lying or exaggeration are also MSBP red flags, and it made her look terrible in the hospital staff's eyes. Geyer reported there were concerns about her "deliberately deceitful" behavior.

Dunlavy never thought it would go so far.

"The only thing I ever said to the doctors that was not true was that I had a degree. I have self-esteem issues; I think that's pretty obvious. But I don't feel in my heart that because of what I told [her father] I deserve to lose my daughter," she says. "She was completely separate from that. It was 4 1/2 years before she was even born."

On the morning she lost her daughter, Dunlavy left the hospital, planning to go home, do some laundry, and get back to Sarah's bedside by afternoon.

Instead, at 10 a.m. there was a knock on her door. It was a CPS case manager, there to serve Dunlavy with a notice to remove her child. The official accusation: neglect.

Dunlavy doesn't remember the first moments after finding out. She says she stayed in a state of shock for days; she lost 16 pounds in two weeks.

She barely got to say goodbye. She was allowed to visit Sarah for one hour with her father's supervision.

According to hospital notes, when visiting hour was over, the child began to cry and say, "Don't want mommy and daddy to go." She was used to spending every night with her mom. She was in a new room where the hospital was using a pseudonym so Dunlavy couldn't find her. She had an ankle bracelet on — the kind that people on house arrest wear — so she couldn't leave the room.

"Do you know how horrific it was to see her like that? With an ankle bracelet on her?" asks Dunlavy.

Dunlavy began to cry.

"Can't I just stay with her until she calms down?" she asked the nurse.

She couldn't. She didn't see her daughter again for three weeks.

Though she was first accused of neglect, by October 30, CPS had changed its allegation to Munchausen Syndrome by Proxy.