Overview of The Preventionist — Ep. 3
This episode follows Amanda Saranofsky’s four‑year ordeal after a December 2019 incident in which her newborn suffered a brain bleed and fractures. Child abuse pediatricians at Lehigh Valley Health Network concluded the injuries were abusive head trauma, leading to criminal charges against Amanda, removal of all five of her children, years of foster placements, and a long legal fight. The episode examines how a single medical opinion can trigger dramatic family separation, the contested medical evidence, the human harms that follow, and broader systemic questions about how child welfare decisions are made.
Key narrative and timeline
- December 2019 — Amanda’s newborn found on the floor, with onesie unzipped and diaper off. EMTs transport the baby to Lehigh Valley Hospital; exams later note brain bleed and fractures.
- Child protection team evaluation: Dr. Rashida Doshi (and later Dr. Deborah Asernio Jensen) concluded the injuries reflected violent shaking with impact — i.e., abusive head trauma — and certified the case as a near‑fatality.
- Children removed from Amanda: all five children were placed in various foster or relative settings; contact was restricted.
- Criminal case: Amanda charged with multiple felonies and misdemeanors. After years of delay and public scrutiny, she pled no contest to reckless endangerment (a plea with no sentencing) rather than risk trial.
- 2023 — Lehigh County Comptroller Mark Pinsley released a report highlighting numerous disputed cases tied to Dr. Jensen; protests and lawsuits followed (27 families sued the hospital and clinicians).
- Post‑report actions: DA’s office reviewed cases where Dr. Jensen testified; at least one long sentence was reduced. Dr. Jensen was removed as medical director, later retired from LVHN, but remains active professionally (including work as an FBI consultant).
- Amanda’s aftermath (2024–2025): Four of her five children were reunited with her; the youngest (placed in a program making reunification unlikely) remains with foster parents. Amanda filed a civil custody action seeking shared legal custody and a gradual plan for physical custody.
Main takeaways and themes
- Single expert influence: The episode shows how determinations by child abuse pediatricians can make removal and criminal prosecution imminent, even when medical certainty is disputed.
- Medical disagreement: Three independent child‑abuse experts who reviewed the anonymized records said the scans and clinical course did not show classic hallmarks of abusive head trauma, and none would have recommended removing the children.
- Human cost of removal: The podcast emphasizes ambiguous loss and trauma — for children and parents — created by separation, unstable foster placements, and the long uncertainty of the system.
- “Better safe than sorry” questioned: The episode critiques reflexive removal as a policy posture that, when applied without clear evidence, can cause serious harm.
- System-level reforms and accountability: Pinsley’s report and subsequent reviews prompted reexamination of cases, lawsuits, and institutional changes — but accountability and remedy remain slow and incomplete.
Evidence and expert disagreement
- Drs. Doshi and Jensen concluded injuries required tremendous force (violent shaking with impact), asserting the newborn was near‑fatal.
- Three external child abuse experts, reviewing the same records, found:
- No classic signs of rotational injury, no severe retinal hemorrhages, no neck injury.
- The infant remained conscious/alert and didn’t require life‑saving interventions — conflicting with the “near‑fatality” label.
- None recommended separation of the children; one would have labeled the event an accident and monitored the family.
- The episode argues for routine second opinions and cautions against treating one CAPs’ assessment as dispositive.
Systemic context, statistics, and policy points
- Removal calculus: Legal scholarship cited in the episode stresses removal should happen “only when absolutely necessary to protect children from serious imminent harm.” Overreach causes its own harms.
- Prevalence: An estimate referenced says nearly 40% of U.S. children will be subject to a child abuse investigation; for Black children the estimate is ~53%.
- Legal reforms: Texas, Washington, and Georgia have laws that allow for independent reviews/second opinions in child abuse medical assessments — a model the episode suggests other states could adopt.
- Local reform example: Northampton County shifted toward prevention and family preservation; it halved its foster care population over four years (from 319 children).
Human impact: Amanda’s experience (highlights)
- Separation trauma: Her children experienced multiple foster placements, witnessed domestic violence in a placement, and one child had repeated moves (10+).
- Parenting under scrutiny: Amanda lost employment, limited social interactions for fear of scrutiny, and endured years of legal uncertainty and stigma.
- Reunification complexity: Four children returned home before the episode; the youngest remained with foster parents who sought to retain him under a subsidized permanent legal custodianship program (SPLIC), forcing Amanda to fight in civil court.
- Emotional dilemma: Amanda agonized over whether removing her son from a stable foster home would cause further harm; she ultimately sought gradual, therapy‑supported reunification rather than abrupt removal.
Notable quotes and perspectives
- County executive Phil Armstrong: “I’m very, very confident in our youth program… we’ve been following the correct steps.”
- Hospital’s court filing: Praised Dr. Jensen as “dedicated, passionate, and eminently qualified” and warned that allegations against child abuse pediatricians are dangerous for children.
- Episode’s thesis: “Families deserve a second opinion.” The host frames second opinions and institutional humility as practical protections against catastrophic errors.
Outcomes, accountability, and unanswered questions
- Litigation: 27 families sued Lehigh Valley Health Network, Dr. Jensen, and members of the child protection team; resolution will take years.
- Institutional changes: Dr. Jensen stepped down as medical director and retired from LVHN; yet she continues to work publicly (e.g., conference talks, consulting).
- Criminal adjustments: DA review led to sentence reductions in at least one case.
- Ongoing cases: Amanda’s custody trial (as of the episode) is scheduled for the fall; the outcome remains unresolved.
Recommendations and policy implications offered by the episode
- Require and fund routine second medical opinions in contested child abuse evaluations (as several states now do).
- Shift child welfare practice toward prevention and family preservation where safe and possible, rather than default to removal.
- Increase transparency, independent review, and accountability for child abuse medical findings that trigger removal or criminal charges.
- Provide more supports for families (in‑home services, mental‑health care, economic supports) to reduce unnecessary separations.
- Recognize and mitigate trauma caused by removal — prioritize sibling placement stability and kinship care where appropriate.
Credits and production notes
- Host/reporter: Diane Neary; produced by Serial Productions and The New York Times.
- Additional reporting: Ben Phelan and Janelle Pfeiffer.
- Editors and fact‑checkers and many contributors acknowledged on the episode.
- The episode uses interviews, court filings, medical records, and expert reviews to tell Amanda’s story and examine broader systemic issues.
This episode is both a case study and a policy argument: it shows the consequences when a contested medical opinion triggers removal and prosecution, and it urges systems to build checks (second opinions, prevention, and care) so that interventions intended to protect children do not themselves become a source of lasting harm.