Doctors for a 15-year-old Omaha girl have taken steps to make sure she undergoes radiation and chemotherapy treatment that they say her mother wasn’t pursuing. Her mother, meanwhile, says she’s not refusing to seek treatment for her daughter, she just wants a second opinion.
In February, Angelica Koenig underwent two surgeries to remove a tumor on her brain.
More than a month after the second surgery, Angelica’s neuro-oncology team, including doctors and social workers, met to discuss the prognosis, which, according to court documents, had been repeatedly shared with Angelica’s mother and stepfather.
With radiation and chemotherapy, the five-year survival rate for Angelica’s type of brain tumor is between 50 and 70 percent, according to an affidavit. Without radiation and chemo, the affidavit says, the likelihood of her surviving past one year is less than 10 percent.
But Angelica has yet to start those treatments, according to a motion for immediate custody filed this week.
The motion asks that the 15-year-old be placed in the temporary custody of the Nebraska Department of Health and Human Services so she can receive urgent cancer treatments that, according to the affidavit, her mother, Stefanie Koenig, decided to forgo.
Stefanie Koenig’s lawyer, Renee Mathias, said Thursday that the affidavit is “hearsay upon hearsay.”
“You have a mom who is advocating for the best interest of her child,” Mathias said, adding that religious or financial concerns are not factors in the case. “She does not want to be portrayed as someone who is refusing medical treatment for her child. That’s the farthest thing from the truth.”
If a judge decides to grant custody to the state, Angelica could remain living with her mother but would receive the recommended treatments, Douglas County Attorney Don Kleine said.
According to the affidavit from Dr. Suzanne Haney of Children’s Hospital & Medical Center:
On Feb. 27, two weeks after Angelica’s second surgery to remove the tumor, her mother refused to allow doctors to place a port for the girl’s chemotherapy, as was scheduled.
The family also failed to attend an appointment to start radiation therapy, scheduled for March 12.
After multiple phone calls to reschedule, Stefanie Koenig replied to an email stating, “We want to hold off on her treatment” and that she wanted “to get a hold of my own referrals from other doctors.”
A port placement then was scheduled for March 16, but the family again refused. More than 10 phone messages were left on the family’s phone that “emphasized the urgency of initiating treatment for child survival.”
A social worker was sent to the family’s home. Stefanie Koenig refused to commit to a March 19 appointment and said that chemotherapy and radiation were not in the family’s plan because her daughter didn’t want those treatments. Stefanie Koenig told the social worker that she “felt negative energy” and had a “gut feeling” to not pursue treatment. The mother was informed that a report would be filed if the family did not return to the hospital on March 19 “due to risk to the child in continuing to delay curative-directed therapy for her brain tumor.”
Mathias said Stefanie Koenig has scheduled an appointment at Nebraska Medical Center to receive a second opinion about further treatment for her daughter. She also has reached out to St. Jude Children’s Research Hospital, Mathias said.
Mathias said Stefanie is not opposed to radiation or chemotherapy for her daughter if the oncologist they visit on Monday decides it is the best treatment. Jennifer Walkingstick, a guardian ad litem for Angelica, declined to comment on whether Angelica wants those treatments, citing her client’s privacy.
Kleine said these cases are rare and difficult.
“There’s always the line of whether the state should get involved,” he said.
In this case, Kleine said he hopes the issue is resolved before a hearing scheduled for Wednesday.
“It sounds like maybe if the family is seeking other opinions, they will answer the question in their minds of whether treatment is the best option,” Kleine said.
In juvenile court, he said, the goal is always to do what is in the best interest of the child, which may not always be what the parents want.
“Doctors have told us they want to treat this child, that it would be beneficial,” he said. “Then it comes down to whether the child should have the treatment if the parents are saying no.”