Tuesday, April 27, 2004 | 10:46 a.m.
Metro Police homicide detectives and prosecutors from the district attorney's office will meet today to determine if charges will be filed against a mother whose diabetic daughter's February death was ruled a homicide last week.
Ariel Botzet died because she did not receive proper care for her Type 1 juvenile diabetes, Clark County Coroner Michael Murphy said last Friday. Her type of diabetes requires continued treatment, and without the treatment, which involves a strict diet and prescription drug regimen, a patient can become ill or die, Murphy noted.
Murphy concluded that the complication that killed Botzet -- keto acidosis -- was a result of medical neglect. Cases of keto acidosis in diabetics involve an acidifying of the blood caused by insulin deficiency.
Because the death apparently was the result of medical neglect, and because the coroner's office defines a homicide as a death at the hands of a person, Murphy classified Ariel's death as a homicide.
Lt. Tom Monahan of Metro's homicide section said the investigation into Botzet's death was "extensive." After looking over the case file and discussing the matter today, police and prosecutors will decide whether to charge the girl's mother, Cheryl Botzet.
One issue that investigators need to sort out is whether Ariel Botzet was supposed to be administering her own medication, Monahan said.
It's not clear why Cheryl Botzet allegedly failed to care for her daughter, Monahan said. The alleged neglect "wasn't (over) a week or two weeks or a month," Monahan said. "It was an extended period of time."
Ariel was a fifth grader at Dearing Elementary School and missed more than 30 days of school last year, authorities said.
Susan Klein-Rothschild, director of Clark County Family Services, said two investigations were conducted into the care of Ariel Botzet in 2003. Both investigations were prompted by complaints from people who felt the girl was not receiving proper medical care, Klein-Rothschild said.
The first investigation began in January 2003. Family services authorities interviewed Cheryl Botzet, Ariel, other family members and Ariel's physician and school nurse.
Cheryl Botzet "provided a great deal of information that indicated to us that she understood her daughter's needs," Klein-Rothschild said. "There was nothing that led us to believe her needs were not being met."
That investigation was closed in May 2003.
The agency received another complaint that summer. Authorities investigated again and followed up to make sure Ariel Botzet was safe, Klein-Rothschild said. They were satisfied that she was not being neglected and closed the case.
Her agency will be reviewing the investigation to see what they can learn from it and determine if they should have done anything differently.
"No child should die like this," Klein-Rothschild said." It's a tragedy in every sense of the word."
The American Diabetes Association Web site states that Type I diabetes requires checking blood sugar and glucose at least once a day. Depending on blood levels, insulin shots are injected.
In addition, the association said that diet plays an important role in balancing a diabetic's blood levels of sugar and glucose. Each person is different and a physician prescribes the proper doses of insulin. The patient learns to test blood and inject insulin.
Diabetes patients and caretakers in the Las Vegas Valley had a variety of opinions about the Botzet case.
Las Vegas resident Howie Cooperstein has lived with Type I diabetes for 22 years. His condition was diagnosed when he was 7 years old and his mother had to help him survive for the first decade or so.
"Mom learned as much about the disease as I did," Cooperstein said. "If it wasn't for my mom learning about the disease, I wouldn't be here today."
That's part of the reason why he believes Cheryl Botzet should be charged in connection with Ariel's death.
Diabetic complications "definitely are preventable," Cooperstein said.
Kidney failure is one of those complications. Blindness is another. A severe complication can lead to death, as in the case of Botzet.
But Sharon Coffman, whose mother and stepmother are diabetics, said she has a "Mommy perspective" on it and wasn't ready to blame Cheryl Botzet.
"Even a child with diabetes is very hard to monitor," Coffman, said.
Coffman wondered whether Cheryl Botzet had any help from school nurses and teachers. Coffman said her 10-year-old daughter suffered from a rare virus in her kidneys and she had to work closely with doctors, school nurses and teachers to ensure her daughter recovered.
"School nurses and the teachers have to know about medical cases like that," Coffman said.
Coffman's mother, Cynthia Vranken, a registered nurse in Carson City, was diagnosed with diabetes in 2001, Vranken said she is on oral medication and a strict diet to control diabetes. She has not had to inject insulin.
"There are so many factors; if you're not with the child 24 hours a day, you can't control the disease," Vranken said.
"We don't know all the facts," Vranken said, whether the family had financial problems and could not afford all the necessary equipment. Diabetes and its treatment are "complicated, and it's not cheap," she said.
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