Friday, May 21, 2004 | 11:10 a.m.
The mother of an 11-year-old diabetic girl who died because her insulin level dropped too low was charged with murder Thursday.
A doctor told Metro Police investigators that if Cheryl Botzet had sought medical care for her daughter, Ariel, the girl would not have died, the arrest report notes.
Police and prosecutors allege Botzet neglected Ariel.
"Under the statute if a child dies as a result of abuse or neglect it can be considered murder," District Attorney David Roger said. "This wasn't a one-incident case, this happened over a long period of time."
However, Herb Sachs, Botzet's attorney, called the murder charge "absolutely ridiculous" and said Ariel died as a result of her illness.
"If you read the (police paperwork) it says she had malice aforethought," Sachs said. "My client did not sit down in a chair and think, 'I want to kill my daughter.' "
Botzet, a union laborer who works on an on-call basis, was expected to surrender this morning to Metro Police, Sachs said.
"She is tremendously upset by this," he added.
Ariel, who had Type 1 or juvenile diabetes, died Feb. 9 at University Medical Center of diabetic ketoacidosis, a condition involving an acidifying of the blood caused by insulin deficiency.
An autopsy showed the condition was a result of chronic medical neglect.
Dr. Alan Rice, a pediatric endochronologist, told investigators that Ariel's type of diabetes was easily controllable with a balanced diet and regular doses of insulin, the police report says.
For Ariel to have ketoacidosis, she must not have been receiving proper levels of insulin, probably for several days, Rice told police.
Ariel was diagnosed with diabetes when she was three years old, and Cheryl and Ariel's father, Randy Botzet, received training on how to monitor and control her disease, the arrest report notes. Cheryl and Randy Botzet are in the process of divorcing.
Diabetic ketoacidosis can be mistaken for a cold or flu, the report says, and parents of diabetic children are instructed that if their child appears ill that immediate medical attention should be sought.
Rice told police Ariel was last in his office in April 2003. He told investigators that even when a diabetic child is receiving perfect care the child should be checked by a doctor every three months, and blood sugar readings should be done at least four times a day.
When Ariel was seen by Robert Lynn, a nurse practioner in Rice's office, Botzet told him her daughter was "a new diabetic," the report says. Lynn gave Botzet a training session on how to manage her daughter's disease, according to the police report.
Lynn became concerned after getting phone calls from a nurse at Laura Dearing Elementary School where Ariel was a student indicating Ariel was getting "inconsistent" care from her mother, the report says. He set up several follow-up appointments with Botzet but she allegedly cancelled them.
Botzet told investigators she and Ariel moved to Colorado in April 2002 to receive care from a diabetes educator "who ran a very good illness management program." They returned to Las Vegas that December.
Clark County school records show Ariel was absent from school 26 times between December 2002 and July 2003. She was absent 17 times in the 2003-2004 school year.
During her absences from school there is no record through insurance billing records that Botzet took Ariel to the doctor, the report says.
Botzet told the school nurse that she was managing Ariel's illness at home and didn't want the girl's blood-sugar levels to be tested, the report says. The nurse began having Ariel come to the nurse's office to test her own blood sugar levels.
The logs from the nurse's office show that during the 2002-2003 school year, if Ariel's blood-sugar levels were too high, Botzet would come to school to give her a shot, the police report says.
But through that school year and into the next, the report says, Botzet stopped coming to the school altogether. By October 2003, each time Ariel called to tell her that her blood-sugar was too high, Botzet allegedly told her to drink water, do some exercises and return to class.
In January 2003 the nurse called Child Protective Services regarding Ariel's care. An investigator conducted a home visit and found that Botzet had insulin and proper supplies, and Ariel said she was receiving good care from her mother.
CPS opened a new investigation in June 2003 based on a different complaint. Officials asked Botzet to submit to a drug test and methamphetamine was found in her system, the report says.
Botzet denied using drugs and a second test conducted a week later showed no illegal drugs.
The police investigation showed that Rice ordered two vials of insulin for Botzet in August 2003 but they were never picked up from the pharmacy.
Two days before Ariel died, Botzet brought her into a University Medical Center Quick Care clinic and the medical staff determined the girl was suffering from severe dehydration and diabetic ketoacidosis.
She was transferred to UMC but had already lapsed into a coma, the report says. Efforts to revive her failed and she was pronounced dead.
Botzet told investigators she had given her daughter insulin in the days leading up to her death. Four days before the death, she had called Rice's office and said she had run out of insulin and received a perscription.
Botzet said she didn't take Ariel to the doctor more often because when she called she was placed on hold for too long, the report says.
She admitted to not checking Ariel's blood sugar levels four times a day as required by the doctor.
When asked about the police allegations that Botzet was not giving Ariel proper care, Sachs, her attorney, said, "Proper care is what one thinks proper care is."
"My investigation showed she did what was required of her with a diabetic daughter. She tested her and gave her shots," he said.
Sachs said Botzet planned to plead not guilty to the murder charge.
"She is being over-charged," he said. "I don't think any charges are proper."
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