DCF v. K.B, A.B

DISTRICT COURT OF APPEAL OF FLORIDA
SECOND DISTRICT
In the Interest of A.B. and K.B., children.
DEPARTMENT OF CHILDREN AND FAMILIES and
STATEWIDE GUARDIAN AD LITEM OFFICE,
Appellants,
v.
K.B. and A.B.,
Appellees.
No. 2D2025-2510
February 18, 2026
Appeal from the Circuit Court for Hillsborough County; Leslie Schultz-
Kin, Judge.
Mary Soorus of Children's Legal Services, Tampa, for Appellant
Department of Children and Families.
Sara Elizabeth Goldfarb, Statewide Director of Appeals, and Sarah Todd
Weitz, Senior Attorney, Tallahassee, for Appellant Statewide Guardian ad
Litem Office.
Rinky S. Parwani of Parwani Law, P.A., Tampa, for Appellee K.B.
David A. Dee, Tampa, for Appellee A.B.
BLACK, Judge.
The Department of Children and Families appeals from the order
denying its expedited petition for termination of parental rights as to the

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parents of A.B. and K.B.1 We reverse and remand for further
proceedings.
The children, ages six and two, were sheltered on September 21,
2024. The Department filed its expedited petition for termination of
parental rights as to both the mother and the father on October 15,
2024. The petition alleged egregious conduct, pursuant to section
39.806(1)(f), Florida Statutes (2024), and chronic abuse, pursuant to
section 39.806(1)(g). The petition also alleged grounds for single parent
termination pursuant to section 39.811(6). A trial was held on June 9,
2025.
Because our conclusion as to egregious conduct is dispositive, we
address the evidence relevant to that ground for termination. We note
that section 39.806(1)(f) permits termination of parental rights to
siblings, even in the absence of proof of a nexus between the egregious
conduct and the potential harm to the siblings, such that a discussion of
the evidence of A.B.'s abuse is unnecessary.
The record reflects that K.B., two years old, was taken by her
parents to Advent Health Hospital's emergency room on September 6,
2024. She was hypothermic, bradycardic, and severely emaciated. In
the emergency room K.B. received two "code doses" of epinephrine and
atropine. She weighed sixteen pounds. K.B. was subsequently flown
from Advent Health to St. Joseph's Children's Hospital where she was
admitted to the pediatric intensive care unit (PICU). An abuse report for
failure to thrive and medical neglect was made following K.B.'s
1 Though the court denied the petition, it determined that the
children would remain in their respective placements and that case plans
for the parents would be developed.

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September 8, 2024, admission to St. Joseph's. While in the PICU, K.B.
required an epinephrine drip.
At the trial on the petition for termination, the Child Protection
Team advanced practice registered nurse (APRN) who evaluated K.B.
following the abuse report was accepted as an expert in the fields of child
abuse and child neglect. The APRN testified that K.B. was nonverbal,
had no purposeful movements, and was severely emaciated. K.B. had
muscle wasting; she had no fatty subcutaneous tissue. She was in the
third percentile for both height and weight, indicating failure to thrive,
and her Z-score was negative six, indicating severe malnutrition. The
APRN testified that she had "never seen" in her twenty-three-year career
a negative six Z-score. K.B.'s medical records included that cardiologists
had determined that K.B.'s heart failure was the result of severe
malnutrition; her body had begun to break down her muscles and organs
to be used as energy. K.B. could not sit unassisted, and her body was
rejecting nourishment, indicating "a prolonged period of starvation." K.B.
remained in the hospital for two months. During that time the parents
declined some medical intervention, including a feeding tube. The APRN
testified that the parents' medical decision-making rights were removed
by court order, and a feeding tube was placed. During her
hospitalization, K.B. gained nine pounds.
In addition to evaluating K.B., the APRN also spoke with K.B.'s
mother. K.B.'s mother reported that K.B. had not seen a doctor in more
than a year. The mother reported that K.B. began having difficulty
keeping food down a month prior to her admission to the hospital.
The APRN's opinion was that there was evidence of medical neglect
for the parents' failure to seek medical care, and she testified, over

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objection, that she had "concerns about the family's ability to recognize
when there is a problem with the child."
Subsequent to her hospitalization and shelter, K.B. had significant
testing completed. She was diagnosed with chromosome six deletion and
sickle cell trait. The APRN could not testify as to whether or how those
diagnoses may have been responsible for K.B.'s malnourishment. She
clarified that chromosome six deletion is present at birth and causes
developmental delays but that K.B. would not have become emaciated
within a short period of time. The APRN testified that had medical care
been sought, the child would not have presented to the emergency room
in critical condition with heart failure.
The mother testified that K.B. began showing signs of sickness in
the month before her hospitalization. The mother believed that K.B. had
acid reflux, causing her to spit out foods. According to the mother, K.B.
did not spit up at every meal and stopped spitting up completely for a few
weeks after the parents implemented changes to accommodate the
suspected acid reflux. However, K.B. began spitting up again, and the
parents took her to the hospital a few days thereafter. K.B. had not been
to a pediatrician since she was four months old, but K.B. had no medical
issues and there were no health concerns prior to the month preceding
K.B.'s hospitalization. The mother testified that K.B. had lost some
weight due to the spitting up, but she did not know how much because
she did not weigh the child.
K.B.'s case manager testified that K.B. requires around-the-clock
care and has been in medical foster care since her release from the
hospital. K.B. has a cardiologist, neurologist, and gastrologist, among
other specialists. She still has a feeding tube.

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The court ordered written closing arguments and ultimately denied
the petition for termination. In its order, the trial court found that the
Department had failed to prove by clear and convincing evidence that
K.B.'s parents had engaged in egregious conduct. While the court found
that the evidence demonstrated that K.B. was the victim of medical
neglect, the court determined that the medical neglect did not rise to the
level of egregious conduct. Specifically, the court found that while the
Department's witnesses were credible, none could explain whether or
how K.B.'s diagnosed medical conditions impacted her medical crisis.
The court also found the evidence insufficient to prove that the parents
failed to timely seek medical care. The court found that the
Department's evidence only "somewhat refuted" the mother's testimony.
The court also found that the Department had failed to meet its
burden to establish chronic abuse. Importantly, the court acknowledged
the testimony that K.B. would have needed medical care for a lengthy
period of time and had not had pediatric care in two years; but it
reiterated that no evidence established how or whether K.B.'s diagnosed
conditions impacted her medical crisis.
On appeal, the Department contends that it presented clear and
convincing evidence that K.B.'s life was threatened as a result of the
parents' failure to seek medical care, meeting the definition of egregious
conduct. The Department points out that the parties stipulated that the
APRN was an expert in child abuse and child neglect and that she
testified:
[E]ven if the child had a chromosomal deficiency and had
difficulty eating, that would have been present for a period of
time. It would have been present since birth. So had medical
care been sought, those issues would have been resolved and
. . . would not have resulted in critical condition with—and
heart failure, and . . . arriving to the emergency room.

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The Department argues that the clear and convincing evidence
established that notwithstanding K.B.'s diagnoses, the parents engaged
in egregious conduct by failing to seek care for K.B. until she was
severely malnourished, experiencing muscle waste and heart failure. As
the APRN testified: "[T]he chromosomal deficiency is not what caused the
child to crash. It was the malnourishment and the heart failure that
caused the child to crash."
Our review is highly deferential, even in appeals from denials of
termination. See Dep't of Child. & Fams. v. D.E., 325 So. 3d 277, 279
(Fla. 5th DCA 2021) (quoting C.D. v. Dep't of Child. & Fams., 164 So. 3d
40, 42 (Fla. 1st DCA 2015)). Nonetheless, "an appellate court is not
required to defer to the trial court where there is no theory or principal of
law that would support the trial court's conclusions of law." Id. (quoting
Statewide Guardian Ad Litem Program v. A.A., 171 So. 3d 174, 177 (Fla.
5th DCA 2015)). And "[a]n appellate court may reverse the trial court's
order denying a petition to terminate parental rights when the denial is
not supported by competent substantial evidence and is not in the best
interests of the children." Dep't of Child. & Fams. v. K.F., 916 So. 2d 948,
950 (Fla. 4th DCA 2005) (citing Dep't of Child. & Fams. v. A.D., 904 So.
2d 480, 482 (Fla. 1st DCA 2005)); see also Dep't of Child. & Fam. Servs. v.
L.McC., 820 So. 2d 1064, 1065 (Fla. 2d DCA 2002) ("Where clear and
convincing evidence is required, the trial court's findings should not be
overturned on appeal unless the findings are clearly erroneous or lacking
in evidentiary support." (first citing Fla. Bar v. Hooper, 509 So. 2d 289,
290 (Fla. 1987); and then citing Doe v. Dep't of Health & Rehab. Servs.,
563 So. 2d 655, 662 (Fla. 1st DCA 1990))). Further, "[w]here the
testimony on the pivotal issues of fact is not contradicted or impeached
in any respect, and no conflicting evidence is introduced, these

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statements of fact can not [sic] be wholly disregarded or arbitrarily
rejected." Dep't of Child. & Fams. v. J.J., 368 So. 3d 1017, 1022 (Fla. 5th
DCA 2023) (quoting Guardian ad Litem Program v. K.H., 276 So. 3d 897,
902 n.2 (Fla. 3d DCA 2019)). "A trial court may reject an unrebutted
expert opinion when ruling on a case, but 'it is not free to do so
arbitrarily.' " E.L. v. A.L., 357 So. 3d 792, 795 (Fla. 2d DCA 2023)
(quoting Morroni v. Wilmington Sav. Fund Soc'y FSB, 292 So. 3d 514, 518
(Fla. 2d DCA 2020)).
To prevail in its petition for termination of parental
rights, [the Department] must prove three elements by clear
and convincing evidence. Two are statutory: (1) a ground for
termination; and (2) "the child's manifest best interests would
be served by granting the petition to terminate parental
rights." The Florida Supreme Court requires the third:
termination must be "the least restrictive means of protecting
the child from serious harm."
Dep't of Child. & Fams. v. S.S.L., 352 So. 3d 521, 523-24 (Fla. 5th DCA
2022) (citations omitted) (first quoting E.K. v. Dep't of Child. & Fams., 326
So. 3d 149, 152 (Fla. 1st DCA 2021); and then quoting Padgett v. Dep't of
Health & Rehab. Servs., 577 So. 2d 565, 571 (Fla. 1991)). However, if the
Department establishes egregious conduct "[r]easonable efforts to
preserve and reunify families are not required." § 39.806(2). That is,
once egregious conduct is found, termination is the least restrictive
means of protecting the children. K.E. v. Dep't of Child. & Fams., 263 So.
3d 202, 213 (Fla. 2d DCA 2019) ("Ordinarily, to prove that termination of
parental rights is the least restrictive means of protecting the child, the
Department must show that it has made a good-faith effort to
rehabilitate the parent and reunite the family, such as through the
provision of a case plan. However, in cases involving egregious conduct
by a parent, 'the termination of parental rights without the use of plans

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or agreements is the least restrictive means.' " (citation omitted) (quoting
In re T.M., 641 So. 2d 410, 413 (Fla. 1994))).
Section 39.806(1)(f) provides that termination may be warranted
when "[t]he parent or parents engaged in egregious conduct or had the
opportunity and capability to prevent and knowingly failed to prevent
egregious conduct that threatens the life, safety, or physical, mental, or
emotional health of the child or the child's sibling." Subsection (1)(f)2
specifies that " 'egregious conduct' means abuse, abandonment, neglect,
or any other conduct that is deplorable, flagrant, or outrageous by a
normal standard of conduct" and "may include an act or omission that
occurred only once but was of such intensity, magnitude, or severity as
to endanger the life of the child."
The court's basis for denial—that the evidence was insufficient to
establish egregious conduct—is not supported by competent substantial
evidence. The court laid out the mother's testimony and found that the
APRN's testimony "somewhat refuted" the mother's testimony. But the
trial court offered no explanation for rejecting the APRN's unrefuted
testimony. The parties stipulated that the APRN was an expert on child
abuse, and her testimony regarding K.B.'s physical condition was
unrebutted. The undisputed evidence included that K.B. presented to
the hospital in critical condition: she was bradycardic and hypothermic
and required an epinephrine drip. Cardiologists determined that K.B.'s
heart failure was the result of severe malnutrition; her body had begun
to break down her muscles and organs to be used as energy. While
K.B.'s mother testified that it was only in the month before being taken
to the hospital that K.B. began spitting out food, that testimony did not
contradict the APRN's testimony that K.B. presented to the emergency
room hypothermic, bradycardic, and severely emaciated or that she

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required an epinephrine drip while she remained in PICU. Thus even
crediting the mother's account of the timeframe—that K.B. had only been
spitting up for a month before her hospitalization—rather than the
expert's testimony that K.B.'s condition was the result of "a prolonged
period of starvation . . . probably many months," the parents' failure to
provide medical care before K.B. was in critical condition is egregious
conduct. It is neglect that on the unrefuted evidence presented to the
court endangered the life of the child as required under section
39.806(1)(f). See K.F., 916 So. 2d at 949-50 (reversing for termination of
parental rights where the undisputed evidence included that the children
had not received medical care since birth and exhibited signs of
starvation or were nutritionally at risk).
The court's denial of the petition for termination is not supported
by competent substantial evidence. The Department presented clear and
convincing evidence of egregious conduct supporting termination of
rights as to both K.B. and A.B. See § 39.806(1)(f) ("Proof of a nexus
between egregious conduct to a child and the potential harm to the
child's sibling is not required."). As a result, we do not address the
second basis for termination, chronic abuse. See § 39.802(4)(a)
(requiring that "at least one of the grounds listed in s. 39.806 has been
met"); M.S. v. Dep't of Child. & Fams., 210 So. 3d 147, 152-53 (Fla. 2d
DCA 2016) ("Only one ground is required for termination." (first citing
S.B. v. Dep't of Child. & Fam. Servs., 80 So. 3d 438, 439 (Fla. 2d DCA
2012); and then citing A.H. v. Dep't of Child. & Fams., 63 So. 3d 874, 877
(Fla. 1st DCA 2011))).
Because the trial court found that termination was not supported
by clear and convincing evidence, it did not address whether termination
is in the manifest best interests of the children. And while there was

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testimony presented regarding the children's manifest best interests, the
Department does not ask this court to make a manifest best interests
determination. It asks this court to remand the matter to the trial court
for the trial court to make findings regarding manifest best interests. See
Guardian ad Litem v. S.P., 412 So. 3d 944, 954 (Fla. 5th DCA 2025)
("[W]e find that [the Department] established the[] two elements regarding
termination of the Mother's parental rights. As a result, the trial court
erred by not determining if the termination was in the manifest best
interests of the child. We therefore reverse for proceedings consistent
with this opinion and for the trial court to make findings as to the
manifest best interests of the child."); Dep't of Child. & Fams. v. C.R., 397
So. 3d 803, 805 (Fla. 5th DCA 2024) ("[T]he trial court has not yet
considered the best interests of the children. Accordingly, we reverse the
order. On remand, . . . the trial court should make findings.").
Based on the foregoing, we reverse the order denying the
Department's petition for termination of parental rights and remand for
further proceedings consistent with this opinion.
Reversed and remanded.
SILBERMAN and ROTHSTEIN-YOUAKIM, JJ., Concur.
Opinion subject to revision prior to official publication.