When Emery Patterson was suffering from a fentanyl poisoning due to his mother’s drug use in Scottsdale, Arizona, in 2022, his mother, Gabrielle Marshall, Googled whether she might be imprisoned if she called for help.
She texted her friend to request Narcan, an opioid reversal medication, but ultimately waited too long to seek professional medical help, and the little boy, who was just one year old, died.
In 2023, an eight-month-old baby, Serenity Hernandez, died of a fentanyl poisoning in Avondale, Arizona, after she was found unresponsive and turning purple in bed.
Even though she was airlifted to a hospital, doctors could not save her.
And in 2024, the Phoenix mother of one-year-old Jody Jackson “delayed seeking medical care” after she realized the child may have ingested fentanyl.
The baby did not survive.
In each of these cases and many other Arizona child deaths and near deaths, the children's families had had previous contact with the Arizona Department of Child Services, the state agency charged with child protection.
“Any time a child that is known to us dies is horrendous,” said Kathryn Ptak, director of the Arizona Department of Child Safety. “It’s horrendous for the agency. It’s horrendous for the workers.”
Ptak, a long-time AZDCS employee, was confirmed as the agency’s director in May 2025 after being appointed in January.
“Nobody comes into this work, making no money and putting themselves in danger, and spending time away from their families, to have a kid on their caseload die, right? It’s terrible,” she said.
In Jackson’s case, the department previously investigated the child’s mother, Natalie Tate, after receiving a 2022 report that Tate had abused drugs during her pregnancy, “resulting in the child being born substance exposed.”
According to an AZDCS review of the death, “the investigation assessed (the child) and a sibling as safe with their mother with a safety plan in place. The family was referred for services but did not engage in services.”
The case was closed about eight months before Jackson died.
Fentanyl Cases
Ptak said Arizona has seen an “uptick” in drug exposure cases in the past year, including several involving fentanyl.
The drug is being taken “much more seriously” when it comes to considering whether or not to remove a child from the home, she said.
“It is so much more deadly than some of the other drugs," Ptak insisted.
According to child fatality reports publicly released by AZDCS and other records and information gathered by Scripps News, at least 42 Arizona children have died or nearly died of a fentanyl poisoning since 2020.
There may be other cases about which Scripps News is unaware.
“The vast majority of children who die of fentanyl poisoning and who die of any type of abuse in our country are known to social workers, so our system is failing,” said Darcy Olsen, the founder and CEO of the Center for the Rights of Abused Children.
“Every single one of these children's lives needs to be respected and honored, and the way to do that is to force the agencies to open up these cases so that the public can see exactly what went wrong, so that it doesn't happen again,” she said.
While some agencies keep many details of state and local child fatality reviews private, the state of Arizona makes public its summaries of fatality reviews and the agency’s history with families that have experienced a death or near-death of a child.
If there is a simultaneous criminal case involved, however, sometimes the details of the incident may not be revealed immediately.
In some cases, it may take months or years.
“We try to be as open and transparent on (the cases) as possible,” said Ptak.
Child safety agencies also have varying statutory powers when handling child protection as well.
In Arizona, for example, AZDCS is a “secondary prevention agency,” Ptak said. The agency can only intervene in a child’s welfare after it has received a call about abuse or neglect, she said.
“We are waiting until a child’s already been abused or neglected before we’re statutorily allowed to intervene, so, a lot of times when we’re seeing these cases for the first time is after something bad has already happened,” Ptak said.
When to Remove a Child
In Arizona, making the decision to remove a child from a home is based on many factors.
Ptak said the agency uses a safety decision-making guide.
The agency asks, “Is the child safe, or is the child unsafe? And if the child’s unsafe, are there ways to keep the child safely in the home with other protections around?”
A case may be closed if a caregiver successfully participates in support services and has a clean drug test, Ptak said. However, “we all know relapse is part of recovery. And so, we might then see six months later or a year later that the parent has returned to using substances, and then we get another call. We don't have a crystal ball. We don't know what's going to happen in these cases.”
The decision about a child’s safety may also be made based upon whether a reliable relative is available to assist in oversight or management of the child’s care, she said.
“We have a lot of cases where we interact with families and we close (the case), and everybody goes about their lives and are just fine,” Ptak said.
Child Advocates Weigh In
“Most of these children who die are known to authorities. What also happens is they’re just sending them home,” Olsen said.
Olsen said her pro bono law clinic recently handled an Arizona case in which an infant was placed back in a home where a teenager had recently died of a fentanyl overdose. Without specific names and records, Scripps News could not verify details of the incident.
“This is happening every single day, not just in Arizona, but all across the country,” she said.
She acknowledged that sometimes children in abuse and neglect cases are wrongly taken from their homes, but the reality is, she said, “that children are dying even though they’re on the radar of these agencies. And we need to put a stop to it. We need to hold the agencies accountable, and we need to save these children’s lives.”
“The reality is that if you’re an addict and you can’t take care of yourself, you can’t take care of a child,” Olsen said.
“Sometimes removal is better than keeping the child at home,” said Marie Cohen, a Washington, D.C.-based child advocate who has spent years reviewing abuse and neglect cases in various parts of the country.
She also writes a blog called Child Welfare Monitor.
“I’m all for not removing the child if you can protect the child at home,” she said.
However, “I think we have to adjust our thinking a bit more where sometimes removal is better than the alternative, which would be keeping the child at home,” she said.
“It doesn’t make sense to give a family chance after chance after chance.”
Ptak said sometimes her agency is hindered by the court system when making decisions about whether a child should be removed from their home.
Sometimes, the kids are returned home over the agency’s objection, Ptak said. “There are a lot of parties involved in these cases. Parents have attorneys, children have attorneys, and everybody kind of sees it a little bit differently.”
Prevention Programs for Older Youth
In Arizona, fentanyl poisonings are also prevalent among older youth, many of whom live in group homes, Ptak said.
The agency has been working to address that demographic in recent months with treatment programs and other safety measures.
“We came up with a policy where all caregivers have to have Narcan in their possession. So, if you are a foster caregiver, if you’re a group home, you have to have a dose of Narcan available to you in case a child in your care is exposed or overdoses,” she said.
Child welfare agents who investigate cases involving child neglect and abuse, however, are not required to carry Narcan or distribute it to the families they are investigating, Ptak said.
“Depending on the severity of the allegations and depending on what happened, sometimes we can do interventions, like we have a lockbox program where we talk to parents about, ‘You gotta lock up your drugs... here's Narcan ... the things they need to make sure that the child is staying safe.”
