PER CURIAM.
The South Carolina Department of Social Services (SCDSS) brought this action against Heather Smith (Mother), James D. Hughes, Joshua K. Smith, and Gregory Meno, seeking removal of Mother's four children.
SCDSS's allegations of medical neglect resulted from reports that Mother's youngest child suffered a skull fracture the day before her third birthday and Mother missed several follow-up medical appointments for the child without rescheduling them. In the appealed order, the family court found all four minor children were at a substantial risk of medical neglect by Mother based on her failure to keep appointments to assess and treat this injury and to follow proper procedures for assessment of the injury after the fact. The family court also approved a modified treatment plan under which Mother was to complete parenting classes, undergo a mental health assessment, keep all medical appointments for the minor children, and cooperate with SCDSS.
In finding the children were at risk of medical neglect by Mother and intervention by SCDSS was necessary, the family court cited section 63-7-20(4) of the South Carolina Code (2010). Under section 63-7-20(4)(c), "`[c]hild abuse or neglect' or `harm' occurs when the parent . . . fails to supply the child with . . . health care though financially able to do so . . . and the failure to do so has caused or presents a substantial risk of causing physical or mental injury." (emphasis added). When SCDSS initiates protective services in an abuse and neglect proceeding such as the one before us, it "must prove its case by the preponderance of the evidence." Aiken Cty. Dep't of Soc. Servs. v. Wilcox, 304 S.C. 90, 93, 403 S.E.2d 142, 144 (Ct. App. 1991).
Without question, one of the children suffered a serious traumatic head injury and Mother admitted she missed several follow-up medical appointments for this child, including CT scans ordered by a neurosurgeon. However, we find no evidence in the record indicates that Mother's failure to keep any of the appointments caused or presented a risk of injury to this child or any of her siblings. SCDSS did not challenge Mother's testimony that during the two days immediately following her injury, the child underwent at least two scans and was checked for signs of trauma and physical abuse before she was released and that the discharge papers indicated a follow-up appointment would be set up "if needed." Although the neurosurgeon who saw the child at a follow-up visit later advised conducting another CT scan "to ensure the skull fracture was resolved" and the child was "neurologically intact," he did not testify at the merits hearing or give a deposition, and no other medical professional gave an opinion as to whether an additional scan was necessary. Significantly, SCDSS had custody of the children from September 11, 2012, when the family court signed the ex parte order placing the children in emergency protective custody, until May 9, 2013, when the merits hearing concluded; however, there was no evidence it ever attempted to schedule the CT scan previously ordered by the neurosurgeon. In addition, although SCDSS was notified on August 14, 2012, of the child's injury and several missed appointments, it apparently never invoked its right to petition the family court for an order finding that any of the medical care Mother allegedly failed to supply was "necessary to prevent death or permanent harm to the child." S.C. Code Ann. § 63-7-950 (2010).
We also find no evidence demonstrates that any of the other missed appointments resulted in harm or a risk of harm to any of the children. As to the child who was injured, Mother admitted she missed appointments in August and September 2012; however, at SCDSS's direction, she took the child to a well-child checkup on August 20, 2012, and nothing was discovered during that visit that would require additional medical care. In early September 2012, Mother also took the child to a forensic interview scheduled by SCDSS. The forensic interview took place at the same facility where Mother had missed an appointment that was scheduled for the child immediately after her injury.
We also find no evidence that Mother subjected the older children to a risk of medical neglect. In its written order, the family court made no findings specifically addressing risk of harm to any of the older children, and during oral argument, counsel for SCDSS conceded the family court's finding that there was a risk of harm to these children was problematic.