GRAND JURY INDICTS MOM; BABY'S DEATH LINKED TO ICE

For the first time in Hawai'i, a mother has been charged with manslaughter
in her 2-day-old son's death that prosecutors said occurred because she
smoked crystal methamphetamine in the days before and after his birth.

Kane'ohe resident Tayshea Aiwohi, 31, was indicted by an O'ahu grand jury
yesterday on the charge of recklessly killing Treyson Aiwohi on July 17,
2001.

The indictment does not refer to Aiwohi's alleged methamphetamine use. But
in asking that bail for Aiwohi be set at $50,000 and that a bench warrant be
issued for her arrest, city deputy prosecutor Vickie Kapp told Circuit Judge
Dan Kochi that Aiwohi had smoked ice before and after her son's birth.

The charge covers the period of July 12-17, 2001. The baby was born July 15.

The medical examiner's office listed the cause of Treyson's death as
"poisoning by psychotropic agents" or "psychotropic stimulants" and
classified it a homicide.

The indictment comes at a time of heightened community interest in crystal
methamphetamine abuse, with Lt. Gov. James "Duke" Aiona hosting a drug
summit, a joint House and Senate committee holding hearings on the ice
problem, and the broadcast of the Edgy Lee film "Ice: Hawai'i's Crystal Meth
Epidemic."

"If a mother has a choice between proper care of her child and drugs, and
she chooses drugs and that leads to the child's death, we will prosecute the
case," City Prosecutor Peter Carlisle said yesterday.

If convicted of manslaughter, Aiwohi would face sentencing options that
range from probation to up to 20 years in jail.

Aiwohi could not be reached yesterday for comment.

Pat Puakea, Aiwohi's mother, said that in the past three years, her daughter
had fought her way out of drug addition, worked hard to hold her marriage
together, survived the death of a child and strengthened ties with her five
surviving children.

"She has worked so hard," Puakea said. "She has done everything they told
her to do and more.

"She is telling her kids, 'Don't get mad, don't get angry over it,' " Puakea
said. "She has her faith, and that is what she is holding on to."

Puakea said her daughter did not expose Treyson to methamphetamine during
her pregnancy.

"She has been clean," Puakea said.

California Case Noted

A California jury last month found a 31-year-old woman guilty of murder
after her three-month-old son overdosed on methamphetamine in her breast
milk, but Carlisle said Aiwohi was not charged with murder because there was
no indication that the infant's death was intentional.

In a manslaughter case, the prosecution must show that the accused
consciously disregarded the risks associated with the behavior that led to
someone else's death, Carlisle said.

Recklessness Alleged

He used "Russian roulette" as an example, saying that a person who points a
revolver loaded with a single bullet at someone else and spins the barrel
before firing may not be intending to kill the other person, but has chosen
to disregard the dangers associated with that behavior.

"We prosecute cases where parents intentionally kill their children ... and
prosecute cases where parents recklessly kill their children as well,"
Carlisle said.

Some local medical officials were divided in their views on the prosecution.

"Yes, it is appropriate to prosecute if there is an abnormal death and they
think the mother was responsible," said Sherry Loo, a pediatrician at
Kapi'olani Medical Center for Women & Children.

Loo said she thought the prosecution should go forward whether the
methamphetamine was delivered to the baby before it was born -- through the
mother's blood system -- or afterward.

Consequences Weighed

Chris Derauf, a Kapi'olani pediatrician involved in a national study to
determine the effects of methamphetamine exposure on the babies of women who
used it during pregnancy, said the prosecution of mothers based upon what
they did during pregnancy can have negative consequences for other children.

"It will drive people away from seeking care. From coming in prenatally.
>From coming to hospitals to deliver their babies. From bringing up the issue
of drug use and from reaching out for possible treatment," Derauf said.

The mothers of ice-exposed babies are not using drugs to hurt their
children, Derauf said.

"They are heavily addicted to these drugs and they are doing it because they
can't help themselves -- despite the consequences that may come to their
child," Derauf said.

Loo said she would add a caveat to her support for prosecution in cases of
meth-exposed babies: The prosecution has to prove the death was caused by
the means alleged, and in the case of an infant death, that might not be
easy.

Authorities have said that after leaving the hospital, Aiwohi may have
breast-fed her baby while she continued to use meth, a practice that, as
pediatricians routinely caution mothers, can deliver lethal doses to the
child.

But Loo said breast milk usually isn't flowing freely enough two days after
birth to deliver a dose like that, and Derauf said methamphetamine routed
through the baby's system before birth could remain in the child's urine for
72 hours. Its presence, he said, does not mean the child died from the meth
exposure.

Does State Have Role?

Loo also said she thought the state's role in the death should be examined.

"I think CPS (Child Protective Services) has some accounting to do, too,"
she said.

Lillian Koller, head of Human Services, which oversees Child Protective
Services, said that no state has laws that require all children to be taken
from every mother who uses drugs during her pregnancy.

Hospitals are required to report the mothers to CPS when babies are found to
be meth-exposed. Social workers then must decide on a case-by-case basis
where the babies' best chances lie, Koller said.

She said an average of 80 percent of the 17 meth-exposed babies born in
Hawai'i each month do not go home. They are sent to foster homes. Some of
the outcomes in either case are positive, she said. Others are not.

"I am hopeful this case will be a wake-up call for mothers using ice to
understand and appreciate that it can be lethal to breast-feed newborns,"
she said.