by Chas Sisk and Tony Gonzalez, The Tennessean
RED BOILING SPRINGS, TENN. - Derek and Sherry Head live down a gravel driveway that forks in two directions. The short path goes to their small white home, and the other runs up the hill to the Clementsville Cemetery. They buried two of their children there last year.
Beneath black headstones, they first buried their 407-pound son, Adam, 15, and then their daughter, Tamara, who suffered from cystic fibrosis for 14 years - two children whose dire medical conditions had raised concerns and sympathies across the small community.
Each time, the churches and the schools raised money for the Heads, who had no income, health problems of their own, and - at the time - a 12-year-old daughter to care for at home.
In August, almost a month after Tamara died, an anonymous caller to DCS questioned the circumstances of her death and raised concerns about the safety of the youngest child.
That triggered an investigation - at least the fourth against the family since 2002 - the removal of the surviving sibling from the home, and the latest heartache for the Heads, who insist they did everything they could for Adam and Tamara.
But what wasn't done for the children - and how DCS overlooked two deaths of children known to the agency - emerges in newly obtained DCS fatality records. Adam and Tamara were two of 105 children who died in 2012 after some form of prior DCS contact.
"If you're looking to lay blame on somebody, a lot of people could be blamed," said Gerald Papica, state ombudsman for children and families. "There could be a dozen people who knew about it. Probably, some of these people were helping these parents."
Papica said he was left to wonder if those who knew about the sick children and struggles of the family had come to accept their living conditions.
"The community, somehow," he said, "becomes desensitized."
'They should help you'
"They thought me and Derek were starving her to death," Sherry said, recalling her first encounter with DCS in 2002, an allegation that she and Derek were not providing adequate care for Tamara.
"She wouldn't drink. Couldn't keep nothing down."
The complaint led Tamara, who was preschool age, to be diagnosed with cystic fibrosis, an incurable disease that fills the lungs with bacteria, stunting her growth.
A year later, she was found alone at a trailer park down the road from the family home, leading DCS to cite the parents a second time. They had to complete an in-home parenting class.
The Heads' second child, Adam, suffered from the opposite problem. Developmentally disabled and struggling with speech, he would eventually grow to 450 pounds, a giant among his classmates in a field-trip photo propped against a lamp in the Heads' sparse living room.
"He was like a teddy bear," Sherry said.
DCS next visited the family six years later.
By that time, Derek, now 37, was no longer working, beginning the couple's run of years without any regular income except for food stamps and the disability checks Adam and Tamara received.
They supplemented that income by scrapping metal and mowing lawns. Neither parent qualified for state disability payments.
The Heads have deep roots in the lush hills and farmland that straddle the Kentucky border. The family, and especially Adam, were well known in Clay County, which is about two hours northeast of Nashville.
Adam almost always wore a camouflage jacket, no matter the weather, and loved to talk about movies. In 2009, someone told DCS that Adam wasn't getting the nutrition he needed.
"It was kinda hard for me and Derek to shop because we had to get foods for Adam that wasn't fattening and foods for Tamara that had a whole lot of fattening in it to help her gain weight," Sherry said.
DCS files do not document what happened, but Sherry said a caseworker visited the home.
"She said she didn't see no problem, that we had done all we could for our children," she said. "She said, 'Instead of people picking on you all,' she said, 'I think they should help you.' That was her words."
But that caseworker, records show, marked the family as "no services needed" and closed the case.
Department spokeswoman Molly Sudderth said DCS checked to see that the family was working with a nutritionist and seeing a specialist at a hospital. A doctor reported the family was following all recommendations.
"At the time our case was closed the youth was losing weight," Sudderth said in an email.
'Nail down every cupboard'
Even after the case was closed in 2009, Adam's health needs persisted. He had a history of mild mental retardation, sleep apnea, an unknown thyroid problem and morbid obesity, records show.
The family missed several doctor's appointments, especially in Adam's final year. But the Heads said they had tried many things, including twice enrolling him in Weight Watchers, before their insurance ran out.
A charity group gave them a van to help move Adam when he became too large for a car.
In November 2011, a letter from one doctor to another said the boy's appetite had become extreme. The doctor gave the parents an order.
"Nail down every cupboard and chain refrigerator door to keep him from eating," he wrote.
In his last three months, Adam could not attend school. He spent most of his time in the Red Boiling Springs rental home where the family still lives.
"The last few months with him was pretty terminal," Sherry said. "I was trying to do everything I could about it."
By March 2012, a doctor again told the family to address Adam's needs and referred him to a specialist.
But no doctor called DCS to intervene - a point the Heads use in their defense.
"If the doctors thought we were doing anything wrong and not taking care of our children like we should, then they should have reported," Derek said.
Days later, on March 13, the family traveled to the Clay County Library, where Sherry noticed Adam turning pale and struggling to breathe.
As the family tried to leave, to get him to the hospital, he seemed to have a seizure and fell through the open door of their van, landing face-first on a seat.
"The last thing he said to me was: 'Am I going to remember you and Daddy?' " Sherry said. "I didn't think anything about it, because, you know, kids say things."
A blood clot lodged in Adam's lungs killed him that day. In an autopsy, a medical examiner ruled his death to be of natural causes and listed morbid obesity as a contributing factor.
The Heads' two daughters appeared to handle Adam's death as well as could be expected. Family friends said they seemed to be in good health and Tamara, who had always struggled, looked to be thriving.
"We always made sure she got her medicines," Sherry said. "You couldn't tell there was anything wrong with her."
Tamara's death came swiftly. At 3:29 a.m. on the morning of July 19, an emergency call came in from the Heads' home. Paramedics arrived and found her unresponsive, propped up in a recliner as Sherry and her younger daughter tried to perform CPR. Tamara was bleeding from the nose.
Accounts of what happened that night conflict. The discrepancies have been exacerbated by the fact that the investigation was delayed for nearly a month, forcing DCS to piece together information from the family members, paramedics and doctors long after Tamara's death.
The Heads appear to have become aware something was wrong with Tamara when she went into a seizure. They first attempted to take the girl to a doctor, but when she collapsed, they moved her to the recliner, where they believed she could breathe easier.
When that was unsuccessful they attempted to revive the girl by throwing water on her and by using Derek's ventilator.
The Heads told paramedics they did not know what had caused the attack, according to the DCS case file. But their younger daughter later said to DCS that she had told her parents that night that her sister had overdosed on Adderall, which she had been prescribed for attention deficit hyperactivity disorder.
The possibility of a drug overdose was not mentioned by police or paramedics in their reports, according to the medical examiner who performed an autopsy. A paramedic did mention the home was full of old food and roaches. But the examiner agreed that the cause of death was an overdose.
The younger daughter also gave investigators a troubling timeline of that night.
She said Tamara started getting sick around 11 p.m. - four hours before the call to 911. And the girl said it was she, not a parent, who called.
Sherry said she knows DCS determined that the family didn't act fast enough for Tamara, but said the allegation is untrue. The parents say any delays were caused by 911 services, as their call bounced between jurisdictions on both sides of the state line.
"Nobody knows what it is like to have to do CPR on your own child," Sherry said, as she began to cry. "I wouldn't go through it again, not in a million years. I done everything I could ... to bring her back."
The region's Child Protective Investigative Team, which includes law enforcement officials and DCS, concluded the family was responsible for neglect in Tamara's death, but not Adam's. Tamara's case was referred for possible prosecution.
The parents have not been charged. The local prosecutor said he was reviewing the case file and knew the family "had a lot of issues and a lot of medical issues."
Clay County Sheriff Brandon Boone, whose deputy responded to Tamara's death, said the family was well known but never in trouble.
"This is a sad situation," he said.
'Set up to fail'
DCS was not alerted to the situation until Aug. 10, nearly five months after Adam died and more than three weeks after Tamara's death.
That day, DCS interviewed both parents and the surviving daughter. The girl was moved immediately to a foster home.
A DCS investigator began to compile notes about the family, including medical records and the family's case history.
Many in the community are upset - not at the Heads, but at DCS - for removing the younger daughter.
"Why go in and just take somebody away when you haven't helped at all?" asked Connie McHenry, whose husband, Tim, presided over Tamara's funeral. "I have prayed for them because I feel like they need their child."
Nelda Clements, a second cousin to Derek, who allows the family to live rent-free in the home next to the cemetery, said the state's claims of neglect are "ridiculous."
"Everyone knows the circumstances behind those deaths," she said. "They done everything they need to do to those children. We could just not understand why they took that girl.
"They're just your everyday parents that had a lot less than anybody else," she added. "What they did have, they made it go a long way."
The Heads said they are trying to abide by the court orders and DCS demands that could return the child to their home. They've been under pressure to pay child support and have had to complete IQ tests and undergo a home inspection.
But they say the department hasn't done its part and has blocked at least three of their court-approved visits with their daughter. They filed a court motion to hold DCS in contempt and go back to court next month.
"They twist around what the truth is and don't take time to talk to the parents to know what's going on," Derek said. "They didn't live with us. They didn't know what we were doing.
"It's strange that two kids died within five months, but Adam was natural causes and Tamara was accidental," he added. "It's very difficult when you lose your oldest daughter and oldest son."
"I still can't get over the shock," said Sherry. "My kids were a blessing."
Boone, the local sheriff, said the Heads earnestly believe they did nothing wrong.
"No matter what's happened, you've had two children that passed away, whether it's neglect or just a coincidence, it's sad no matter how you look at it," he said.
Papica said the deaths of Adam and Tamara will factor into DCS' decision whether to reunite the family, and the family's income and housing probably will be part of the decision on the girl's future. He said DCS probably will take a tough stance on this case, but he has seen situations in which children do return home after the death of a sibling.
"Maybe society or the community has neglected or failed this family," he added. "Also, at the same time, maybe the family could not do it on their own.
"In some ways, the situation was set up to fail."