As parents face murder charges, total NC child abuse and neglect death count is unclear

Christmas presents were still under the tree when Tiffani Holloway’s phone rang on New Year’s Eve.

Her daughter Madison Holloway sobbed over the Facetime call. Madison’s 5-year-old son, Karter, had been rushed to UNC REX Hospital in Raleigh.

Madison panned the camera around the hospital room. Karter was in bed, bruised and unconscious. He was breathing through a ventilator. “No! No! No!,” Tiffani Holloway screamed.

Karter was airlifted to UNC Children’s Hospital in Chapel Hill, where he had emergency brain surgery but died the next day.

He was one of three children killed late last year in Wake County.

Gunner Bliss, 3 weeks old, died in October in Raleigh.

Vinil Tiwari, 9, died in December in Morrisville.

Parents are charged with murder in each death.

“To have that sort of cluster of cases is unusual,” Wake County District Attorney Lorrin Freeman said. “To have three cases happen in such a short time is heartbreaking.”

It is also part of a tragic trend in North Carolina.

While the number of confirmed cases of abuse and neglect among children in this state have declined over 30 years, the official count of children dying from abuse or neglect has increased since 2018.

Unknowns with NC child abuse, neglect deaths

In April, the N.C. State Center for Health Statistics reported a second year of rising child death rates for all causes in 2022, with 1,474 children dying before the age of 18.

That includes 93 children who died from abuse and neglect, representing 4.05 deaths for every 100,000 children. That was 1.3 times the state’s 2018 rate, and higher than the 2022 national fatality rate of 2.73 deaths for every 100,000 children.

The state expects to see higher death rates from child abuse and neglect continue because of the post-pandemic behavioral health crisis, NCDHHS officials said.

But for many reasons, it’s impossible to state with precision how many North Carolina children have died from abuse and neglect.

North Carolina is among multiple states trying to better identify and report child deaths to the national data system. The state’s Division of Social Services began working more closely with law enforcement and the Office of the Chief Medical Examiner in 2017 to identify those deaths.

State officials attribute some of the reported increase to improved tracking of child deaths. But they also acknowledge that mental health and substance abuse, especially the use of addictive opioids, play an increasing role in child deaths.

The number of child deaths from abuse and neglect nationwide could be two to three times higher than what is reported, according to a May report from the Lives Cut Short project.

UNC-Chapel Hill social work professor Emily Putnam-Hornstein led the project’s effort to document ways that deaths from abuse and neglect get missed due to inconsistent reporting, delayed data and other shortfalls.

“It’s a real problem, because it means that we’re not able to even remotely begin to track in any real way whether things are trending up or down,” she said.

Cases may not be recognized even when child welfare, law enforcement and social services workers are involved, Lives Cut Short has found.

That not only leaves important stories untold, but it limits the lessons learned that could help prevent more deaths.

Losing Vinil Tiwari

The stories of children who die from abuse or neglect are painful to hear.

Police found 9-year-old Vinil Tiwari’s body when they were called to his Morrisville home in December.

His mother, Priyanka Tiwari, had a severe mental illness that grew worse in 2020, according to police and court records reviewed by The News & Observer.

At that point, she started seeing “imaginary people” and accused her husband, Shashikant Tiwari, and others of spying on her, according to an application her husband filed for a domestic violence protection order in 2023.

Shashikant Tiwari accused his wife of locking Vinil in the house for hours without food.

“My kid and dog didn’t see the outside world for three months. My kid was in behavior therapy because he has developmental delays. She stopped his therapy (may be due to covid fears) but she even stopped online therapy option,” Shashikant Tiwari wrote in the filing.

In March 2023, Priyanka Tiwari was involuntarily committed to the Triangle Springs behavioral health hospital in Raleigh, where she stayed for about two weeks. But she refused medication and therapy after being discharged, according to court filings.

A judge gave Shashikant Tiwari the protective order and primary custody of Vinil in April 2023. Priyanka Tiwari had in-home visitation rights two nights a week, the order said, though police reports suggested the child spent more time with her.

Morrisville police were called to the family’s home six times for 911 misdials and “welfare checks” from March 2023 to Dec. 20, 2023, when Vinil was found dead. The police reports don’t make clear who was being checked.

Priyanka Tiwari was charged on Dec. 21 with first-degree murder and felony child abuse. Shashikant Tiwari was arrested in early February, charged with felony child abuse and neglect.

He “failed to care for his own child and left the child in his mother’s care who he knew was in mental decline,” arrest warrants say.

Less neglect & abuse overall

State records indicate the long-term trend regarding some child abuse cases is positive. There was a 64% decline in physical abuse cases and a 63% decline in sexual abuse cases from 1990 to 2021, data say. Neglect cases fell by 20% over that same period.

There wasn’t just one thing that improved conditions for North Carolina children during that time, said Sharon Hirsch, president and CEO of the Positive Childhood Alliance North Carolina.

“A lot of it is norms change, and we’re doing a better job of raising awareness about what’s not appropriate in terms of physical discipline. We’ve raised awareness about sexual abuse, and what to look out for and how to keep our kids safe,” Hirsch said.

The state’s child fatality prevention officials are digging deep into the data this year to learn why more kids are dying, said Kella Hatcher, executive director of the N.C. Child Fatality Task Force.

Some root causes of abuse and neglect are very difficult to fix. Substance abuse, housing instability, mental illness and domestic violence affected at least half of the state’s child abuse and neglect victims in 2022, federal data shows.

Poverty is often at the root of those issues, said Hirsch, whose nonprofit uses data to learn which programs are working, influence Department of Social Services policies and provide local agencies with training and support.

Emotional and mental health support for parents is part of the formula, and the goal is to avoid having Child Protective Services get involved with those families, Hirsch said.

“That often isn’t the way we think about it,” she said. “As a society, the key to kids growing up healthy and safe is to support parents and support caregivers.”

In response to an increased threat to children from adult substance abuse, the Child Fatality Task Force will take a closer look at fentanyl-related deaths in children and teens.

Fentanyl — a synthetic opioid that is lethal in very small amounts and about 50 times stronger than heroin — wasn’t an issue for infants and toddlers before 2017, the Task Force reported in April.

In 2021, 11 North Carolina children, ages birth to 4 years old, died from fentanyl poisoning and 10 from that same age group died in 2022, according to data from the N.C. Office of the Chief Medical Examiner.

Task force members think younger children are being exposed to fentanyl in pills or liquids left within their reach, or because they ingest residue from drug trash or paraphernalia. The issue has become a state priority, with more money approved last year for toxicology tests in child deaths, according to the Child Fatality Task Force report.

More comprehensive data could confirm trends and suggest ways to prevent children’s deaths, Hatcher said.

Infants and toddlers are vulnerable

North Carolina’s Chief Medical Examiner Office reported that 103 children and teens were killed in 2022, including 31 killed by their parents or caregivers. In 2021, the office reported parents or caregivers were accused in 19 of 86 homicides involving children or teens.

Infant homicides doubled in 2022, showing “the increased necessity for resources to support parents and caregivers during this critical stage,” the report said.

Blunt force trauma was the leading cause of death, state data says, followed by firearms and abuse or neglect.

In mid-September, Savannah and Noah Bliss became parents to premature twins Madelyn and Gunner, who were admitted to the WakeMed Neonatal Intensive Care Unit.

Gunner was discharged from the hospital first, so while Savannah Bliss tended to Madelyn in the NICU, Noah Bliss, Gunner and the couple’s 1-year-old child stayed at the Heart Center Inn adjacent to WakeMed, according to a WakeMed police search warrant.

Noah Bliss handed Gunner, who was mostly blue, unresponsive and wrapped in a blanket, to his wife and a nurse when they returned to the room on Oct. 6, the warrant said.

The nurse and Savannah Bliss rushed Gunner to the nearest nursing station. The baby had “unusually high blood pressure for that of a newborn,” indicating he had experienced a major trauma, the warrant obtained by The N&O said.

“Savannah Bliss appeared to be very upset about Gunner, but the father did not appear to show any emotion,” the warrant said.

On Oct. 13, Noah told Johnston County Sheriff’s deputies that “he was rocking the baby and may have done it too hard,” the warrant said. He then told his wife he was leaving for Florida, because “he did not want to go to jail for murder,” it said.

Noah Bliss was charged later that day with felony child abuse, and three days later, Gunner died. His father was charged with first-degree murder.

Remembering Karter

Karter Holloway was also in his father’s care when he suffered life-threatening injuries, police say.

Diagnosed with autism, Karter would “make himself comfortable” while visiting his grandmother’s northeast Raleigh home, stripping down to his Superman underwear and wearing his mother’s shirt around his neck as a magical cape.

He would cheer “Suuuuuper!” as he danced around her living room, Tiffani Holloway said.

As a Head Start teacher who works with both special needs and neurotypical children in Wake County, Holloway said she felt prepared for her grandson’s unique needs.

Last summer, Karter’s father, Amir Hines, reached out about spending time with his son. He had just been released from prison after a robbery conviction, and she and Madison were thrilled to welcome him into Karter’s life, Holloway said.

They started with visits at the Holloway home, and then family outings together. As trust grew, Hines and his girlfriend, who had her own children, would pick up Karter for dinner and playdates, Holloway said.

In November, Karter stayed overnight at his father’s apartment for the first time. He left before Christmas for his first multiple-day visit with his father, Holloway said.

They waved goodbye to Karter, expecting to see him again after a happy holiday with his father and his girlfriend, she said, but a week later in UNC Children’s Hospital, Holloway wrapped Karter in a blanket covered in family photos that she had ordered.

She laid a hand on his chest, and he took his last breath.

An arrest warrant said Karter died from head trauma that caused swelling on his brain and spinal cord. Hines says his son fell in the shower, Holloway said.

“I still feel like he’s supposed to be here with me, because he’s a child,” Holloway said about her grandson. “He’s supposed to live life, and he never got a chance to do that. That’s so unfair.”

To report child abuse or neglect

North Carolina law requires all adults to report suspected cases of child abuse or neglect. Cases can be reported to 911, or your local Social Services office or Health Department. The National Child Abuse Hotline is also available at 800-4-A-CHILD (800-422-4453).