Matter of Cynthia M.: Unified Multi‑Domain Neglect Findings—and Sibling Derivative Neglect—Based on Unrebutted Medical, Dental, and School Records

Introduction

In Matter of Cynthia M., 2025 NY Slip Op 05621 (4th Dept Oct. 10, 2025), the Appellate Division, Fourth Department, revisits foundational principles of neglect under Family Court Act article 10 and clarifies how documentary evidence—medical records, dental records, and school attendance data—can, by a preponderance of the evidence, establish multiple forms of neglect across a sibling group. The petitioner, Chautauqua County Department of Mental Hygiene and Social Services, and the attorneys for the children appealed from a Family Court order that had largely dismissed amended neglect petitions against the respondents, Emily W. (mother) and James L.M. (father), except for findings against the father based on domestic violence and a derivative finding as to one child.

On appeal, the Fourth Department unanimously modified the order, holding that each of the subject children is a neglected child under Family Court Act § 1012(f)(i)(A). In doing so, the court:

Rejected the petitioner’s mid-hearing recusal motion challenge;
Found medical neglect as to two children based on failure to follow necessary treatment and missed medical appointments;
Found dental neglect as to four children based on inadequate dental care;
Found educational neglect as to four children based on unrebutted evidence of excessive school absences;
Applied derivative neglect to two siblings based on the breadth and severity of the established neglect;
Remitted for a dispositional hearing as to each respondent.

Summary of the Opinion

The Fourth Department affirmed the denial of recusal, concluding there was no abuse of discretion despite intemperate remarks from the trial judge. Turning to the merits, and notwithstanding the deference generally owed to Family Court’s factual determinations, the court held that the petitioner proved neglect by a preponderance of the evidence on several independent grounds under § 1012(f)(i)(A):

Medical neglect: Respondents failed to follow necessary medical treatment for one child (Rocky M.) with a serious medical condition and failed to take another child (Jemma M.)—a premature infant with developmental delays—to medical appointments during most of her first year, resulting in impairment.
Financial ability or reasonable means: Contrary to the Family Court’s determination, the record (including medical records) established that respondents were financially able or had reasonable means to obtain necessary medical care.
Dental neglect: Inadequate dental care was established for Cynthia M., Gwen M., Emmitt C., and Rocky M.
Educational neglect: Unrebutted records of excessive absences for Cynthia M., Gwen M., James M., and Emmitt C. sufficed to establish educational neglect.
Derivative neglect: The established neglect reflected such impaired parental judgment as to create a substantial risk of harm to any child in respondents’ care, warranting derivative findings for Nova M. and Trenton M.

The order was unanimously modified on the law and facts to grant the amended petitions as to all children under § 1012(f)(i)(A). The matter was remitted for a dispositional hearing for each respondent.

Analysis

Precedents Cited and Their Influence

The court’s decision is tightly anchored in established New York neglect jurisprudence:

Recusal standards:
- Matter of Murphy, 82 NY2d 491 (1993) and People v Moreno, 70 NY2d 403 (1987) confirm that, absent legal disqualification, recusal lies in the judge’s discretion and appellate review is for abuse of discretion.
- Matter of Indigo S. [Rajea S.T.], 213 AD3d 1205 (4th Dept 2023) and Matter of Allison v Seeley-Sick, 199 AD3d 1490 (4th Dept 2021) recognize that judicial impatience or ill-advised comments, without more, do not mandate recusal absent evidence of unjust bias affecting the outcome.
Neglect elements and burden:
- Matter of Afton C. [James C.], 17 NY3d 1 (2011) articulates the two-part test and objective “minimum degree of care” standard under § 1012(f)(i): (1) actual or imminent impairment; and (2) causation through the parent’s failure to exercise a minimum degree of care, proven by a preponderance of the evidence (see also Family Ct Act § 1046[b][i]).
Medical neglect:
- Matter of Kal-El F. [Damon H.], 232 AD3d 1277 (4th Dept 2024) and Matter of Jamiar W. [Malipeng W.], 84 AD3d 1386 (2d Dept 2011) support findings where parents fail to follow necessary treatment for serious conditions.
- Matter of Josephine BB. [Rosetta BB.], 114 AD3d 1096 (3d Dept 2014) underscores that missed infant medical appointments, particularly for medically fragile infants, can result in impairment sufficient for neglect.
Dental neglect:
- Matter of Fay GG. [John GG.], 97 AD3d 918 (3d Dept 2012); Matter of Ciara Z., 58 AD3d 915 (3d Dept 2009); Matter of Alyssa L.D., 56 AD3d 1184 (4th Dept 2008), lv denied 12 NY3d 703 (2009) establish that failing to provide adequate dental care constitutes neglect under § 1012(f)(i)(A).
Educational neglect:
- Matter of Tu’Real A.E.B. [Patricia S.], 237 AD3d 1532 (4th Dept 2025), lv dismissed 44 NY3d 962 (2025); Matter of Airionna C. [Shernell E.], 118 AD3d 1430 (4th Dept 2014), lv denied 24 NY3d 905 (2014), lv dismissed 24 NY3d 951 (2014); and Matter of Gabriella G. [Jeannine G.], 104 AD3d 1136 (4th Dept 2013) recognize that excessive, unrebutted absences can establish educational neglect.
Derivative neglect:
- Matter of Olivia W. [Courtney W.], 184 AD3d 1080 (4th Dept 2020); Matter of Dayshaun W. [Jasmine G.], 133 AD3d 1347 (4th Dept 2015); and Tu’Real A.E.B., 237 AD3d at 1533, hold that conduct demonstrating impaired parental judgment creating a substantial risk of harm supports derivative findings as to siblings.

These authorities collectively frame the Fourth Department’s approach: an objective standard applied to concrete, documentary evidence that demonstrates impairment or imminent risk and a failure to exercise minimum care across medical, dental, and educational domains.

Legal Reasoning

The court begins by restating the statutory elements and burden: neglect requires proof of actual or imminent impairment resulting from a failure to exercise a minimum degree of care, established by a preponderance of the evidence. It acknowledges deference to Family Court’s fact-finding but concludes the record here compels different outcomes on multiple grounds.

Medical neglect (two children): The respondents’ failure to follow necessary treatment for a child with a serious medical condition, and failure to ensure a medically fragile infant’s appointments during her first year—especially in light of prematurity, low birth weight, and developmental delay—established impairment or imminent risk. Importantly, the court rejects the trial court’s view on financial inability; the appellate record, including medical records, demonstrated that respondents were financially able or had reasonable means to secure care, satisfying § 1012(f)(i)(A)’s “though financially able or offered reasonable means” clause.
Dental neglect (four children): Established by evidence of inadequate dental care, consistent with prior holdings that oral health is an integral component of “medical or dental care” under the statute.
Educational neglect (four children): The court emphasizes “unrebutted evidence of excessive school absences.” Under the objective minimum-care standard, proven patterns of excessive absenteeism, without credible countervailing evidence, meet the burden for educational neglect.
Derivative neglect (two children): The breadth and seriousness of proven neglect reflect a level of impaired judgment posing substantial risk to any child in respondents’ care, warranting derivative findings for the remaining siblings. The court applies the familiar principle that neglect as to some siblings can imply risk to others, even absent individualized proof for those children.
Recusal: While acknowledging that certain judicial comments “would have been better left unsaid,” the court finds no evidence of actual bias affecting the outcome or of a predetermined result. Without legal disqualification, the recusal decision stands absent abuse of discretion, which was not shown.

Impact

The decision has several practical and doctrinal implications:

Documentary proof is central: Medical records, dental records, and attendance data—when unrebutted—are sufficient to meet the preponderance standard and can compel appellate modification even in the face of deference to Family Court findings.
Integrated, multi-ground neglect theory: Petitions alleging medical, dental, and educational neglect in combination can support comprehensive findings across a sibling group, strengthening derivative neglect as to the youngest or least directly affected children.
Financial ability/means clarified: The court’s reliance on medical records to establish that respondents were financially able or had reasonable means underscores that the statutory qualifier is an evidentiary question the petitioner can meet through objective records; a parent’s generalized claim of inability will not prevail against concrete proof.
Attendance matters: The opinion reiterates that excessive absences, if unrebutted, constitute educational neglect—a point likely to inform both school collaboration with child protective agencies and parental compliance plans.
Domestic violence context not exclusive: Even where domestic violence-based neglect is found as to a parent, independent neglect grounds (medical, dental, educational) can and should be adjudicated, broadening the remedial scope for all children and both parents.
Recusal motions: The court signals continued restraint in overturning recusal denials; intemperate remarks, without demonstrable prejudice or predetermined outcome, will not suffice.
Remedial posture: By remitting for dispositional hearings for each respondent, the court emphasizes individualized, forward-looking planning after a multi-ground fact-finding, which can include services, supervision, and compliance benchmarks tailored to medical, dental, and educational needs.

Complex Concepts Simplified

Neglect (Family Ct Act § 1012[f][i][A]): A child is neglected if their physical, mental, or emotional condition is harmed or at imminent risk of harm because a parent fails to exercise a minimum degree of care in providing adequate education, medical, or dental care—despite being financially able or having reasonable means to do so.
Minimum degree of care (objective test): Looks at what a reasonable, prudent parent would have done in the circumstances, not the parent’s subjective intentions or best efforts.
Preponderance of the evidence: The proof shows that it is more likely than not that neglect occurred; it is a lower threshold than “beyond a reasonable doubt.”
Derivative neglect: When a parent’s conduct toward one or more children shows such impaired judgment that other children are at substantial risk, the court can find neglect as to those siblings even without specific direct harm to them.
Educational neglect: A subset of neglect where excessive absences or failure to ensure school attendance impairs or risks impairing a child’s condition.
Medical/dental neglect: Failing to secure necessary health care, adhere to treatment, or attend vital appointments, leading to actual or imminent harm.
Recusal: Removal of a judge from a case. Unless there is a legal disqualification, recusal is the judge’s call and is reviewed only for abuse of discretion.
Dispositional hearing: The stage after a neglect finding where the court decides what orders (services, supervision, conditions, or placement) are necessary to protect the child and remediate risks.

Application to the Sibling Group

The appellate findings, by category and child, as reflected in the opinion:

Medical neglect: Rocky M. (failure to follow necessary treatment for a serious condition); Jemma M. (missed medical appointments during most of the first year, with prematurity and developmental delays).
Dental neglect: Cynthia M.; Gwen M.; Emmitt C.; Rocky M.
Educational neglect: Cynthia M.; Gwen M.; James M.; Emmitt C. (unrebutted excessive absences).
Derivative neglect: Nova M.; Trenton M. (risk inferred from the severity and breadth of established neglect affecting siblings).

Conclusion

Matter of Cynthia M. reinforces and synthesizes key strands of New York neglect law: the objective “minimum degree of care” standard from Afton C.; the sufficiency of straightforward documentary proof; and the permissibility of derivative findings when a parent’s overall caregiving reflects impaired judgment posing risk to any child. The Fourth Department’s modification to grant the petitions as to all children under § 1012(f)(i)(A) underscores that courts will consider medical, dental, and educational domains collectively and that unrebutted records—especially where parents have the means or reasonable access to care—will typically carry the petitioner’s burden.

For practitioners, the opinion provides a practical roadmap: compile clear medical, dental, and school records; address the “financial ability or reasonable means” element directly; and, where multiple children are involved, link established neglect to derivative risk for siblings. For trial courts, it is a reminder that while deference to fact-finding is real, appellate courts will intervene where the preponderance of the evidence compels a different result. Finally, the court’s treatment of recusal reiterates that criticism of litigants or agencies, without demonstrable bias affecting the outcome, does not warrant disqualification.

The case now proceeds to disposition, where the focus shifts to remediation and the crafting of orders that ensure sustained access to medical and dental care, consistent school attendance, and the protection of all children in the household.