Dehydration, Not Injection, Killed Girl, 1 1/2

An 18-month-old girl who received a penicillin injection at a back-room clinic inside a Tustin gift shop died from severe dehydration and not from the medicine administered at the store, police said Thursday.

The Orange County coroner’s office said an autopsy determined that Selene Segura Rios died Feb. 22 from “acute dehydration caused by chronic enterocolitis,” said Tustin Police Lt. Mike Shanahan. Enterocolitis is inflammation of the colon and small intestine.

Officials at the coroner’s office declined to comment on the report, nor would they release the full autopsy or toxicology findings Thursday. But Shanahan said a county pathologist told him the enterocolitis resulted “from a bacterial infection of the inner lining of the colon.”

“I don’t know what caused the bacterial infection, but at the point that the parents sought medical help, it may have already been too late,” Shanahan said. “The child had been sick for some time. . . . They had sought out treatment with over-the-counter drugs before taking her to the clinic.”

The autopsy findings mean that manslaughter charges will not be sought in the case. Tustin police had arrested Monica Bernabe, 23, the store cashier who allegedly administered the injection. Bernabe, who maintained her innocence throughout the ordeal, was jailed on suspicion of possessing illegal prescription drugs but released three days later.

Police had also been investigating Laura Escalante, who owned the store and illegal clinic, Shanahan said. Shanahan said Escalante prepared the penicillin injection and is believed to be hiding in Mexico. She disappeared the day Tustin police delivered a search warrant on the store, Los Hermanos Gift Shop, and investigators were never able to talk to her.

Shanahan said the little girl probably “was already dehydrated and gravely ill” when her parents took her to the McFadden Avenue store, which had a tiny, unlicensed medical clinic in back. In addition to receiving injections, customers also purchased illegal prescription drugs imported from Mexico at the clinic, police said.

The child’s parents, Alberto Ramirez Segura and Maria Lucia Rios, had been blaming themselves for their daughter’s death for taking her to an illegal clinic, Shanahan said. The news that she died from natural causes did not erase the guilt or ease the pain suffered by the parents, who live in Anaheim, he said.

“When we talked to them and told them of the autopsy results, that didn’t help them in coping with their loss,” said Shanahan. “They had already been feeling guilty, and it was little relief for them to know the injection didn’t have anything to do with the baby’s death. They’re always going to second-guess themselves.”

Police said Segura and Rios, both 27, believed Selene was suffering from the flu. The child was vomiting and had diarrhea, and the “symptoms became increasingly worse,” Shanahan said.

On the day the girl died, she had been sick for days.

“She died two hours after receiving the injection,” Shanahan said. “It may have been too late even if they had taken her to a hospital rather than the [unlicensed] clinic.”

In an earlier interview, Alberto Segura said he drove the baby to Anaheim Memorial Medical Center when she failed to respond to the injection. The hospital is about two minutes from the family’s Anaheim apartment.

The family had their own doctor, but it was after hours and the couple decided to take the baby to the unlicensed clinic because they could not afford to take her to a hospital, Segura said. They drove to Tustin, where friends had told them they could find a “doctor” at the gift shop.

Segura, a construction worker, and Rios, a stay-at-home mom, could not be reached for comment Thursday.

Shanahan said investigators have finished their probe of the unlicensed clinic and forwarded a report to the district attorney’s office. Aside from the fact that the store was illegally selling pharmaceuticals, Shanahan declined to say whether police uncovered other evidence of illegal activity.

“Manslaughter is no longer an option. But you still have to look at the fact that this was a clandestine, illegal operation,” Shanahan said. “But it’s up to the district attorney to decide what the best course of action is.” Prosecutors are expected to decide next week whether to charge any suspects.

Selene’s death was the second in 10 months that focused attention on underground clinics in Orange County that cater to Latino immigrants. Christoper Martinez, who was 13 months old, died in April 1998 after receiving treatment at an illegal clinic in Santa Ana.

The boy received multiple injections for flulike conditions at Consultorio Medico Santa Ana from an unlicensed practitioner. The man told the boy’s parents not to give him food or liquids, and the child died from complications resulting from dehydration.

The practitioner fled the country and has never been caught. The clinic was closed by authorities, and the Martinez family filed a wrongful death lawsuit in February against several employees and a licensed doctor associated with the clinic.